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	<title>... in a Bottle</title>
	
	<link>http://www.inabottle.org</link>
	<description>Genie wuz here</description>
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		<title>Cheap date</title>
		<link>http://feedproxy.google.com/~r/messageinabottleblog/~3/2XU8q6fDBMo/</link>
		<comments>http://www.inabottle.org/2013/05/13/cheap-date/#comments</comments>
		<pubDate>Tue, 14 May 2013 03:15:47 +0000</pubDate>
		<dc:creator>Genie Alisa</dc:creator>
				<category><![CDATA[Message]]></category>
		<category><![CDATA[Parenthood]]></category>

		<guid isPermaLink="false">http://www.inabottle.org/?p=2954</guid>
		<description><![CDATA[Me: &#8220;When we were at the beach yesterday, Ian was doing his best Sports Illustrated swimsuit issue poses in the surf. He kept yelling, &#8216;Splash me, Mommy! Splash me!&#8217; while rolling around.&#8221; Rich: &#8220;Sigh. I love my gay son.&#8221; We were originally just going to go for a bike ride. But then Ian wanted to [...]]]></description>
				<content:encoded><![CDATA[<p><em>Me: &#8220;When we were at the beach yesterday, Ian was doing his best Sports Illustrated swimsuit issue poses in the surf. He kept yelling, &#8216;Splash me, Mommy! Splash me!&#8217; while rolling around.&#8221;<br />
Rich: &#8220;Sigh. I love my gay son.&#8221;</em></p>
<p>We were originally just going to go for a bike ride. But then Ian wanted to ride towards the beach. Then he wanted to ride up the boardwalk to the beach. Then he wanted to walk down to the firm sand to draw in it. Then he wanted to walk near the water. Then his shoes were wet. And then he tripped and his pants got wet. At that point, in for a penny, in for a pound. He splashed all over and raced me in the surf&#8217;s edge. We stayed until he was soaked to the bone.</p>
<p><center><a href="http://www.flickr.com/photos/geniealisa/8737542646/" title="IMG_2380 by Genie Alisa, on Flickr"><img src="http://farm8.staticflickr.com/7283/8737542646_dee151510e.jpg" width="500" height="375" alt="IMG_2380"></a></center></p>
<p>He purposely put his head underwater when a wave came in while wearing his bike helmet. When he came up, sea water was pouring down his face and he was laughing with delight. This is the kid who flips out if I try to wash his hair in the bathtub. </p>
<p>When it was time to leave, he wanted me to carry him and his bike but physics don&#8217;t work that way. We opted for him sitting on his bike and me pushing it home. It&#8217;s a wonder I can type because my forearms are still sore. He agreed to letting me clean him up in the shower and put on clean clothes. He then snuggled up for spaghetti dinner while watching Spider-Man. </p>
<p><center><a href="http://www.flickr.com/photos/geniealisa/8737546152/" title="IMG_2403 by Genie Alisa, on Flickr"><img src="http://farm8.staticflickr.com/7287/8737546152_fb327a52a5.jpg" width="500" height="375" alt="IMG_2403"></a></center></p>
<p>Since it got colder today, we opted to go see dancers instead of going back to the beach to catch pneumonia. <a href="http://www.strangefruit.net.au">Australia&#8217;s Strange Fruit</a> was performing downtown for free tonight and it looked interesting. We were not very well prepared in that we didn&#8217;t have warm clothes or blankets, but we did have light jackets and his blankie and some peanut butter crackers for snacks. </p>
<p>I wasn&#8217;t sure if he was going to like it, but the entire thing was only 30 minutes long and the price was right. He sat there in relative silence other than a few times he demanded my phone so he could take pictures. When it was over, he was willing to leave for dinner but kept asking about the dancers and where they were and when they would be back. He later told me he took soooo many pictures of the girl dancers because they were his favorite. Then he wondered why the girl dancers had boobs. I offered it was maybe to feed their babies and he assured me they had &#8220;baby dancers&#8221; too and that those were also girls and he liked them too. </p>
<p><center><a href="http://www.flickr.com/photos/geniealisa/8736429421/" title="IMG_2521 by Genie Alisa, on Flickr"><img src="http://farm8.staticflickr.com/7288/8736429421_803031e0a8.jpg" width="500" height="333" alt="IMG_2521"></a></center></p>
<p>The only way I could keep him from staking out a spot on the lawn for the 9pm show was to remind him how cold it is and to promise we can come back tomorrow. So Ian and I have a date tomorrow on the lawn at the corner of Bank and Charlotte Street. We&#8217;ll bring warm clothes and blankets and dinner and watch the dancers again. He might even take more pictures. Afterwards we might walk to the mall to play on the indoor playground until it closes. </p>
<p>All this is to say that despite him being a NO factory this morning, hanging out with a three-year-old is pretty awesome. It&#8217;s amazing all the fun we can have for free.</p>
<p><center><a href="http://www.flickr.com/photos/geniealisa/8737548684/" title="IMG_2412 by Genie Alisa, on Flickr"><img src="http://farm8.staticflickr.com/7286/8737548684_04033a30e0.jpg" width="500" height="375" alt="IMG_2412"></a></center></p>
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		<title>Great Wolf Lodge with a three-year-old</title>
		<link>http://feedproxy.google.com/~r/messageinabottleblog/~3/a_YWGTlBXmo/</link>
		<comments>http://www.inabottle.org/2013/05/07/great-wolf-lodge-with-a-three-year-old/#comments</comments>
		<pubDate>Wed, 08 May 2013 01:42:42 +0000</pubDate>
		<dc:creator>Genie Alisa</dc:creator>
				<category><![CDATA[Message]]></category>
		<category><![CDATA[Parenthood]]></category>

		<guid isPermaLink="false">http://www.inabottle.org/?p=2948</guid>
		<description><![CDATA[When we were flying home from Nashville on Friday, Rich looked over and said, &#8220;Thanks for setting up the Great Wolf Lodge visit. I&#8217;m really looking forward to it and the timing is good.&#8221; I actually had booked it because Ian kept saying he wanted to play at the beach but it was too cold. [...]]]></description>
				<content:encoded><![CDATA[<p>When we were flying home from Nashville on Friday, Rich looked over and said, &#8220;Thanks for setting up the Great Wolf Lodge visit. I&#8217;m really looking forward to it and the timing is good.&#8221; I actually had booked it because Ian kept saying he wanted to play at the beach but it was too cold. The fact it was right after a week of drug trial stuff and being away from Ian, was just a happy coincidence, one I was pleased about too.</p>
<p>I wanted to give a little run down of how Great Wolf was for us. I had never been before and was booking our stay based only on a few reviews from friends and the fact that they had warm water inside when it is still cold outside. </p>
<p>There is no entry fee for the park itself; you have to be a guest of the lodge to enter. So that makes sense why rooms have a maximum number of occupants. We decided to go on a Sunday/Monday because the price of the room was literally half the price of Saturday/Sunday. But then when we got there and checked in, they upgraded us to the <a href="http://www.flickr.com/photos/geniealisa/8715578181/in/photostream">Grizzly Bear Suite</a>. </p>
<p>With Ian being a tall three, we were in a sweet spot for stuff. He ate free for all breakfast, lunch, and dinner in the restaurants but since he&#8217;s over 42&#8243; tall, he could ride on more rides than tiny kids. </p>
<p>I had pre-paid for a <a href="http://www.flickr.com/photos/geniealisa/8716688240/in/photostream">Wolf Pass</a>, hoping that it would give us an itinerary and save a little cash. It did save us a tiny bit of money, but it also just made it easy to check off things to do. We were able to do everything on the pass except for mini golf, and that was mostly because it was chilly outside and we were uninspired. A note about the Wolf Pass or Paw Pass. Write your cell phone number on the pass because if you (or your kids) lose it, you&#8217;re out of luck. Hopefully a good samaritan will call you. </p>
<p><center><a href="http://www.flickr.com/photos/geniealisa/8715579565/" title="Stranded on the shore by Genie Alisa, on Flickr"><img src="http://farm8.staticflickr.com/7353/8715579565_b662ec4753.jpg" width="500" height="375" alt="Stranded on the shore"></a></center></p>
<p>I&#8217;m pleased we did the Sunday/Monday stay because while Sunday was not super crowded, Monday was a pleasant ghost town. At one point we literally had the arcade to ourselves. We also found that since our Wolf Pass had one movie pass, the dude actually let all three of us ride on Ian&#8217;s ticket since he was so little and we were literally the only people he had probably seen in the last hour. We also got to share Ian&#8217;s &#8220;<a href="http://www.flickr.com/photos/geniealisa/8715571005/in/photostream/">button game</a>&#8221; (Oliver&#8217;s Time Challenge) where we just all pushed buttons as they lit up. </p>
<p>We played in the <a href="http://www.flickr.com/photos/geniealisa/8716707296/in/photostream">Ten Paw Alley</a> bowling alley while we ate lunch on Monday and that worked out great. Low drag, easy, $15 for a large pizza for us all. I would have thought the bowling games were expensive except that we recently priced bowling in an alley recently, so $5 a game didn&#8217;t seem horrible. But again, we all shared Ian&#8217;s games since he&#8217;s three and was lucky to get the ball to go all the way down the lane. </p>
<p>You&#8217;re not supposed to bring any outside food or drink into the water park area, but I saw plenty of people breaking that rule. There was a family next to us that brought in PBJ sandwiches and chips and bottles of water. We had a smaller kid, so we didn&#8217;t need to eat in the water park, just timing it so we took our breaks around mealtimes. I brought some emergency snacks in but only used them to fix my constantly tanking low blood sugar (walking up three flights of stairs to ride down burns calories apparently). We rented a locker for $10 each day and that was all we needed. A safe place for iPhones and a change of clothes and my illegal snacks. It was also nice to have even after we were done with the water to not have to head for the car after playing. </p>
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<p>Our big splurge was the <a href="http://www.flickr.com/photos/geniealisa/8719447524/in/photostream">robot ice cream machine</a>. I actually asked Rich later, &#8220;What is Robot Fusion and why is it on our credit card bill?&#8221; Oh, right. But we totally got our $7 worth out of that. I recorded the whole thing and this evening when Ian was sad about leaving the park, he consoled himself by watching the robot over and over on my phone. </p>
<p>There are lots of cheap food places off site that are under two miles away. You could send someone out to retrieve Chick-fil-a, Quiznos, Burger King, Pierce&#8217;s BBQ, or whatever. But that was not our idea of fun. There was a mini-fridge and microwave in our room so we could have even reheated stuff and made food for ourselves to eat there, but again, we had not even been home long enough from Tennessee to properly pack for our adventure. Rich forgot t-shirts for the weekend, so packing dinner was not happening. We spent $120 on food for two days (including robot ice cream!), so if we had brought all our own food for the room, we could have saved that much. Meh, I&#8217;m not upset about it. </p>
<p>Our Wolf Pass also got us a giant souvenir drink ($8.99 value) that we filled with Coke Zero the first day and refilled with ice water from the same machine the rest of our stay. Best thing ever. That souvenir cup, a piggy bank and wooden car from the Cub Club craft area, and the prizes Ian got with his tickets were all we took home, but that was plenty for us. </p>
<p><center><a href="http://www.flickr.com/photos/geniealisa/8716708612/" title="Motorcycle racing by Genie Alisa, on Flickr"><img src="http://farm8.staticflickr.com/7436/8716708612_9c11738a90.jpg" width="500" height="375" alt="Motorcycle racing"></a></center></p>
<p>The only thing I&#8217;d do differently next time is bring sandals versus flip flops for in the water and bring a Lifeproof case for my iPhone. We did find that if Ian ever took off his water shoes, he would slip and fall, no matter if he walked or ran. Rich told him at one point that if he didn&#8217;t want to leave the park for the hospital he would have to put his water shoes back on. </p>
<p>We got there as soon as we were allowed to start in the park on Sunday (1pm) and were able to check into our room by 3pm (they say check in is at 4, I think). We could have stayed all day today until 8pm, but we have a three-year-old so he fell asleep in my arms at 3pm waiting for his piggy bank to be glazed in the craft room. We didn&#8217;t maximize our water time but we had a small kid. I saw families with bigger kids arriving at 1pm in their suits and heading straight for the water as soon as their wrist bands were on.</p>
<p>The <a href="http://www.flickr.com/photos/geniealisa/8716715624/in/photostream">wrist bands</a> were super neat. They had chips in them that would work as your room key so you always had it on you. You could also link it to your room charge to use it to buy things on site (it&#8217;s how we paid for our robot ice cream). They really wanted to make sure you weren&#8217;t swimming with your wallet but still free to spend money all over the lodge. Pretty cool.</p>
<p>Oh! The bathroom/shower/locker room was neat. You could put your wet bathing suit in a drying machine thing that would gyro all of the water out of it. We&#8217;re living in the future. The robot ice cream, credit card wrist band, leaving with a dry swimsuit future.</p>
<p><center><a href="http://www.flickr.com/photos/geniealisa/8715584867/" title="Water slide finish by Genie Alisa, on Flickr"><img src="http://farm8.staticflickr.com/7304/8715584867_0e144e6e9d.jpg" width="500" height="333" alt="Water slide finish"></a></center></p>
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			<wfw:commentRss>http://www.inabottle.org/2013/05/07/great-wolf-lodge-with-a-three-year-old/feed/</wfw:commentRss>
		<slash:comments>5</slash:comments>
		<enclosure url="http://www.flickr.com/apps/video/stewart.swf?v=109786" length="131784" type="application/x-shockwave-flash" /><media:content url="http://www.flickr.com/apps/video/stewart.swf?v=109786" fileSize="131784" type="application/x-shockwave-flash" /><itunes:explicit>no</itunes:explicit><itunes:subtitle>When we were flying home from Nashville on Friday, Rich looked over and said, &amp;#8220;Thanks for setting up the Great Wolf Lodge visit. I&amp;#8217;m really looking forward to it and the timing is good.&amp;#8221; I actually had booked it because Ian kept saying h</itunes:subtitle><itunes:author>Genie Alisa</itunes:author><itunes:summary>When we were flying home from Nashville on Friday, Rich looked over and said, &amp;#8220;Thanks for setting up the Great Wolf Lodge visit. I&amp;#8217;m really looking forward to it and the timing is good.&amp;#8221; I actually had booked it because Ian kept saying he wanted to play at the beach but it was too cold. [...]</itunes:summary><itunes:keywords>geniealisa,genie,message,in,a,bottle</itunes:keywords><feedburner:origLink>http://www.inabottle.org/2013/05/07/great-wolf-lodge-with-a-three-year-old/</feedburner:origLink></item>
		<item>
		<title>The Hope Lodge</title>
		<link>http://feedproxy.google.com/~r/messageinabottleblog/~3/yDP25v-ez4Y/</link>
		<comments>http://www.inabottle.org/2013/05/01/the-hope-lodge/#comments</comments>
		<pubDate>Thu, 02 May 2013 01:50:53 +0000</pubDate>
		<dc:creator>Genie Alisa</dc:creator>
				<category><![CDATA[Cancer]]></category>
		<category><![CDATA[Message]]></category>

		<guid isPermaLink="false">http://www.inabottle.org/?p=2941</guid>
		<description><![CDATA[This whole post is just one huge photo dump. The Hope Lodge here in Nashville holds 41 rooms for guests, each that can hold three people (one double bed and one twin). It&#8217;s nothing fancy and the room smells a bit like old lady, but there are a lot of old ladies around here, so [...]]]></description>
				<content:encoded><![CDATA[<p>This whole post is just one huge photo dump. </p>
<p><a href="http://www.cancer.org/treatment/supportprogramsservices/hopelodge/nashville/index">The Hope Lodge</a> here in Nashville holds 41 rooms for guests, each that can hold three people (one double bed and one twin). It&#8217;s nothing fancy and the room smells a bit like old lady, but there are a lot of old ladies around here, so that&#8217;s logical. </p>
<p><center><a href="http://www.flickr.com/photos/geniealisa/8699715961/" title="Corner suite by Genie Alisa, on Flickr"><img src="http://farm9.staticflickr.com/8138/8699715961_86e06107ec.jpg" width="500" height="375" alt="Corner suite"></a></center></p>
<p><center><a href="http://www.flickr.com/photos/geniealisa/8699716247/" title="Rest of suite by Genie Alisa, on Flickr"><img src="http://farm9.staticflickr.com/8539/8699716247_9a415a6ee0.jpg" width="500" height="375" alt="Rest of suite"></a></center></p>
<p>You do have a private bathroom, but you are not allowed to have any food or drinks in your room. (I kept orange juice for going low and the front desk lady just said don&#8217;t tell anybody.) There are so many residents with lowered immune systems they don&#8217;t want to risk mold or allergies or anything in the rooms. All food has to stay in the kitchen and dining area on the first floor. </p>
<p><center><a href="http://www.flickr.com/photos/geniealisa/8699714939/" title="Kitchen by Genie Alisa, on Flickr"><img src="http://farm9.staticflickr.com/8268/8699714939_e0a10fc360.jpg" width="500" height="375" alt="Kitchen"></a></center></p>
<p>But the kitchen area is pretty cool. They have a wall of <a href="http://www.flickr.com/photos/geniealisa/8700837422/in/set-72157633383148089/">large fridges for guests</a>, an <a href="http://www.flickr.com/photos/geniealisa/8700816778/in/set-72157633383148089/">ice machine</a>, filtered hot and cold water, coffee machines, <a href="http://www.flickr.com/photos/geniealisa/8700838148/in/set-72157633383148089/">pantry space</a>, freezer space, a <a href="http://www.flickr.com/photos/geniealisa/8699714081/in/set-72157633383148089/">fridge just for meds</a>, and four distinct kitchen areas. There are three gas grills out back for grilling or dining al fresco. And everyone is incredibly sweet.</p>
<p><center><a href="http://www.flickr.com/photos/geniealisa/8699715463/" title="Day room by Genie Alisa, on Flickr"><img src="http://farm9.staticflickr.com/8408/8699715463_9030dc5503.jpg" width="500" height="375" alt="Day room"></a></center></p>
<p>Each floor has a day room with <a href="http://www.flickr.com/photos/geniealisa/8699697995/in/set-72157633383148089/">puzzles</a>, a TV, and several couches if you&#8217;re tired of being in your room. There&#8217;s also a laundry room with <a href="http://www.flickr.com/photos/geniealisa/8699713419/in/set-72157633383148089/">washers</a> and <a href="http://www.flickr.com/photos/geniealisa/8700835908/in/set-72157633383148089/">dryers</a>. There is no laundry service here so you have to wash your own sheets and towels. </p>
<p>Everything is completely free. There&#8217;s wifi, DirecTV, donated snacks, an exercise room, free parking and it&#8217;s across the street from the hospital complex. My only complaint is the <a href="http://www.flickr.com/photos/geniealisa/8700835378/in/set-72157633383148089/">stairwells</a> are a little creepy. There is a security guard on duty at night and a front desk attendant until 10pm. There is a free shuttle that will take you to any appointments within the medical complex. </p>
<p>This is the first time I&#8217;ve seen for myself what donations to the American Cancer Society do. We almost didn&#8217;t get a space here but were called as soon as we landed in Nashville. The Hope Lodge is saving us about $750 in hotel costs (and that&#8217;s at the medical necessity rate at the Holiday Inn). This last minute trip was not cheap, but it is now significantly cheaper thanks to the American Cancer Society. </p>
<p>We are very grateful.</p>
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		<item>
		<title>Science!</title>
		<link>http://feedproxy.google.com/~r/messageinabottleblog/~3/bTTb99fjE_c/</link>
		<comments>http://www.inabottle.org/2013/04/29/science/#comments</comments>
		<pubDate>Tue, 30 Apr 2013 02:13:17 +0000</pubDate>
		<dc:creator>Genie Alisa</dc:creator>
				<category><![CDATA[Cancer]]></category>
		<category><![CDATA[Message]]></category>

		<guid isPermaLink="false">http://www.inabottle.org/?p=2932</guid>
		<description><![CDATA[Or how to tell a cell protein that he should stop calling. We&#8217;re just not that into you. There have been a lot of acronyms and medical terms floating around lately and it&#8217;s been a bit of a jumble, but it&#8217;s finally starting to make some sense. First, let me show you the picture Dr. [...]]]></description>
				<content:encoded><![CDATA[<p>Or how to tell a cell protein that he should stop calling. We&#8217;re just not that into you.</p>
<p>There have been a lot of acronyms and medical terms floating around lately and it&#8217;s been a bit of a jumble, but it&#8217;s finally starting to make some sense. First, let me show you the picture Dr. Bendell drew for us. </p>
<p><center><a href="http://www.flickr.com/photos/geniealisa/8693755357/" title="cell sketch by Genie Alisa, on Flickr"><img src="http://farm9.staticflickr.com/8258/8693755357_3e521a0dbe.jpg" width="500" height="500" alt="cell sketch"></a></br>Kudos to her for drawing all that upside down and she talked to us.</center></p>
<p>The big circle is a cell and the circled N at the bottom is the nucleus. Remember that for growth to happen, cells have to divide or produce something else. What makes cancer a problem is that those cells grow faster than normal and they don&#8217;t know when to quit. In Rich&#8217;s case, the cell is question is a tumor cell from his appendix that is desperately trying to produce slime. There aren&#8217;t a lot of those cells, but they are creating a big messy byproduct all over the place.</p>
<p>Ok, back to the picture. All that alphabet soup inside the cell is a collection of proteins. They create pathways to the nucleus with information telling it what to do, generally if it should grow or produce something (e.g. slime). Let&#8217;s focus on the list on the left. It says:</p>
<p>RAS<br />
RAF<br />
MEK<br />
ERK</p>
<p>In real life, the road is <a href="http://en.wikipedia.org/wiki/MAPK/ERK_pathway">a little more winding</a>, but you can pretend it&#8217;s a straight line like that. Dr. Bendell called it a telephone game, where RAS tells RAF tells MEK tells ERK that tells the nucleus to grow. Rich&#8217;s RAS is mutated (hence the M pointing at it) and stuck in the on position so it just keeps telling the proteins below it to keep producing. If he had done the monoclonal anti-body treatment they discussed in Maryland, it would have done no good because it targets stuff right outside the cell (that Y looking thing). RAS would has kept on spamming down the line and the cells would have kept producing. </p>
<p>The drug trial we are going to start this week inhibits the ERK protein, so that it will hopefully ignore the repeated messages of the mutated RAS protein and ideally the nucleus would chill out and stop producing mucin. The cells that we&#8217;re targeting are the appendix cells that got scattered all over Rich&#8217;s abdomen and are mutated and constantly deciding to make more mucus. If we can tell those cells to chill out, then the mucus won&#8217;t grow. There is also a hope that without growth, the mucus could slowly be reabsorbed back into his body. </p>
<p>Those letters on the right are another pathway to the nucleus. It is possible that if we block the ERK, the cell could get all huffy and find a new way to tell the P13K to tell the MTOR to tell the AKT to tell the nucleus to grow. The other study Dr. Bendell was investigating was one that targeted both the MEK and the P13K proteins (so both pathways), but that trial isn&#8217;t available until July and she didn&#8217;t want to wait that long. They did not expect to have an opening in the ERK trial but one happened on Thursday so they eagerly jumped on it. </p>
<p>As Dr. Bendell said, if we can get to the point where there is no growth with this drug, she&#8217;s happy. If we find that there is actual shrinkage then she&#8217;s extra super happy. But we have to just play it by ear. If the drug makes Rich feel awful or he&#8217;s just tired of flying to Nashville, we&#8217;ll reassess. But for now, this is the best plan. </p>
<p>We talked a bit about the strong language in the trial. She laughed and said they all sound like that but she feels like this is very safe. She said the drug companies will be all spastic when a drug is first being administered and she will tell them, &#8220;Yes the patient received the drug. Miraculously, the patient&#8217;s head is still attached!&#8221; Everything is super new technology, but we feel safe.</p>
<p>Tuesday is the day of a thousand pre-trial tests. Rich has an eye exam, MRI, x-rays, and a CT scan. There is a slight chance we could start the drug trial on Wednesday but they need a room to be available. Right now it looks like Wednesday will be our day to work from Tennessee and then start the trial on Thursday. </p>
<p>I&#8217;ll update more on our accommodations and other interesting details of this trip, but as Ian would say, I&#8217;m tuckered after all that. And we thought we would never use biology in the real world. </p>
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		<item>
		<title>We got the call and are heading to the show</title>
		<link>http://feedproxy.google.com/~r/messageinabottleblog/~3/xnN3sBDp4Vg/</link>
		<comments>http://www.inabottle.org/2013/04/26/we-got-the-call-and-are-heading-to-the-show/#comments</comments>
		<pubDate>Sat, 27 Apr 2013 01:52:35 +0000</pubDate>
		<dc:creator>Genie Alisa</dc:creator>
				<category><![CDATA[Cancer]]></category>
		<category><![CDATA[Message]]></category>

		<guid isPermaLink="false">http://www.inabottle.org/?p=2927</guid>
		<description><![CDATA[Everyone assumes that waiting around must be the hardest part. I can attest, though, getting the call to action on a Thursday afternoon can be a little unsettling too. Donna the Nurse called around 2:45pm Thursday to tell me Good News! There is an opening in a drug trial if Rich is interested in participating. [...]]]></description>
				<content:encoded><![CDATA[<p>Everyone assumes that waiting around must be the hardest part. I can attest, though, getting the call to action on a Thursday afternoon can be a little unsettling too. </p>
<p>Donna the Nurse called around 2:45pm Thursday to tell me Good News! There is an opening in a drug trial if Rich is interested in participating. What&#8217;s not in the brochure is you have to show up on a particular day to start the trial. That day happens to be this upcoming week. Yes, she was calling on Thursday afternoon to see if we could be in the office on Monday afternoon. We said yes. $2400 later and we&#8217;re set for our trip. </p>
<p>Reading all the details on a drug trial is not exactly fun. I&#8217;m not sure who writes these things but they need to work on their pacing for dramatic effect. &#8220;You are being invited to volunteer for a research study because you have advanced cancer for which no therapy exists that is curative and the standard drugs to treat your disease are no longer effective, or there is not an effective treatment known for your type of cancer.&#8221; Technically true, but not really how you want to lead.</p>
<p>The next paragraph gets better in that it&#8217;s really just more of an all capital bolded sentence that says:</p>
<p><strong>THIS RESEARCH STUDY WILL BE THE FIRST TIME THE STUDY DRUG WILL BE GIVEN TO HUMANS.</strong></p>
<p>Donna actually said that Rich will be the second person ever to receive this drug. So there is one other person on the planet who has ingested the pills Rich will take next week. I think the only thing more extreme would have been if the nurse said, &#8220;The first patient, God rest his soul, didn&#8217;t react very well, but we have high hopes for you!&#8221;</p>
<p>We&#8217;re flying to Nashville on Monday morning for an afternoon appointment to go over all the details. Tuesday, Rich will get a CT scan, eye exam and EKG for a pre-trial base line. We hope we can start the trial on Wednesday but they might not have a room available for him, so we might have to wait until Thursday to start the trial.</p>
<p>The drug is in pill form that he takes twice a day, but on Day 1 and Day 15 they want to monitor him from 7am to 7pm to see how he absorbs the drug. I hope they have good wifi. Once his first day is done at the center we can fly home, but that&#8217;s just the start. For the first six weeks of the trial, Rich has to show up for checkups once a week. So every Wednesday in May, Rich will be flying to Tennessee for the day. On Day 15, he&#8217;ll have to come in the night before and leave the next morning. </p>
<p>After the first six weeks, Rich will continue receiving the drug and will go for a checkup once every three weeks. Every other visit (so every six weeks) he&#8217;ll get a CT scan to see how the slime is faring. We have no idea how long he would be on the trial. He can continue until either the side effects are unbearable, the drug seems ineffective, or the doctor says he should try something else. </p>
<p>Rich is worried that he will have the worst of all possible side effects, be miserable and not get any benefit from the drug. But that seems to be his tendency to assume that life is setting aside a shit sandwich at every buffet just for him so that every one else can enjoy the prime rib. </p>
<p>We are happy to see progress. But it is a little alarming to find out Rich&#8217;s Wednesdays are spoken for for the next year or so. Needless to say, we&#8217;ll have a lot of Southwest points by Christmas. </p>
<p>For those inspired for some light reading, you can read about the <a href="https://www.dropbox.com/s/wtargzt7smq4ol9/SCRI-trial2-ERK%20gene%20blocker.pdf">BVD-523 drug trial</a>. Riveting stuff. </p>
<p>This is our best option to shrink the slime. Let&#8217;s hope these magical pills focus on the slime and leave the rest of Rich alone. </p>
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		<item>
		<title>Test results – now with twice the confusing acronyms</title>
		<link>http://feedproxy.google.com/~r/messageinabottleblog/~3/fTzgMuAdTJw/</link>
		<comments>http://www.inabottle.org/2013/04/16/test-results-now-with-twice-the-confusing-acronyms/#comments</comments>
		<pubDate>Wed, 17 Apr 2013 00:29:15 +0000</pubDate>
		<dc:creator>Genie Alisa</dc:creator>
				<category><![CDATA[Cancer]]></category>
		<category><![CDATA[Message]]></category>

		<guid isPermaLink="false">http://www.inabottle.org/?p=2924</guid>
		<description><![CDATA[I texted Andi with an I today to get an update and she said someone would be in touch. When we were in the grocery store at 6:15pm, the nurse called Rich&#8217;s phone which happened to be in the car so of course we missed her. In some ways I&#8217;m glad she left a voicemail [...]]]></description>
				<content:encoded><![CDATA[<p>I texted Andi with an I today to get an update and she said someone would be in touch. When we were in the grocery store at 6:15pm, the nurse called Rich&#8217;s phone which happened to be in the car so of course we missed her. </p>
<p>In some ways I&#8217;m glad she left a voicemail versus talking to us while we were in the produce section of Food Lion with a three year old. I was able to play her message several times and transcribe it. I have no idea what it means but Rich and I heard very different versions of the same thing. His version was basically, &#8220;we found cancer but there&#8217;s no room on the bus for you so go with God.&#8221;</p>
<p>The nurse (Donna) said that they completed the molecular profiling and found two mutations &#8211; KRAS and GNAS.</p>
<p>There are two clinical trials that they have at the Sarah Cannon Cancer Center. One is an oral medication that combines a MEC and AKT inhibitor. The other &#8220;hits the ERK pathway.&#8221; (I have no idea what that means. Is that what the kids are calling it these days?)</p>
<p>Neither clinical trial has an opening at the moment but Rich&#8217;s name has been put in for when one becomes available. Dr. Bendell is also looking for other solutions in the meantime. Donna will call us again on Wednesday to try to reach us in person. </p>
<p>I know those terms are right because Google confirmed them, but I have no idea what they mean. I might give my PubMed account a workout or I might just hope for a better translation in the morning. </p>
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		<item>
		<title>No news</title>
		<link>http://feedproxy.google.com/~r/messageinabottleblog/~3/Q1egkUFVRhM/</link>
		<comments>http://www.inabottle.org/2013/04/08/no-news/#comments</comments>
		<pubDate>Tue, 09 Apr 2013 01:03:05 +0000</pubDate>
		<dc:creator>Genie Alisa</dc:creator>
				<category><![CDATA[Cancer]]></category>
		<category><![CDATA[Message]]></category>

		<guid isPermaLink="false">http://www.inabottle.org/?p=2921</guid>
		<description><![CDATA[We&#8217;re all alive here, I just haven&#8217;t been up to posting much. It&#8217;s been busy with our huge annual conference a few weeks ago and all the prep for our huge SCA event that was yesterday. Now I feel like we can all breathe a little more. I don&#8217;t even remember when we went to [...]]]></description>
				<content:encoded><![CDATA[<p>We&#8217;re all alive here, I just haven&#8217;t been up to posting much. It&#8217;s been busy with our huge annual conference a few weeks ago and all the prep for our huge SCA event that was yesterday. Now I feel like we can all breathe a little more. </p>
<p>I don&#8217;t even remember when we went to Nashville &#8230; oh, right, March 14. When we were there, Andi with an I (our patient navigator) said that we should have test results in a few days. I was doubtful, based on the findings from University of Maryland where the number of cells was sparse. I texted on the 21st and they said, &#8220;had our biomarker guy talk to the path[ology] group and they said they can do the sequencing.&#8221; No idea what that means, but it sounds like they&#8217;re working on it. I texted again on the 29th but Andi was out. On Monday April 1, Andi said, &#8220;still haven&#8217;t heard back but we are looking into it. Stay tuned.&#8221; So then this Friday the 5th, I asked again and Andi said, &#8220;Just checked again. No word yet. Maybe path group is backed up? Dr. Bendell is having people look into it.&#8221; </p>
<p>So no news, really. </p>
<p>Meanwhile, I went to California for work, came home via a red eye flight and then took Rich to an endoscopy. Ever since the MoAS (Mother of All Surgeries), he has had mild indigestion and frequent burping. No one is really sure what causes it, but they wanted to put a camera down his throat to look around. They found nothing wrong (which was a relief to Rich) but did notice the bottom of his esophagus is slightly inflamed, in keeping with acid reflux. But that&#8217;s all we know about that so far and no one can yet explain why Rich burps more. </p>
<p>We&#8217;re in a bit of a holding pattern. </p>
<p>Last week, Rich caught some sort of stomach bug that laid him up from Wednesday through Friday. I was a little concerned he wouldn&#8217;t make it to our big SCA event, but in the eleventh hour he rallied. Now we&#8217;re home, the car is unpacked and we&#8217;re back to life as usual, including another conference this week. </p>
<p>While no news is supposedly good news, it would be nice if we at least had something that helped us move forward.</p>
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		<item>
		<title>No answers yet, but one heck of a plan</title>
		<link>http://feedproxy.google.com/~r/messageinabottleblog/~3/iEVqGrJUWFY/</link>
		<comments>http://www.inabottle.org/2013/03/06/no-answers-yet-but-one-heck-of-a-plan/#comments</comments>
		<pubDate>Thu, 07 Mar 2013 00:33:50 +0000</pubDate>
		<dc:creator>Genie Alisa</dc:creator>
				<category><![CDATA[Cancer]]></category>
		<category><![CDATA[Message]]></category>

		<guid isPermaLink="false">http://www.inabottle.org/?p=2766</guid>
		<description><![CDATA[While it&#8217;s only been one day here, Nashville certainly has a culture all its own. They love them some rhinestones here. Also, everyone has a guitar. You get one at birth with your rhinestone onesie. We made it to the Sarah Cannon Cancer Center way ahead of schedule. It&#8217;s right next to Vanderbilt University but [...]]]></description>
				<content:encoded><![CDATA[<p>While it&#8217;s only been one day here, Nashville certainly has a culture all its own. They love them some rhinestones here. Also, everyone has a guitar. You get one at birth with your rhinestone onesie.</p>
<p>We made it to the Sarah Cannon Cancer Center way ahead of schedule. It&#8217;s right next to Vanderbilt University but on a pretty run down street. There is a giant Parthenon across the street, though, so there is that.</p>
<p><center><a href="http://www.flickr.com/photos/geniealisa/8535727162/" title="Our belly slime Mecca by Genie Alisa, on Flickr"><img src="http://farm9.staticflickr.com/8513/8535727162_a14a5ddb7e.jpg" width="500" height="375" alt="Our belly slime Mecca"></a></center></p>
<p>While we waited, we were treated to homemade breads from a woman who apparently is there daily passing out treats to patients and their families. She was super sweet.</p>
<p><center><a href="http://www.flickr.com/photos/geniealisa/8534620111/" title="Free bread by Genie Alisa, on Flickr"><img src="http://farm9.staticflickr.com/8107/8534620111_9aaf3a07d2.jpg" width="375" height="500" alt="Free bread"></a></center></p>
<p>Rich had some blood drawn and then we went to an exam room. We then were visited by the Charlie&#8217;s Angels of medical team. Jan came in wearing shoes I would never dare try to walk in to go over Rich&#8217;s history. Next came Dr. Bendell herself in an alarmingly short skirt and quite the silver chain around her neck. Then came Donna in her leopard print shirt with rhinestones to have us sign the case study paperwork. And finally we met Andi (with an i) in <em>fishnet stockings</em> to explain how she was our direct contact for everything. When she left, Rich surmised it&#8217;s either Ladies Night at the Research Institute or they&#8217;re shooting a tawdry film in another room. </p>
<p>Everyone was super nice and they move at a very quick pace. Dr. Bendell said that they want to test Rich&#8217;s tissue using their panel of tests that covers 35 different types of malignancies (versus the K-RAS test we could never get done that only covered one or a few malignancies). She felt confidant that the test would give us the information we need to target Rich&#8217;s treatment for the malignant cells that are there. She also mentioned that no one else in the country has the same level of testing except for MD Anderson Cancer Center in Houston. We noted that Southwest flies to Nashville direct so we&#8217;re good with Sarah Cannon. </p>
<p>Bendell offered that we could stay over tonight and have the biopsy to extract more tissue Friday morning but we are completely unprepared seeing as we have no luggage, no medications, no clean underwear and no backup plan for all our other commitments this week. So we opted for a biopsy on Thursday the 14th. Rich will fly in Wednesday the 13th for a pre-op appointment with Dr. Geer (his name is Richard Geer, I am not even kidding) and I&#8217;ll fly direct to Nashville from my University of South Florida site visit. He&#8217;ll have the biopsy done Thursday morning and we&#8217;ll fly home that night. The biopsy is laparoscopic where they fill you full of air to see better and then harvest a bunch of tissue. Since the sample they had in Baltimore wasn&#8217;t enough for even a K-RAS test, Dr. Bendell suspects they&#8217;ll need their own sample anyways so we&#8217;re going that route. </p>
<p>Once the sample is retrieved, they should have results in one to two weeks. And then from that we should know what treatment options we have. Everyone was very positive and upbeat. I feel good about the plan. </p>
<p>Rich got a little bit of the puffed out upper lip for a bit (which makes him look just like his father) as he pondered all the negative ways to digest the plan. But I won&#8217;t have any of that and the facial expression passed. I wore my slime shirt special for this trip.</p>
<p><center><a href="http://www.flickr.com/photos/geniealisa/8535734848/" title="Slime shirt by Genie Alisa, on Flickr"><img src="http://farm9.staticflickr.com/8251/8535734848_a790b42211.jpg" width="500" height="375" alt="Slime shirt"></a></center></p>
<p>As we waited for someone to come back to the exam room, we could hear this dude out in the hall talk about the treatments he&#8217;s been getting. They are injecting molecular radiation into his arteries to attack the tumor in his liver. It was working like a charm and he said it didn&#8217;t even hurt. We are living in the future.</p>
<p>Also, Andi (with an i) gave us her cell phone number and I spent the afternoon texting back and forth with her arranging our trip for next week. She is my new BFF and I have her on speed dial. Again, how did we treat illnesses before smart phones? Got cancer? There&#8217;s an app for that.</p>
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		<item>
		<title>Casting pearls before slime</title>
		<link>http://feedproxy.google.com/~r/messageinabottleblog/~3/S_GXMgqYBJQ/</link>
		<comments>http://www.inabottle.org/2013/02/12/casting-pearls-before-slime/#comments</comments>
		<pubDate>Wed, 13 Feb 2013 02:04:22 +0000</pubDate>
		<dc:creator>Genie Alisa</dc:creator>
				<category><![CDATA[Cancer]]></category>
		<category><![CDATA[Message]]></category>

		<guid isPermaLink="false">http://www.inabottle.org/?p=2760</guid>
		<description><![CDATA[We went to an SCA event this past weekend and several people mentioned they were looking for an update on Team Stryker. As Kevin of Thornbury said, &#8220;Are you sure you have the premium subscription to Team Stryker? That updates more often.&#8221; And that&#8217;s why we love Kevin. But really, I haven&#8217;t been updating you [...]]]></description>
				<content:encoded><![CDATA[<p>We went to an SCA event this past weekend and several people mentioned they were looking for an update on Team Stryker. As Kevin of Thornbury said, &#8220;Are you sure you have the premium subscription to Team Stryker? That updates more often.&#8221; And that&#8217;s why we love Kevin.</p>
<p>But really, I haven&#8217;t been updating you all on the latest for Team Stryker because there hasn&#8217;t been a lot to update. We&#8217;re in a bit of a holding pattern. We went to see Dr. Lee here in Virginia Beach and like him very much. He said that he could give us the chemo treatments for colon cancer if we wanted, but he honestly didn&#8217;t think it would help. Certainly doesn&#8217;t make one want to jump at the chance for that! </p>
<p>Dr. Lee did mention that he has a friend from school who might be interested in our case, though. Her name is Teresa Bendell and she works at the <a href="http://sarahcannonresearch.com">Sarah Cannon Research Institute</a> in Nashville, Tennessee. <a href="http://en.wikipedia.org/wiki/Minnie_Pearl">Minnie Pearl</a>&#8216;s real name was Sarah Cannon and after battling breast cancer, she started a non-profit foundation to explore cancer research. That led to the Sarah Cannon Research Institute in her name. </p>
<p>So I called the Sarah Cannon folks and got ahold of Dr. Bendell&#8217;s nurse Melanie. Melanie has been super helpful but we have been going through a lot of shenanigans to get all of Rich&#8217;s medical records transferred to Dr. Bendell so she can review them. Bendell specializes in GI malignancies, particularly the &#8220;odd&#8221; ones like Rich&#8217;s. The idea is that we can get Rich into a case study where they would do a genetic panel of both Rich and his tumor cells to try to isolate something in particular to treat them. This is highly preferred to regular chemo which is a bit of &#8220;carpet bombing&#8221; your system in hopes of getting rid of the stuff you don&#8217;t want there.</p>
<p>While we&#8217;ve been waiting for more information from Nashville, we went for &#8220;chemo training&#8221; at Dr. Lee&#8217;s office. No matter what kind of treatment we decide on, it will most likely involve going to our local oncologist to have it administered and they require you complete chemo training before you can get treatment. </p>
<p>Hoo boy, that was depressing. We went for our two hours of training and as we sat in the car, I told Rich, &#8220;I didn&#8217;t get bummed when we had the initial diagnosis. I didn&#8217;t get bummed when Dr. Hanna called me 30 minutes into your eight hour surgery. I didn&#8217;t get bummed when I saw cell phone pictures of your insides. But that right there? That really bummed me out!&#8221; I didn&#8217;t necessarily have a panic attack while we were there, but I had a very strong sensation that everything this nice lady was telling us didn&#8217;t apply to our situation. He doesn&#8217;t need Xeloda. He shouldn&#8217;t take Oxaliplatin. And nobody likes to hear someone tell their husband, &#8220;you can be sexually active but be sure to wear a condom for seven days after treatment and you do NOT want to get anyone pregnant.&#8221; Then again, maybe our next kid could be Spiderman. </p>
<p>If anything, the chemo training solidified my desire to do whatever we can with the folks in Nashville. I still believe that Rich doesn&#8217;t necessarily have cancerous cells in him but just misplaced mucus from his appendix rupturing. It&#8217;s hard to target appendix cells to nuke those while not nuking other &#8220;normal&#8221; cells. We&#8217;ve been trying to get medical records shuffled since January 21 and it&#8217;s been slow going. But the good news is the folks at Sarah Cannon are very friendly and they know us by name. That&#8217;s the advantage of working with a small private research institute. And Southwest flies direct to Nashville, so it should at least be an easy trip there whenever it does happen.</p>
<p>In the meantime, Rich has gone back to fighting as of January 13 and back on the ice as of February 8. Those are two very big milestones. I should go get the slime notebook and write those dates in it so we can reference it in the same context. He had surgery on November 12 and nine weeks later was in armor. Another three weeks and he was in the crease playing goal. So while there is still slime inside him and we&#8217;re dealing with all the frustrations of being one in 12 million (or more), things are still pretty okay.</p>
<p><center><a href="http://www.inabottle.org/wp/wp-content/uploads/2013/02/minniepearl.jpg"><img src="http://www.inabottle.org/wp/wp-content/uploads/2013/02/minniepearl.jpg" alt="minniepearl" width="336" height="381" class="aligncenter size-full wp-image-2761" /></a></center></p>
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		<title>An evening at home with a three year old</title>
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		<comments>http://www.inabottle.org/2013/02/06/an-evening-at-home-with-a-three-year-old/#comments</comments>
		<pubDate>Wed, 06 Feb 2013 06:28:25 +0000</pubDate>
		<dc:creator>Genie Alisa</dc:creator>
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		<category><![CDATA[Parenthood]]></category>

		<guid isPermaLink="false">http://www.inabottle.org/?p=2756</guid>
		<description><![CDATA[I mentioned on Facebook last night that I was ordering a bed wetting alarm to help Ian stay dry overnight. There were lots of helpful suggestions like deny liquids an hour before bed, pee before bed, use pee pads, don&#8217;t let him in our bed, use pull ups, or wait it out. I thought of [...]]]></description>
				<content:encoded><![CDATA[<p>I mentioned on Facebook last night that I was ordering a bed wetting alarm to help Ian stay dry overnight. There were lots of helpful suggestions like deny liquids an hour before bed, pee before bed, use pee pads, don&#8217;t let him in our bed, use pull ups, or wait it out. I thought of all these suggestions as we went through our evening together to see where they might fall into our routine. Here&#8217;s an example from today:</p>
<p>5:30pm &#8211; pick Ian up from school. He asks for Mama milk but I tell him no cause I wanna get home. He complies. </p>
<p>6:00pm &#8211; Grocery shopping on the way home. Ian cheerfully sits in the cart eating strawberries and goldfish crackers. </p>
<p>6:30pm &#8211; We get home. I change pants and refill cat food that the damn dogs ate while Ian decides he doesn&#8217;t like his shirt then cries because he is cold and can&#8217;t get his shirt back on by himself. </p>
<p>7:15pm &#8211; Dinner of homemade chicken soup is served. Ian has two bowls plus a half a box of Horizon chocolate milk. We play trains and watch Caillou on the iPad. </p>
<p>8:00pm &#8211; Ian pees right before we go upstairs. We read our two new books (<a href="http://www.amazon.com/gp/aw/d/0399255141/ref=mp_s_a_1?qid=1360131497&#038;sr=8-1&#038;pi=SL75">The Three Ninja Pigs</a> and <a href="http://www.amazon.com/gp/aw/d/1596434023/ref=mp_s_a_1?qid=1360131599&#038;sr=8-1&#038;pi=SL75">A Sick Day for Amos McGhee</a>). </p>
<p>8:20pm &#8211; Mama milk</p>
<p>8:30pm &#8211; We both lie in the dark trying to help him wind down for falling asleep There are many questions like how does his Lightning McQueen car sleep if his eyes don&#8217;t close. </p>
<p>8:40pm &#8211; Ian asks to pee again. He insists Lightning McQueen come too. He asks for the rest of his chocolate milk but I tell him we have to wait so he won&#8217;t pee. He complies. </p>
<p>9:05pm &#8211; Ian gets up to pee again but says I don&#8217;t have to come. Upon his return he asks for water. I tell him no and he cries for 5 minutes that he&#8217;s thirsty and another 5 minutes that he doesn&#8217;t want to sleep. </p>
<p>9:15pm &#8211; We both fall asleep in the big bed. </p>
<p>11:30pm &#8211; I wake up and transfer Ian to his bed. Rich comes home and I make Ian&#8217;s lunch. </p>
<p>12:00am &#8211; We go upstairs for bed. I get to put our freshly washed comforter on the bed. I notice Ian has half fallen out of his bed. </p>
<p><center><a href="http://www.inabottle.org/wp/wp-content/uploads/2013/02/20130206-0126252.jpg"><img src="http://www.inabottle.org/wp/wp-content/uploads/2013/02/20130206-0126252.jpg" alt="20130206-012625.jpg" class="alignnone size-full" /></a></center></p>
<p>12:50am &#8211; Ian wakes up, crawls into our bed but moves to the sidecar crib next to me (surprisingly). He asks for more covers and Mama milk. I tell him milk can come later. He complies. </p>
<p>Part of the reason I let Ian in our bed is it&#8217;s some of the only time we get to hang out. Otherwise we get from 5:30pm-8:30pm and a lot of that is bedtime routine and tears over the injustice of the t- shirt he&#8217;s worn all day that is suddenly unacceptable. </p>
<p>Other than the bed wetting soaking us all, he is a delight at 3am.</p>
<p>*Update*<br />
4:50am &#8211; Ian woke up and said, &#8220;I don&#8217;t wanna be in the crib.&#8221; and moved next to me. He asked for Mama milk and I complied, figuring this will be his morning dose versus at 6:45 when I&#8217;m trying to get out of the bed. Of course, that dose of milk led him to pee just a little. He didn&#8217;t soak the bed, just his undies and fleece pants. But that&#8217;s a start &#8230;</p>
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