What is the difference between Dandy Walker Syndrome and Hydrocephalus

UPDATE: At the behest of my wife, and she’s right, I am posting that I am NOT a doctor, only a father of a child with DWS and Hydrocephalus. What I’m saying here is what I’ve learned as such, and I have no formal medical training.

As I’ve been a little more active on my blog lately, I’ve noticed that a search term that brings many visitors to my blog is “What is the difference between Dandy Walker Syndrome and Hydrocephalus?” I’ll admit that when I first learned #4 had Dandy Walker, I didn’t know the difference either. Nor did my wife’s OBGYN. He was full of great hope saying that we’d need to outfit our homes for wheelchairs and a life of sadness.

I want to let all who come to this blog know that if you are facing a life with Dandy Walker Syndrome (or a Dandy Walker Malformation) OR with Hydrocephalus, you should not believe all the FUD being fed to you (Fear, Uncertainty, Doubt). You will be rewarded 10 fold for any troubles you experience by your little one. Work through it — they certainly will.

Dandy Walker Syndrome is a scenario where part or all of the vermis is missing. If the whole thing is missing, that’s Dandy Walker Syndrome. If part of it is missing, that’s Dandy Walker Malformation.

Cerebellum

Cerebellum

What does the vermis do? It’s the part of your brain that controls your fine motor and core motor skills. So the ability to correctly articulate your fingers to pick up a dried pea, and the ability to lean to your right or left and not fall over. It is also responsible for eye movement and timing skills. Our son’s neurosurgeon said that when elderly people get a stroke, it’s often in the vermis, and that person has to relearn how to master these abilities again. The human brain is very malleable, and over time it will figure these things out. With developing children, they have nothing to relearn. Their brain just has to identify what it takes to keep their balance while walking/running/leaning/bending/etc. Then it’s done. They need how to control their eyes, just like every other baby. And everyone who has to practice getting timing right (I’m looking at you, junior high percussionists) has to learn how the same way. If you have a vermis, that’s where it’s taken care of. If you don’t, some other part of the brain will step in and take care of it.

So that’s Dandy Walker Syndrome. What is Hydrocephalus? That’s water on the brain (hydro=water cephalus=brain). Hydrocephalus is a symptom and common side-effect of Dandy Walker Syndrome. Not all DWS cases also have hydrocephalus. It can also be a condition resulting from an injury, stroke, etc. So it’s not limited to children.

Where does this water-on-the-brain come from? Where does the water come from?

It’s not actually water, it’s Cerebrospinal Fluid, or CSF. Your brain, my brain, and everyone else’s too has ventricles in it that create CSF. The CSF runs through your brain, your cranium, and then down your spine, lubricating and insulating everything important. Interestingly, it’s also like a little swimming pool for your brain. You know how everything is lighter in the pool? Well, your adult brain weighs 1400 grams. Suspend that brain in CSF and it has a net weight of 25 grams (this gives the brain a neutral buoyancy — it can grow and not be crushed by its own weight). Once it flows through your spine, it radiates out into your internal cavities, and is then reabsorbed by your organs. Daily you and I generate more CSF than we need, so there’s always some being recycled, repumped, reabsorbed, etc.

MRI of CSF flowing. Not my nose.

MRI of CSF flowing. Not my nose.

With Hydrocephalus, the brain is making WAY more CSF than it needs. Hundreds of percent more. The plumbing designed to absorb this cannot handle that flow, and it gets backed up in the cranium (the doctor will tell you about a cyst, which makes you think it can be removed — it cannot). This fluid backs up and creates pressure. In the womb, the cranial plates will expand and the head gets bigger. I guess that happens outside the womb too (I’ve heard some sad stories). So you’ll see a head that is much bigger than it should be. In addition to the big head, the brain inside that head is under pressure. A lot of pressure, and it’s being crushed.

This is where you’re going to see troubles. Even with our son, who is doing fantastic, we can see the effects of this brain crush. The doctors were fast and got his shunt in just days after his birth. He’s 28 months old, but developmentally, he’s between 10 months on some things, 17 months on others, and everywhere in between. Are we angry? Not at all. Are we full of regret? Not one bit.

What’s that shunt thing I said? That’s how you deal with Hydrocephalus. A shunt is placed in the cranium, down into the ventricles of the brain. A drain line is run under the skin, behind the ear, down the neck, down the chest, and into the torso. Then it drains the excess CSF, just like your spine does for you.

Shunt technology hasn’t improved much since it was invented in the 60′s by a plumber who’s child had Hydrocephalus. And shunts have a 50% failure rate. Even our son contracted a meningitis staph infection and had to have his first shunt yanked just a month after it was in. He’s now be using his second shunt for over two years. He’s going to have a shunt for the rest of his life, unless some new treatment for Hydrocephalus is found.

How can that be found? Research. Time. You can help! Participate with one of the Hydrocephalus walks in your area. They’re all over, and they’re annual. Raise funds. Those funds go towards that research. That’s how we can eventually find a cure. I’ll be posting about the next walk here in Utah when it gets closer (September).

By the way, now that you’ve read this, you should know that September is National Hydrocephalus Awareness month. Blue ribbons and shunt drain lines are appropriate for display.

So there you go, that’s the difference (as I understand it) between Dandy Walker Syndrome and Hydrocephalus. Let me know if you have any questions, or I have any data wrong. BTW–I got the images from Wikipedia.

The State of #4 (as of today)

So as you might be able to tell from past posts, if you’ve read them, I blog most when I’m in pain.  When things are going well, I don’t feel the need to vent.  Many have asked for an update, and I feel bad that I haven’t provided one in some time.  The thing is, we had a few good weeks, and when things went south, I’ve spent just about every free minute either at the hospital or taking care of my kids at home.

Nevertheless, here’s an update.  With pics. Continue reading

This last chapter ended with a climax!!

Ok, so I’ve not blogged about Festus and Natalie for a while.  It’s been kinda busy, kinda stressful, and I’ve not really spent my free time at the computer.

I’m sitting in Nat’s hospital room, she’s recovering, but not as well as I want.  Festus is come and gone, his name replaced with the one he’ll be known with: [edited] #4.  He’s downstairs and across the bridge at Primary Children’s Hospital.  Natalie is in the University of Utah Hospital. Continue reading

I’ve had weekends that were more funner

Don’t get me wrong. I’m not complaining. I don’t want to sound like things aren’t good, aren’t positive, and that we’re not blessed. We are blessed. I just wanted a more….relaxing weekend.

We went in for a checkup with the neonatal specialists on Friday. It was determined that the amniotic fluid around Festus is low. It should be between 10 and 20 cubic centimeters, and he’s floating in only 8.

What causes this? Well, amniotic fluid is just fetal urine. He gets blood, nutrients, and fluids from Mommy through the placenta, processes it, and his kidneys produce urine. So if it’s low, they check bladder, then kidneys. Both are 100%. They check umbilical cord, it’s 100%. Then the problem is likely with the placenta.

The placenta is fetal material, which I didn’t know. It’s from the baby, not the mommy. If baby has a developmental problem, the placenta might too.

What’s the risk of low amniotic fluid? I don’t know them all, but one that our doctors are worried about it crushed umbilical cord. They checked the flow through his umbilical cord, and they essentially checked his blood pressure. I know! His blood pressure! So Natalie has to have Non Stress Tests twice a week where they can see if Festus is having a good ‘trace response’ heart rate. So far he’s doing fantastic.

It’s determined that we’re going to deliver by Caesarean section and the date set is October 13th. My sister is born on that day, and she’s agreed to share the date that she’s enjoyed for so many years now on her own.

That will be week 37, which is almost time to pull the baby out of the oven. To be sure his lungs are fully baked, Natalie was given two steroid shots to jump start that process.

On the day (Saturday) of the second steroid shot, she was flush. They checked her blood pressure. It was high. I had spent the morning laying sod at a Habitat For Humanity project in Springville, and was planning on going to Authorpalooza at Barnes & Noble to meet Brandon Sanderson and Dan Wells. I called Nat to let her know I finished the house project, and was going to the book store. She then called me back a minute later and said (I’m paraphrasing), “You need to come get Noah — they’re hooking me up to tests — you need to stop at home and get a diaper — I need you here — you need to come to the hospital.” I-15 is under construction, so the speed limit is 55. When I pulled out of Springville, I was doing 55. My mind was racing with possibilities. The biggest one was that her messages were changing mid-sentances, and the plan (going in for a steroid shot) had taken an unexpected turn. By the time I reached the 1600 N exit, I had visions of her being life-flighted to the U of U, and my speedometer said I was doing a little over 85 MPH.

When I got to the hospital, it was clear I was prepared for defcon 3, and I was incorrect. What had happened is this: when Natalie showed up for her steroid shot, she was flushed and they checked her blood pressure. It was high. So they said they were going to hook her up to the fetal monitor and it was going to take longer than expected. Noah was with Nat, and he was poopy and she hadn’t brought a diaper. Natalie had called to tell me this, but as nurses are want to do, once you think you have all the information, they spout off lots of instructions and information that you want to hear, so Nat was distracted with me.

So….we sit there for TWO AND A HALF HOURS. Grrrrr. When it’s all done, they need to get a 24-hour urine sample from Nat, and they don’t think she can pee three liters in 24 hours (I knew she could). It turns out Festus is fine, but her BP is higher than the Dr. wants. So he says bedrest. Duhn Duhn Duuuuuuuhhhhnnnn!!!

*sigh* As the Saturday plods onward, we cut to evening. Festus has been moving fantastic this whole pregnancy. Kicks, punches, elbows, stretchings, twistings, etc. Saturday night, he kinda….stopped. We started counting how long it took to get to 10 movements. A week ago, it took 10 minutes at best. Saturday night it took 40. I didn’t like that.

Sunday morning we had Nat eat some sweet cereal, and have a bit of ice cream. She lay on her side and we counted. Again, he wasn’t performing like he did. I kinda freaked out. It was Sunday, and it would be impossible to reach any of the neonatal specialists or Dr. Young. I started calling Primary Childrens, asking if it would be better to take a mother up there or deliver down here and transport a primi baby. Turns out they actually have a newborn recovery unit that would do it. Huh. I like knowing that. I spent a little bit of time trying to reach people to ask what to do. All the signs I knew to look for were telling me that Festus wasn’t doing well. Orem Community puts me on hold and then tells me Dr. Young says to come on in.

I grab the ward list so I can call people and tell them we’re not going to be in church. We get shoes on the kids, and we’re off. They hook Nat up again, and check her BP again. It’s still high. I look at the monitor, and I see that Festus’ heart rate is kinda flat. It’s up where I want it (150-153), but it’s flat. You want to see peaks and valleys — they call it a reactive tracing. It means the heart rate is fluctuating. If it doesn’t, then the baby is in stress. Natalie sends me out because I’m not a calming influence on the situation. I step out with the kids to make some phone calls about church (organ, primary program, Natalie’s sunbeam class, piano for primary). My oldest and I had a good conversation about why were there, what it means for Festus, what it means for Mommy, and why Daddy is a cry baby when his family is in duress.

After some time, the nurse comes out and says while I was absent, Nat’s BP actually went down (a fact that she’s going to delight in sharing for a long time), but it’s still high. Festus is doing fantastic, despite our concerns. I’m welcome to come back in.

After I left, Festus had a good reactive trace pulse, and things are great for him. He’s not making the same big movements because he doesn’t have room. So rather than kicks and punches, we’re looking for knee shifts and elbow adjustments. They’re glad we came in, and want us to come back as much as we need to. Mommy and Festus are home, all is well, all are prone and resting.

Nat starts the NSTs this week, and she’s now on strict bed rest. She doesn’t like that, I don’t blame her. We meet with the neurologists on Wednesday, and they’ll have a lot of answers for us, plans, and time lines.

When we first found out about Festus, it was a stressful week or two. Then the stress abated a bit. It was still there, but not making me sweat for no reason. The closer we get, it’s been building, but it’s like some kind of horror movie where every time the actor looks away and back again, the evil monkey toy has inched forward a bit. My monkey is not evil, and he’s inching forward a little every day. This past weekend, the stress ratcheted up a whole lot. We’re still blessed, still happy, still looking forward and positively. I just wish the muscles in my neck and back would stop constricting all day and night for no reason.

I wrote most of the blog before today, and wanted to wait until I had an update from my wife before publishing. I have that update now.

After her 24-hour urine test, it’s determined that she has preeclampsia. You can read about it on your own. See if you can find one of the articles that tells you the mother can die from it in 1 out of 100,000 cases.

Is it raining? Or are rocks just falling from the sky? It sounds like its pouring out there.

An update on Festus 4.0

A lot of people read my last post about our next child.  For those who have, here’s the latest:

We had an echocardiogram done, and it blows my mind that they can do such a test on an unborn child.  The doctor basically dismissed the VSD, saying that it doesn’t look like any kind of a threat.  Also, (at the time of the test) his heart is the size of a thumbnail.  So a tiny leak in the membrane between the two ventricles would be the size of a pin hole.  And it’s not going to get bigger.  The pressure between the two chambers was equal, and if the leak was a problem, one would have a greater pressure.  By the end of the visit, the doctor said that anything that might be wrong with his heart is not his challenge.

Which takes us to his challenge.  The working model is Dandy Walker.  The part of his brain that is not developed is the vurmis.The CerebellumWhat does this mean?  What does the vurmis do?  I’m told, those are both great questions, which science cannot answer.  The only one who can answer is Festus, and that, when he gets here.  We won’t know what his challenges will be until they are challenges.  Kinda scary, but honestly, really encouraging.  We’re hopeful and I can’t wait to hold him.

Hit me up with questions.  I would SO prefer people knew what was up than people guessing or getting second-hand news.  I promise, I won’t withhold anything if I trust you.

Which reminds me to say–to all the many people who have loved, cared, prayed, fasted, thought of, and otherwise supported us through this, we love you.  More than you know.

Thank you!

I had no idea it was that bad

I’ve been wanting to write this post for a week now.  It’s been on my mind; I have been deliberating on what to say, what to share, how to say it.  I feel like at most, maybe two, possibly three people read this blog.  What do I want to say to that tiny audience?  I don’t think I want to point my blog to that audience, I want to write for the world to read, even if it doesn’t.  So what do I tell the world?  Do I stomp my feet and shake my fist at it?  Do I scream about injustice and cruelty?  Do I claw at the blind, yet all-seeing eyes of the world and wish I could cause it pain for what I’m feeling?  Or do I just weep while I change my son’s diaper and tell him over and over that I love him.

My children are so valuable to me.  I love them more than anything, my wife excluded (she wins).  My children are the most intelligent, sweet, and loving children I’ve ever met.  They’re my children, so they’re not all that athletic.  They don’t see Dad doing anything physical, he just works and reads.  So they do the same.  They go to school and read.  They’re reading years beyond their age level, and they don’t even notice. At the birthday party

As my oldest is becoming more and more self aware, she seeks opportunity to help out with the other kids, tries to assume burden from my wife, and offers kind words of support at the most appropriate of times.

My second is still somewhere between a toddler and a little girl, so she’s looking to her mother and older sister for direction on how to be so gracious.

My son is…well…two and a half.  So he’s loud, impatient, and I wouldn’t have him any other way right now.  :)

For those who don’t know (and how could you?  I don’t blog!), we are expecting our fourth child.  We went in for a gender-revealing ultrasound last Tuesday.

Pardon me, but if you don’t know me, you need to understand this: I am a medical practitioners nightmare.  I ask SO many questions about the instruments, I ask SO many questions about the tests, if I’m left alone, I’ll actually play with the instruments, I will play with the models, I will read what they’re typing (discreetly), I’ll ask them about their education, the list goes on and on.  It’s all about how I deal with stress.  I need to ask questions to feel at ease.  I need to know a little of what they know to feel like I have an understanding of what’s going on around me.  Understand, I know a lot.  And that’s on purpose.  I need to feel like I understand the world I live in.  I need to know why things happen, how they happen, and what happens next.  I have a layman’s understanding of a lot of science, more than a bit of psychology, physics, biology, mathematics, computer programming, I have dabbled in real estate investing, mortgage and investment vehicles, I am pretty good at games, puzzles, riddles, and I read an awful lot about lots of things, factual and fictional.  So when I’m in a hospital, I’m usually looking for anything that is foreign to me, or isn’t what I’m expecting.  So I can ask about it.

Ok, so we’re at the ultrasound.  The doctor is out of town, but my wife scheduled the ultrasound with the sonographic technician because we were at the right week and could find out the gender.  We took the kids along so they could share the experience.  It’s a boy!  Yay!  And then we explore the rest of the body, doing measurements and visual checks.  Here’s his brain, his heart, his legs, feet, hands, face, etc.  It’s all standard procedure.  Then I notice the technician is back on the brain, then the spine.  Then the brain, then the spine.  She’s slowly going through the brain, top to bottom, back to top, back to bottom.  Then she’s going to the spine, middle to the top, slowly.  Back to the brain.  Then she’s all done, and towels off the goop from my wife’s belly and says, “Well, we’re going to have you meet with a specialist.  A neonatologist.  Have you ever been to a neonatologist?”  We both said no, and I said, “Why are you sending us to meet with a specialist?”  “Oh, there’s something a little different on the back of the brain.”

The little people in my head that raise and lower the red flags are very fast.  And the wind was making the flags just snap and flap like there was a Beaufort 10 on the horizon.

So we shuffle the family out into the end of the hallway where you make your next appointment with the doctor.  The receptionist says, “Ok, so we’re going to be making an appointment for you with the neonatology specialists at Utah Valley Regional Medical Center, correct?” and she picks up the phone and dials.  She’s verifying names and dates and whatnot, and then asks, “And what are you going in for?”  I say, “something different on the back of the brain”.  She repeats that into the phone, then looks back at us and says, “Ok, but what are you going in for?” I repeat, “something different on the back of the brain,” and my head is rifling through my memories of the copy of Gray’s Anatomy I had as a child, trying to think of what could be different on the back of my future son’s brain.  The receptionist repeats it again into the phone, and then asks, “Right, but what is different?” Slightly flustered, I snap, “That’s all she said!  She wouldn’t tell us, go ask her!”  I’m trying not to freak out, but I’m feeling tunnel vision start to close down on me.  She gets up and goes to talk to the technician.  When she comes back, she picks up the phone and mumbles two words that made absolutely no sense so paired, “absent cerebellum.”

Suddenly the red flags stop blowing in the wind, and the flagpoles just collapse, crashing to the ground.  We stammer and mumble through the courtesies, my wife turns to me and says, “don’t you freak out,” and I tell her I won’t.  I can’t because I know she’s going to lose it, so I’ve got to be strong.  I push away all emotion and embrace logic.

As we’re walking back to the car, Natalie starts crying, and I’m trying to remember what the cerebellum is responsible for, and how can you possibly survive without one?  All I can come up with is you can’t, and this is surely not a viable fetus.  The moving arms and limbs we saw in the ultrasound must be just the random firings of a developing brain, like electrical impulses coming off a biological battery or something.  Natalie is falling apart, and I’m on the edge.

When we get home, she’s trying to pull herself together, and I’m going to stay in control and do something to the effect of ‘figure it out’.  My son needs his diaper changed, and I go upstairs in the hall with him to do so.  As I’m fastening his new diaper on, I look at him, and imagine what it’s going to be like in four months when we deliver a stillborn child and start to cry.  He stands up and hugs me.  While he’s hugging me my breath catches and he feels my chest hiccup.  He is learning how to laugh when others do, and he thinks I’m laughing so he chuckles.  I love it.  When he leans back to see if he was right, he sees I’m actually crying, and starts to ask, “Happy now?”  He keeps asking whether I say yes or no.

So that’s Tuesday.  It feels like a year ago.  The appointment with the neonatologist was originally set for next Wednesday, which is two days from today.  I called up and expressed my dissatisfaction with the appointment being so far out, and they agreed to fit us in Friday morning.  It actually was a pretty cordial conversation.

Natalie and I had some pretty deep conversations about what the worst-case scenarios would be.  You can imagine them for yourself.  We determine that we can survive such a situation and will do our best to do so with our heads held high and making the best of it.  Anything less than the worst-case scenario would be better, and we would do our best to handle that outcome as well.

Days later, and many shell-shocked stares into space, while conjuring up the most horrible scenarios you can muster from the depths of your brain, we are finally meeting with the specialists.  I’ve done all the layman’s internet research I dare do, and think that the technician was looking for signs of spina bifida because she was looking at the brain and the spine a lot, and one sign of spina bifida is a misdeveloped cerebellum, and an unfused spine at the top of the spinal column.  A friend from work showed me a site about Joubert Syndrome (I’ve thought of linking to sites with research and foundations for spina bifida and Joubert Syndrome, but that was back when I was thinking of what to blog about).  Natalie is enjoying a good hour and fifteen minutes of ultrasounds and they are checking EVERYTHING with great detail and precision.

Festus' profile

I ask about the lemon or banana sign (indicators for spina bifida) and I’m wrong.  I ask if the doctor is familiar with Joubert syndrome, and she is.  And this is not Joubert Syndrome.

She says we’re probably looking at Trisomy 18, or Edward’s disease.  At the time, this meant little to me.  She went on to explain that there are a number of symptoms for Trisomy 18, and Festus (the name for our children until we name them) is not displaying most of them.  What he does have is a VSD heart defect and an under-developed cerebellum.  She knows we were told it was absent, but it is not indeed absent, only under-developed.  She goes on to say that Trisomy 18 babies often don’t make it to delivery, and those that do don’t usually live more than a month.  The other possibility is that we’re looking at an isolated heart defect and an isolated brain development issue, which would mean that Festus has Dandy-Walker syndrome and a heart defect.  There are a number of indicators for that, and I won’t go into them all.  The doctor tells us the difference between screening tests and diagnostic tests, and there is a diagnostic test that we can do to test for Trisomy 18, an amniocentesis.

We meet with a genetics counselor, and she’s very nice (very tall too), and she retells much of what the neonatologist said in common English.  We talk about odds, likelihoods, possible outcomes, etc.  We talk about the risks behind an amniocentesis, and Natalie and I decide to have it done.  There are two kinds of tests they can do with an amniocentesis, one with quick results (FISH) and one with very definitive results that takes longer.  We opt for both.

So, if Festus has Trisomy 18, we may never get to hold him, and we won’t get to see him grow up.  If he does not have Trisomy 18, then he does have Dandy-Walker, and he will very likely be born, and grow up.  He could have no symptoms at all, or he could be very severely developmentally retarded.  Or anything in between.  I think I’m eventually at peace with both.

The weekend then comes and there are a few expressions of concern at church.  We haven’t told anyone in the neighborhood, but Natalie has alluded to concerns on Facebook because she’s got to vent some of the pressure in her head somewhere.  There are a lot of people in our ward that are her friends, and a couple people ask out of concern.  We’re trying to keep it on the DL because we feel conspicuous already, and there is a big part of me that is pretty angry.  Other parts of me are hurt, scared, sad, frustrated, and confused.  I don’t really want ANY of them to be seen.

NOW–Today.  Monday.  The FISH results would be back Monday or Tuesday, and we email the genetics counselor to call me on my cell with results rather than call Natalie at home.  She replies that the results will be in this afternoon and she’ll call.  Awesome!

At 4:00 she hasn’t called, and I ask Natalie to give me her number so I can call.  I need to know.  I would rather them say the results will be here tomorrow than to wait.  I call, leave a voice mail.  I call again, don’t leave a message.  I called again, didn’t leave a message.  I clock out at 4:45 and decide I’m going to drive over to the hospital and ask for someone to give me the results.  As I’m pulling into the parking lot, the counselor calls me!  The news is good, and we are 98.3% sure that Festus does NOT have Trisomy 18.  The full results will be back next week, and then we will be 99.5% sure.  This lab has never had the full results differ from the FISH results.

I realize as I’m going home that I’m doing 60 MPH on Bulldog Avenue.  I can’t get home with the news fast enough!  This is fanTAStic news!!!!  This is the best news I’ve heard in years!!!

When I get home, we are excited, we’re crying, we’re laughing, we’re celebrating.  I decide we’re going to go out and finally buy some clothes for the boy (a tradition we’ve done for each child upon knowing the gender — which we delayed because we didn’t know if we were going to bring a baby home or not — no baby, no need for an outfit), go have dinner with the family, and go visit the temple for FHE.

My son needs a diaper change before we go, and as I’m sitting on the floor in the hall, with my two girls sitting next to me, and I finish doing up the new diaper, I start laughing.  I just can’t get over how great this news is!  And less than a week ago I was in the same place, crying for the loss of my future child.  Now I’m laughing.  And that’s where I realize I had no idea it was that bad.  I was so ready to lose him to Trisomy 18. And when I realize that my son having an under-developed brain is a blessing and 100% better than I was thinking just an hour previously I have to laugh.  I could not be happier.

It is going to be tough.  This will be unlike any of our previous pregnancies, to be sure.  But I’m going to have another son.  And I’ll get to know him, and raise him, and be his father.  I will get to bathe him in love, and wrap him in my arms both physical and spiritual.  I still want to curse you, world, but that’ll come another day.

I called the bishop to tell him the good news (I don’t think bishops get good news very often late at night), and I said to him, “We’re not out of the woods yet, but a whole lot of the forest was just chopped down”.  In fact, I think a nice space has been cleared out for a cabin, maybe a picnic table.  This might not be so bad after all.

Let it here be said, and let it so be recorded: I love my wife, I love my children.  I am a blessed man.