Lymph Node/Salivary Gland (Parotid)/Bronch/Enterobacter

 Lymph Node/Salivary Gland/(Parotid)/Bronch/Enterobacter

    I ended seeing the senior surgeon for a second opinion. He did a biopsy right in the office since we were unsure if the first biopsy actually went into the right spot. The results came back as benign salivary tissue. In the meantime, I also went for an MRI with contrast. I just had an appointment with the surgeon two days ago and he explained that the parotid gland, which is the largest salivary gland, did indeed have a tumor on it. He said, looking at the MRI, it shows clear margins which is suggestive of being benign. He does believe it's benign but can't be 100 % sure. The surgery will take 2 hours. It would take a lot less time if there wasn't the problem of trying not to nick my nerve that controls that side of my face. This is the part that makes me nervous to get this surgery. He also said I will have a permanent numbness that may shrink a bit over time. The plan was to get surgery on Jan 6. While I was at the transplant hospital, I decided to get a pulmonary function test as I knew I would need to see my transplant doctor for clearance. I tried getting blood work and an EKG but, I waited an hour and still had 20 people ahead of me. So my mom and I left. I did end up having a video visit with my transplant doctor the next day. She said I couldn't get the surgery so soon because of my lungs. 

    So last Thursday, I had a bronchoscopy because I had a ct scan of my chest that showed the bottom right lung had more scar tissue. I was given the option of a bronch or going on Tobi. I decided a bronch because, one, I'm not sure I'm even sensitive to Tobi, two, I wanted to know what was up with the bottom right lobe, and three, my bottom right lobe had been feeling wheezy and tight and there were a few secretions there that I was having a very hard time getting up. I got very sick soon after I got home from the bronch. I had a fever of 101.9, I had the chills, and I was achy. This lasted two days. I was pretty sure the bronch would culture a bacteria since I had such a reaction The bronch results showed I had enterobacter. I was set to go on an antibiotic I had never done before. I'm also not sure I ever cultured enterobacter before. That was only supposed to be a 10 day course of IV antibiotics so, I figured I would still be able to get the surgery. During the telehealth visit, the doctor told me I also cultured Psuedomonas and would need to throw out the meds I had received and go on a different antibiotic, one I did have before. The doctor told me she didn't want me to get the surgery so soon. She said a month from now would be ok. She wanted to make sure my lungs were fully healed before going under general anesthesia. So the plan is hopefully for Jan 28.

Lymph Node/Salivary Gland (Parotid) Update

 Lymph Node/Salivary Gland (Parotid) Update

 

    I did get the biopsy of my lymph node done. Well, I should say, that was the plan. The doctor tried to biopsy the lymph node but couldn't, so he biopsied some tissue near my salivary gland. That tissue came back as saying category three, atypical. That didn't make me feel too good, I looked at the results through my my chart. The ENT didn't have much to say. He said the good news is it's not cancer, but it's not benign either. He gave some options like repeating the ultrasound to make sure it didn't get bigger, and monitoring it for a year, or getting a second opinion with the senior surgeon. I opted for the surgeon. So once again, back to the city to see the surgeon. The surgeon said he's not quite sure what to make of the results. He wasn't sure if the doctor had actually biopsied what we thought was a lymph node, or if he biopsied something else. He also said the results of atypical cells means they couldn't really get an accurate reading on the material. Right there in the office, the surgeon asked if I would let him do a biopsy of the supposed lymph node. I said sure, if you can, go for it. So as I was sitting, he cleaned off the area and proceeded to gather some fluid from the lymph node. At this point I'm still waiting for results. I also need an MRI of the site as the ultrasound didn't really say much. Unfortunately, the MRI is scheduled for the 27th, I believe, so that's a bit far off. After the MRI, I can schedule an appointment with the surgeon once again and see what all the results say. I feel like the ultrasound and first biopsy were all for naught; like I'm starting all over. I still hope for a good outcome. 

ENT, Lymph Node/Salivary Gland (Parotid) (short)

 ENT, Lymph Node/Salivary Gland (Parodid) (short)

 

    I saw the ENT this week. I was hoping he would biopsy my lymph node. He told me that in order to know if it's a lymph node or a salivary gland, I'd need an MRI, a cat scan, or an ultrasound. I can't have contrast due to my kidney function so he opted for the ultrasound. I though I would just do that locally but he told me I had to do it in the city. I wasn't too pleased with that. I was just there twice and now I have to go back two more times, once for the ultrasound and once for the checkup afterwards. I'm hoping if a biopsy needs to be done it will be done there at that time so this can all be over with.

Arenesp, Lymph Node/Salivary Gland (Parotid) Hemochromatosis

 Lymph Node/Salivary Gland (Parotid) Hemochromatosis

 

 I know I haven't updated in a while. I have been taking Aranesp shots and finally my hemoglobin has come up enough for me to stop them. I went to lung clinic two days ago and I told the doctor I had a palpable lymph node behind my ear. My doctor tried to get me an appointment with my ENT doctor to do a possible biopsy the same day but he wasn't available. So instead, I go next Tuesday.  The doctor also said the lymph node was pretty small so the ENT doctor may not be able to biopsy it. In the meantime I was put on Doxycycline and Vancomycin. The Vanco is to prevent C.diff from the antibiotic. The doxy is to hopefully get rid of whatever bacteria could be potentially causing the lymph node. The docy  has given me some headaches and nausea. To combat the nausea, I am taking some Zofran that I had leftover from the last time I was nauseous. The reason for the biopsy is to make sure this isn't cancer. That part is a little concerning, but I feel in my gut that it isn't cancer. I also had a viral swab done but that came back all negative.

 

    I also received an email from my coordinator saying that upon a second look, my MRI of my abdomine showed I had hemochromatosis. This is a condition where your body absorbs too much iron and stores it in your organs which could become a serious problem. I have to make an appointment with a liver doctor as my coordinator said this is a liver issue. They may want me to do genetic testing as well as this could be hereditary.

Quick Update

 Quick Update

 

    After my pancreas biopsy, I had to call the office because no one called me about results, despite the results being in my MyChart records for a good four days. I didn't want to read them as the results always have medical jargon I don't understand and then I panic thinking something terrible is wrong. After two phone calls and talking to the nurse practitioner, as the doctor never bothered to call back, they told me the cyst sample was sent to a company that closed down and therefore no results could be gathered. I said can you send it to another company? He replied 'this is the only company that analyzes cyst fluid'. I don't know if this could possibly be true, but basically the procedure was for nothing and we know nothing about the cyst in my pancreas. The plan is to keep monitoring it via MRIs. I really wasn't pleased with this but there's nothing I can really do. 

   

 We left off with my ankle being fractured. I had to stay in the boot for about 7 weeks. After that the boot came off but my ankle still wasn't 100%. It's doing better now, it's almost healed all the way. I still have very little energy and I did attempt walking at the park twice, but i did need to sit on several benches for a .75 trail. It's also been so hot it's hard to walk.

    I also left off on Aranesp shots. So I did the shots once a week for a month and my hemoglobin did not improve. So now my doctor prescribed a higher dose of the medicine. We'll see if that works at all.  

 

    When I got my right eyelid biopsied last, I also had the left eyelid biopsied. That came back as a precancer with squamous cell not being able to be ruled out due to the small sample size. The MOHS surgeon didn't want to do anything about the left eyelid. I've been noticing a few different areas on my eyelid that have tiny scabs that form. They eventually fall off and they do not bleed but I know they are the beginnings of cancer. So I went to the MOHS surgeon yesterday to see what he thought; my intention was to get biopsies done. The surgeon didn't really want to do biopsies. He instead froze the eyelid. I had this done before at a different doctors office and it was so light it did nothing. This time it hurt really bad, but no where near the pain of lidocaine injected into the eyelid. It felt like my eye also had brain freeze. It took a little while for it to calm down. Here's to hoping that means it will do something. My eyelid is still swollen today. He said that I should come back in 6 weeks and if it's better, good, if not he'll do a biopsy. I was a little worried he'd want to do surgery and I have two vacations planned in August and I worried that surgery ad healing would interfere with them. So I'm glad that won't happen. This time around I'm trying to nip this in the bud and be as vocal as possible because the last eyelid situation was torture.

 

    I started an antidepressant a week or two ago. I'm hoping it will help give me more motivation. I haven't been feeling a bit apathetic. I haven't really felt the same since I started and antipsychotic several years back. I'm going to stay with my sister for a week at her house, so that should be fun. 

 

 

Endoscopy Results

 Endoscopy Results

 

    My results made it to my MyChart last week but I didn't want to look at them. Often when I have a scan done or something like this, I go to read the results but they are hard to understand and often say things that I take to mean as significantly bad, but are actually fine. My mom really wanted me to read the results and I figured if they hadn't called me, the results must not be that bad. So on Saturday, I read the results.  There were four different entries in my MyChart and I read them all with not much clarity. In one finding it said something about a Bethesda category III and something else was atypical. There was no definitive answer. So I called the office, and asked if someone could get back to me about the results. They told me it would be 24-48 hours before someone would contact me. After a day of no answer, I wrote to my Lung Transplant coordinator and asked if she could get in touch with the doctor as I couldn't understand the results. My coordinator got back to me the same day saying she looked it over with my doctor and didn't see anything concerning. She said we may just monitor this more frequently like every 6 months. That same day, a nurse practitioner got back to me to say that the results are inconclusive as the lab that tests the pancreatic cyst fluid is now closed, permanently. I asked if they were gonna send the sample to another lab but I was told that is the only lab in the US that tests pancreatic fluid. I find this hard to believe. I guess no one can find out now if their cysts are mucinous or not not? He basically said I would not have needed surgery even it was mucinous as my cyst wasn't that big. I wasn't under the impression, originally, that the size of the cyst meant anything. He assured me they had many patients with musicnous cysts that were being watched over. He also said the yes we would repeat the scan in a month or two but that as long as that came back fine, I would not need scans more frequently than once a year. I was a little dissapointed by this outcome. I wanted to know if I had a mucinous cyst and if it was cause for concern. It seems the whole procedure was for nothing.

Ankle Update, Endoscopic Ultra Sound

 Ankle Update and Endoscopic Ultrasound

 

    So I had my ankle MRI two days ago. I got a pone call yesterday morning from the doctor wanting to go over the results. He said according to the MRI, I had a stress fracture and would need to wear a boot. I guess when I was walking my sister that one day, walking faster than usual, my ankle got injured. The doctor said it was most likely due to the fact that my bones are a bit weaker from decades of steroid use. So today, I went to see another doctor in the practice as my doctor wanted me to get a boot as soon as possible, and he was booked up. I received the boot but can't wear it for driving. So, the doctor showed me how to put it on, then I took it back off. I of course can't wear it showering either. The worst part is, I can't go to yoga for at least three weeks. In three weeks, I go back and they will do another X-ray and see if the area that looked funny is gone.  Otherwise, I may need another MRI, as MRI's are the only concrete way of seeing a stress fracture.

 

 

     I had my endoscopic ultra sound and biopsy done yesterday. This isn't my first ERCP. I've had several after my gallbladder was removed and I would get pancreatitis a lot. We got to the appointment 15 minutes early but they didn't' take me back inside until the time the procedure was set to start. They want you there an hour earlier so they can get you changed, go over your medical history-including your medicines, put in an IV, talk to anesthesia, etc. I woke up pretty well. I was really tired for the first two minutes but then I started coming to, and after say a broncoscoy, I'm usually starving and asking for food every two minutes even though after a bronch you can't eat or drink for tan hour. This time I could eat, and I was lucid and remembered everything I was told after I woke up, unlike the bronch. I had to have an IV infusion of an antibiotic after the procedure in the recovery area. They originally were going to give me levaquin but I get problems with my tendons sometimes so I requested a different antibiotic and received clyndomycin instead. The doctor finally came around about an hour after the procedure. She said that they were able to get some fluid out of the largest cyst. It didn't look to concerning to her. I was told earlier by the assistant that I as breathing very heavy and so they could only biopsy one cyst. I just wanted to make sure it was the one that had grown, and indeed, that's the one they got. Now to wait for results. 

 

Gout? MOHS Surgery

 Gout? Mohs Surgery

  Vacation was great. We had sunny warm weather. We did some small hiking and sat at the beach a bit-don't worry I wore a hat, zinc sunblock, and a rashgaurd. My ankle wasn't too bad. I wore the brace I was given and it seemed to help a lot. My ankle does feel a bit better but still hurts a bit.

That brings us to today, I saw the ankle doctor I had wanted to see in the first place, unfortunately he had been booked three weeks out. I'm glad I went to the other ankle doctor before vacation and got that brace though. This doctor wanted another set of x-rays done. I guess that's my fault. I should have brought the x-rays that were taken at the last doctor's office. The x-rays did not show any fractures or breaks but he did see a white spot on the ankle and when he pressed that area, it did hurt. He wasn't sure what it was and he said he's never seen anything like it before. There were also some darker spots on the bones and he said that's most likely due to the prednisone eating my bones. He examined my ankle and foot as well as my healthy ankle and foot. He said, in his opinion, it was mostly likely gout, that you didn't need to be in excruciating pain to have gout and he would know as he's had gout many times. I also told him I had kidney disease and elevated Uric acid levels after he mentioned that I might have gout. I had suspected it could be gout which is why I mentioned it to the last doctor. So, he said I should get in touch with my lung transplant doctor and ask if I could do 10mgs of prednisone instead of the usual 5mg as that is the treatment for gout. I would take that for 7 days. If the pain goes away, great. If it's mostly better but still there, ask for another 7 days of 10mg prednisone. If it's not getting better at all, we will need to do an MRI. He said it also looked like it could have been a bug bite, but I don't recall any bites or it looking like a bug bit me.

    Yesterday I got the skin cancer removed from my ear. I had to come at 7:30 am because somehow even though I called the office to cancel the appointment that was set for the Monday before I left for vacation, AND I made an appointment for 9:30, none of these changes were recorded in the files. I got a call confirming my Monday before vacation appointment and I hit the proper number to cancel. Then, a few days later I got a call asking if I would like to reschedule. So I had no choice but to go at 7:30am or wait another week. My ear was already quite sore and I didn't want to wait. I get it, humans make mistakes. No one is perfect. But, 7:30 was a bit early for me. My mom accompanied me in case I would be in great pain afterwards like the situation with my eyelid, though just from the biopsy alone, I felt this wasn't going to hurt as much, even though the bump was quite big. I felt two insertions of the lidocaine needle. It stung a bit but was nowhere near the pain of the eyelid injection. I'm not sure if there was only two injections or if i just didn't feel anything after that. I didn't feel him cut the lump off, though I could sense a sawing like motion was happening on my ear. I waited in the waiting room for an hour. When I was called back, they said they needed another layer taken off. I was bummed. Again with the lidocaine shots, though I felt absolutely nothing this time. He cut deeper, I could sense a feeling of cutting into the cartilage a little but no pain. We waited an hour and a half an then we were told the borders were clean. YAY! I was sooo tired. So, the doctor proceeded to sew up the ear with stitches and then we were on our way. A few hours later I had a little pain in my ear that lasted the rest of the day but by the next morning my ear did not hurt at all. I made it the whole day without any pain. It only hurts if I accidentally touch it. Right now it's covered in a bandage. I will take the bandage off tomorrow and put cream and a band-aide over it.

 

 

(updated, I took the bandage off)

 

    I also went to CVS and picked up a cream for under my eye as I have been having a dry flaky patch of skin there for years and I get it frozen every time I see the dermatologist. I had two biopsies done there and they both came back precancerous. I asked the MOHS surgeon if there was something more I could do and he suggested a cream that I had to be super careful putting on as it would be very bad to get in my eyes. I also picked up doxycycline to ensure no infections set in with the ear surgery. This means I also need to take oral Vancomycin to prevent C. Diff as I have a history of C. diff.

Skin Cancer, Ankle Pain, and Pacreatic Cysts

 Skin Cancer, Ankle Pain, and Pancreatic Cysts

    The skin biopsy of my ear came back as skin cancer, squamous type. I was going to have a MOHS procedure this Monday, but I was worried that because I was going on vacation this Saturday, the stitches might've been in for too long, should they be needed. Because of this, I had to move my appointment for MOHS to the Monday I come back from vacation. I definitely would've preferred getting the MOHS before I left and in hindsight, probably could have. My dad said that when he gets stitches for MOHS they leave the stitches in for about 10 days, and I would've just had to have left them in slightly longer, at two weeks. I do regret not doing it but sometimes you make a decision and it's not the right one. Unfortunately, the doctor only does MOHS on Mondays so I couldn't have gone anther day.

    About a week ago I noticed my ankle starting to hurt. I thought if I just waited a while the pain might go away, which has worked in the past for my ankle pain. My right ankle had become mildly swollen, red, and a touch warm. I could still walk on it so I knew it wasn't a bone issue. I figured I must've hurt it during one of my walks, although I could not pinpoint any such moment where I noticed the pain beginning. I thought perhaps I might have torn a tendon, although I think I'd've been in greater pain than I was, which is not to say that there hasn't been much pain, because there has been. I thought perhaps it was gout as my Uric Acid levels were mildly elevated in February when they were last tested. My mother went to get her hip checked out and said that the place she went to had signs saying people could walk in between 3pm and 6pm and get things like their ankle injuries checked out. I decided for peace of mind, especially with going away for a week, I should go and get it checked out. I waited 'til 3pm and then I was off. After getting a set of X-rays, I saw the doctor. He palpated my ankle and moved it in different directions, and he checked the films of my X-ray on the computer. He could see no fractures on the X-rays, and after moving my foot in various directions, and pressing on the area that was red and swollen, he ruled out infection, gout, and said most likely this was not a tear of any kind. He didn't have an answer as to what was wrong other than to say I might have hurt it walking but it didn't seem to be a serious. He recommended I get fitted for an ankle brace and try wearing that for a week, and then come back. If the problem wasn't gone by then, he said we'd need to further investigate and do more tests, such as an MRI. I asked why he didn't think it was gout, and he said that gout usually presented in the big toe, or other places. Besides that, he said patients with gout are usually in severe pain. He recommended taking NSAIDS but I can't due to having had two transplants. He then recommended a higher dose of Tylenol but I told him that I'm on antifungals and I really don't want to take a higher dose of Tylenol. Besides, my ankle only hurts when I walk.  I still have an appointment with another ankle doctor the week I come back from vacation. I will keep that appointment and I also made a follow-up to see the doctor I just saw also on that same week I come back. Hopefully it's nothing to be concerned about and it goes away on it's own. 

    I had an MRCP, which is an MRI of the pancreas about two weeks ago. It showed one of the cysts in the tail of my pancreas had grown. This warranted a trip to the GI doctor. On Wednesday, which was yesterday, I saw said GI doctor. I wasn't asked to bring in the MRI disc and I didn't think to do so as my coordinator had access to the films and sent them over. For some reason they didn't have access to the films when I got there. I was told that I probably wasn't going to need an Endoscopic Ultra Sound but that it would depend on the films, which would need to be reviewed by a team of surgeons and doctors. It was up to them to evaluate whether or not my cysts seemed to be benign and were just the usual cysts someone with CF gets, or if they were of the mucinous type which had the potential to develop into cancer. I would've preferred that they definitely did the procedure just for peace of mind. I'm not sure how they determine if a cyst is benign or mucinous just by looking at films but I'd rather know for sure. My coordinator re-sent the films and they were reviewed today, Thursday, and they decided they wanted to do the procedure after all. I was already tentatively scheduled as the GI doctor is leaving in a month. Of course there are other doctors in the practice so if I should need to followup with someone else after the procedure, there will be other doctors to see. My appointment for the procedure is May 1st.

Walking, Yoga, Iron Infusions, Pancreatic Cysts, and a Skin Biopsy

 Walking, Yoga, Iron Infusions, Pancreatic Cysts, and a Skin Biopsy

 

    I received my first iron infusion three weeks ago. It was simple and fast and I had no reactions. I had to go into clinic to get it as my home infusion company doesn't infuse iron. It took a half an hour and I had to stay another half hour to make sure I didn't have any side effects. In the meantime, I had started walking at the park, just twice. The first ten minutes of each walk was very difficult. It felt like I was very out of shape. My muscles were burning and I was going at the pace of a snail! After the first ten minutes, my legs felt better and I was able to walk the rest of the mile. I noticed the next time I went for a walk after the iron infusion, I did not have the ten minutes of agony. Perhaps the iron helped with my stamina. 

    The next iron infusion I got went a little differently. I was given paperwork before I started the infusion, like the first time but this time I noticed that the type of iron seemed to be different. I also noticed this one had a potential side effect of high potassium. That concerned me. It turned out my insurance wasn't going to cover the cost of the first iron. The high potassium side effect lead to me not continuing the infusion. The nurse unhooked me and told me I would still need to stay as I had received some of the iron and it was a different formulation, one I hadn't had before. In the meantime, my coordinator was called and she suggested I stick with the infusion, that I was pretty anemic, and the iron would help. She also said that she hadn't had any patience have high potassium afterwards. I felt better knowing this. I agreed to restart. She also said that instead of needing just two infusions, I would now require a third. She said there was one other medicine available but that would take a total of 6 more infusions. So naturally, I tried my luck with this one. Pharmacy was called, and within an hour of being there, we finally started for real. The problem was that it was already pretty late. I had a 4pm appointment. Now it was 5pm and the infusion was for two hours with a half hour of waiting afterwards. I'm pretty sure they infused it in just one hour. We ended up being the last people in the infusion suite and the last people on the clinic floor. Everyone else had left.

    They had me come in earlier for my last infusion since it would take two hours. It went by very slow but uneventful, which is great. This time I didn't have to stay the extra half hour as I had the same formulation the time before. When I went to walk again with my sister, I was able to do the 1.1 mile loop as well as the .75 mile loop at the park. My stamina had increased and I even walked a bit faster. I've walked two more times at that same distance. I noticed yoga is a little easier to keep up with now too. I didn't think the iron would make a big difference as my red blood count is pretty low and my hemoglobin isn't too bad at 8-9. I'm glad to have more energy and strength.

    I went for my yearly MRCP, and MRI to check on my pancreatic cysts. The results came back fast, and last Friday, my coordinator called to say one of the cysts had grown. I will need an endoscopy guided with ultrasound to take a biopsy of the cyst. I scheduled the appointment for April 9th for a consultation with the GI doctor.

        Today I had a skin appointment. I made the appointment because at the top of my right ear, a small bump was forming and scabbing and it hurt. So, I got a biopsy and will get the results back in a week. I'm pretty sure it's skin cancer, which means I'll need another appointment to have it removed. 

Quick Update, Back to Yoga, Winter Activities

 Quick Health Update, Back to Yoga, Winter Activities

    My creatinine continues to bounce around between 2.45 and 2.7.  This is still better than the 3.15 it was at, at one point. My iron is slightly low and I will be going for one to two iron infusions starting either next week or the week after. I have been steadily gaining weight, a little too much, perhaps due to the birth control I have been on. I'm perpetually hungry. I weigh more than I have in a very long time. I also find I can't eat as healthy as I'd like because I'm limited to 2,000mg of potassium a day. I'd love to eat bananas, especially when I night eat, rather than the junk I have been eating. Just in general though, it's hard to get a lot of veggies in. My lungs are doing well. I can breathe well. The airways are clear, and I don't have my usual squeaking bottom right lung; or at least I can't hear or feel it. I can even lay on my right side at night without mucus vibrating and making it uncomfortable.

     I started back at yoga two weeks or so ago. I have been doing it via live stream as I'm a bit out of shape from not really moving much while I was out of breath and not feeling well for several months. I believe the anemia I have from CKD is also contributing to me not feeling as strong. I like that I can do the yoga at my own pace and take classes that are a little more challenging than I can handle, that I would not want to take if I went in person. At home, I feel comfortable and I can just not do the hard parts without feeling self-conscious. I can also cough up mucus without being looked at like I'm sick or drawing any unwanted attention my way. I don't get a lot of mucus but now and then a little builds up and doing the different postures helps to loosen it. After lung transplant, I have always had trouble just coughing up my mucus, and it takes me several coughs to get it out. I don't like to go full on cough in yoga in a class full of people. If it only required one cough that wouldn't be so bad. I find it's also a plus to do yoga at home in the winter for two other reasons. One, my chances of catching something is much less as there's a lot going around right now, and two, I usually have to park on a side street as the parking lot fills fast and the class before usually gets out late, so even arriving early, the parking lot is already full. Every now and then I get lucky and get in the parking lot but not usually. The walk isn't that far, it's just cold. I do plan to go back to the studio in March. I wish it was warmer so I could walk outside. I suppose I could put on a bunch of clothes and a hat and walk but I do seem to have a cold intolerance that is magnified by the kidney disease which causes anemia. The past few winters were not as cold. I could walk if it 45 degrees or above and no wind.

    Winter is a little rough for me as I get a bit of seasonal depression. I like being outside. I miss going to the park and taking a stroll. I feel like even music just sounds better in the spring/summer.  I also need the sun to be out to feel motivated, regardless of the season. I've been reading a lot and doing some jigsaw puzzles. I go for drives. I've been kind of hermitting for the winter. For my birthday, my sisters and a family friend went to see Chicago and then we ate pizza at my favorite pizza place. It was a super fun day. We also have plans to see Mystic Pizza mid February so that's something to look forward to. There are some vacations down the line that hopefully will pan out, so long as my kidney cooperates. I go to sound healing sessions on Wednesday nights. I had gone briefly to a yoga studio some years ago, specifically just for sound healing sessions. The studio closed when covid hit. A few years later, I got in touch with the teacher that used to teach and expressed how I missed the classes. She told me would be hosting class in her basement in a week. I couldn't believe it. So now she hosts class there every Wednesday and we hang out afterwards and talk and it's a lot of fun. In slightly warmer weather, we gather around a fire pit and talk outside instead. On Fridays, I got to my sister's house and hang out with her and my two nieces, as I've been doing even before they were born.