"What's It Called Again?": clostridium difficile

October 2010

Fall fun!

I had more and more energy every day as the mono left my body. I was still enjoying speech class and the last few weeks of nice weather. I was able to do school, babysit, and volunteer at the hospital with my usual spunk and energy, even if I got tired around 3:00 in the afternoon. Volunteering in the playroom at a children's hospital in Des Moines on Thursday afternoons was something that I really enjoyed. My shift started at 1:30 and ended at 3:30. My responsibilities included making rounds on the pediatric floors asking kids if they wanted to come up to the playroom or if they wanted anything brought to them. I also held babies who were all alone (one of my favorite duties!), played with kids in the playroom, colored and made crafts, and cleaned toys. Sometimes we were very busy and other times all the kids wanted to stay in their rooms. My volunteering partner, J, was one of the best things about volunteering. She was one of the the sweetest girls I have ever met. She was 100% Italian and very small. She always talked and laughed non-stop. Cleaning the toys was so much fun when we were chatting about anything and everything.

  I still remember the exact day, October 21, when we cleaned toys for two hours straight. There weren't very many kids in the hospital, but there were several big wagons full of dirty toys. Volunteers were required to wear gloves while  using disinfectant wipes to wipe down the toys. J and I made great progress as we talked and laughed. In two hours we had cleaned almost every single toy in the playroom. We gave each other a high-five when the clock hit 3:30 and it was time to go. One of the perks of volunteering was free food from the hospital cafeteria. Volunteers got up to $5 worth of food for free whenever they volunteered. After my shift was over, I would head down to the cafeteria. I usually got an ice cream treat or a frozen lemonade stick and then met my mom outside the hospital. When I got home, my stomach was kind of upset. I took a Tums (which tasted more like candy than an antacid) and didn't think anything more of it. However, my stomach was still upset during next few days, and I didn't have much of an appetite. When I told my mom that my stomach had been upset since Thursday, she said that it was "that time of the year" for stomach bugs. I figured she was right and popped another Tums in my mouth. Over the next few days my stomach got more and more upset and I had completely lost my appetite.

 On Tuesday, October 25, I woke up with a strange feeling. It was unlike anything I had ever experienced. I pushed all my covers off and ran to the bathroom. I then proceeded to empty what seemed like my entire colon into the toilet. Please excuse my bluntness...everybody poops! :) When I recovered, I went downstairs to find my mom who was washing dishes in the kitchen.
"Mom, there's something wrong with me."

I told my mom everything that happened upstairs. By this point I was feeling very hot, dizzy, and sick. We determined that I caught a bad flu bug. I went to the basement to feed my cat, Oliver, and I was taken over by waves of nausea. I quickly sat down and waited for it to pass. I was also burning up. I went to my room and changed into short sleeves. More waves of nausea continued to pass over me, only this time I was freezing so I changed back into long sleeves. I didn't want to eat any breakfast because I knew I would throw it up. I did some school subjects that didn't require a lot of brain work and rested on the couch. I had more diarrhea, dry heaves, and nothing to eat for lunch. Since it was a Tuesday, speech class was in the afternoon, but there was no way I was going to make it. I watched TV on the couch for the rest of the day while sipping on 7up.  That evening, I was watching the Biggest Loser while my parents ate dinner. I got up at a commercial break to go tell my mom something. I had been dizzy all day due to not eating anything, but when I found my mom at the computer I got extremely light-headed. Neon yellow spots were flashing in front of my eyes and then everything went black. I couldn't see or talk at all. I felt myself fall against the wall and slid down to the floor while my mom said, "Sarah?!?" with panic in her voice. When I reached the floor I could see and talk again. My mom was standing over me with a horrified expression on her face, and I burst into tears. My mom later told me that my eyes were open (even when I couldn't see anything), and my face was bright red. For the rest of the evening, my mom insisted on escorting me around the house with both her hands on my arms. I found this slightly irritating, but I understood her motives.

 The next day I ate food, even if it was just a tiny bit, to prevent another passing out situation. I didn't eat much, but it was better than nothing. This "stomach bug" was really tough. My diet consisted of 7up, grilled cheese, quesadillas, macaroni and cheese, applesauce, and crackers. I could barely stand the sight of most food, especially meat and milk. 

Feeling like crap while eating
my graham cracker lunch with
Meghan and her dad, Dan



Wingdarium Leviosa!



 On October 30, my parents and I woke up at the crack of dawn to drive to Iowa City to see my brother, Daniel, receive a scholarship for his efforts in the Hawkeye Marching Band. As was our tradition, we watched the marching band practice before the Saturday afternoon game. My mom had packed 7up and food for me since the vendors around the stadium sell food that made me want to vomit even more than I already did. After the band was finished on the practice field they moved to the rec hall--a warm building used for the marching band's pre-game pep rally. There we met up with my brother's girlfriend, Meghan, and her parents. I munched on my "lunch" of 7up, graham crackers, and some kind of fruit. I felt so awful. The pep rally is always fun so that cheered me up a little bit. After Daniel received his scholarship and left to go to the stadium, we headed back home. Well, we weren't actually going home. Next we had to go to Rachel's band concert at Grand View University. I just wanted to go home where I would be so much more comfortable. After the concert, however, we quickly rushed home to get ready for trick-or-treating. I was planning on handing out candy dressed up as Hermione Granger. Before the little trick-or-treaters came, my mom had prepared one of Rachel's favorite meals: taco chili. The sight and smell of the meat, beans, and tomatoes made me want to vomit so I ate nothing but a Grand biscuit for dinner. 

On November 1, my mom decided it was time to see Dr. S. I didn't think it was necessary to go to the doctor for a "stomach bug", but the appointment was already made and I was going. Dr. S ordered three vials of blood and two x-rays. While I waited for a lab tech to come, I read Harry Potter. The world's sweetest lab tech, S, shortly came in. She called me "Sarah-Belle" and chatted as she drew blood and took me into the x-ray room. The last time I had an x-ray was when I broke my arm in 2003. As my mom and I awaited the lab and x-ray results, Dr. S. also ordered a urine and stool sample. I just about died of embarrassment. I did the urine sample in the office and took a kit home to do the stool sample. All the blood work and urine sample came back normal, along with the x-rays. 

"You don't have any twisted intestines!" Dr. S. said with a big smile. Even though I hated going to the doctor, I had to admit it: I liked Dr. S!

Dr. S. wasn't quite sure why my stomach was upset and my appetite was gone. I had lost six pounds in 11 days that I had been wrestling with my stomach troubles. Dr. S. suggested that we get some probiotic drops to help bring out the good bacteria in my gut while we waited for the stool sample. The next day, we brought that lovely stool sample kit back to Dr. S's office. 

"Can you image having to look at people's poop all day for a living? Talk about a crappy day at work." I said a we drove to Dr. S's office. I then laughed hysterically at my pun all the way to the hospital.

 On November 4, my parents and I were once again on the road to Iowa City. This time we were going to see Daniel perform in the Hawkeye Band Extravaganza--a show featuring all the music from the football season. On the way to Iowa City, my mom's cell phone rang. I was listening to my iPod, but I turned it down when I heard my mom say, "What's it called again?" I had a gut feeling (no pun intended) that it was the result of the stool sample. My mom seemed confused when she got off the phone. She said it was Nurse T, Dr. S's great nurse. 

"You have c.diff toxins." My mom told me. None of us knew what it was, but nurse T had told us that it was a bacterial infection of the digestive track. I was immediately grossed out!


My favorite marching band member!



I forgot about my disgusting diagnosis once we got to Iowa City. We went out for dinner with Daniel, Meghan, and Meghan's parents at one of their favorite restaurants. While everybody else purged on greasy pizza piled with all sorts of meat and other toppings, I enjoyed grilled cheese on rye bread. After dinner we went out for ice cream and then went to the Band Extravaganza. It was great fun; the marching band's music and dancing, along with Daniel's distinct swaying while playing, distracted me from my horribly upset stomach. I couldn't wait to get on some medicine for whatever this infection was. After the extravaganza, we said goodbye to everybody. As Meghan's mom went to hug me goodbye, Daniel joked, "Don't hug Sarah...she has the plague." :)

When we got home, my mom immediately looked up "c.diff" on Google and told me what it was when I woke up the next morning:

*********************************************************************************

Clostridium difficile (pronounced klos-TRID-e-uhm dif-uh-SEEL), also known as c.diff, is a bacterial infection of the digestive track that is found most commonly in hospitals. Bacteria from c.diff is passed in the feces and produces spores that are ingested upon touching any surface or item that contains these spores. Only two types of antibiotics can kill c.diff. Both medicines are known to severely upset the stomach and leave a metallic taste in the mouth. In 2010, c.diff was hardly recognizable. However, it is now considered to be almost a superbug--an infection that medicine cannot treat. 24% of patients with c.diff had a relapse within two months. Severe complications can come from bad cases of c.diff: bowel perforation (a hole in the large intestine due to bacteria), c.diff colitis, toxic megacolon (the colon becomes distended due to inability to expel gas and stool so the colon ruptures), and even death. There are approximately 30,000 deaths a year due to c.diff

*********************************************************************************

I was completely disgusted when I learned about how c.diff is spread. It was clearly obvious where I picked up this terrible infection: the hospital while cleaning toys. I felt even more sick to my stomach when I thought about how much fun my volunteering partner and I had while cleaning toys for two hours straight, a perfect opportunity to ingest bacterium filled spores. I thought the best idea was to sue the hospital, that didn't get very far. Dr. S. prescribed metronidazole (me-troe-NI-da-zole), one of the two antibiotics that treats c.diff, to be taken twice a day for 15 days. There were two nasty side effects: a metallic taste and an upset stomach. I can still taste that metallic taste today; I chewed gum, sucked on Lifesavers, and even brushed my teeth to try to get rid of that awful taste but nothing worked. I took my medicine with breakfast and dinner, along with probiotic drops. My stomach felt absolutely horrendous after breakfast and dinner, due to the side effects and the infection. 

 I thought after I was finished with the medicine, everything would go away! Unfortunately, I was about to be proven very, very wrong. 

TO BE CONTINUED!!!

"Mono Sucks" Part Two

Fall 2010

One of my favorite parts of my new room!

As the trees in Iowa started changing color, students everywhere focused on going back to school. I was looking forward to my freshman year of high school. In addition to the basic subjects, I would be learning French with my mom. Bonjour! Je suis Sarah. I had to take things very slowly at first; sometimes I could only do a half day of school because I was just too tired from the mono. My very flexible and understanding teacher (mom!) was a huge source of support and comfort. I quickly grew tired of laying on the couch and watching TV so my mom was nice enough to play some board games with me. One afternoon, we played Clue for three hours! In addition to feeling tired and weak, mono effected my respiratory system. My ears were so sensitive to any kind of noise. I cried through the hymns at church one Sunday because the organ seemed so loud. Plus, my immune system was busy fighting off the mono so I caught one cold after another.

  September of 2010 brought several fun and exciting things that had been planned before I got mono. I was moving into Daniel's room and completely re-decorating it! My paint colors were "Rose Glory" and "Chocolate Curl". My mom was going to help me with painting anyways, but she actually ended up doing a majority of the work while I layed on the floor and kept her company. Mono was making me very tired and weak. I spent most of my "free time" lying on the couch watching Full House. School wise, I was going to start a home school speech class that was being taught by a mom in our home school group. Painting my room, French, school, and speech class were all keeping me distracted from how I was feeling, but the biggest distraction was coming at the end of September. Before I got mono, my parents planned a mini-vacation to Orlando, Florida to go to the Wizarding World of Harry Potter! I was beyond excited. On days when I couldn't cope with how I was feeling, I would go to the computer and watch videos about the theme park and look at pictures. I couldn't wait to taste the butterbeer and ride all the rides.

 September also brought my follow-up appointment with Dr. S to make sure my spleen wasn't  in danger of rupturing. My dad made a comment the night before the appointment about me not being able to ride the rides at the Wizarding World if my spleen was enlarged. This crushing thought sent me into a panic at the doctor's office the next day. My heart was racing so fast that I had a heart murmur. There was nothing to worry about; my spleen was its normal size! Dr. S asked for an update on how I was feeling when he first saw me.
"Mono sucks." Dr. S replied with a smile when I told him that I had been feeling like crap. He was excited that I was going to Orlando and said that I had medical permission to ride any ride that I wanted!

=)

 As our trip got closer, my mom began to get concerned about my lack of feeling better. I had some energy in the mornings, but it wasn't much. I was still putting full days of school in, volunteering at the hospital on Thursdays, babysitting on Friday afternoons, and going to speech class (which I was really enjoying!) on Tuesdays. Even though I wasn't feeling that much better, I was still determined to go to the Wizarding World. My mom joked that she would wheel me around in a wheelchair if walking around the park was too tiring. I had not been exercising at all since mono struck in August.

Butterbeer!

 Four days before we left for Florida, mom took me back to Dr. S to make sure I was still clear to go on the vacation. Dr. S told us that the mono was probably "75% over" and that I would start feeling better soon. With Dr. S's blessing we left for Florida on September 27. I had SO much fun! The Wizarding World of Harry Potter was absolutely fantastic. I didn't feel tired or weak at all as I burst into tears of joy when I first entered the park, drank butterbeer, explored the castle, rode the rides several times, and shopped in Hogsmead. I was dead-tired at the end of the day, but ready for another fun day in the morning. We went back to the Wizarding World and checked out the rest of Islands of Adventure and Universal Studios before flying back home three days later.I had so much fun that I almost forgot I had mono!

Mono slow me down? NEVER!

 September quickly left and ushered in October. By the middle of October, I was starting to feel like my old self again. I had more energy and got tired later in the day, instead of later in the morning. I was still putting up with endless colds, but at least I had most of my energy back.  I had fought the fight against mono and finished what I thought was the race, but I had no idea that I had only finished the first couple laps of the race...

TO BE CONTINUED!!!

"Mono Sucks" Part One

The Wedding

At the wedding

August 20, 2010: My family (minus brother bear) hit the road very early in the morning to start the eight hour drive to Wisconsin. We stopped by QuikTrip to get some fun breakfast food to eat in the car. Growing up, we took mini-vacations to Wisconsin to visit my Grandpa Burt--my dad's dad--so the long car ride was something that we were all used to. My Aunt Deena (mom's side) let Rachel and me borrow her portable DVD player to watch movies in the car. I also brought a knitting project and the first Harry Potter book...yes...I was re-reading the series after finishing them just two months earlier. Our road-trip-to-Wisconsin tradition always included stopping for pizza at Rocky Rococo Pizza in Madison. Their pieces of pizza were huge and delicious. I always got the pepperoni pizza which consisted of large amounts of cheese, pepperoni, sauce, and grease. After lunch we were on the road again. We eventually made it to our hotel in Heartland, a suburb of Milwaukee. After checking in and refreshing from the drive, we went down to the lobby to meet other members of the family. In addition to a wedding, this was also sort of a family reunion. My dad's other two siblings were coming along with some my dad's nieces, nephew, and their spouses. I was looking forward to seeing my aunts, uncles, and cousins that I had not seen for many years. Every one began pouring in to the hotel as the evening grew closer. We spent most of the afternoon visiting and catching up with all the family members, especially Leda, who we had not met yet! Aunt Pat spearheaded a girls-only shopping trip to the nearby strip mall before we had to get ready for the rehearsal dinner. After we were dressed, all the family members went to the rehearsal dinner at my uncle's (father of the groom) house. The rehearsal dinner was nice--there was lots of food, family, and fun. As the night wore on, my throat began to feel a little sore. I took some Tylenol, grabbed another Sierra Mist, and forgot about it. Back at the hotel, I was having a hard time falling asleep. I usually don't sleep well in hotels, but this time was especially bad. I kept having the same dream over and over and over again. When I woke up from this repetitive dream, I was so angry. I even punched my pillow because I was so mad. Why? I have no idea. Maybe it was because the storm that had been brewing was about to break loose and wreck havoc inside of me.

August 21, 2010: My throat felt like it was on fire. My body also felt like it was on fire. I woke up confused and remembered a night full of strange dreams. It was early in the morning and only my mom was awake, checking her e-mails on the lap top. I crawled out of bed and tapped her on the shoulder. My mom turned around with her usual smile, but I saw worry fill her face as soon as she saw me.

"What's wrong?" She asked.

I shook my head as my eyes filled with tears. "My throat feels like it's on fire, and I'm so hot." I croaked through quiet sobs.

My crying woke my dad up, who was informed by my mom what was going on. I asked for some ice to suck on and Tylenol. While my dad got some ice for me to suck on, my mom gave me some Tylenol and talked about asking Aunt Pat (the world's smartest former nurse. She literally knows just about everything!) where the closest urgent care office was. Dad came back with the ice and Rachel woke up. Today, August 21, was her 18th birthday.

" 'Appy 'irthday" I mumbled through my ice filled mouth.

Goofing off with Rachel

After Rachel was filled in on how I was feeling, we surprised her by giving her the birthday presents we brought from Iowa to Wisconsin. She was so surprised and opened her presents before we went down for breakfast. I felt a little bit better after the Tylenol had kicked in and I ate something. I was feeling well enough to play in the pool with Rachel for a little bit. We had made plans to go have lunch with my uncle, Tom, and cousin, Dottie at Panera Bread. I began to feel awful again as I ate my soup in a bread bowl. After lunch I took a nap at the hotel before getting ready to go to the wedding ceremony. While waiting in the beautiful church for the ceremony to start, I started to feel uncomfortable hot again. August in Wisconsin by itself is extremely hot, and my fever did nothing but add to the heat. It was time for me to have more Tylenol, but there wasn't a water fountain in sight. I have never been able to take Tylenol dry, but it was my only choice. I tried swallowing the first pill, and my efforts resulted in gagging on the rust colored pill and coughing it up, getting the rust colored coating all over my hands. I would have to wait until we got to the reception. The reception was at a huge country club. It was so air conditioned inside the club and it felt great! I almost ran over to the bar and asked for a glass of water to take more Tylenol. While we waited for the bride and groom to finish taking wedding pictures, Rachel and I explored the country club golf course. Rachel offered several times to head back to the club where it was air conditioned, but I was having fun (but burning up) outside on the golf course. The reception started, toasts were given, dinner was ate, and the dancing began. I usually tear up the dance floor with my siblings at weddings, but I was not feeling up to dancing so we went back to our hotel where I put in another rough night's sleep.

In good company on the way home

We headed back to Iowa the next morning after saying goodbye to our family at the hotel. My aunt Pat told me that no one could have guessed that I was feeling so awful. I slept and listened to music a lot on the way home. I couldn't wait to be home and snuggle with my cat, Oliver. The next days would be full of getting Rachel ready to move into her first dorm for her first semester of nursing school. My mom tried encouraging me that I just had a virus that would probably go away. "At least your lips have color again!" She cheerfully said on the way home.

Dr. S and the Diagnosis

Four days later I was still feeling terrible. My sore throat and fever were gone, but I was still tired all the time. My mom came to say goodnight to me one night and I asked her, "What's wrong with me?" My mom then decided to make an appointment with my pediatrician. I didn't even put up a fight; that's how awful I was feeling. On August 26 we met with Dr. S, who had been our pediatrician since Daniel was born. My mom loves to brag about Dr. S who has "never been wrong in over 23 years". Dr. S is a tall doctor who always wears black pants and a white shirt. He has a graying beard and hair and is always smiling and joking. Dr. S asked questions about my symptoms (he seems particularly interested that I had a fever and sore throat that went away), did a brief physical exam, and ordered some in-office tests. I had my finger pricked and a strep test. The blood pressure cuff squeezing my arm is nothing compared to the strep test. I gagged, choked, and cried as the lab tech stuck the swab stick down my throat. My mom and I waited in the exam room for a little bit while the in-office lab looked at my blood work and throat swab. The colors of the exam rooms have always bothered me.  Part of the routine when I see Dr. S is complaining about the colors every time I go see Dr. S. The top part of the wall is mustard yellow and there is a purple and blue border under the mustard yellow. The tile on the floor is white with purple, blue, and green tiles scattered throughout the white. Those colors do not go together!! Dr. S came back into the exam room with the results of the blood work: mononucleosis, a.k.a mono. Mono is a highly contagious viral infection that is passed through saliva. Its symptoms include: sore throat, fever, loss of appetite, fatigue, general discomfort, and feeling ill. My first thought was: Well that sucks. Put me on medicine. Soon I learned the horrid truth: there is no medicine for mono. The only "medicine" is rest, plenty of fluids, blah, blah, blah. Dr. S said I would be dealing with mono symptoms for two-three months. Mono actually enters the blood stream six months before symptoms are presented and leaves the blood stream six months after symptoms are gone.  In addition to all of this, mono can cause the spleen to enlarge and possible rupture. Dr. S wanted me to come back a few weeks to check my spleen. He gave us a info sheet about mono and sent us home. It said on the sheet that fluids, especially milkshakes can help so my mom and I stopped by QuikTrip to get some  milkshakes. I was so tired when I got home so I laid down on the couch. Rachel was moving into her first dorm the next day, but I was going to have to stay home. I drank one of my milkshakes while watching old episodes of Full House.

Yuck! An absolutely awful picture of me on the
day Rachel moved out.

My summer break was coming to a close; I was going to start my freshman year of high school soon. I spent my last days of summer break lying on the couch watching Full House, sleeping, and reading Harry Potter. I told myself that as each day my body was fighting the mono off, I was getting closer to feeling better. I'm almost glad that I didn't know then what was next to come....

TO BE CONTINUED!

Pre-Sick Sarah

Summer, 2010

Me on Easter, 2010, 14 years old

Meet a girl who I like to call Pre-Sick Sarah: 5'8'', 152 pounds, glasses, braces, and short black hair. She had just finished 8th grade--her last school year before high school. She lives with her parents, Paul and Denise, brother, sister and cat, Oliver. She is the youngest of her siblings and is home schooled. Her brother, Daniel, is studying abroad in Buenos Aries, Argentina and her sister, Rachel, has just graduated from high school. Sarah's summer plans include volunteering at the children's hospital in Des Moines, babysitting twice a week, reading the Harry Potter series, getting her braces taken off in July, and welcoming Daniel home from his five month long trip, also in July. In August, a cousin is getting married and Sarah, Rachel, Paul, and Denise are driving to Wisconsin for the wedding.

Pre-Sick Sarah is, of course, me! In case the title isn't totally obvious, the biggest storm I've ever walked through is a mere few months away. Before I can start telling my story, there are several things that I must say:

Daniel after arriving home from Argentina!

Oliver <3

*Pre-Sick Sarah hated going to the doctor, even for just a yearly check-up. I was convinced the doctor would find out that I was going to die in six months. I would get so worked up about going to the pediatrician that my mom would wait to tell me the terrible news that I had an appointment until the day before the appointment. I always viewed this as a backstabbing act. It wasn't that I didn't like the doctor, he was always so nice, but I just really despised going to see him. My heart was always racing around 160 beats per minute and I would sweat. The nurses always made comments about my racing heartbeat as they took my blood pressure--what I then thought was the worst thing that could ever happen at a doctor's office. My medical knowledge and vocabulary was very limited; my main "medical" problem was my teeth. I have had 13 teeth pulled, braces on the top, and four retainers. I was even more (and still am) terrified of the dentist than I was my pediatrician. Rachel was always the sick child of the family: she had chronic ear infections, tubes in her ears, walking pneumonia, swine flu, and a slew of other health problems. Me? My mom called me the "healthiest of all her children". I was very proud of my two-time record at the pediatrician, meaning I had only been to see the doctor twice in my whole life because I was actually sick.

*Pre-Sick Sarah enjoyed working out. I used to whine and complain every time my parents made us go to the gym once a week to work out, but something changed when I was 13 or 14. I found that I enjoyed jogging on the treadmill, riding the electrical bike, and moving to the rhythm of great songs on the elliptical. My mom made a chart for me to track my progress. I went from doing five sit-ups with my mom holding my feet to 60 sit-ups with no help at all! On summer mornings when I wasn't babysitting, I would wake up, eat breakfast, and work out. I ran laps around the garage, kicked a soccer ball around, and jumped rope. I discovered the Jillian Michael's 30 Day Shred and loved doing it so much that I did it on my birthday!

*Pre-Sick Sarah discovered Harry Potter. I first became acquainted with the Boy-Who-Lived through my sister, Rachel, who was reading the books and watching the movies. I decided to give the series a shot after my brother, Daniel, left for Argentina. I fell in love right away. I was completely transported to Harry's world when I read the books. I was at #4 Privet Drive with Harry in his cupboard under the stairs, I journeyed through platform 9 3/4 to get on the Hogwarts Express, and accompanied Harry, Ron, and Hermione on all their adventures. I cried in multiple parts during all the books--especially the seventh book. I sobbed for a good 45 minutes when Dobby died and cried through the last fourth of the book. Little did I know that the story about the Boy-Who-Lived would have so much impact on my life.

Now that you have met Pre-Sick Sarah, I invite you to follow my story through a long, twisting and turning health journey!

Family!