Haylee and I had a bit of a rough night. Her rash under the CVL dressing was really bothering her. She tries as hard as she can to not to scratch it but I'm sure its hard. So we slept on the couches so not to bother Adam and Mason :(
The nurse today gave us a few dressings to try that may help but we won't know for a few days. I hope these work!! Our new home health company is going to send us dressing for sensitive skin (thank you!!). I changed the dressing to the a new one from the nurse so keep your fingers crossed! I'll just continue to give her Benadryl and heat and icepacks until it's tolerable. It's really all I can do at this point.
I made Haylee do some school work during infusion. She's such a good student and is super smart but trying to get her to focus and do the work is the hard part. I can't wait for next week when the teachers at the hospital as well as the homebound teacher can work with her and not me!!
Infusion went well again! Haylee's responding so well to the Arsenic. I hope it continues!
~Hope for Haylee~
January 6, 2012
January 5, 2012
1/5/12 - Rest of the school year...taken care of!
Arsenic infusion went off without any issues! We were there at 8:30am and out by 11:45am. Pretty good day if you ask me!
I had a meeting at Haylee's school along with the H/H teacher today. She's set for the rest of the year. Her assignments will come in 1-2 weeks at a time. The H/H teacher will come to our house and work with her and she will get instruction time during clinic as well. I was worried about the CRCT test this year but since she's ahead in her academics, she has 1 of 4 options and they will all depend on her treatment schedule: 1) the H/H teacher will administer the test at our house, 2) she will have the option to make up the reading and math portions in May, 3) she could attend school when the test is being administered should her counts be fine and she's not inpatient at the time, 4) she just doesn't take it and according to her teacher and the assistant principal that would be fine. She would still go to 4th grade without taking the test. I also let them know that she will have 2 weeks where she won't be in clinic and she could return to school at that time as long as her restrictions are followed (no PE, unlimited breaks, close watch during recess, ability to wear hats, carry around hand sanitizer and a water bottle, etc.).
I gave her teacher the Monkey In My Chair monkey that 'replaces' her at her desk when she can't attend school. It gives the kids a way to 'include' Haylee in their everyday activities and allows them to journal about their day with the monkey, take pictures with the monkey, and even name it. Haylee will get to see and read about the things they have done with the monkey when she is able to return to school. She was excited that she may be able to go to school for a few weeks. Regardless of what she may say, she misses school. Haylee is one of those kids who actually likes school! She must of gotten that from her Nonna, because she didn't get it from me or Adam!!
She's been complaining that the skin itches under the dressing covering her line so I thought maybe it was from the actual dressing itself. I changed her dressing 2 days early in hopes that putting a different dressing on her may help...I think I made it worse. Since it has to be cleaned with Chloraprep and her skin underneath is sensitive, it's like putting rubbing alcohol on scraped skin. Poor baby, it's been burning! The skin underneath has a raised rash on it. I called the Hem/Oc doctor on call at Egleston and he didn't seem too concerned unless she was running a fever (which she's not). I gave her some Benadryl and had her rub and icepack on it but it only helps some. She will be fine for a minute and crying the next. I don't know what to do for her and she won't leave it alone enough for it to 'calm down'. I can imagine that it's uncomfortable but I'm just at a loss on this one. I don't know what to do.
I had a meeting at Haylee's school along with the H/H teacher today. She's set for the rest of the year. Her assignments will come in 1-2 weeks at a time. The H/H teacher will come to our house and work with her and she will get instruction time during clinic as well. I was worried about the CRCT test this year but since she's ahead in her academics, she has 1 of 4 options and they will all depend on her treatment schedule: 1) the H/H teacher will administer the test at our house, 2) she will have the option to make up the reading and math portions in May, 3) she could attend school when the test is being administered should her counts be fine and she's not inpatient at the time, 4) she just doesn't take it and according to her teacher and the assistant principal that would be fine. She would still go to 4th grade without taking the test. I also let them know that she will have 2 weeks where she won't be in clinic and she could return to school at that time as long as her restrictions are followed (no PE, unlimited breaks, close watch during recess, ability to wear hats, carry around hand sanitizer and a water bottle, etc.).
I gave her teacher the Monkey In My Chair monkey that 'replaces' her at her desk when she can't attend school. It gives the kids a way to 'include' Haylee in their everyday activities and allows them to journal about their day with the monkey, take pictures with the monkey, and even name it. Haylee will get to see and read about the things they have done with the monkey when she is able to return to school. She was excited that she may be able to go to school for a few weeks. Regardless of what she may say, she misses school. Haylee is one of those kids who actually likes school! She must of gotten that from her Nonna, because she didn't get it from me or Adam!!
She's been complaining that the skin itches under the dressing covering her line so I thought maybe it was from the actual dressing itself. I changed her dressing 2 days early in hopes that putting a different dressing on her may help...I think I made it worse. Since it has to be cleaned with Chloraprep and her skin underneath is sensitive, it's like putting rubbing alcohol on scraped skin. Poor baby, it's been burning! The skin underneath has a raised rash on it. I called the Hem/Oc doctor on call at Egleston and he didn't seem too concerned unless she was running a fever (which she's not). I gave her some Benadryl and had her rub and icepack on it but it only helps some. She will be fine for a minute and crying the next. I don't know what to do for her and she won't leave it alone enough for it to 'calm down'. I can imagine that it's uncomfortable but I'm just at a loss on this one. I don't know what to do.
January 4, 2012
1/4/12 - Insurance...friend or foe??
Haylee's clinic visit was a good one! I hope it keeps going this smooth for the entire Consolidation 1!! This has been the easiest part aside from driving back and forth everyday. To answer a question that was asked by Michelle if she will be able to return to school part-time, to be honest I'm not sure of that answer. Consolidation 1 consists of 66 days of Arsenic treatments (Monday-Friday for 10 weeks with a 2 week break between each 5 week session). Because the treatments are daily, she may only be able to return to school for 'social visits' only. And since she's in remission and her immune system is normal, I won't feel like I'm putting her in harms way (except her having her CVL line dangling from her chest which will have me worrying all the time).
Adam went to the pharmacy today to pick up a prescription for her anti-nausea medication. The pharmacist said she was terminated from her Wellcare insurance. Can you imagine the terror that I went through at that moment?? In a nutshell and after calling Peachcare (twice), Georgia Healthy Families, and Wellcare, she was terminated from Wellcare and enrolled in SSI Medicaid as of January 1, 2012 because of her SSI disability benefits kicking in at the beginning of December. Because I paid for both the kids Peachcare coverage before January 1, she still qualifies for Peachcare through January. Do you think anybody thought this was something I needed to know?? Apparently not, because I wasn't informed at all. No letter, no email, no phone call, no certified letter, no singing telegram...nothing. Medicaid requires pre-authorizations on certain medications and doesn't at all cover the cost of Haylee's line supplies (line caps, dressing changes, flushes, etc.) or skilled nursing visits like Wellcare did. We will have to pay out-of-pocket for the cost of monthly delivery of supplies. UGH! If it's not one thing, it's another!!! At least I didn't find out when she was in need of medications or supplies or that she isn't covered at all! I did breathe a sigh of relief that she's still covered and that's whats most important!!!!
Adam went to the pharmacy today to pick up a prescription for her anti-nausea medication. The pharmacist said she was terminated from her Wellcare insurance. Can you imagine the terror that I went through at that moment?? In a nutshell and after calling Peachcare (twice), Georgia Healthy Families, and Wellcare, she was terminated from Wellcare and enrolled in SSI Medicaid as of January 1, 2012 because of her SSI disability benefits kicking in at the beginning of December. Because I paid for both the kids Peachcare coverage before January 1, she still qualifies for Peachcare through January. Do you think anybody thought this was something I needed to know?? Apparently not, because I wasn't informed at all. No letter, no email, no phone call, no certified letter, no singing telegram...nothing. Medicaid requires pre-authorizations on certain medications and doesn't at all cover the cost of Haylee's line supplies (line caps, dressing changes, flushes, etc.) or skilled nursing visits like Wellcare did. We will have to pay out-of-pocket for the cost of monthly delivery of supplies. UGH! If it's not one thing, it's another!!! At least I didn't find out when she was in need of medications or supplies or that she isn't covered at all! I did breathe a sigh of relief that she's still covered and that's whats most important!!!!
January 3, 2012
1/3/12 - Bone Marrow results are in...
We had our first official clinic visit today - Consolidation 1 begins! Haylee had to have an EKG and a repeat Echo cardiogram done. I was a little irritated with that because she just had one on Wednesday. A cardio RN came in and explained that the doctors ordered another one and that it happened often. Both tests went fine.
We went up to the outpatient clinic and had a physical exam and labs drawn. Haylee having a CVL line really helps so she's not having to be poked every time they need something from her or to give her meds. She was pretty grateful for that! The doctor came in a talked with me for a while about what to expect during the arsenic treatments - warning signs to look for and possible side effects (aside from the normal nausea, vomiting, diarrhea, constipation that are possible with every other medication). She also explained to me about the repeat Echo. Haylee had a decrease in heart function, about 6%, although her heart function was still normal. They said that it was probably because she had been fasting and had little to drink so she could've been a little dehydrated. Because of the decrease was why it was repeated. I felt a twinge of guilt since I got irritated about it but if they would've told me why then, I would've understood. The arsenic can cause a disruption in electrolyte levels as well as heart function so at the beginning of every week, she will get an EKG, blood levels checked, and a BMP panel (potassium, magnesium, calcium, cholesterol, and triglycerides) checked. Currently, her cholesterol and triglycerides are high but the doctor said the ATRA can cause that. They will continue to watch it and if they have to treat her for it, they will if the time comes.
Now, her bone marrow results.....she is currently in remission!!!!!!!!!!!!!!!!!!!!!!!!!!! She has no leukemia cells in her bone marrow. Her treatment plan will continue as normal but it shows that what they have already done is working and working very well!! I started crying when they told me and Haylee said, "Mommy, don't cry!" I had to explain they were happy tears and those were OK (LOL). Her immune system is NORMAL. It's the first time it's been normal since....sometime before she was diagnosed. She doesn't have to wear her mask anymore!!! She's doing great, her blood and bone marrow are great, she's responding well to treatment...we couldn't be happier!!!
We are still in need of all the prayers, thoughts, and support! Haylee still has a long road, she still has a lot of treatment left, and it's possible she may have a few setbacks from time to time. Every little thought, every small prayer...they all count and they count BIG in our eyes.
WBC - 6480
Platelets - 364,000
HGB - 11.2
ANC (infection fighting cells) - 3270
We went up to the outpatient clinic and had a physical exam and labs drawn. Haylee having a CVL line really helps so she's not having to be poked every time they need something from her or to give her meds. She was pretty grateful for that! The doctor came in a talked with me for a while about what to expect during the arsenic treatments - warning signs to look for and possible side effects (aside from the normal nausea, vomiting, diarrhea, constipation that are possible with every other medication). She also explained to me about the repeat Echo. Haylee had a decrease in heart function, about 6%, although her heart function was still normal. They said that it was probably because she had been fasting and had little to drink so she could've been a little dehydrated. Because of the decrease was why it was repeated. I felt a twinge of guilt since I got irritated about it but if they would've told me why then, I would've understood. The arsenic can cause a disruption in electrolyte levels as well as heart function so at the beginning of every week, she will get an EKG, blood levels checked, and a BMP panel (potassium, magnesium, calcium, cholesterol, and triglycerides) checked. Currently, her cholesterol and triglycerides are high but the doctor said the ATRA can cause that. They will continue to watch it and if they have to treat her for it, they will if the time comes.
Now, her bone marrow results.....she is currently in remission!!!!!!!!!!!!!!!!!!!!!!!!!!! She has no leukemia cells in her bone marrow. Her treatment plan will continue as normal but it shows that what they have already done is working and working very well!! I started crying when they told me and Haylee said, "Mommy, don't cry!" I had to explain they were happy tears and those were OK (LOL). Her immune system is NORMAL. It's the first time it's been normal since....sometime before she was diagnosed. She doesn't have to wear her mask anymore!!! She's doing great, her blood and bone marrow are great, she's responding well to treatment...we couldn't be happier!!!
We are still in need of all the prayers, thoughts, and support! Haylee still has a long road, she still has a lot of treatment left, and it's possible she may have a few setbacks from time to time. Every little thought, every small prayer...they all count and they count BIG in our eyes.
WBC - 6480
Platelets - 364,000
HGB - 11.2
ANC (infection fighting cells) - 3270
January 2, 2012
Please read! About the Arsenic treatments.
Taken from ScienceDaily to better understand the why Haylee will be receiving the Arsenic treatment for her leukemia. It's a very interesting read although it can be a bit scientific at times. It even helped me understand it more.
Wake Forest University Baptist Medical Center. "Arsenic early in treatment improves survival for leukemia patients, study finds." ScienceDaily, 11 Nov. 2010. Web. 2 Jan. 2012.
Researchers with the Cancer and Leukemia Group B, a group of cancer and leukemia researchers funded by the National Cancer Institute, led a study to determine if, by administering arsenic trioxide earlier -- after a patient has finished standard initial treatment and reached first remission -- they could improve survival rates. The results were dramatic.
"Patients with APL can achieve remission with standard treatment (chemotherapy plus ATRA, an oral vitamin A-based compound), but it often comes back," said Bayard L. Powell, M.D., a professor of hematology and oncology at Wake Forest Baptist, principal investigator and lead author on the study. "Arsenic trioxide is then used to get them back into remission, often followed by a bone marrow transplant to try to cure the patient. For this study, we used arsenic as an early "consolidation therapy" after the initial standard treatment to essentially, as one of our first patients described, 'seal the deal' the first time around. Not only did the leukemia rarely return in the patients who received the arsenic, those patients also lived longer."
The findings appear in the November 11 issue of Blood.
APL accounts for about 10 to 15 percent of acute myeloid leukemia cases and presents most frequently in young adults. It is associated with a very high risk of severe bleeding complications, including early death from bleeding into the brain.
Current treatment of APL involves a combination of all-trans retinoic acid (ATRA) plus chemotherapy to induce remission, followed by additional "consolidation" chemotherapy to strengthen the remission, followed by further ATRA with or without oral chemotherapy to maintain remission. This approach yields complete remission rates of about 90 percent and improved event-free survival, with an "event" defined as failure to achieve complete remission, relapse after achieving complete remission, or death.
Those with high white blood cell counts at diagnosis have a worse prognosis, however, with higher risk of early death during initial standard treatment. If they survive initial treatment and enter remission, they are also more prone to relapse, at which point arsenic is introduced to push them back into remission.
While arsenic can be toxic and is used in potent pesticides and poisons, it also exists naturally in the environment and, when manufactured under carefully-controlled conditions and used appropriately by doctors and nurses experienced in the treatment of cancer, can provide a significant health benefit.
Arsenic has been proven effective in pushing those unresponsive to initial treatment, and those who relapse after initial response, into remission. But researchers wanted to know what would happen if they used the arsenic trioxide after initial standard treatment, rather than wait until a patient relapses.
For the study, North American Leukemia Intergroup trial C9710, investigators randomized 481 patients with untreated APL, age 15 and older, into two groups. Both groups would receive standard treatment of ATRA plus chemotherapy, followed by standard consolidation therapy. One of the groups received an additional two 25-day courses of intravenous arsenic trioxide before administration of the standard consolidation therapy.
The patients in the investigational group received arsenic trioxide intravenously for one hour, five days a week, for five weeks, with a two-week break between courses.
After initial standard treatment, both groups experienced similar rates of remission, at about 90 percent, and there were no treatment-related deaths reported from either group during consolidation therapy, indicating that the addition of arsenic treatment earlier introduces no additional safety concerns.
Analysis of the overall results revealed that event-free survival, defined as the time from study entry to first event (defined above), was significantly better for patients randomized to receive the arsenic trioxide consolidation therapy, For example, after three years, event-free survival was 80 percent in the arsenic group versus 63 percent in the non-arsenic group. Arsenic trioxide consolidation provided significant benefit to patients in the investigational group regardless of their initial prognosis based on white blood cell count and other risk factors.
The group who received arsenic also faired better in relapse rates and overall survival, researchers found. Out of 196 study participants who received at least one dose of arsenic after initial standard treatment, only seven individuals -- four percent -- relapsed within three years of follow-up.
"We think people who received the arsenic trioxide after initial standard treatment are likely cured," Powell said. "There have been no relapses in that group after 36 months. The use of arsenic earlier in treatment improves the cure rate and survival, and it does so with little or no additional toxicity."
The results are exciting, Powell said. "It gives us hope that, with the addition of arsenic trioxide earlier in treatment, we may be able to eliminate some of the chemotherapy and reduce toxicities and costs."
However, 19 patients (eight percent) in each group died during the initial standard treatment, Powell pointed out, and those who were randomized to receive the arsenic never got a chance to benefit from it, since they didn't live through the initial treatment.
"One of our next objectives is to reduce or eliminate these early deaths -- most common in patients with high white blood cell counts -- possibly by introducing arsenic even earlier than we did this time, as part of initial induction therapy, to help them achieve remission," Powell said. "Some of these patients are at such high risk that they may need the arsenic just to get them into remission, so they have a chance."
Wake Forest University Baptist Medical Center. "Arsenic early in treatment improves survival for leukemia patients, study finds." ScienceDaily, 11 Nov. 2010. Web. 2 Jan. 2012.
ScienceDaily (Nov. 11, 2010) — Arsenic, a toxic compound with a reputation as a good tool for committing homicide, has a significant positive effect on the survival of patients with acute promyelocytic leukemia (APL), when administered after standard initial treatment, according to a new, multi-center study led by a researcher at Wake Forest University Baptist Medical Center.
While arsenic trioxide (As2O3) is known by clinicians to be a highly effective treatment for patients with relapsed APL, its benefit earlier in treatment, after first remission, has remained unknown…until now.Researchers with the Cancer and Leukemia Group B, a group of cancer and leukemia researchers funded by the National Cancer Institute, led a study to determine if, by administering arsenic trioxide earlier -- after a patient has finished standard initial treatment and reached first remission -- they could improve survival rates. The results were dramatic.
"Patients with APL can achieve remission with standard treatment (chemotherapy plus ATRA, an oral vitamin A-based compound), but it often comes back," said Bayard L. Powell, M.D., a professor of hematology and oncology at Wake Forest Baptist, principal investigator and lead author on the study. "Arsenic trioxide is then used to get them back into remission, often followed by a bone marrow transplant to try to cure the patient. For this study, we used arsenic as an early "consolidation therapy" after the initial standard treatment to essentially, as one of our first patients described, 'seal the deal' the first time around. Not only did the leukemia rarely return in the patients who received the arsenic, those patients also lived longer."
The findings appear in the November 11 issue of Blood.
APL accounts for about 10 to 15 percent of acute myeloid leukemia cases and presents most frequently in young adults. It is associated with a very high risk of severe bleeding complications, including early death from bleeding into the brain.
Current treatment of APL involves a combination of all-trans retinoic acid (ATRA) plus chemotherapy to induce remission, followed by additional "consolidation" chemotherapy to strengthen the remission, followed by further ATRA with or without oral chemotherapy to maintain remission. This approach yields complete remission rates of about 90 percent and improved event-free survival, with an "event" defined as failure to achieve complete remission, relapse after achieving complete remission, or death.
Those with high white blood cell counts at diagnosis have a worse prognosis, however, with higher risk of early death during initial standard treatment. If they survive initial treatment and enter remission, they are also more prone to relapse, at which point arsenic is introduced to push them back into remission.
While arsenic can be toxic and is used in potent pesticides and poisons, it also exists naturally in the environment and, when manufactured under carefully-controlled conditions and used appropriately by doctors and nurses experienced in the treatment of cancer, can provide a significant health benefit.
Arsenic has been proven effective in pushing those unresponsive to initial treatment, and those who relapse after initial response, into remission. But researchers wanted to know what would happen if they used the arsenic trioxide after initial standard treatment, rather than wait until a patient relapses.
For the study, North American Leukemia Intergroup trial C9710, investigators randomized 481 patients with untreated APL, age 15 and older, into two groups. Both groups would receive standard treatment of ATRA plus chemotherapy, followed by standard consolidation therapy. One of the groups received an additional two 25-day courses of intravenous arsenic trioxide before administration of the standard consolidation therapy.
The patients in the investigational group received arsenic trioxide intravenously for one hour, five days a week, for five weeks, with a two-week break between courses.
After initial standard treatment, both groups experienced similar rates of remission, at about 90 percent, and there were no treatment-related deaths reported from either group during consolidation therapy, indicating that the addition of arsenic treatment earlier introduces no additional safety concerns.
Analysis of the overall results revealed that event-free survival, defined as the time from study entry to first event (defined above), was significantly better for patients randomized to receive the arsenic trioxide consolidation therapy, For example, after three years, event-free survival was 80 percent in the arsenic group versus 63 percent in the non-arsenic group. Arsenic trioxide consolidation provided significant benefit to patients in the investigational group regardless of their initial prognosis based on white blood cell count and other risk factors.
The group who received arsenic also faired better in relapse rates and overall survival, researchers found. Out of 196 study participants who received at least one dose of arsenic after initial standard treatment, only seven individuals -- four percent -- relapsed within three years of follow-up.
"We think people who received the arsenic trioxide after initial standard treatment are likely cured," Powell said. "There have been no relapses in that group after 36 months. The use of arsenic earlier in treatment improves the cure rate and survival, and it does so with little or no additional toxicity."
The results are exciting, Powell said. "It gives us hope that, with the addition of arsenic trioxide earlier in treatment, we may be able to eliminate some of the chemotherapy and reduce toxicities and costs."
However, 19 patients (eight percent) in each group died during the initial standard treatment, Powell pointed out, and those who were randomized to receive the arsenic never got a chance to benefit from it, since they didn't live through the initial treatment.
"One of our next objectives is to reduce or eliminate these early deaths -- most common in patients with high white blood cell counts -- possibly by introducing arsenic even earlier than we did this time, as part of initial induction therapy, to help them achieve remission," Powell said. "Some of these patients are at such high risk that they may need the arsenic just to get them into remission, so they have a chance."
1/2/12 - Post New Year Day
My dear friend, Meth, and her beautiful girls, Abby and Jasmine, came by for a visit today. All 3 girls played so well together and it's always great catching up with Meth. Mason put on quite the show for them (as always!).
After they left, Haylee played with Savannah for a little while. She enjoys it so much and with clinic starting full time tomorrow, I'm not sure how much they will get to play. I'm sure it will all depend on how well she handles the treatment and what time the appointments are. I really have no idea what to expect from these treatments...only what the side effect paper tells me could happen. I'm afraid to Google it, ya know?
Well, nothing much to tell today! That's always good, right??
After they left, Haylee played with Savannah for a little while. She enjoys it so much and with clinic starting full time tomorrow, I'm not sure how much they will get to play. I'm sure it will all depend on how well she handles the treatment and what time the appointments are. I really have no idea what to expect from these treatments...only what the side effect paper tells me could happen. I'm afraid to Google it, ya know?
Well, nothing much to tell today! That's always good, right??
January 1, 2012
HAPPY NEW YEAR!
I ended up getting a tattoo in honor of Haylee...a blue and purple butterfly with an orange leukemia ribbon for its body. Kim and Durena went with me (ya'll are the absolute BEST!). They were good helping me keep my mind off of the pain! Haha!
We went to Cracker Barrel for dinner (yum, biscuits and gravy) then shopped a bit afterwards. We came home, the kids went to bed around 9:30pm and we stayed up and watched the New Year's Eve shows (which were awful this year) and watched the ball drop. Very uneventful and I like it that way :)
New Year's Day, again, was just another Sunday to us. We went book shopping and had dinner at Nonna and PawPaw's house. We made sure we ate our greens!
Haylee has been doing AWESOME! She's pretty much been back to normal (attitude, being mean to Mason, playing with her friends). She had her line caps changed on Thursday and her line dressing changed on Saturday with no problems! We're getting used to the lifestyle change we have had to make.
The end of 2011 was a very trying and emotional time for our family due to Haylee's diagnosis. We have found a way to deal with everything that has been handed to us lately, whether we wanted them or not. We pay more attention to the little things in life, we love a little stronger, and we stay as routine as possible to give Haylee and Mason the most normal lives we can give them at this point. Both of their lives, along with ours, have been completely turned upside down. We have learned to take everything one step at a time. Adam and I take time to be with just each other and we spend lots of time as a family. I've said this before...the road ahead is a very long one. We have many more treatments and hospitalizations coming. The love and support we have received and are still receiving from everyone is so amazing to us. Thank you to everyone, near and far, for everything. We are truly blessed to have someone like you in our lives.
Another fresh new year is here . . .
Another year to live!
To banish worry, doubt, and fear,
To love and laugh and give!
This bright new year is given me
To live each day with zest . . .
To daily grow and try to be
My highest and my best!
I have the opportunity
Once more to right some wrongs,
To pray for peace, to plant a tree,
And sing more joyful songs!
- William Arthur Ward
Learn from yesterday, live for today, hope for tomorrow.
- Einstein
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