Just Look at that Face!

When you look at someone’s face, where is your dominant focus? The mouth and teeth? The eyes? I expect it’s one or the other.

With a Parkinson’s diagnosis we know we need to prevent falls and deal with many other symptoms, but we may overlook our vision health and dental health. However, those two areas are extremely important to the person with Parkinson’s also.

Two different neurologists told us that Parkinson’s does not affect these areas, while we really felt that it did. Recently my research* has shown that we were indeed correct! We knew it all along, and we’re so glad the medical profession has caught up to us.

Let’s take these one at a time.

DENTAL

If we thought our dental health was important before Parkinson’s, it is now doubly important. The risk of tooth decay and periodontal disease are tripled when complicated by PD. Some reasons for this are:

• Difficulty with small motor functions which translates to slower movement causing our spouse to brush less effectively (we use an electric toothbrush)
• Apathy or depression which leads our spouse to brush less often (we might be tempted to nag)
• Dry mouth which can be a side effect of the medications, a symptom of the disease, or just a natural progression of aging. There are some good mouthwash products that help. We use “xylimelts” – mint discs that really helps! There can be increased jaw discomfort over the progression of Parkinson’s. This is due to rigidity, tremors, or dyskinesia. Those three things, singly or together, may make dental health even more difficult, and that can make time in the dentist chair uncomfortable or painful. Many PD patients also experience grinding of their teeth, both in the daytime and while sleeping. A mouth guard is recommended for this, but it wasn’t very successful for us.
• Drooling is sometimes associated with PD, and it can cause irritation or infection in the corners of the mouth. One way to prevent this is to rinse the mouth with water or mouthwash often, but especially after each meal.

Regular visits to the dentist are crucial for PD patients, and twice a year is recommended.

VISION

Our eyes are equally important, as we need to see to navigate our surroundings and to remain independent. Here are some common issues after a PD diagnosis:

• Dry eyes are annoying and painful, occurring mostly due to lack of blinking. This can also be caused by certain medications. There are several brands of artificial tears available that can help this condition.
• Blurry vision is sometimes a result of PD, as can be double vision. These can be quite disturbing and bothersome. An unusual side effect of the lack of dopamine in the brain is difficulty with color vision. (Since I am not a medical professional, I won’t attempt to explain the reason for this. Please research it yourself if you are interested in the “why”.) This can lead to other difficulties visually, such as problems with depth perception, difficulty perceiving overlapping objects, detecting motion and direction, and even recognizing faces, facial expressions, and emotion.
• Hallucinations are another disturbing effect of Parkinson’s. In our experience it is difficult to tell whether they are really hallucinations or just the eyes playing tricks. Stay tuned for an additional post on this topic.

The bottom line is that a visit to our favorite optometrist or ophthalmologist is crucial at the onset of Parkinson’s with regular follow up visits.

It might seem as if the neurologist is the only doctor necessary for the Parkinson’s patient, but that is far from the truth. Regular check-ups by dental and eye care professionals are doubly important for our spouse on this Parkinson’s journey.

The good news is that help is available for these problems. We are all in this together, to help and encourage each other as caregivers to our spouse or family member. Thanks for reading, and I look forward to your comments.

*Reference: Every Victory Counts by Dr. Monique Giroux and Sierra Farris

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Care Partner vs. Care Giver

I learned a new term this week – Care Partner.

In the past I have called us caregivers, and we are. But this week in my research the term “care partner” has come up several times. Here is what it means.

Soon after a diagnosis of any degenerative disease or condition, we become partners with our loved one in their journey. We are there to help, but the majority of the responsibility for the disease is on them, the patient, our loved one.

That is the time when you and your spouse will want to research the disease. This is also the time to have sincere conversations about the future, including long-term care, government assistance, long range plans, and even death and dying. (More on that topic in a few weeks.)

While their mental state has not been severely altered by the disease or condition, we can hear and record their wishes and desires for the future.

No matter their condition, it is best to let them take care of themselves as long as possible. The day will likely come when they cannot. We are their partner in this, their sounding board, their cheerleader.

As we begin to assume responsibility for more of their care, we become their caregiver. It is usually a gradual transfer of duties – sometimes so gradual we don’t even realize it until we look back. Then we see that our job has morphed from mostly talking to mostly doing.

But as certainly as physical assistance will be required, so will mental assistance. Hence the warning to talk about their wishes for the future now, while it is possible.

As we assume more of the responsibilities of everyday life and transition into caregiver, we enter a delicate phase of life. How do we help more and more, yet simultaneously preserve their dignity?

This is a slippery slope, and it seems that our attitude is most important. Sometimes we must separate what we do to help, from who they are to us. This is tricky, but possible. In my mind, I think of it as cleaning up spilled milk that resulted from a 4-year-old trying to be independent. I want my spouse to remain as independent as possible, while knowing that will mean I may have to clean up afterwards.

Think about your situation right now. Are you partners as you have always been? Or are you becoming the one with more of the responsibility for the workings of your household?

This journey of life, whether Parkinson’s or not, is fluid. It is ever changing. We have all heard the saying, “change is inevitable.”  And as we transition from care-partner to care-giver, we know that this is normal and natural, that many have walked this road before us, and that many are walking with us.

Thanks for reading, thanks for commenting, and please let me know how I can help in your journey.

Happy Anniversary!

How many times have we started something, not knowing how it will play out? How many times have we started something, done it a few times, and then just stopped, for one reason or another? Those are quite normal experiences for us as humans, right?

Exactly 52 weeks ago I began this blog with the blessing and encouragement of my friends at our Parkinson’s Support group. “The Journey Begins” was the first posting, and if you’re new to the blog, I hope you’ll stop and read that one now. Who knew that one year later there would still be things to write about?

We should have known the answer to that because Parkinson’s Disease is so multi-layered. There seems to be no end to symptoms, side effects, and new physical problems that leave us all asking, “Is this a result of PD?”

On the academic front, there is news every day about a new drug, a new study, a new development in understanding this disease, and my inbox is filled with newsfeeds to inform me about them.

But the purpose of this blog is not just to keep you informed about research, or to tell you about the latest inventions that might help your spouse deal with PD. While those are important, that is not why I write this blog.

I write because it is the best way to reach out to you to let you know you are not alone. As a spouse of a PD patient of 20 years, I feel what you feel. I live what you’re living. I understand.

Do I have all the answers? Can I solve all of your problems? Can I make this disease go away? No to all those questions.

The only thing I can do is tell you that you are not alone. There are many of us who understand what you’re going through. And as you reach back to us, we can help you realize that we are here to help.

Will you be a perfect care-giver? I smile as I write that because there is no such creature!

Will you get it right all the time? Only if you’re not human! (Smiling again.)

Will it be difficult sometimes? Oh yes.

Will you want to quit sometimes? For sure!

Will there be rewards along the way? That is a definite yes. And when there are good days, when things are going well, write those things down so you can remember them.

So be encouraged, my friend, because we are in this together. You are blessed with many others walking this same road, and we are here to help.

Thank you for reading, whether this is your first time or your 52^nd!

Thank you to those who comment. You encourage me!

A Reality Check

We can talk about the causes of Parkinson’s Disease, and we can list the possible effects of the disease all day long, both of which are helpful. At the same time, reality is where we live. Reality is that we need suggestions that will help us deal with everyday life.

Let’s get specific. Someone recently asked me what we are doing to cope. Here are several things that have made life simpler at our house, and they may also work for you.

Handrails and ramps – About 10 years ago some dear friends wanted to do something nice for us, and they suggested installing handrails along the hallway in our house. Our hall is in the shape of a T, and they predicted that my husband would need to hold onto something one day, especially as he made the turn. Looking back, we realize these railings have prevented many falls. And when my husband does fall in the hallway, the railings give him something to hold onto as he gets up. In addition, we had only 2 steps leading up into our house, both at front and back doors. These same friends insisted that their handyman install ramps at each door. We will never be able to thank them enough for this, just as we will never know how many falls these ramps and railings have prevented. (Thanks to you, P & L.)

Grocery pick-up and/or delivery – When we realized my husband could not be left alone at home anymore, and we had to pay for a sitter every time I left him to grocery shop, we found Kroger Clicklist. This has been a time saver for us in so many ways. Recently we have tried Walmart grocery pick-up which is similar and even more convenient for us, and this week we even used Walmart grocery delivery. (I found a code for 3 free Walmart grocery delivery orders!) Let me know if you have questions about these, and please comment if you have tried them.

Support groups – I am so thankful for our local support group. Parkinson’s is not a sprint – it is a marathon of a journey. If you don’t feel like you need help today, just wait. You will need it tomorrow. Some days I feel like I have it all together and I don’t need any help. But the next day the loneliness and doubts and confusion overtake me. On those days I reach out to family, friends, and my fellow caregivers in my support group.

  Family is important – I need to do all I can to keep those lines of communication open. My family is my life-long support group. They love me unconditionally.

  Friends are important – Thank you to the 2 friends who brought us dinner last week. We truly appreciate it. I need to stay in touch and let them help when they offer.

  My support group is important – they understand Parkinson’s. They are in a similar situation. They can tell me that my feelings are normal – feelings I may not convey to others.

Reality is where we are. It is where we live every day. These are just a few things that make life easier at our house – the handrails and ramps, using grocery pick-up and/or delivery, and our network of people – family, friends, and support group.

What is it that makes life easier at your house? What have you done to prepare your house for the time when mobility is limited? What helps you the most?

Thanks for reading, and thanks for sharing. We are here to support each other.

A New Neurologist

Myth #1 – One doctor is as good as the next doctor.

Myth #2 – Finding a general practitioner to help when you have a cold, is the same as finding a neurologist when you have Parkinson’s Disease.

We know these are myths. We know they’re not true. Choosing a specialist when one has a chronic condition is HUGE! Speaking of doctors, here’s what’s been happening since last October.

October 2018 – our neurologist of 8 years (our favorite so far) notifies us that he is retiring in December.

November 2018 – after asking around, we got the name of a neurologist about 35 minutes away, called and got an appointment for February 12, 2019.

December 2018 – our pharmacy suggests we get a prescription for three months before our neurologist actually retires on December 5.

February 9, 2018, is today’s date. It is Saturday, and I have just published this week’s blog. I don’t usually begin the next blog so soon, but this doctor visit is on my mind.

We are anxious to meet this new doctor and see if she is a good fit for my husband in his 20^th year of Parkinson’s. Our appointment is Tuesday of next week. I gather together the medication chart I created, our medical journal, and the notes from our former doctor. I have already taken a copy of these notes to the new office, but you know how sometimes things get lost? Better safe than sorry. The new doctor is in the Piedmont group, as is our GP, so that is something new for us. It means we don’t have to fill out tedious paperwork ahead of time. We are already in the system!

Hubby is a bit nervous. He really liked our former doctor, mostly because the doctor liked him and valued him. They seemed to connect on an academic level. He hopes he can connect with this new lady.

February 11, 2019 – tomorrow is the big day. I have everything set out by the door to take with us. Hubby wonders if the new doctor will want to change his medications. They are working for us right now, so we hope not. If she does, will we object? He hopes she doesn’t want him to do a new swallow test. He has already had 3.

February 12, 2019 – this morning I typed up the questions that hubby wanted to ask the doctor so he could be the one to ask. My thought was that she would like to interact with him as much as possible.

We arrived at the office about 20 minutes early because the traffic was light. Hubby already had more dyskinesia than usual because he was obviously nervous.

We were called back about 5 minutes after arrival – a good sign.

He has lost 7 pounds in 2 months without trying. I’m not sure what that means.

The visit went pretty well. She treated us as if we were novices at first, not knowing that hubby has written a 500-page book on Parkinson’s and that I write a blog. But she soon figured out that we have both done our research.

Our takeaway is this: she is very knowledgeable about Parkinson’s, its causes, its symptoms, motor and non-motor, and the side effects of the medications. She began to warm up to us near the end of the visit. We’re willing to go again to see if she is a good fit for us. This is a process as we learn more about each other and how we can all work together for the best quality of life possible for my husband.

There are many stressors in everyday life and choosing a new specialist doctor is definitely one of them. If you are a healthcare professional reading this, I hope you gained new insight into this process from our vantage point. If you have a chronic illness, you are probably identifying with this. If you are a caregiver, you are probably smiling, knowing that new situations bring many emotions and challenges.

I am so thankful for the many healthcare professionals who are patient and accepting as we come into their world with great angst. Thank you for treating us with respect and dignity.   

5 Things to Remember about Parkinson’s Disease

This week I have been interested in several different videos and articles that have been sent to me, so I have put them all together for your reading and watching pleasure.

  1.The most common drug to treat PD is levodopa. What does Levadopa really do? Why is it paired with Carbidopa? Here’s a short video that gives us the scoop!

  2. Exercise really does help with movement. This is not news to us, but here on some interesting ideas to make exercise more fun:

a. Try a treadmill with varying inclines and surfaces. This article tells how it helps with gait.

b. We like this YouTube video because it’s fun for both of us.

c. And we heard about a live-streamed presentation on increasing the effectiveness of your exercise routine. (I’m going to check this one out because it sounds like an extension of “BIG AND LOUD”!) Notice that this presentation will be available later online for those who cannot watch live today.

  3. Parkinson’s Disease affects more than just movement. This disease puts a strain on relationships, and it can cause increased frustration on the part of the patient and the caregiver. The author of this article is a lady with Parkinson’s whose blog I follow. Sometimes her writing helps me to know how my husband may be thinking. This particular blog post begins with the negative side of the relational effects of PD, and it ends with great suggestions for keeping connected to our spouse. (We tried the one about sitting on the porch, but instead of watching people, we watched birds!)

  4. Food and drink affect medication effectiveness as well as other non-motor symptoms. Here is an interesting article about changing eating habits and medication times for optimum benefit from carbidopa/levodopa, and also how diet affects constipation – a huge problem in advanced PD. Speaking of medications, this website offers a handy free printable medication management chart. I made my own, but I like this one even better! Enjoy.

  5. There is encouraging news when we see the volume of research into the causes and effects of Parkinson’s Disease. Many organizations are working tirelessly to find cures, find causes, and find ways of helping patients and us, the caregivers. Here is the newsfeed that is the source of many of the articles in this post. I hope you’ll sign up to stay current on PD news. In the middle of the page, you’ll see “Sign up for our mailing list.”

So do not lose hope, my friend. A cure may come during our lifetime. If not, we can be assured that many more aids in coping with PD will be found. Stay connected to your support system, your healthcare professionals, and this blog.

Did you know that more people are reading and writing than ever before? Who knew there were so many blogs online and so many people who are passionate about something? And they write for many different reasons and on such varied topics!

It is important to me that you know the purpose of this blog is to support and encourage those who care for a patient with Parkinson’s Disease. That is my passion. That is my goal.

Thank you for reading, and please feel free to comment and share below.

Darkness – Then Light

Being totally honest here, there are moments in my day when life is dark. Within one 24-hour period, my husband can go from walking across the room without any aid to not being able to lift his fork to eat. Totally independent, to totally dependent, with the entire spectrum in between – all in a day.  Many of you have experienced the same phenomena.

Because of this, there are times when I feel that the weight of the household is really on me now. Do you feel that way? We used to be partners in life, and in the pure sense of the word we still are. But in reality, it is all up to me now. I used to rely on him to physically help with things around the house, and to give me moral support and comfort. But Parkinson’s has changed all of that. He just cannot do those things physically, mentally, or emotionally. I believe it takes everything he has to just make it through another day. There is nothing left to contribute to our household or to me.

There are times when the weight of this feels like it will suffocate me, like I cannot possibly do it all. In those dark moments, I feel totally alone.

But those moments are few and brief. It seems that just as I feel that the situation is hopeless and I am bearing the weight of the world on my shoulders, God gives me a wink like this.

As I type this, it is early morning, and I look out the window at the sky above the roof to see a beautiful cloud formation with gorgeous colors, and it makes me smile. Then a male cardinal lands on the roof of the patio, just at the edge of my vision. He is beautiful – bright red against a colorful sky. And I realize how blessed I am.

Recently a dear friend loaned me a book entitled “When God Winks at You”, by Squire Rushnell, and it opened my eyes to these little winks from God to let me know I am not alone. The book describes ways in which the author feels close to God and feels God is communicating with him.

After reading that book, I realize that every time I’m in a dark place emotionally, God sends me a wink. Sometimes I get a text from a family member, just checking in. A dear long-time friend calls almost every Monday on her way to volunteer for a charity, just to say hello. My gaze lands on something in my home that was made by my mother or grandmother many years ago. The beautiful morning sky comes into my view – complete with a contrasting red cardinal. Each of these makes me smile and remember that I am not alone. The whole of life is not dark, just some brief moments.

All these little things in life, the sky in morning, the birds, our pets, a song we have loved, a memory of a favorite person or event, all of these are reminders of the good things in life. While there may be short dark times in our lives caring for our loved ones, there are so many more bright times, beautiful times, even loving times, on which we can focus, and for which we can be thankful.

The purpose of this blog today is not to convert you to any religion or belief, but my belief in God is central to who I am, and it is important that I mention it here. At the same time, the purpose of this blog is to encourage you to realize you are not alone in this journey with Parkinson’s Disease, or with anything else you may be experiencing. In your darkest moments, just hang on. They will pass, and the beautiful parts of life will appear.

Is THAT Part of Parkinson’s Disease?

When thinking about Parkinson’s Disease, most people think of shaking or tremors, and shuffling of feet. Those symptoms can certainly be part of the disease, and they can even be the most annoying or bothersome.

However, not all of our Persons with Parkinson’s (PWP) have some or all of those symptoms. That might lead you to ask, “What other symptoms are typically Parkinsonian?”

Here is a partial list:

• Soft speech
• Slurred speech
• Constipation
• Freezing, especially at doorways
• Double vision
• Eczema
• Difficulty swallowing – choking, coughing

In our 20 years with Parkinson’s Disease, hubby has had all of the above at one time or another. Some of these have come for a short time and then disappeared. Some are still with us.

The body type, predisposition, and other physical ailments of your PWP will factor into which of these they exhibit.  If you’re like us, every time a new problem occurs, we ask ourselves, “Is this part of Parkinson’s, or is it something entirely different?” We had no idea at the outset that all of these symptoms can be caused by Parkinson’s or are side-effects of the drugs. Now we know!

It helps to know what to look for in our loved one. So, let’s share. Feel free to leave one or two words in the comments. It will help all of us to know what to look for.

Have you noticed any of these?

What other symptoms are you seeing?

We’re in this together, to help each other and encourage each other.

A Day in the Life

Warning – this post is long, but so are my days! No apology – just fact.

5:00 AM 

Getting up early is the only way to have time to myself.  I put away last night’s clean dishes, write the agenda for today on the whiteboard, set out hubby’s breakfast pills and dishes for breakfast, and watch the recording of my favorite TV show from the previous night that hubby doesn’t enjoy. Then it’s off to my computer where I work a few puzzles, check my email, check my blog, read a few other blogs, read my focus Bible verse for the day, and pray. A beautiful time to do whatever I wish – all with a cup of coffee.

6:00 AM

He awakens, just to go to the bathroom.  He needs a change of clothes.  I clean up behind him in the bathroom. He moves to the recliner chair.  I get him settled, straighten his bedroom, turn off the electric mattress pad and the lights. Now back to my computer while eating breakfast.

7:30 AM

It’s daylight so I turn off outside lights and open curtains.

8:00 AM

I shower and get dressed for my day, keeping my ears open in case he calls me.

9:00 AM

I wake hubby to get him dressed. Today Alex comes to care for him at 9:45 so I can leave the house. (Alex is a former student, about 29 years old, who comes 2-3 days a week for a total of about 8 hours, so I can go out.) 

I show him the whiteboard displaying the schedule for today. He asks what time I’m leaving and what time I plan to be home, even though it is on the whiteboard. He wants to know exactly where I am going. I give him his 7 morning pills in applesauce, and get him started on breakfast. Today he wants cold cereal, which is easy to fix, but I know there will be a spill to clean up when I get back home.

When Alex arrives, I again recite where I’m going and approximately when I plan to return. I also tell them about the next meal and pills, and what time those should occur.

9:45 AM

Today I have a 30-minute drive to get my haircut, so I call a girl friend just to chat on the way.

12:15 PM

On the way home, I stop at the pharmacy to pick up prescriptions, 3 grocery items, and get cash to pay Alex

1 PM

I arrive home to find hubby has fallen once while I was gone. Alex was right there to help, and he was not injured, so that’s a good thing. I pay Alex and we talk about the next time he is coming, just to remind us both. I write it on the countertop paper calendar, and Alex enters it into his phone on his way out the door.

1:15 PM

Lunch time for me and hubby. It takes him nearly an hour to eat, and at the end I feed him pills. He takes 4 at lunch in applesauce.

2:15 PM

Now I get him settled in his office, and I go back to clean up the floor around his chair from both breakfast and lunch and put away the remainders of lunch.

2:45 PM

Time for laundry. I put in the first load and then check email.

3:30 PM

The first load is finished, so I transfer it to the dryer and put the second load in the washer. I check on hubby, get him a snack, refresh his drink, and remind him that my tutoring student arrives momentarily.  

3:45 PM

James arrives and we work for an hour on Algebra. This is my only connection to my former life, and I really enjoy it.

4:45 PM

James leaves, I check on hubby, and I get the dry laundry, put the wet load into the dryer, bring in the dry load and fold it while watching the end of my favorite taped show on TV.

5:30 PM

Time to begin dinner prep while folding last load of laundry for the day.

6:30 PM

Dinner is served. I finish eating in about 15 minutes, but hubby has only taken a few bites. I help him get the food to stay on the fork or spoon, and by this time he has almost no energy left. Tonight I have to help him lift the fork or spoon up to his mouth. He has 9 pills tonight, taken again with applesauce. He is exhausted and moves to his recliner chair while I clean up the floor, clean off the table, and wash the dishes.

8:00 PM

I sit down to 2 hours of primetime TV with hubby, but lately he has slept through most of it. I look over and he has fallen to his right, nearly out of the chair. So, I walk over and rouse him a bit to pull him back into the middle of the chair.

10:00 PM

Time for me to go to bed. I help hubby change into pajamas, set the security alarm, get his bed ready, check the thermostat, be sure the stove is off and the lights are set for the night. I kiss him good night, and I’m done!

He stays up until around 2 AM, watching shows on Netflix, then gets himself into bed. On some nights he falls during this time, but I hear him. He can call me if he needs to, and I will usually hear him. Thankfully that doesn’t happen often right now.

The next thing I know it is morning and time to begin all over again! This is a typical day for us. What is different about your typical day?

I would love to hear from you. Thanks for reading and commenting.

Blogs, Blogs, and more Blogs

Welcome to this week’s edition of the blog designed to bring encouragement and support to those giving care to patients with Parkinson’s Disease.

If this is your first time reading my blog, please stop right here and read the first edition, “The Journey Begins.” It will make more sense to you.

After reading 2 blogs this week and taking a short free online course for bloggers, I am overwhelmed by the number and variety of blogs in the universe!

It’s kind of like buying a red car, thinking it is a novelty, and then noticing the abundance of red cars on the road! There are a lot of blogs out there because so many people have something to say. I am so encouraged that writing is not a forgotten art!

Two blogs I read this week were written by caregivers of patients with other diseases. As I read, I could not help but compare their journey to ours with Parkinson’s Disease.

The first was written by the wife of a man whose condition is curable through rest, gradual increase in specific exercise, and less stress. She was very positive and saw a light at the end of the tunnel. She is confident that he will regain his energy and original health, and she is so thankful for that.

The second was written by a cancer patient, experiencing a second bout with cancer, going through chemotherapy again. She knows what to expect and is confident it will be in remission again soon, just like the first time.

But we have Parkinson’s Disease. It will not get better. It will not go away. It does not enter a stage of remission.

However, , ,

As we have noticed before, it does remain static for periods of time, and it does provide periods of comfortability where it is manageable.  We can be very thankful for that.

And it does give us time. We have time to do little things we have always wanted to do together. It gives us time to prepare for the future. And it gives us time to enjoy life right now.

So, to us on this Parkinson’s journey – Let’s LIVE! We adapt as needed, but we also must live! Let’s plan our next trip, laugh, play, enjoy, and not worry about how long we have together.

The extent of our trip, our laughter, and our play, will depend on the health of our spouse or patient. At our stage, our 20^th year since diagnosis, ours might have to be a day trip. We caregivers might do more of the laughing, and we may not be able to tell how much our spouses enjoy themselves, but let’s do what we can to spice up our lives.

This might mean going only one place each time we leave the house. It might mean canceling plans sometimes because it just isn’t a good day. On occasion our spouse might refuse to go out, but at least we have offered and tried.

We are doing these things for us as well as for them. Because the truth still exists that we don’t know how much time we have together.

My husband has a new PD friend who has 3-wheel bikes, and he has invited my husband to ride. Here’s to a new experience! What is your new experience? What would you and your spouse like to try?

Thanks for reading, and thanks for commenting.