Power of Empathy

Lately, I've been seeing a lot of those posts/essays/articles. You know the ones; “10 Things Not to Say to Someone with a Chronic Illness” or “Sorry I Don't Fit Your Idea of Looking Sick”. That point of view has always bothered me a bit; how we (people with MS, or just people in general) expect other people to always know what to say or how to act. There could be lots of reasons people say things that upset you. Perhaps, on a different day, it wouldn't bother you at all.

Point is, everyone has days where they do or say things out of character. EVERYONE. I bet there are things you wish you hadn't said or done. Maybe not to the point of regret, but things that might make you cringe a bit when you look back.

Maybe the person who said it didn't know what else to say! I mean, think about it. When you meet someone with a chronic, incurable disease, you don't expect them to look “fine”. I'm sure 99% of the people who say things about your MS that rub you the wrong way do NOT intend to annoy you.

Maybe that person is having a bad day. Maybe that person is having job troubles, health troubles, money troubles, or just didn't get enough sleep. Maybe they need a bite to eat.

Let's dissect a hypothetical conversation:

Person one: I took my elderly neighbor to the doctor the other day. His daughter lives nearby but she can't take him. She's in a wheelchair. She has MS.

Person two: I have MS as well!

Person one: Really? But you look fine!

Okay, person one is relating something, and sort of defending why he/she took the neighbor to the doctor instead of a family member. Person one is heading off the “why do you have to take your neighbor to the doctor” question. Person two is looking for a common thread in the conversation. Person one is surprised because the only person he/she knows with MS is the neighbor's daughter who is in a wheelchair.

Person two has options at this point. Person two can choose to be offended and defensive. Person two can shrug it off. Or, person two can take this moment to tell person one a little something about MS. Even something simple like, “MS is different for everyone” is more knowledge than person one had earlier.

Maybe person one wants to know more and ask questions, maybe not. But if we just wish people knew more about MS and don't do anything to further the public's education, we're just as culpable in feeding the ignorance.

How many times have you said the wrong thing because you didn't know what to say or for whatever reason? We've all done it. Having MS doesn't make me an expert on having a conversation. I just try to realize where the comment is coming from.

Yes, sometimes it's irritating to hear how "good" you look outside when there's so much happening inside. Your legs are vibrating like a tuning fork, you have vertigo sitting in a chair, the heat makes you rage like a wild animal, you are dealing with optic neuritis, and you have a headache that no medicine can touch. My personal opinion is that if you don't take the time to enlighten someone, there's no way you can lament people's ignorance about MS.

There will always be those who don't believe anything is wrong with you. As long as those people aren't your neurologists just ignore them, the best you can. And if you do snap at someone, remember: We're all people, trying to make our way on this planet. We all have days we wish we could do over. We all have days that are better than others. Let's try to be a little gentler to ourselves and other people.

Let's Get Something Straight

Tomorrow is my septoplasty. I'm really looking forward to being able to breathe easily again!

I know it's been a while since my last post, and a lot has happened. I'll fill you in at some point, but not today.

After the surgery during my recovery at some point I will have an actual post.

Waiting for- But Not Wanting- an Exacerbation

If you have MS, you know first hand. If you've ever talked with anyone who has MS, talked with a doctor, a nurse, or someone who knows someone with MS, they will probably all tell you that stress makes MS symptoms feel worse. Aside from me and my doctor, no one in my life was more acutely aware of that than my sister. My sister always kept in close contact with me, even more so around stressful times for me.

When my mom passed, my sister would call me more often than usual. Of course, she wanted to chat, but she was also gauging how I was doing. I could always tell the difference between when she asked me how I was versus how I was. What I mean is she would say “How are you” in a different way when she was worried about me having an exacerbation.

My mom's passing was the culmination of a couple of months of loss in my family. Our family lost an uncle on October 27^th. He was my mom's brother. We went back and forth about telling my mom. In the end, we didn't tell her. By then, my mom couldn't stand on her own. There was no way I would be able to get her to the services, even with a wheelchair.

Then on October 31^st, we lost another uncle. Again, we went back and forth about telling my mom. Again, we didn't tell her for the same reasons.

Lastly, my mom in December. December 12^th. It was just like my mom to decide on that particular day.

When my husband and I lived in Chicago, my husband worked overnights. It seemed as though I always got bad news when I was home alone. My mom, of course, knew this. So December 12^th was probably the most selfless day possible. It was a Saturday afternoon, and everyone was home at my house. My grandmother's birthday was December 10^th, and my mom's birthday was December 16^th. My mom left us between those days.

Through it all, my sister kept a very watchful eye on me. She was always so concerned about how I was coping. Actually, more precisely, she was concerned with how my body was coping. From the day of my diagnosis in 2004 when she sent me flowers until the days where texting became too much, my sister was the one person in the world who always watched out for me.

My sister never said any of the hated phrases to me like: “I know exactly how you feel”, “I know what you're going through”, “I feel the same way because I didn't sleep well”, “Everyone gets tired”, “It could be worse”, or everyone's favorite “You don't look sick”.

After my sister's cancer diagnosis we would talk, and she never expected that I would put my disease aside when talking to her. One day, I said to her that I felt ridiculous talking about my symptoms to her. She said, “Why? Your MS didn't go away with my diagnosis”.

Since my sister passed, I've seen my neurologist a few times. Every time I'm in her office, I get the impression that she fully expects me to be having a terrible exacerbation. Truthfully, so am I. I was there just the other day, and she asked how I was feeling. I told her the truth; I feel really good. She stopped in her tracks and turned into a mouth-breather for just a second. She turned to me slack-jawed with a look of genuine surprise. It's not that she didn't believe me, but she was really happy when my exam echoed what I said. I'm doing pretty well.

I've been on Aubagio for nearly 3 months without any appreciable side effects. My symptoms aren't gone, of course, but I seem to be managing them fairly well. Losing my sister has essentially disintegrated my soul, so maybe that's why I'm managing so well. It's hard to feel symptoms when you're empty inside.

Reading. Writing. Not So Much 'Rithmetic

The post yesterday got me thinking about how other people formulate thoughts and write. When I'm writing, one thought leads to another, and another, and another. In my head, they all seem to tie into my central idea. But do they?

The ideas in my mind are like tendrils curling around a lattice. Some meander and don't quite make it to the lattice, and some hold fast to it. Are the tendrils that don't make it back to the lattice superfluous? Well, let's be honest. My whole blog is superfluous, so maybe I asked the wrong question.

When looking for photos to add to my post, I found a website that will teach you “how to mindmap”. Here I go sounding curmudgeonly and stodgy, but way back in the 1980's, we learned to mindmap in ELA. In yesteryear we called it “brainstorming”, and we did it while taking creative writing in English. If we had an idea, we would essentially do word/thought association until we had a direction. Sometimes the teacher would make us do an outline if we were writing something with a lot of detail. My outlines were never any good. mostly because I let the story tell itself. Half the time, my outlines weren't accurate because the finished product ended up so far from where I thought it was going.

I thought I would do something different today. I am asking you questions, and I'll also answer the same questions. My questions to you today are: What is your process for writing? Do you have one? Have you read any books that helped you write better? Has any author influenced your writing? They say prolific writers are prolific readers. Do you read a lot? Do you get ideas from random things?

I don't necessarily have a process for writing, but I sort of have little rituals. I prefer to have coffee nearby, even if I don't drink it. After (I think) I've finished something, I will do something else for a bit. I might water the plants, throw in a load of laundry, or do the dishes. Sometimes I think of things to add, or a better way to convey what I mean. Sometimes, it just clears my head so I can do a little editing. Yes, I actually edit. You might be surprised at what I don't say.

I've read books and articles through the years about writing. The commonality is that they say “write”. If you have an idea, write, If you enjoy writing, write. Just write.

I read in fits and starts. I may read several books in a row, then nothing for a while. I have a few books waiting for me right now, including a couple I started and didn't get back to. I would love to say I read all genres, but I honestly don't. I have a few authors I return to, like old friends; Stephen King, Charles Dickens, and Clive Barker. I wouldn't say any of them influenced my style of writing, though. I do read other things, too, but these few are my favorite jeans of authors.

If you've ever read my blog, you know I get ideas from random things. Essentially, every encounter with anything is raw material for me. I do try to be mindful of other people's privacy, though. You will see me use the phrase “not my story to tell”. I might be an open book, willing to share so much with the world, but I know not everyone feels that way.

It's So Trivial

I was listening to the radio the other day, and a commercial came on. The male voice in the commercial was very distinctive, and I wondered to myself if he sounds like that all the time. I also wondered if I would recognize his voice if I heard it in a random setting.

While looking for articles on sound and memory, a cursory glance told me that we don't retain information we hear nearly as well as information we see. I'm not talking about information, though. I'm talking about the sound of a voice, not necessarily what the voice was saying.

Basically, our senses create memories that are either in our long-term or short-term memories. It's been my experience that sound is instant and intense in its ability to transport me to a time and/or place. I hear a certain song and instantly remember where I was, who was with me, and what I was doing.

A couple of years ago I took an ambulance ride because of severe spasms in my back. The spasms were so intense that with each spasm, my legs would involuntarily pull up and I was in a fetal position. Anyway, I had to go for physical therapy (after I was able to walk).

At PT, I heard a voice. A familiar voice. I knew that voice. I looked around to see whose voice it was, and it was a DJ from a local radio station. I don't listen to that station regularly anymore, but I'd been listening to him since I was in high school. I didn't know how deep in my memory his voice was until I heard him.

I digress, because I was really talking about the male announcer in the commercial, and how his voice jarred a memory.

Before the internet made information accessible in the blink of an eye, I co-hosted a call-in trivia show on a local college radio station. It was a weekly show, and it may have been an hour long. I'm not quite sure anymore.

My friend was a cashier at a grocery store (I know this seems completely unrelated to the previous paragraph, but it's not). I was there to get her from work so we could go out. As I'm chatting with her, a guy approaches me and says, “You're Lauren Haulass”!

Lauren Haulass was the name my co-hosts gave me at the radio station; the name I used on the air.

I froze for a few seconds. My mind was volleying questions and answers to itself.

He said that he listened to the show every week, and he would have recognized my voice anywhere. It was kind of cool, but I felt very weird. This was back in the day where radio and television were two decidedly separate media outlets. Radio afforded you anonymity. Only to a degree, though, as I discovered that night in a grocery store.

The Flying Ring

A few months ago, our family got together to commemorate my sister's birthday. It was good to see everyone, especially under better circumstances. There was food, cake, laughter, and gifts. Scattered tears, too, but they were mostly dried by the laughter.

My brother's church sent a live plant arrangement to my sister's services. It was lovely. My brother and sister-in-law took it home afterward. What they did with the planter, though, was wonderful. They split it up and gave each of us a plant from that arrangement. I actually still have mine, and it's doing okay!

I'm usually not good with houseplants (see the Boston fern post). However, I do have a plant that belonged to my mom. That plant was part of a live plant arrangement sent by my employer to my father's services in 1996! When my mom came to live with us, the plant came too. Let's think, it's been here since 2013 and it's still growing! I guess it depends on the plant.

Back to the family function, though. Sorry, I always get sidetracked!

The other gift was that my niece made small photo albums for each of us. It's full of lovely photos of my sister. It was weeks before I could even open the book. I still can't look at it without crying, but it's a wonderful and thoughtful gift.

Lastly, my sister's daughter (yes, she's my niece too, but I didn't want to call her the other niece) gave us each jewelry that had belonged to my sister. It must have taken her a long time to choose each piece because she gave us pieces that were perfect for us.

She chose a beautiful necklace for my daughter. After looking at it for some time, I realized that I had given that necklace to my sister. My daughter loves it. My niece gave me pieces that she knew I had bought for my sister (including the sister Alex and Ani bracelet) through the years. She also selected a Celtic-looking filigree ring for me. I've worn it every day since.

Every time I come in the house, I take off my rings. I can't leave the house without them, and I can't wear them in the house. One of my (many) quirks. I put them in the same place all the time so I know where to find them. I've kept the photo album there, too, so I can always see it.

One day last week, the photo album and the ring that belonged to my sister crashed to the floor. Just those two things. In addition to that ring, I always wear my wedding ring and another ring. I keep all 3 of them together, sometimes in a pile. Neither of the other 2 rings left their resting place, just the one from my sister. Also near the photo album were envelopes with my daughter's recital tickets. They didn't come down, either. Just the photo album and the one ring.

There wasn't a breeze because my windows have been closed. My wonderful husband put in the air conditioners when it first got hot. Even if there were a breeze, the recital tickets should have blown off before the photo book.

Draw what conclusion you will. I know what I believe, and I don't believe in coincidence. A few weeks before the flying ring, I noticed some pictures were crooked. As I was straightening the pictures, I told my daughter that my sister and I would send this meme to each other. 

Was it my sister visiting me? 

Sound the Alarm

It's been a while since I wrote about my MS. Oh, stop groaning; it's not going to be a whiny post today.

Anyway, it's been a while since I wrote about MS. Two medicines ago, in fact.

Last time I wrote about MS, I was on Tecfidera. I had virtually no side effects on it but I was concerned about compliance when we go on vacation. Tecfidera is an oral medication that has to be taken with food twice a day, ideally at the same time. I wasn't sure I could commit to doing that while we're away. After talking with my neurologist, we decided to try Tysabri* again. I was on Tysabri many moons ago, but my old neurologist stopped it because my white cell count was starting to climb. He didn't want to risk me developing PML.

Anyway, my current neurologist seemed to think it was worth trying again, especially given my track record of blowing through treatments. Up to that point, I'd taken 5 different MS medicines, including Tysabri.

After my insurance company approved Tysabri for me, I scheduled my first infusion.

Now I'm in the infusion center. The nurse had no problem starting the infusion, but the alarm insisted on beeping repeatedly, to the point of being obnoxious. As the alarm kept ringing and the nurse decided to change my IV, I just kept thinking that this was the Universe's way of telling me that I shouldn't get this infusion.

Ignoring the feeling inside (something I know better than to do), I let the infusion proceed. Because really, what am I going to say? “Um, the Universe is telling me not to get this infusion”?

The nurse changed the IV, and the Tysabri started flowing freely into my veins. And I got itchy. First the back of my neck. Hmm. Coincidence? Then my lips started tingling. Double hmm. Then I started coughing, sneezing, and felt my throat constricting ever so slightly. Then the IV alarm beeped again.

When the nurse came over to check my IV, I told her what was happening. She checked my back and the back of my neck. Lo and behold, I was breaking out in hives. Of course I was. The nurse stopped the infusion, called upstairs to my neurologist, and explained what was happening. She came back and told me, “When I told ___ what was happening, she said 'that's weird'. I've never heard her say 'weird' before”. I told the nurse it's very fitting that my neurologist used that word in connection with me.

The nurse gave me a steroid infusion and a couple of Benadryls. After a bit, my reaction started subsiding. She made me call for a ride home because of taking the Benadryls.

I made an appointment to see my neurologist. When she walked in the exam room, she just laughed. She's really getting to know me. After she stopped laughing, she said, “Now what are we gonna do”?

We talked about my (limited) options, and we decided to try Aubagio**. Aubagio is a once-daily oral medication that doesn't need to be taken with food. There are some risks (of course), but we're doing blood work once a month to watch for those things. So far, I don't seem to have any adverse reactions to it, and I'm nearing the end of my second month on my little blue pill. No, not that little blue pill! 

I would have loved to try Ocrevus***. Ocrevus is an infusion given twice a year after the initial dose. But my neurologist told me that it might be linked to breast cancer. Since it's relatively new, we decided that I shouldn't risk it. Perhaps if new data comes along, we'll revisit it, but for now I'm happy on the Aubagio.

Through all this, how are my symptoms? I'm still walking, so there's a major plus. I don't feel much worse than I did last year. Struggling to breathe through a messed-up nose really pushes other things to the back burner!

*Tysabri is a disease-modifying drug developed specifically for MS. It's given once a month as an infusion. It's also linked to PML. Here's a link about Tysabri and PML if you want to read more.

**Aubagio is an oral medication developed specifically for MS. Here's a link about Aubagio if you'd like to read more.

***Ocrevus seemed like the perfect drug for me. An infusion twice a year? Amazing! If you'd like to read about Ocrevus, here's a link.

Happy Mother's Day

Another Mother's Day is here. Another one without my mom, my first one without my sister and mom. Nothing can prepare you. Oh, sure, intellectually, I knew this day would come, but the feeling is stifling.

I don't know if you've ever seen the movie “Death Becomes Her” with Goldie Hawn, Meryl Streep, and Bruce Willis, but there's a scene in the movie that perfectly shows how I feel right now. It's actually a really funny movie if you ever see it on cable. Anyway, it's really accurate.

I've written about my mom before, and I've written about my sister before. Being without both of them is pain beyond words. All I want for Mother's Day this year is to crawl into a cave, tighten into a fetal position, and be in the dark. Then my environment would match my mood.

However, I have two wonderful kids who love me and I need to be present for them. It's funny, I never thought I would make Mother's Day about my kids, but if it weren't for my kids, I wouldn't have a reason* to notice Mother's Day this year.

If you're celebrating this year, Happy Mother's Day. Hope it's more than you dreamed of!

*It's not my intention to slight all the great moms I know or the dads who are dads and moms. It's not that you're not important; you are. I'm just empty this year. 

A Picture Is Worth 624 Words

My parents were married in 1948. There were places they wanted to go, but my dad just wasn't able to travel. After my dad passed, my mom took a few trips. On what would have been my parents' 50^th anniversary, my sister and brother-in-law decided to take my mom to Cape Cod. My mom had always wanted to go, and this seemed like the perfect time.

My mom was really looking forward to going. She was finally going to be able to see and do all things my sister and I had talked about. Take the ferry to Martha's Vineyard and explore Martha's Vineyard, see the Dunes, go to The Christmas Tree Store, and get her feet in an ocean other than the Pacific.

What my husband and I didn't tell anyone was that we planned to surprise them in Cape Cod that weekend.

We flew into Boston from Chicago, spent the day in Boston seeing the sights with a friend, picked up the rental car, and drove to the Cape.

Only it didn't quite go that smoothly. It rarely does. We went to the rental place to get the car. I had reserved a Mustang; I figured it would be cool driving around the Cape in a 'Stang. The rental place tried to give me Contour*. I don't know if you remember the Contour, but it was like a poor relative of a Taurus. At first, the company wouldn't budge and tried to force me to take the Contour. I stood my ground. They offered me a size upgrade, but I didn't want to learn how to drive an SUV on the road to Cape Cod. In the dark. Finally, an available Mustang appeared. As soon as we get in, we notice it's dirty, as though it's being driven by someone as their everyday car.

Still, we're finally on our way in a Mustang! So we're driving down the very dark highway, and it seems darker than it should be. I don't know what route it is from Boston to Cape Cod, and I don't know if it's still completely unlit, but it was wooded and pitch black driving in 1998. Once I stop behind a car, I discover why it seems so dark. There is a headlight out in the rental.

My husband and I finally make it to the Cape, surprise everyone, and head back to our hotel. In the morning, I call the car rental company. They were nice enough to offer to let me take their car to a dealership and have the headlight replaced. And oh, by the way, they would reimburse me for the headlight. You want me to have YOUR car repaired AND pay for it? On my vacation? WHAT?! No. Next, they offer to let me drive back to Boston to exchange the car. Thanks for playing, but guess again. They finally say that they will drive a car down from Boston for me. They will meet me at Hyannis airport with an upgrade. That works for me because we were going to Hyannis anyway.

They show up with an SUV.

At this point, I don't even care, and at least it's daytime. I just make sure all the lights work, the radio works, and it's clean. I drive around the parking lot to get my bearings, and I'm finally comfortable enough to drive in Massachusetts. If you've ever driven in Massachusetts, you know what I mean.

Anyway, I told this story because it popped into my head when I saw this picture. The photo was taken on the 1998 Cape Cod trip and I love it.

*My apologies if you owned a Contour, but we both know that they were nothing like a Mustang. 

Happy Birthday Lee!!

Today is my husband's birthday. Every year, I ask him what he would like for his birthday, and every year, he requests the same thing. “Nothing”. I have such a hard time giving “nothing” to the man who gives us his everything.

He is kind, generous, helpful, resourceful, devoted, and loving.

No task is beneath him, no task is too difficult for him to attempt.

When anyone needs a helping hand, he's always there, tools at the ready.

On weekends, 99% of the time, you will find him at the ice rink with our son for hockey. He has never missed our daughter's dance recital, and she started dancing in 2007. He is a doting father, and there's nothing he wouldn't do for our kids.

We've been together for 27 years and married for 23+ of them. I wouldn't trade a minute or change a second. Nobody's perfect, but he's perfect for me.

If you're reading this, I love you, Lee. If Lee's not reading this, I love my husband.

Happy birthday.

PS- When looking for a photo to go with this post, I found the one I'm using, but it reminded me of when Lee and I first met. Lee's brother and his wife used to live down the street from Lee, and sometimes we'd go over to their house to play Scrabble. I don't want to say it was competitive, but there was a Scrabble Championship belt, similar in construction to a wrestling championship belt. This belt was infinitely more prestigious, though.

Dr, Touchy-Feely and the Deviated Septum

A long time ago (back in the 1990s), in a city far, far (about 600 miles west of where I am now) away, my PCP wanted me to deal with my sinus problems once and for all. Ever since I was a teen, I called myself “Our Lady of Perpetual Sinus” because I was constantly congested. My PCP referred me to an ENT who my husband and I called Dr. Touchy-Feely.

Dr. Touchy-Feely didn't touch me in a predatory way, he just made it a habit of touching you when he talked to you. He would touch your arm, a “safe” part of your leg, he would touch a shoulder, but in a way that I suppose was meant to show his sincerity, emphasis, and self-assurance. He did it to me, and he did it to my husband. He was an equal opportunity toucher.

During my first visit to Dr. Touchy-Feely, he looked at my CT scan and told me I needed surgery. I had teeny-tiny sinuses*, and a deviated septum. One side of my nose was nearly closed off because of the deviation in my septum. Though he wanted to do surgery, I asked him to try non-surgical options first. He did. For almost two years. One visit he said, “LouAnn, really. It's time”. He meant it was time to do the surgery that deep down I always knew I needed. I was only prolonging the inevitable.

Once I agreed to the surgery, He casually mentioned that he could perform any cosmetic procedure because he was already fixing my septum and insurance would cover essentially anything done to my nose. Though I had a very large nose with a bump in it, it was me. I didn't want to become unrecognizable because of a medical procedure. I did consent to him straightening my nose and shortening the tip of my nose. I specifically told him that I didn't want the nose of an iconic fashion doll. It's a lovely nose, it's just a nose that wasn't meant for my face.

We went over the risks, the downtime, what he would do during the procedure, and what I should expect. I know he said, “You can expect some swelling and some discoloration”. In my head, I didn't think I was going to look like I went through the windshield of a car. You can imagine my surprise when I looked in the mirror.

In the post-op consultation before my release, Dr. Touchy-Feely told me that I bled more than he expected, and the discoloration was due to the blood settling. Oh. Great.

Once I looked less scary, I felt a lot better. My sinuses didn't bother me at all. For a while. I'm not sure how long I was actually better, but last summer, I really started noticing lots of problems. The first problem is that I was having a hard time breathing. I've been on several different antibiotics and a few courses or steroids with little or no relief.

I finally mentioned it to my neurologist (only because I saw her before my PCP) and she referred me to an ENT locally. I told my husband that if this ENT mentions surgery, I'm not going to prolong the torture.

I had my consultation with the new ENT this past Thursday. He looked at my MRI and asked if I had injuries to my face. I told him that I don't make a habit of fighting and I hadn't face-planted, so I didn't recall any injuries.

My septum is deviated again, almost closing my nose on one side again, and the inside of my nose is corkscrewed. He also mentioned something about the sides of my nose, but I don't remember exactly what it was. Basically, all this translates to surgery for LouAnn. Again.

He did say something very interesting. He said whoever did the original procedure didn't do it properly. He pointed out all the reasons why it was, for lack of a better word, botched. What's interesting about Dr. Touchy-Feely is that he was a fellow in Otolaryngology and he's still ranked as one of the best ENT's in the nation.

I haven't been scheduled for surgery yet, but I'll keep you updated.

*not a medical term

Awkward

It's been a while. Quite a while. I'm not sure if I should apologize for my absence or apologize for my return. Either way, I apologize. I've had much to process and I'm not nearly finished processing.

Writing used to be cathartic for me, and I'm hoping once I get into a rhythm, it won't feel so awkward.

I lost my biggest fan and one of my strongest supporters. My sister, who I wrote about before, is at rest. Her passing has left a rift in me deeper and wider than any chasm on earth.

So while I want to write, all of my thoughts are sister-centric. That might be something I'll share in the future, but right now, they are private thoughts.

Eventually, I'll get back to writing about my MS because that's the reason I started this blog. Not today, though. Today, I just wanted to dip my toe in the ocean and test the waters.

Thanks for being patient.