I dug my heels in yesterday with my Dr. and said I would not participate in
continuing therapy with Avastin after my therapy with the other 3 drugs is
completed. I am re-assessing my reaction and seeking advice here.
I had a medium differentiated colorectal cancer and had the diseased portion
of you colon removed, which included the rectum, anus, and stump. Since the
cancer had spread I'm considered a stage 4 patient. The lymph nodes were
not involved and the margins were clear. At the same time we discovered 5
spots on my liver and one on my lung. Three of the lesions on my liver were
surgically removed, but we haven't even taken a biopsy sample on my lung.
Prior to surgery I had radiation and chemo to reduce the size of the
colorectal tumor, to which I responded very favorably.
I just completed my 6th round of chemo, of 12, and am doing very well. I
get Leucovorin, 5-FU and oxylaplatin, bolus, and 5-FU continuous infusion for
46 hrs. afertword, as well as the Avastin in my treatments on a 2 week cycle.
I know that the FDA approved Avastin for treatment of Colorectal cancers, but
since they got it all and the margins were clear, why should I continue with
the Avastin to treat the remaining 2 spots on my liver, now undetectable on
CAT and PET scans and the lesion on my lung? I didn't like the
recommendation and don't want to follow up after my chemo is complete by
getting bolus treatments every 2 weeks after my standard chemo treatments
have been concluded. There is no definite end to the Avastin treatments.
My chemo oncologist has been great, and has been on top of everything, but
this last recommendation is throwing me. I'm looking for help and advice.
Thank you.
George
I don't know much about the drug, but the doctor must think you are strong
enough to handle the extended treatment. Maybe after that you will be done with
the treatments for good, think of it that way.
Do you have reactions to cold air from the 5-FU? I start it on Monday, and I
was told to have a pair of gloves handy to open the refrigerator. It sounds
like I have almost exactly the same treatment you have gone through. I have to
take the 5-FU through the pump for 46 hours also, every 2 weeks.
> I know that the FDA approved Avastin for treatment of Colorectal cancers, but
> since they got it all and the margins were clear, why should I continue with
> the Avastin to treat the remaining 2 spots on my liver, now undetectable on
> CAT and PET scans and the lesion on my lung? I didn't like the
> recommendation and don't want to follow up after my chemo is complete by
> getting bolus treatments every 2 weeks after my standard chemo treatments
> have been concluded. There is no definite end to the Avastin treatments.
Those seem to be good questions.
What do you gain (nothing to monitor at the moment). No symptoms to improve,
right?
I'm pretty sure Avastin is claimed to "may inhibit growth"
Is that first line treatment you're having?
Since the response was good and you're tolerating it well, after a break, if some
growth occurred, could you restart the same combo?
(these are questions I'd ask myself)
Steph did say on sci.med.diseases.cancer ... well now I can't find it, so I
forget what he said.
They don't mention liver or lung here
<http://www.bccancer.bc.ca/ABCCA/NewsCentre/2004/Newadvanceinantiangiogenesis.htm>
Let's see what he would tell one of his patients in your situation.
Oh the other thing I meant to mention is asking the other patients here on
Avastin to let you know what their responses are (as their scan results come in),
while you're continuing on your protocol. That might give you a clearer idea of
what you intend to do once your current regimen ends.
J
Holden
Keep fighting.
Hugs
Sinead
> <snip>
>
> Hi J, group,
>
> FWIW, I recently got a CT report back, eleven weeks since last scan.
> My "yardstick" liver tumor (i.e. the large tumor that gets the
> attention as far as determining how things are progressing) is
> "without significant change". BTW, this particular mass is at present
> a whopping 9 x 7 cm. That's a little scary if you think about it too
> much ...
Hi Holden, Well, are you a (possible) candidate for surgery?
http://tinyurl.com/3fno6 Follow along with Orac and Steph, they're talking about liver
mets.
Since you don't archive, it's difficult for me to go back (through your posts in the
archives) and see (for instance) which type of surgeon you've consulted.
J
I do have the sensitivity to cold, it usually lasts a week and a half. I
use thinsulate glove liners made by the Golden Needle company. If you need
a pair we have a source that I can ask where they can be ordered from, let me
know if you need a pair. They are thin enough to pick up a dime with them
on, but insulate well enough to be used for 10 minutes without gloves at -25
deg. F. Also do not drink anything cold, your throat will feel like it is
closing up and you could choke. It doesn't really happen, it just feels
like it will. My sense of taste is also off for about a week after the
treatment, it returns to normal, and doesn't affect the taste of chocolate,
thank goodness something tastes like it should to get me through.
I don't worry so much about having the treatments, like setting needles stuck
in me, though I have a Grochon central line now, my caution stems from the
fact that the Avastin inhibits formation of new blood vessels. Our bodies
defense against damage of vessels in one area is to grow new vessels around
the afflicted ones. There are no studies on the long term use and no-one
has been able to tell me that the use of Avastin will inhibit the formation
of other lesions.
I am handling the treatments well, but the side effects are building up. I
just made it over the 100,000 mark for platelets last week and elected to
take the treatment, since I was on the borderline and it was left up to me.
If I have to continue beyond the 12 treatments that are scheduled, then I can
hack it - even if I have to work at it for longer. Getting back to work is
getting to be an issue, but my Dr. advises against it. I caught a cold 4
weeks ago and am just now getting over it. I can do some work at home, but
not as much as my supervisors want, I get tired easily also.
I'll keep on whittling this thing down until it's gone, and just keep on
concentrating on getting through each day, one day at a time. I learned in
the service that you always have something to fight with, even when you feel
you can't go on. There is always something left to take you one more step,
if you can will yourself just to take the next step. A person who won't be
beat can't be beaten.
Good luck with your therapy and let us know how it goes. All the best.
George
>archives) and see (for instance) which type of you've consulted.
>J
Hi J,
X-no archive is turned off now. I probably should have had it turned
off for all posts here since the general idea I suppose is not only
having posts available for current discussion, but also to have them
available in the future for those that might come along and get some
benefit from older messages.
Thanks for the pointer to the sci.med thread. I haven't been
evaluated lately for surgery, but have previously. When my hepatic
artery infusion pump was put in in 2001, the plan was also to use
cryoablation to knock out as many liver tumors as possible (there were
three known masses based on scans). After it was all over, it turns
out that none of the tumors were ablated. As I recall (with help from
my wife), the surgeon found five other tumors using ultrasound that
were pretty much evenly distributed throughout the liver. Apparently,
the one large mass and the numerous smaller masses, if ablated with
necessary margins, would not have left much liver.
I am past due for followup with my surgeon. I suppose it wouldn't
hurt to ask about surgery again but I suspect I'll get the same answer
as before. (Now that you bring it up though, it might not hurt to
have a fresh set of eyes take a look and give an opinion.) I'm really
not too crazy about going back for more surgery. Earlier I inquired
here about microsphere radiation therapy. At the moment, I'm more
inclined to go with that than with a "conventional" surgery. For now,
I'll continue with the Avastin and see how things go.
Thanks for your thoughts and caring.
Best wishes,
Holden
> On Sat, 19 Jun 2004 05:26:25 -0400, J <unnew...@example.com> wrote:
> >
> >Hi Holden, Well, are you a (possible) candidate for surgery?
> >http://tinyurl.com/3fno6 Follow along with Orac and Steph, they're talking about liver
> >mets.
> >Since you don't archive, it's difficult for me to go back (through your posts in the
> >archives) and see (for instance) which type of you've consulted.
> >J
>
> Hi J,
>
> X-no archive is turned off now. I probably should have had it turned
> off for all posts here since the general idea I suppose is not only
> having posts available for current discussion, but also to have them
> available in the future for those that might come along and get some
> benefit from older messages.
Thanks Holden
It sometimes helps me point someone to another newsgroup discussion too.
He also mentioned "radiofrequency ablation" which you apparently also tried in the other
reply of his (same thread) and "the exact number is controversial, but usually more than
four is the cutoff)" and he is mentioning a special type of surgeon, so I guess (based on
what you posted below) I'm wasting your time and giving false hope, really.
I'm sorry for that.
Thanks for clarifying or repeating if you'd mentioned this in your previous posts.
J
> Thanks for the pointer to the sci.med thread. I haven't been
> evaluated lately for surgery, but have previously. When my hepatic
> artery infusion pump was put in in 2001, the plan was also to use
> cryoablation to knock out as many liver tumors as possible (there were
> three known masses based on scans). After it was all over, it turns
> out that none of the tumors were ablated. As I recall (with help from
> my wife), the surgeon found five other tumors using ultrasound that
> were pretty much evenly distributed throughout the liver. Apparently,
> the one large mass and the numerous smaller masses, if ablated with
> necessary margins, would not have left much liver.
>
> <snip> For now, I'll continue with the Avastin and see how things go.
George,
Hang in there. Sounds like you are handling it well, and taking the time to
help other people. Will the doctor give you a short break before starting the
new treatment? That would give you time to recoup and to think about it. I know
it is a waiting game.
I have also been able to do some of my work from home, I am accountant, but
will be able to go back soon, I hope. I will know more after the first
treatment, and see how I handle it.
I have a pair of driving gloves, and hoping I only need them to open the
fridge. I thought the nurse was exagerating about the gloves. I will let you
know how this works out.
As you said, One Day At A Time. Keep in mind that this is curable, especially
today. Tammy Faye Baker had the resection surgery 10 years ago, but she refused
the chemo treatments, and she was clean for 8 years. Had she had the
treatments, she may have gotten rid of it. Who knows.
Hang in there George. Sounds like you have a strong constitution and are
remarkable. It is the mental health that plays a big part in recovery, and your
attitude will fight it off, and keep in mind that it is possible to get rid of
it completely with the chemo.
<snip>
>
>He also mentioned "radiofrequency ablation" which you apparently also tried in the other
>reply of his (same thread) and "the exact number is controversial, but usually more than
>four is the cutoff)" and he is mentioning a special type of surgeon, so I guess (based on
>what you posted below) I'm wasting your time and giving false hope, really.
>I'm sorry for that.
>Thanks for clarifying or repeating if you'd mentioned this in your previous posts.
>J
Hi J,
No apologies necessary at all, and as far as time goes, I consider
time spent here well worth it and welcome your suggestions and
opinions. Take care.
Holden
> <snip>
>
> No apologies necessary at all, and as far as time goes, I consider
> time spent here well worth it and welcome your suggestions and
> opinions. Take care.
Thank you Holden,
I look forward to reading your posts too !
My best wishes to you,
J
> Hi George,
>
> I think I understand what's going on. Right now, the end is in sight
> with the 12 rounds of chemo but treatment is "never ending" with the
> Avastin. I guess most people would prefer to have some definite point
> to look forward to for when the treatments would be over. I know I
> certainly would; but unfortunately (or maybe fortunately <g>) I've
> been getting some kind of treatment on more or less a continuous basis
> for just over four years. Anyway, I guess your doc wants to play it
> safe and continue with the Avastin "just in case". It's good that you
> have a choice - and you do have a choice in regard to continuing
> treatment or not. If you do stop after the 12 cycles, I suppose you
> would have the option of picking up the Avastin treatment later on
> should the need arise (pray that is not the case.)
>
> My opinion (not a medical practitioner) is that if you tolerate the
> Avastin fairly well, and there are no financial hardships due to the
> treatment, would be to continue with the Avastin. If not the Avastin,
> then something else like Xeloda to take care of anything that might be
> trying to hide in the scans. I am stage IV also like you so I have to
> be prepared for the fact that more mets could pop up at pretty much
> anytime. Continuing with something like the Avastin just might
> prevent or delay that from happening.
>
> On the other hand, you seem to be pretty averse to continuing with
> treatment beyond the 12 cycles. There are no guarantees with Avastin,
> so it could very well be that you don't miss anything by not taking it
> - other than regular visits to the doctor's office and the associated
> bills.
>
> HTH
>
> Best regards,
> Holden
Holden,
I was just stretched from 8 to 12 treatments (this last week), and 2 months
ago from 4 to 8. My latest CAT scan shows that the spot on my lung is
responding to the treatments and my CEA is bouncing between 0.8 and 1.6, so
my chemo oncologist is fairly sure that the spot on my lung is responding to
the treatments and she suggests that we continue the bolus infusions that
include Avastin through the entire updated course of treatment.
I don't have any particular dislike for completing the entire 12 treatments
in one run, if it is possible. However, there is a large section of the
oncology department who urge that there should be a break after 8 treatments
to let the body have some time to recover somewhat. My preference is to
continue charging through the treatments and get as many as possible
completed before having to take a break.
I have a distinct feeling that continuing with only Avastin beyond the
prescribed treatment plan will be a science project. I am fully prepared to
have to fight this cancer for the rest of my life, and I will never give up
on defeating it. My concern revolves around removing one of the bodies
self-repair mechanisms by using a drug which has no track record. If I am
fully informed as to the risks and benefits, I can make an informed choice.
Simply being informed that I am to receive it every 2 weeks for the
foreseeable future does not give me an option of making an informed choice,
and I do not consider myself a lab specimen.
I am living a guarantee free life after being diagnosed (I can't find a
signed guarantee anywhere that specifies how long I am to live or the quality
of life in that time - must have misplaced it somewhere). I also understand
that there are no guarantees that standard chemotherapy will work or continue
to work for me in the future. That pretty much lets me enjoy the important
things in life, playing with my granddaughter (now 3 months old), treasuring
time with family and friends, and helping out wherever I can, without guilt
or regret.
I guess I found the answer with your help and others here. I'll ask for all
the information my oncologist can supply, ask for the reason for continuing
with only Avastin, and ask that the decision be left up to me. If I
continue with the Avastin I want to document my participation in the study in
a manner that will produce revelant results, not just a point in a cloud of
others that can be reduced in a stastical equation. Maximum benefit for the
experience.
Thank you for responding.
George
Continuing with avastin will almost certainly be for 'guinea pig' reasons
only. There are no individually meaningful results in a drug trial. The only
meaning is in the collective data. The four months extra time gained by
adding avastin to the chemo regimen is only statistical....some will get
more, some less on top of an already variable benefit from chemo alone which
is itself a very variable benefit over doing absolutely nothing, especially
in advanced disease..
I don't know that avastin on it's own will do anything but the data
gained, while not benefiting you directly, may be of benefit to others down
the track. You have to weigh that against being tied to the hospital for
another 'however long'
MIKE
On my 13th treatment mine discontinued the oxaliplatin for fear of
what it was doing to the soles of my feet ... numb, tingly sensation
that can lead to falls and is hard to reverse. So now I'm ONLY on 5FU
(+ the leuk of course).
I've mentioned avastin to him several times. Each time he says You
don't need it. My latest scans indicate no new growth of my (CRC)
tumors on liver/lung after 5 months.
I had hoped for shrinkage, but it's better than further growth.
The oxaliplatin is the nasty stuff that causes neuropathy. Once its
out of my system (anybody know how long it takes?) I'm hoping I can
work out so my body will return to its previous in-shape condition.
_________________________________
"Take a little 5FU, leucovorin and oxaliplatin for thy stomach's sake." -- 1 Timothy 5:23 (adapted)
>This thread is interesting on how widely the treatment plans can go,
>according to the onc you have.
>
>On my 13th treatment mine discontinued the oxaliplatin for fear of
>what it was doing to the soles of my feet ... numb, tingly sensation
>that can lead to falls and is hard to reverse. So now I'm ONLY on 5FU
>(+ the leuk of course).
>
>I've mentioned avastin to him several times. Each time he says You
>don't need it. My latest scans indicate no new growth of my (CRC)
>tumors on liver/lung after 5 months.
>
>I had hoped for shrinkage, but it's better than further growth.
>
>The oxaliplatin is the nasty stuff that causes neuropathy. Once its
>out of my system (anybody know how long it takes?) I'm hoping I can
>work out so my body will return to its previous in-shape condition.
<snip>
HI Joe,
When I was on oxaliplatin, I developed neuropathy also. To me it
seemed pretty bad. In the mornings I would wake up and my hands and
fingers would be very "stiff" (arthritis-like) to the point that they
were nearly unusable for about an hour at which point they would
loosen up and be useable. My feet and especially toes were constantly
numb. This did not clear up after waking as the problem with my hands
did.
After stopping the oxaliplatin, everything was back to normal in a
couple of months or so. Overall, it was a very unpleasant experience
and rather scary. I was concerned that the effects may have been
permanent. I believe in some instances that is the case.
Best of luck to you and take care,
Holden
> For now, I'll continue with the Avastin and see how things go.
>
Hello Holden,
How's it going?
Thinking of you,
J
> This thread is interesting on how widely the treatment plans can go,
> according to the onc you have.
>
> On my 13th treatment mine discontinued the oxaliplatin for fear of
> what it was doing to the soles of my feet ... numb, tingly sensation
> that can lead to falls and is hard to reverse. So now I'm ONLY on 5FU
> (+ the leuk of course).
>
> I've mentioned avastin to him several times. Each time he says You
> don't need it. My latest scans indicate no new growth of my (CRC)
> tumors on liver/lung after 5 months.
>
> I had hoped for shrinkage, but it's better than further growth.
>
> The oxaliplatin is the nasty stuff that causes neuropathy. Once its
> out of my system (anybody know how long it takes?) I'm hoping I can
> work out so my body will return to its previous in-shape condition.
How's it going Joe?
It's been a while since we've heard from you..
Best,
J
Hi J,
Good to hear from you and also good to know that you're still looking
out for us.
Avastin treatment seems to be going OK. No serious side effects that
I can tell.
I've had some other things going on though but don't really feel like
getting into it right now. I'll try to give an update soon.
Hugs to you and all,
Holden
>Hi J,
>
>Good to hear from you and also good to know that you're still looking
>out for us.
>
>Avastin treatment seems to be going OK. No serious side effects that
>I can tell.
>
>I've had some other things going on though but don't really feel like
>getting into it right now. I'll try to give an update soon.
>
>Hugs to you and all,
>Holden
>
Hope you feel better. I had a tough time with the 2nd round of chemo, and now
I start the 3rd round on Tuesday. I have a feeling I will get the point where
I will refuse the chemo. I cannot go on like this for 6 months.
My white cell count was low after the second round. Would this be what is
making me so sick? God Bless, hope you feel better Holden.
I'm on the oxaliplatin also. I have a cramp in one leg for the last 2 weeks.
I try to walk around as much as possible. And I wear very soft socks. I have
only had 2 rounds of it so far, and I hope that I have seen the worst symptoms.
If you had 12 rounds of oxaliplatin, then maybe you are finished with it
anyway. I'm sure you will get back to normal soon.
NY to FL Guy,
Holden, I hope you feel better also. NY to FL Guy, sorry to hear that you
had a rough time on the 2nd round of chemo, they had to hold on #8 for me
because the platelet count dropped below 100. My oncologist said that the
white counts should be low and asked me not to freak out when they dropped.
I do catch colds and stuff easier, but only started getting nausia during and
after treatment #6. Took a while to get the toxic effects building up, but
it happened, and is still there.
Don't give up, keep on, you can make it. Just keep going one day at a time
and keep on the march. If the toxic effects are to much see if they can
change the regimen. Hang tough, you'll make it.
George
> Good to hear from you and also good to know that you're still looking
> out for us.
>
> Avastin treatment seems to be going OK. No serious side effects that
> I can tell.
>
> I've had some other things going on though but don't really feel like
> getting into it right now. I'll try to give an update soon.
>
> Hugs to you and all,
> Holden
We're here reading. Hopefully whatever else is going on will be resolved
soon.
Hugs to you too Holden.
J
I wonder where Joe is...it's been since June 20th...
My newsreader seems to show that you've replied to me, instead of Joe.
Hopefully that's not the reason he's not replying to you.
Just an FYI and it could just be my flakey but reliable newsreader ;-)
J
> Thanks for asking, J. All is pretty much as below. My biggest problem
> is with fatigue. Yesterday I was puttering around the house pulling up
> weeds, doing simple yard work and I was on my knees, and when I went
> to get up, I couldn't. I had to ask my wife to help me get up on my
> feet. Just no strength. The neuropathy is there and is causing some
> instability. I've come close to toppling over several times. Otherwise
> I feel good. The plan is to continue on F5U for a few more months and
> re-scan and go from there.
> --Joe
Phew! <wipes brow>
Am I glad to hear from you, Joe ! It's been 3 weeks, I was worried.
Glad your wife's around to help - time to rent a walker or buy a cane (for the duration of the
treatments)?
I haven't checked them out but some walkers may be helpful in helping oneself to get up again. You may
want to look into that before you worsen, so you can "shop in person" and see various styles.
It may be good to keep moving, even doing a little, but be careful you don't fall.
Hugs Joe
J
>Holden, I hope you feel better also. NY to FL Guy, sorry to hear that you
>had a rough time on the 2nd round of chemo, they had to hold on #8 for me
>because the platelet count dropped below 100. My oncologist said that the
>white counts should be low and asked me not to freak out when they dropped.
>
>I do catch colds and stuff easier, but only started getting nausia during and
>
>after treatment #6. Took a while to get the toxic effects building up, but
>it happened, and is still there.
>
>Don't give up, keep on, you can make it. Just keep going one day at a time
>and keep on the march. If the toxic effects are to much see if they can
>change the regimen. Hang tough, you'll make it.
>
>George
>
Hi George,
Glad you made it through the 12 rounds. (I think you had said you completed the
12 rounds). I was in the hospital for 4 days, got home last night. I became
extremely dehydrated. I am feeling much better today. I have an emergency
appointment with the oncologist Thurs. morning.
I am very doubtful that I will continue with the treatments, that is how I feel
at the moment. However, the doctor will probably offer another regimen. (I am
in Stage IV because I have 2 tumors on my liver which they are going to
remove). I am seeking an extremely healthy diet and exercise regimen in place
of the chemo. I have a strong faith in the Lord, and when he thinks it is time
for me to go I will be ready. But I refuse to spend the rest of my days being
too sick to get out of bed from those treatments.
The worst part for me is not having any appetite, and throwing up on my dinner
after one bite. I am really glad the treatments have worked for you. I think
we were on the same regimen. It must be a relief to have completed it. God
Bless, George, I will let you know what happens after I see the doctor. She
may recommend Avastin for me also. Talk to you soon.
I meant to tell you that there is an article in Cure Magazine from last month
(Spring Issue, Volume 3, No. 1, 2004) on the latest treatments for colon
cancer. It mentions Avastin as a treatment option.
You might have seen the article already, or they probably have it on their
website (I'm sure they have a website, I will try to check later). They will
send the magazine to you every month for free, just fill-out the card in any of
the issues and send it in.
It is a very short article, but informative. It also mentions that Stage IV is
curable. I will mail to you if you are interested, or give you a synopsis.
Hope you feel good today.
> Glad you made it through the 12 rounds. (I think you had said you completed the
> 12 rounds). I was in the hospital for 4 days, got home last night. I became
> extremely dehydrated. I am feeling much better today. I have an emergency
> appointment with the oncologist Thurs. morning.
>
> I am very doubtful that I will continue with the treatments, that is how I feel
> at the moment. However, the doctor will probably offer another regimen. (I am
> in Stage IV because I have 2 tumors on my liver which they are going to
> remove). I am seeking an extremely healthy diet and exercise regimen in place
> of the chemo. I have a strong faith in the Lord, and when he thinks it is time
> for me to go I will be ready. But I refuse to spend the rest of my days being
> too sick to get out of bed from those treatments.
Good for you, NY to FL.
Can you have surgery soon (once you're feeling better again?
> The worst part for me is not having any appetite, and throwing up on my dinner
> after one bite. I am really glad the treatments have worked for you. I think
> we were on the same regimen. It must be a relief to have completed it. God
> Bless, George, I will let you know what happens after I see the doctor. She
> may recommend Avastin for me also. Talk to you soon.
Some time back, I collected as much as I could find about Avastin.
You may wish to read the posts.
http://tinyurl.com/4r2js
Best wishes with your treatment decisions.
J
Thank you for the info J, and your kind wishes. I just spoke to my Aunt who
was diagnosed with colon cancer a month after my diagnosis. She is having the
treatments, but not the Oxiliplatin (I probably spelled that wrong).
I think this is the drug that caused all my symptoms. It is very new. I am
seeing the doctor tomorrow, and feel, at the moment, that I may continue the
treatments without the Oxiliplatin. I'm only 38 and have a lot of life left to
live. Thanks again J for the info. I feel good today thank God.
> <snip>
>
> Thank you for the info J, and your kind wishes. I just spoke to my Aunt who
> was diagnosed with colon cancer a month after my diagnosis.
Argh....did somebody say it doesn't run in families? !
> She is having the
> treatments, but not the Oxiliplatin (I probably spelled that wrong).
Perhaps a good idea. I wish her well.
> I think this is the drug that caused all my symptoms. It is very new. I am
> seeing the doctor tomorrow, and feel, at the moment, that I may continue the
> treatments without the Oxiliplatin. I'm only 38 and have a lot of life left to
> live. Thanks again J for the info. I feel good today thank God.
"God Bless" and I hope the doctor will be able to help you, NY to FL
My best wishes go with you,
J