NISSEN Post-OP

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Christopher
Regular Member


Date Joined Jan 2009
Total Posts : 25
   Posted 1/18/2009 8:45 PM (GMT -6)   
Hello,

My name is Chris, and I'm a 45 yo male in Southern CA who underwent a Nissen fundoscopic wrap on Dec 19, 2008 at USC Med Center in LA. I decided to go ahead and schedule after more than 2 years of being on PPI's and not getting sufficient relief from my symptoms on meds alone. After several endo's, and the a wireless PH test lin late summer '08, my doc confirmed I was a candidate for surgery. I believe he said that on my 2nd endo, he was able to go into my stomach, turn the scope around and see back up to my tonsils fairly clearly. So I definitely have an issue with a defective Lower Esophogeal Sphincter, which was the cause of my symptoms.

I decided to go ahead and have the surgery performed. I was in the hospital for 2 nights. The surgery, normally around 1.5 hrs long according to my Dr., was performed in less than 1 hr. I got through the surgery and anesthesia OK, and then was back in my room in a cpl hours on a morphine pump. I was pretty out of it the 1st few hrs after arriving in my room, but was happy to have the pain meds. I was started out on clear liquids, but have to admit it was tough to stomach anything for awhile. I had some issues with liquid vicodin after coming off the morphine, but was glad to be out of the fuzziness and kind of shut-down mode that anesthesia and morphine does to your body. I came around slowly, thus requiring the extra night in the hospital.

I had a scare on the second day, trying to walk and move around without alot of food in my system, I got pretty nauseated and had dry heaves that afternoon. They gave me anti-nausea drugs by injection and was OK for the rest of my hospital stay. Went to stay at a friends place for an overnight, before attempting a 2 hr ride home after surgery. Got home and settled in...and I have to admit it was a tough couple of weeks right after surgery. Pain was manageable, but eating was a real challenge. My stomach would roil and bubble and roll, and it was hard to get it settled. That was the hardest part for me, always feeling agitated. I managed to get off the vicodin after a week, but the diet was difficult to adjust to.

I was better on week 3, and had managed to get to soft foods OK...with some exceptions...but did get caught on some occasions with fighting to get food down and having alot of pain in the process. I was feeling better physically, with some more food in my system, but had lost some weight and wasn't taking enough in to compensate yet. It was a fight on some days to get out of bed, being low on energy and facing issues with getting food down, and feeling sorry for myself and being depressed. Noone prepares you for the reality of recovery from surgery, and everyone snaps back at different speeds, but you do have to persevere and just get to the next day.

I am now at week 4, feeling better and trying to introduce more foods into my system. A major milestone for me was the part of a tuna sandwich I had the other day ( very slowly and in very small bites ). I do get hiccups alot when I try and go too fast. It's frustrating and I have to get rid of them before I can continue eating, but I have to remember that I am still healing and I'm NOT the way I was before, so things will be slow for awhile. I have become a fan of BEANO, and also try and chew some digestive enzymes after I eat meals. I pop alot of GAS-X to try and prevent bloating...sometimes it's successful, sometimes not. I feel the need to burp, but can't and that causes some discomfort, but overall I think I am making good progress for my time out of surgery.

I have learned more since my 4 week follow up with my Dr....mostly about feeling the familiar sensation of reflux after eating later in the day, but my Dr. explaining that the esophagus is kind of a 'dumb' organ, and only translates one kind of pain sensation. He said that food stuck in my esophagus will feel like acid reflux until it gets carried out of the tube. He also explained that the esophagus tends to 'sleep' after surgeries like this and will not totally wake-up until more time has passed, and continue it's normal motility.

I was unsure right after surgery if I had made the right choice, and now that I am a couple more weeks out, have begun to feel better and move back toward a regular diet. I am skittish about some foods, and will probably not push the envelope too hard for the next couple of weeks. I still have some discomfort after eating, but it is certainly much improved from a couple of weeks ago. I have realized I need to exercise more to get my body moving, so I don't lose more strength and to manage to eat enough small meals throughout the day to get back the weight I've lost.

I haven't covered everything here, but if anyone has any specific questions, I'm happy to share what I have experienced.

I thank you all for allowing me to share my story. I hope it helps anyone who might be looking at surgery as an option, and those who are recently recovering from a Nissen to know a little more. I wish everyone a speedy recovery if you have the surgery and to have the patience to let yourself heal.

Take care and good health,

Chris

opnwhl4
Veteran Member


Date Joined Dec 2008
Total Posts : 4961
   Posted 1/19/2009 9:53 AM (GMT -6)   
Chris,
Glad to hear all is going well. I had a Nissen done about 2 1/2 years ago. I sure do remember the hiccups when I tried to eat. I figured it was my stomach telling me to stop. I also remember the pain when you couldn't get something to go down. Which is happening again. I may be in for round 2 of the Nissen.
Don't try to rush things too much, healing takes time. I don't miss the pain of afternoon "heartburn".

Bill

Jeanie J.G.
New Member


Date Joined Jan 2009
Total Posts : 3
   Posted 1/20/2009 11:49 AM (GMT -6)   
Dear Chris,
Would you have it done again as an option ?? My husband has high grade dysplasia barrett's esophagus..We were given options of what to do but the dr. doesn't want to do surgery.. Have you heard of any of the burning procedures and if so what do you think or your dr. think of those methods ?? The Dr. wants to biopsy the heck out of it and take pieces off and try to get all the barretts which is 1 centimeter of barrett's .. Any opinion on this procedure ?? We'd value your opinion.. My husband as you has had many yrs. of endoscopy etc. I'm glad to hear you are alright. sounds like you went through a lot.. Good Luck in the future.. God bless, L.G. p.s. we are scared

Christopher
Regular Member


Date Joined Jan 2009
Total Posts : 25
   Posted 1/20/2009 1:29 PM (GMT -6)   
Jeanie,

In answer to your question...yes I would. Being at this point in my recovery, it's easier to look back and see how far I've come. I was lucky to not have any signs of Barret's in my diagnosis over the last few years, so I'm definitely not qualified to speak on this particular set of problems. I'm also not familiar with the 'burning' procedure you mentioned, I am sorry. I'm sure there are many on this board who must have familiarity .with some of these issues and can better address your questions. I encourage you to post in the general forum with a topic on Barretts so that others can read and offer up their experiences.

I hope that you can find some help/advice here and that your husband will get the appropriate care to help him with his healing. I understand the fear, but don't be afraid to ask questions of your doctor, and if you don't get the answers you feel fit, then continue your search. There are many talented professionals out there, you just need to find one to best help your husband.

My thoughts are with you and wishes for a speedy recovery to your husband.

Good Luck to both of you.

Chris

Christopher
Regular Member


Date Joined Jan 2009
Total Posts : 25
   Posted 1/26/2009 11:38 PM (GMT -6)   
Thanks Bill for your reply.....I am wondering if there are others out there that are still healing and have the same issues I'm having at 5-6 weeks.....just getting back to solid foods this last week and have that 'reflux' feeling in your throat of food being stuck? I am still having bouts of bloating, especially at night, regardless of the Gas-x and Beano I take at every meal. Getting comfortable is a challenge in bed.

It really makes me not want to eat much at night...kind of like I was before the surgery. Still not doing tomato products...I had part of a drink ( alcoholic) the other night and that didn't feel so good either. It's funny, I almost felt better 2 weeks ago than I did this past week. Still having a bit of shoulder pain and sleeping more than I thought I would.

Anyway...would love to hear your insights on the healing process, and was wondering if I should ask my Dr. on my next follow-up to give me a prescription for an anti-naseau drug just to have around if I ever get sick.

Thanks to all who read and reply...I really appreciate it.

Hope all are doing better or getting the help they need.

Take care,

Chris

picklepuss
Regular Member


Date Joined May 2008
Total Posts : 160
   Posted 1/27/2009 3:22 PM (GMT -6)   

Christopher, I'm 1 week out of my Nissen Lap redo with hernia repair surgery.

As far as your idea of just having anti nausea meds on hand just in case I would give 2 thumbs up. You just don't want to get to that state when your sick to start heaving and possibly causing damage to your wrap. A little added security is nice to have in hand and I also recommend to carry a pill or two with you in your car or wallet so you always have something handy when your not at home. That's my thoughts on it anyhow, I love my anti nausea meds... LOL Right now they help me get through the day.

BTW I noticed you said you have shoulder pain. Do you have any remedies or ideas to share for helping with that pain ?

Teala


opnwhl4
Veteran Member


Date Joined Dec 2008
Total Posts : 4961
   Posted 1/27/2009 4:51 PM (GMT -6)   
Christopher,

I had food getting stuck for about 3 months after my surgery. Actually it's doing it again. I was lucky and didn't have much shoulder pain. Only the first day.
Definitely get the anti nausea meds. I didn't and I sure paid for it. Actually I forgot where they were about 2 months ago and had to deal with dry heaves for a couple hours until my wife called me back from work to tell me where they were. I recommend always knowing where they are!


Bill

stkitt
Elite Member


Date Joined Apr 2007
Total Posts : 32602
   Posted 1/27/2009 5:48 PM (GMT -6)   

Hello Chris

Welcome to HealingWell and the GERD/Heartburn Forum.

Also thank you for coming forward with your story.  I can sense that each person headed toward surgery is looking for as much info as they can find from others who have been through the experience.

I know each person is different as well as their recovery but hearing the good and not so good is helpful to all.

Again a warm welcome to you and stick with us. 

Blessings,
Kitt


 

Kitt, Co-Moderator: Anxiety/Panic & Depression
&  Moderator GERD  Forums

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Christopher
Regular Member


Date Joined Jan 2009
Total Posts : 25
   Posted 1/28/2009 1:44 PM (GMT -6)   
Thank you Kit, Bill & Teala,

Teala...sorry to hear about your redo, I hope that you are progressing well. I don't really have anything special that I do to take care of the intermitent shoulder discomfort. I am seeing an acupuncturist to help my body recover and to move things along. He has given me some herbs to help counter the bloating, but I haven't been able to tolerate them very well so far. I take some pain killers occasionally for my shoulder pain, but it's not that severe, just uncomfortable. I figure the more I move, hopefully the better it will get.

I will definitely take your recommendations on getting the anti-nausea drugs, any one in particular that all of you would recommend? Oh and a side note...I planning on a cruise in April...do you think I'll have any problems with being seasick, or will the meds counter that? I'll be interested in hearing your opinions.

I seem to feel pretty good early in the day, my stomach is still doing flip flops later at night before bed. I would suppose that is directly connected to the amount of food I injest, but it's funny...I had half a burrito last night and decaf latte after for dinner and my stomach was pretty calm...go figure.

It's definitely a learning process...but I look forward to the day when I can eat anything and not have to worry about how I am going to feel.

I appreciate all your comments and suggestions...and Kitt..I will definitely stick with the forum.

Take care all !

Chris

snoopy567
New Member


Date Joined Oct 2008
Total Posts : 2
   Posted 1/28/2009 8:54 PM (GMT -6)   
Hi Chris,

Hope your recovery continue to do well. I would like to get some information on the wireless ph test and the motility test as I am also doing these test in the USC hospital in Los Angeles. I just want to get prepare for the test next month. Are these test uncomfortable/painful? Who is your surgeon?

Ivy

LdyJane
Veteran Member


Date Joined Jun 2008
Total Posts : 903
   Posted 1/28/2009 9:35 PM (GMT -6)   
Ivy, the bravo capsule is inserted during endoscopy; you'll have meds for sedation. During endoscopy your Dr. will be looking for signs of esophagitis and any other signs of reflux or disease as well as looking inside your stomach and duodenum. At the end of the examination the bravo capsule will be inserted in the wall of your esophagus; I have had it done twice and it didn't leave much of an impression upon me as far as discomfort. I seem to remember a sensation of some sort, but nothing very noteworthy.

You will be give a digital recorder to wear; this recorder receives signals from the bravo capsule, you will be given instructions by your practitioner on how and what to do. At the end of the period ( 48 hours generally) you will return the recorder to their office. The capsule will detach on its own and pass through your system unnoticed by you.

The motility study is uncomfortable, but provides an exceptional amount of information. You will be given an anesthetic for your nose and throat, a probe will be inserted up through your nose and down through your larynx into your esophagus. The best thing to do for this part is to relax, keep your chin down and allow the probe to pass through; you will be given some water to assist in the passage of the probe. I have found that it's easier to take longer drinks rather than shorter sips, but that's just me. Once the probe is in place, you will be asked to take a series of 10 or so sips of water, each one is done to register the contractions, or motility, of your esophagus. Once the test is done, it's done and, while you may have a bit of a sore throat, it will pass quickly.

You'll be okay, don't fear the tests, they may be uncomfortable, but are well worth the efforts.
Janice

snoopy567
New Member


Date Joined Oct 2008
Total Posts : 2
   Posted 1/29/2009 6:54 PM (GMT -6)   
Hi Janice,

Thank you for your information. My doctor will have me do both test on the same day. I can't take any PPI 14 days prior to the test. I am not sure if I can survive without PPI for that long. He said I could take Zantac and other medications. Do you have differculty swallowing food after the bravo chip is inserted?

Christopher
Regular Member


Date Joined Jan 2009
Total Posts : 25
   Posted 1/29/2009 7:50 PM (GMT -6)   
Ivy,

Thank you for your wishes. I believe that Janice has answered most of your questions, but my Bravo experience was good. The placement procedure was easy ( being asleep ) and the only time I really felt any discomfort was occasionally when I swallowed heavy food.......I did have a bit of a sore throat, but that went away soon after.

Being off my Omeprazole for 14 days was easier than I thought it would be. Watched my diet, slept on my wedge and used Zantac and Tums as needed and specified by my doctor.

My doctor in Orange County was (is) Dr. Robert Lipham who teaches out of USC. I highly recommend him, and the staff at USC was very efficient in the OR and prep before my surgery.

Feel free to ask about anything specific and I'll do my best to relay my experiences.

Thanks to Janice for the great explanation on the testing.

Chris

KME
New Member


Date Joined Jan 2009
Total Posts : 2
   Posted 1/30/2009 4:52 PM (GMT -6)   
My 8 year old is having a nissen in a few weeks,  I am trying to prepare for the procedure.
 
the PH test showed a minimum of 85 refluxes in 24 hours.  does anyone know if this is a lot
or a little
 
What is the shoulder pain from,  how much weight loss in the 3 weeks of recovery?
 
KME

LdyJane
Veteran Member


Date Joined Jun 2008
Total Posts : 903
   Posted 1/30/2009 7:23 PM (GMT -6)   
I'd like to address a few issue with my post, so please bear with me:

Welcome KME, I hope we all can be of some help and comfort. Children are different than adults; but my 24 hour ph showed a Johnson-DeMeester of 126 or so with reluxes numbering in the hundreds; 85 is a lot, so don't get me wrong, but hundreds in mind-boggling; both underscore the need for action.

The shoulder pain is from the gas that is introduced into the abdomen during surgery; the gas is used to inflate the area for better visualization and to move the organs out of the way for surgery. While much is remove during surgery, there is some that remains and for whatever reason, this is felt in the shouder. In an adult, walking and gas-x and even chiropratic adjustments seem to alleviate this more quickly than just hoping it will go away.

Children heal much more quickly, with much fewer side effects than adults; the older you are, the tougher it is and honestly, I raised 3 boys...nothing kept them down! That may be more of a challenge for you than something surgically related; I'm thinking specifically of lifting restrictions, but listen carefully to your Dr.s

I hope this helped.

Chris, and everyone else; I hope you are getting stronger each day! Chris, week 5 and 6 seem to be the magical numbers for turning the corner..you are through the worst and each day you will feel much more normal. 90% of your healing will occur in the first 8 weeks; the final 10% will take a year, so it is not surprising that swallowing issues are still there for you. I had a particularly rough recovery and had to return to Cleveland for an emergency endoscopy and dilation at week 2. Take cues from your body, eat slowly, chew tremendously long and watch out for things like steak...test something when you feel brave enough to do so and if you have problems swallowing, wait another 2 weeks or so before trying it again.

Chris, about the use of anti-nausea meds, many of us used these at night time for 6 tp 8 weeks, one person used them even longer, so it doesn't surprise me that you are still using them and it's really okay (and wise) to do so. I used zofran during the day (they're stronger) and phenergan at night (they helped me sleep but they're not as strong), so if you sleep like a log, use the zofran..may I ask?, how old are you?, did they do an open or a lap?

By April, you will have stopped wondering if you had made a mistake and you will be happy that you went through with the surgery. Unless you have problems with sea sickness before surgery, chances are you won't have it then, but take some with you just in case (they're small!) Drinking alcohol may still be an issue though, so watch that, as will overeating, which is a temptation on a cruise!!)

A word of caution for everyone, and, unfortunately I'm living this problem right now...watch out for catching the any type of flu or intestinal bug, including food poisoning. Remember when I said the last 10% of healing takes a year? In December, 5 months post-op for me, I came down with an intestinal bug (the first time in 25 years) and in the middle of the night I was up having a horrible time. In the middle of this nastyness, mother nature decided that I needed to have more fun than I was already thoroughly involved in; I had to vomit. If this does happen, and you have the presence of mind (which I did not have!!!) see if you can get some anti-nausea meds down..early!

I did not have the presence of mind to do so and having the dry heaves in the middle of the night, whoo hoo! who can beat that! eventually, MN won and I actually did vomit some. The pain was pretty bad, but once I did get it up and out, the heaving stopped. Unfortunately, I am once again symptomatic; I'm on Protonix for heartburn, I have chest pain, intermittent pain ( a knot-like feeling) under my sternum and my voice is getting raspy. I'm scheduled for a barium swallow next week, and when speaking to my surgeons' assistant at Cleveland the other day her response was "oh, Janice, this does not sound good, it sounds like the repair slipped" So, I'll have the test up here, fax the results there and when Dr. Rice reviews them, he'll decide if all is okay and I'm just nuts, or if I have to go back for additional testing there.

So, there's my post, I'm sorry that I dragged on and on!!! Good luck every one, let us know how things are going.
Janice

KME
New Member


Date Joined Jan 2009
Total Posts : 2
   Posted 1/31/2009 1:28 AM (GMT -6)   
Thank you,  this helps  but am still worried about weight loss and other side effects of the surgery.
My child is a bit dramatic and am just trying to hear from others who can help me prepare.
 
How long are most in the hospital and are the 1st 48 hours the worst or the best.
 
I would not consider myself as an over worried parent at this is my 3rd...so we've seen a few things.
but this would be our first major surgery...any insight?
 
 

oakley
Regular Member


Date Joined May 2007
Total Posts : 358
   Posted 1/31/2009 10:08 AM (GMT -6)   
hi Kme ...I am wondering why your young son is having the surgery. I am assuming that he has been on medicine and that his diet is good and he is not overweight...all things that would help him with his reflux , without surgery. I will keep him in my prayers....I have not had the surgery, had motility test and cannot swallow well enough sop my doc said no surgery. In order to be a candidate for the surgery you must be able to swallow well enough BEfORE the surgery... Let me know what brought your son to this point. Do your other children have any issues with reflux? My little two year old nephew has it quite bad and he is on medicine that controls it quite well. All the best to you and your dear son.I love my son so much that I know where your heart is at right now ...I truly do. God bless

Christopher
Regular Member


Date Joined Jan 2009
Total Posts : 25
   Posted 2/2/2009 1:18 AM (GMT -6)   
Janice,

In answer to your questions, I am 45 years old and had the the surgery done laproscopically. I am at about 6 weeks out from my surgery, and going for my 2nd follow-up in Orange County tomorrow. I've had a bit of soreness around one of my incisions over the last day or two...not sure what that is about since I've been very careful about not lifting much. I'll ask tomorrow.

KME.....wow..I feel so sorry that your young son has to go through this stuff...not fun. Try not to worry, as I would think that children do have the ability to heal faster. Just be patient and follow the doctors outlines for diet. There are plenty of ways to get calories, via nutritional shakes etc, so I wouldn't worry about your son losing too much weight. I was in the hospital for 2 nights, but everyone is different. The 1st night was OK because I was on morphine, so I don't remember alot. The 2nd day was tougher, but my pain was very controllable with liquid pain meds.

My particular experience was that the 1st week was the toughest....adjusting to food, getting comfortable, and the shoulder pain from being inflated for the surgery. It all passed and just a few weeks later I am in pretty good shape. I still have some swallowing issues, and am getting my strength back slowly, but all in all I am doing well.

Use this forum to your advantage and ask your doctor anything you can to help your understanding...perhaps he can refer another patient locally who can answer more specific questions for you in regards to your son.

Good luck to all and here's to healing and getting back to living !

Take care,

Chris

opnwhl4
Veteran Member


Date Joined Dec 2008
Total Posts : 4961
   Posted 2/2/2009 9:40 AM (GMT -6)   
Christopher,

I saw you are having soreness at one of the incisions. It wouldn't happen to be the one just below your left rib cage would it? That one gave me fits for at least a year. I still have pain there if I lean on it to much.


Bil

Christopher
Regular Member


Date Joined Jan 2009
Total Posts : 25
   Posted 2/2/2009 7:07 PM (GMT -6)   
Bill,

No, it's the one directly below my belly button. I think I may have strained something a bit working on my car. Not too bad, just a little tender.

Take care,

Chris

rsapooh
New Member


Date Joined Dec 2008
Total Posts : 8
   Posted 2/5/2009 3:57 PM (GMT -6)   
Has anyone who had the procedure drinking carbonated drinks?

Christopher
Regular Member


Date Joined Jan 2009
Total Posts : 25
   Posted 2/5/2009 5:04 PM (GMT -6)   
RSA,

Not me...so far...still too scared to try that..I really have lots of bloating issues with regular food with out adding carbonation. In addition to this question, I have my own:

To the general board:


I am interested in finding out what types of food gives you bloating issues...is it a quantity issue that makes it worse? I ate last night at around 7PM, and went to bed at midnight and was up for an hour with the gurgles, roils and general stomach symphony. I had a small piece of Ahi tuna, mashed potatoes, green beans, a few bites of cake and some milk. Does any of that sound like it should cause such stomach distress?

Still trying to figure it out. Had LOTS of problems with tomato soup and Ritz crackers for lunch....so staying away from tomato based stuff for awhile.

Probably need to start another post for this, but had to ask.

Thanks,

Chris

oakley
Regular Member


Date Joined May 2007
Total Posts : 358
   Posted 2/6/2009 2:07 AM (GMT -6)   
Hi !
I have lots of trouble with dairy products in general.
I don't get near mashed potatoes.
I eat yogurt , which does not seem to bother me.
I will think of others but right now i am exhausted , lol !
I would add real quick that I notice more bloating if I wait to eat past the time when I am hungry.
I almost bloat up before I eat in this case.
Isn't just eating something we have to give so much thought to in our lives due to these health issues ???



Bummer ! Take care

Rangel
New Member


Date Joined Oct 2008
Total Posts : 15
   Posted 2/10/2009 12:36 PM (GMT -6)   
Christopher,

I’m now 3 ½ month post op and still have trouble with some foods. Mainly pasta, Bread and potatoes…in any form. Also still have some trouble with tomato based products.

All I will suggest is to eat regularly and eat slow! They say once you’ve had the op then you can’t be sick again…well believe me you can! And it’s not pleasant.

I’m still trying to figure out what I should or shouldn’t be eating too but I’ve learned you have to take it slow, I’m still taking complan to boost me as shift work is killing my eating pattern, but I do feel ….and been told I look
better

Night time I don’t have trouble with food, but as soon as I lay down my whole stomach area gurgles, and moans n groans, not sure why?! Does it if I have or haven’t eaten.
Just be aware that your body has changed…for the better and all the strange feelings and tightness etc is all part of the healing process. I still have some discomfort in my chest but they say give it time...remember its supposed to be a 9month recovery, so we all still have some time to go before we're back to normal ;-)

Christopher
Regular Member


Date Joined Jan 2009
Total Posts : 25
   Posted 2/16/2009 2:30 PM (GMT -6)   
Just a quick update,

Feeling about the same at about 7 weeks...back to doing a bit more physical activity, but still get tired after a regular day of work. Had a bad spin with a lunch last week and really had issues with swallowing...coughed up alot of saliva and eventually got it all down. Kinda scary and made me pretty tired after....brings me back to the following:

1. Slow down my eating
2. Chew your small bites REALLY well.
3. Drink some liquids with your meal...especially with dry foods or meats
4. Be patient with your healing...

I think whoever wrote that they get more bloating and gas if they don't eat regularly is experiencing the same symptoms I have. It's definitely a day by day thing...haven't tried taking any pills yet. A bit skittish on that...I had a headache last week and was lucky enough to have some leftover liquid pain reliever instead of the big liquid gel caps. So...just have to remind myself every day that I'm not quite back to 'normal' yet.

Hope everyone else is doing well and progressing in their healing process..or finding the answers they need to make themselves well.

Take care,

Chris
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