December Labs, Biopsy Results and a Partridge in a Pear Tree

Hello,

Here we are in December, and 6 weeks out from my last lab work.  I’ll cut right to the chase.

12/4/14 Lab Work

The liver enzymes and CK have returned to normal.  The LDH is mildly elevated; it was normal in October and 659 in July.

ALT – SGPT (8-45 IU/L)  = 25

AST – SGOT (2-40 IU/L)  = 26

CK (29-168 IU/L)           = 67

Aldolase (<7.7 U/L)       = 3.3

LD Total (125-220 IU/L) = 356 (H)

In mid-November, I saw my Dermatologist about my skin.  She took a few scrapes as well as a biopsy of the skin on my decollete.  Only a few stitches, no big deal.  The results came back as steroid-induced acne, which is a bitch.  It is a rash of tiny bumps that sting and hurt, and don’t go away.  

I’m on a new lotion called Clindamycin, which is an antibiotic.  I’m also on another month of twice-daily horse-pill antibiotics.  I’m praying that this finally does the trick, as I’m truly worn out dealing with it.  It does seem to be helping so far, but time will tell. Thank goodness it’s scarf season… although it’s creeping its way up my neck and jawline, so I may need to invest in a nice paper bag at some point.

Since Dermatomyositis and my related medications seem to be making my already delicate skin hyper sensitive, I am having skincare allergy testing done in the New Year.  Hoping that can shed some light on any particular ingredients that may be aggravating my condition.

It’s been a tough couple of months.  The initial fatigue that I felt in October has progressed to extreme weakness in my upper arms and legs.  I have really been struggling with the day to day activities.  I’m working on a new graph, but I think that this has been a trend, that I feel worse in the aftermath of my numbers spiking.  I’m guessing that my Fibro kicks into high gear, and I also think that the LD inflammatory marker may carry much more weight than we originally thought.  This may be our marker to watch.  I’m really looking forward to talking to my Rheumatologist at my next appointment.

We’ll have to see how I feel after the holidays, and if my labs hold before we can continue our conversation about Maybe Baby.  I am starting to feel a little panicked after feeling so awful lately.  I struggle with fears that I’ll never be in a position to be off of my medication for over a year.  We have been referred to a specialist who works with high risk pregnancies and moms with medical conditions.

I am so grateful to spend this holiday season with my darling little family.  We have already enjoyed some truly special time with our extended family and dear friends.  I feel so blessed to have so many wonderful people in my life… pups and kitties, too! 

No matter what struggles we face, there is joy and just so much to be thankful for each and every day.  A grateful life is lived by choice and with intent.  It doesn’t mean that I am not allowed to feel sad, or get upset, but that I remember to return to a place of peace and gratefulness each day.  This isn’t always easy, but it’s worth it… all the best things are!

Thank you for your continued support and love.  Wishing you and yours peace, health and happiness this holiday season and in the New Year!

Maren

P.S.  I recently helped Ben’s Friends by making a video to thank our donors!  

It’s my big-screen debut … and I wouldn’t mind it being the last, but I’m so glad to help out an organization that has meant so much to me!  

If you would like to donate to Ben’s Friends Patient Communities, click here!

Hello! 

Late as usual, so we’re back within par for my blogging habits.  Grab a cup of coffee, this is a long one.

April’s labs were all very positive although I had been struggling in the beginning of the year.  Fast forward to June, I was ecstatic – I felt the best that I have in 4 years!  I felt better than I have in longer than I can truly remember.  Awake, alert, in less pain, more energy and best of all, I felt more alive.  These were all things that I would hope to feel with the great lab results like I had in April.

Immediately I start thinking of Maybe Baby.  Should I begin tapering off my medications so that we can try?  This is what we have been waiting for, right?  After some soul searching and a discussion with my Rheumatologist, we decided to let me enjoy what it feels like to feel good for the summer.  My rheumatologist also said that she’d like to follow my labs a little more while I felt “good” so that we can learn more from them if they spike again.  You may remember that aside from my inflammation that showed in my MRIs and muscle biopsy, the common inflammation markers were not very clear within my labwork. 

Brad and I both felt good about this decision and wasted no time enjoying the summer and taking advantage of the gift that we had been given.  Well, June and July were a huge learning experience for me, full of important reminders and a few slaps back to reality.  While I did feel really great, that this is all relative for a person like me.  This was something that after four years of learning to pace and care for myself was quickly forgotten in a month or two of excitement.  For example, I am used to getting about 10-20 minutes of activity in before I know that I need to stop and take a break, to avoid a flare.  “Feel-great” Maren decided that she felt good enough to skip breaks and after two months of just powering through is now back to where she started. 

Ugh!!!  I brought it on myself.  After months, years of not being able to just do things when I want to do them, I was chomping at the bit to get all kinds of projects done.  I wanted to finally walk my dogs every day, get outside, see my friends and family.  After not having an appetite for months, I wanted to eat all my favorite things, drink beer and just get out and have fun.  The most valuable lesson here is that no matter how great you may feel, “Everything in Moderation” is truly a statement to live by, and for a person like me this rule cannot be broken. 

August brings another [hopefully the last] small foot surgery to remove the wart from hell.

September arrives and I am right back where I was at the beginning of 2014.  Son of a!!

At my appointment in late July, I was just starting to feel the effects of my summer bender.  My lab results came back with an elevated LDH. However, Dr. Grandits said that she had been seeing issues with this test and wanted me to recheck just to be sure. 

If the LDH comes back high again, this is actually something to be positive about.  Since my DM markers haven’t always been right on, it’s been difficult to read my labs, and predict or anticipate any flares.  If the LDH is high again, this may be our “flare” marker to watch! 

Late July Lab Work: 
No liver, kidney or blood cell count abnormalities.  Muscle enzymes are normal except the LDH returned quite high. 

Due to a paperwork error, I actually never got my lab results in time to get rechecked before SURPRISE, you have Lyme Disease!  Yes, you read that correctly!  After a weekend of being sick as a dog with a sore neck and stiff, sore knees to boot, I crossed my leg and saw the tell-tale “Bulls-eye” mark on my calf.  Apparently the marking can be seen within a month of being bit.  The symptoms that I was feeling were in line with the 3-4 week marker. 

I did need to stop taking my MTX for 2 weeks while the Doxycycline did it’s job tackling the Lymes. 

Lyme Disease "Bulls-Eye" marking please forgive my hairy legs

I was actually relieved that it was Lyme Disease, since a common complication with myositis is Dysphagia, which is difficulty swallowing due to a lack of muscle strength in the throat and neck.  This is something that can really take a turn for the worse and in severe cases, even create a need for a feeding tube.  Scary stuff.  The Myositis Association reports that dysphagia occurs in nearly 1/3 of myositis patients.

I had already been on mega antibiotics for 2 weeks (prior to going to the ER) to help control my perioral dermatitis (not eczema as previously diagnosed), so I believe this is why the hospital results came back clear.  WooHoo!  What did not come back in the clear was my CRP, or C-Reactive Protein, which was rather high.

9/28 ER Lab Work:

CRP (0.0 - 0.8 mg/dL)     =1.4

About the antibiotics that I was already on continue to be on…

My skin condition has taken a turn for the worse, and the Triamcinlone cream that I usually use on my hands, can no longer be used on my chest or behind my ears because it’s beginning to break down my skin.  I have tried a million different creams for the area around my mouth and while they may work for a little while, the little red, itchy bumps always return. 

So, for an entire month (I’m halfway there) I am on antibiotics and I am to only use Free & ClearShampoo and Conditioner and Vanicream Soap for my hair and body.  Free & Clear Hair Gel if I need to style my hair.  I already use ultra-sensitive Cerave and Cetaphil on my face.  Also, try to use minimal makeup.  For any rashes that appear from the chest up, I am using Sodium Sulfacetamide Lotion, and yes, it is made with sulfur it does smell like farts.

Perioral Dermatitis

Folliculitis

These photos are mortifying, however I know that there are quite a few readers of this blog who also have dermatomyositis, and if they make someone else feel better about their skin condition, then that is what is most important. 

The new cream wiped out the dermatitis on my face right away, although it got much worse before it got better.  Then, it tackled the area behind my ear, and now it’s working on my chest, which I want to rip off right now because it itches so badly.  Thank God I work from home and can be a hermit hiding in sweatpants rather than scare people off with my living Halloween costume.  Hoping that this crap is on it’s way out!

So here we are, October 30^th. Other than my itchy skin, I have been feeling pretty good!  While my muscles have been weak, I have not been painful or sore.  I get tired easily, but I’m not in pain.  This is great for me!  

I saw my rheumatologist last week and left with some exciting news for my husband.  Dr. Grandits suggested that we try reducing my methotrexate (MTX)!  Now, this would be a very slow process of a 1 pill reduction of the regular 10 for the 3-6 months, then reduce by one more pill for 3-6 months, etc.  (My pharmacist goofed and gave me the pill form MTX last time and I was actually excited.  If I don’t have to take that damn shot, I’m a happy camper.)   Anyway, I went home and talked to Brad about it, and we decided to do it!  That would be one step closer to Maybe Baby.  I started to feel excited, like I was really helping us move forward to that time.

Today however, I got my lab results and am feeling a little defeated.  I haven’t had labs that looked like this in a while, and it has me on edge.

10/24 Lab Work: 

The labs show the muscle enzymes are elevated, the CK, aldolase and AST.  Surprisingly the LDH is normal, it has always been high in the past.  The muscle enzyme elevation may be related to the infection you had in the interim.  Lyme infection can cause myositis.  Will see if this corrects.  I would continue taking the methotrexate for now.  Other labs show a mild increase in the inflammation markers (sedimentation rate, c-reactive protein).  The blood cell counts are normal.  The Lyme testing is negative.  I would suggest rechecking the muscle enzymes in 6 weeks.

AST – SGOT (2-40 IU/L   = 50 (H)

CK (29-168 IU/L)               = 1427 (H)

Aldolase (<7.7 U/L)         = 11.2 (H)

Lyme Screen                      = Negative

Sedimentation Rate
(<22 mm/hr)                      = 22 (H)

CRP (<0.50 mg/dl)            = 0.59 (H

So, where do we go from here?  I guess just get to the next lab appointment in 6 weeks to see what is happening in my body.  Hold my head up and keep going.  Pray for strength so that my fears don’t interfere with the amazing life that is mine each day. 

Kiss my dogs and enjoy being able to spend my days working with them snuggled in by my side.  Hug my husband, my best friend and partner in life, my biggest supporter.  Dress up like Babe the Blue Ox this weekend and have fun with my friends.  And, not forget to take my rests when I need them.  J

Will update in 6 weeks when the new labs are in. 

XO, Maren

Spring Update - Super Late!

Hello there,

So, the last time I checked in with lab work, etc., I was convinced that taking my weekly Methotrexate (MTX) injection with ice cream was going to solve all my problems (not really, but that is my incredibly brief synopsis from the last post).  Well the ice cream trick didn’t make it to a second try, I also quickly remembered why I took the shot at night in the first place, because sometimes it makes me feel sick which is something I would rather experience at the end of the day.

Then, I was feeling sad about the figurative use of the word “orphan”.  I have been around and around with where I’m at with my Dermatomyositis.  It’s this crazy-ass disease that I loathe, yet I’m thankful for the lessons that it has taught me, and the positive changes that have come into my life because of it.  I’m a different person than I was 4 years ago.  My life is so different, but I’m better because of it. 

So without further ado, my recent lab work and all health status.  I’ll get into the nitty gritty after getting the numbers out.

4/29/14

Labs are good.  No liver, kidney or blood cell count abnormalities. 

LDH is now normal after being abnormal since 2010.

Anti-nuclear antibody has increased to 1:640

Thyroid and B12 are both normal.

No systemic inflammation detected.

Blood serum saved to test remaining antibodies.

5/5/14

Remaining antibodies all normal.

5/14/14

MRI report for left proximal arm received. 

No inflammation found.

Previous cyst seen at the subscapularis tendon of left shoulder has shrunk (15 x 6 mm to 2 x 2 mm)

5/17/14

MRI report for cervical spine received.

There is an area of mild degenerative change at the C6-C7 disc caused by degeneration.  There is no pinching of the spinal cord or exiting nerves.

No abnormal signal in the spinal cord suggesting an abnormal lesion such a Multiple Sclerosis (MS).  

If symptoms continue to occur, it’s recommended that I see a neurologist.

The first couple of results are from my regular 3 month check-up with my Rheumatologist.  2014 got off to a rough start and mid-February through mid-May was the worst.  For the first time in my experience with DM, I had intense weakness that came on suddenly and nearly caused me to fall.  Thankfully, I was at home for the majority of these incidences, and when out and about I either had a shopping cart to slump over, or my husband to act as my cane. 

I also noticed increased weakness in my upper arms and thighs, a trademark DM flare indicator.  I struggled with stairs, with drying my hair, folding laundry; the usual suspects.

Both my regular doctor and rheumatologist were very concerned about this, but no one more than me.  As a moderator for the myositis group over at Ben’sFriends, as well as a member of several myositis support groups on Facebook, I am painfully aware of the struggles that my fellow DM patients face.   I know that I am one of the lucky ones. 

After checking a few extra labs that may explain the weakness, my rheumatologist ordered an MRI to check my arm for inflammation.  She also ordered an MRI of my spine to rule out a pinch, inflammation or any lesions (associated with MS) on the spinal cord.  The concern was that there could either be some overlap (MS or other connective tissue disease).  Since my last MRI had been 6 months ago, with such a rapid decrease in strength, the culprit could be a demyelinating lesion or transverse myelitis, both of which can cause a very rapid deterioration of the spinal cord, resulting in sudden loss of strength as I had been experiencing.  Thankfully, it appears that my symptoms were due to neither.

Thank God.

I can’t quite explain what has been happening with my weakness, although I know that I am not alone, as many of my friends within my Myositis support groups go through these flares as well.  My best guess is that after being sick for so long, that my muscles have atrophied and what I have been feeling as “DM weakness”, is really just weakness from being physically weak. 

I asked my Rheumatologist if I would ever get my strength back.  She said that it is all dependent on how badly the muscle cells were damaged when inflamed.  Some patients will never gain back any strength greater than when the myositis was flared.  Some patients will go on and build back muscle and get stronger.  Other patients may gain some strength back, but almost be a combination of the two previous examples, if their damaged cells are surrounded by healthy cells that can rebuild and grow.  Either way they road to recovery is a slow and often frustrating one. 

Both of my doctors have once again recommended that I begin a swim therapy class and some type of core strengthening program and I’m ready to take the plunge (sorry for the terrible pun, I honestly couldn’t think of anything else to say).  It’s been so hard to get going.  

I have been so weak that it has been beyond discouraging to get moving.  It’s hard to feel the momentum of your activity when you can only make it half a block and back and then need to lay down.  Baby steps though!  I’m ready to make a change and get back to a healthy place physically.  Especially since my labs tell me that I’m good to go!

In other efforts to get myself to a healthy place, I have been looking into the Auto-Immune Protocol (AIP) Diet.  I’ll dive into this a little further after reading my first book, but wanted to put that out there.  More on this to come in an upcoming update.

Lastly, and seriously least, my skin. 

The little bumps that I previously mentioned delightfully spread to my chest, jawline, back of neck and side of mouth.  It’s called folliculitis and it sucks.  Well, apparently the part by my mouth is called atopic dermatitis(aka eczema) and it also sucks. 

These skin conditions are often caused by a weakened immune system and inflammatory skin conditions, to which DM fits the bill for both. 

 

• Previously, I was using a combination of Triamcinlone Acetonide Cream USP 0.1% (hands), and Cloderm Cream 0.1% + Desonide Cream 0.05% for the spots on my face and chest. 

• Now, when I notice symptoms I’m using the Triamcinlone for my hands, arms, chest, jawline and neck.  For all of the previously mentioned except the hands and arms, I first apply Clindamycin Phosphate Topical Solution USP 1% to fight off any possible bacteria.  The application is for one week, twice daily and it’s gone on the last day.  I’m also using the Clindamycin Phosphate wash for the area by my mouth followed by Protopic Ointment 0.1%, same schedule.  For the hands and arms, I just apply the Triamcinlone as needed.

The creams and wash do seem to help, but then it’s only a matter of days or a week before the signs return and the application regimen begins once again.  I’m not going to lie; I know that it could be so much worse, but this skin stuff really stresses me out.  I feel so vain.  I guess my skin’s appearance is more important to me than I realized. 

One thing that has helped is to spend time with people who know what’s going on with me, so I don’t feel like I have to explain.  I suppose this is something that I have learned about myself in general with my health.  It’s so much easier to know that the people around you understand and support you.

Oh crap.  My foot. 

The past 6 months have included 5 laser treatments, a small surgery, 2 shots of Bleomycin (a chemo drug), a “burn & scrape”, and most recently a few rounds of freezing.  My dermatologist thinks that it’s finally gone, but wanted to be sure, so he froze it and I nearly flew off the table.  My foot is SO tender, since we’ve gotten down to the very bottom of this beast, I nearly karate-kicked him in the face last week when he hit it with the cold stuff.  I so hope that jerk (my wart, not my dermatologist) is gone.  I’m not sure I can take any more hits on this flipper of mine. 

I just had another appointment last month (July) but I am still waiting on a copy of my labs.  I’ll post that update in the next week or so!  

Have a wonderful week!
Maren

Being an Orphan... Disease, that is.

You learn something new every day.  

I read an article today about company working on new drugs for Polymyositis and Dermatomyositis patients.

You can read the article here.  

In this article I stopped after reading the following, "Both polymyositis and dermatomyositis have been designated as orphan diseases by the U.S. Food and Drug Administration (FDA)."  An orphan?  I'm an orphan?  No one wants to be an orphan, and the use of this word as an adjective for my disease doesn't give one a warm fuzzy feeling.  

I wish that I had a better resource to site, but regardless, The Wikipedia states that, "An orphan disease, is any disease that affects a small percentage of the population."  This is mostly due to the correlation of rare diseases and a the lack of treatment, resources and even the severity of the condition.  Awesome.  

No one wants to be an orphan.  When I browsed some definitions of the word, I came across this (Dictionary.com):  "A person or thing that is without protective affiliation, sponsorship, etc."  Now I understand why this term is giving me such a bad taste in my mouth.  No one wants to be alone.  No one wants a disease that changes their life forever.  No one wants said disease to be one with little to no awareness, treatment, funding, resources, research or options in general; the list goes on.

I know that I have said it before here and I'll gladly say it again.  One of the hardest parts about getting a diagnosis, any diagnosis, is that period before you learn that you're not alone.  This is why when someone tells me about a friend that just got diagnosed with <insert rare disease here>, one of the first things I say is to make sure that they find others that share their diagnosis.  It's often said that there is strength in numbers and this is true when staring a new diagnosis in the face.   

No matter how much your family and friends love you and support you and research what you are going through and listen and hug you, they still don't understand what it feels like to go through what you are experiencing with your diagnosis.  Now, this doesn't mean that others with your condition know exactly how you feel and you're the exact same person, no.  But they know the disease, and they know that feeling of just learning that you're an orphan.

It's my hope that in my lifetime, the Myositis family can drop the label of "Orphan".  I do not wish for more than 200,000 people in the US to experience this disease, but I am hopeful that we can have more research, more treatment options, more awareness.  Since the myositis diseases are rare, it's my guess that when awareness and education increase, so will the number of those diagnosed.  However I feel that more people diagnosed is better than more people suffering without a diagnosis.  So, if the numbers climb with awareness, I guess that is okay to me. 

Ben's Friends, (the online patient community that I belong to) recently got their 501c3 status approved.  This is exciting to me, as this will bring new opportunities to the site and awareness to the growing number of rare diseases represented.  Currently, nearly 40 types of rare diseases have a place to call home there; it's members can be supported and ditch that orphan feeling.  Increased awareness can also lead to increased funding and to more research.  These are all things to be very excited about.  It's just the beginning, but it's a very promising one!

Thanks for listening to today's deep thoughts from Maren.

  
If you liked this post, share the Ben's Friends site with your friends and family, or on your Facebook page.  You never know who may be quietly searching for someone who understands.  Acute Disseminated Encephalomyelitis (ADEM), Addison's Disease, Crohn's Disease, Erythromelalgia, Guillain-Barre Syndrome (GBS), Lupus, Lyme's Disease, Multiple Myeloma, Nephrotic Syndrome, Sjogren's Syndrome and many more.  They're all there! 

You never know who's life you could change by simply giving them the power of numbers.  

www.bensfriends.org

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Greetings from my personal Snow Globe!

Hello there, 

Apparently another 7 months has gone by!  I'd like to refer to the saying, "Time flies when you're having fun," although I feel like it's more fitting to say that, "Time flies when you make the mistake of blinking."

I write today from my little igloo, 2 feet of snow in my driveway and a husband out of town.  My brother in law will be here to plow a path for me later today, but for now I just enjoy some couch time with the pups and a lovely view.

The photo doesn't even do it justice.  It's sparkling and magical.  

Each snow covered branch, even the tiniest twig is glowing under the sunlight.  

I feel so lucky to be able to enjoy such an incredible display.

On that note, I will cut right to the chase!  The holidays were wonderful, but I barely managed to keep my health in check.  I was exhausted beyond my control, but I survived with a handful of memories for our new home and was still able to thoroughly enjoy the season.  

At my most recent appointment I was in a panic over increased fatigue in my upper arms and thighs and slightly labored breathing.  As per the norm though, my labs came back showing nothing alarming.  A terrible cold the following week relieved me of my fears that my lung function was in jeopardy.   If in the next few months my strength doesn't improve, we'll do another MRI or even a biopsy to be sure there isn't something going on under the surface. 

Recent lab work:
No liver, kidney or blood cell count abnormalities.  LDH is high.
The immune tests show the ANA remains positive, the titer is down to 1:160 from 1:640 so less activity which means medications are working.
The remaining antibodies and the complements are normal.  The inflammation markers show a normal sedimentation rate, which in my case this has always been normal so it does not help us determine how I'm actually doing. 
The C-reactive protein is elevated and does fluctuate with the disease symptoms, it can also be up for other reasons like a sinus issue (which I was just beginning to experience at the time of this blood draw).

I also had a check-up with my Dermatologist in the past month.  The appointment couldn't have come at a better time as my arms were in a full flare for her to see. Oh goody!

Dermatomyositis (DM) is very similar to Lupus in that it can not only bring the beloved Gottron's Papules which I have shared before, but a slew of skin reactions to various and often random things.  

Most recently I have been reacting to hair products, causing blister-like bumps around my hairline and on my neck.  I have also gotten horrible tiny sores on my forearms from hand soaps and even ultra-sensitive face moisturizer.  So weird.  

A quick side note: I almost forgot to tell you about my little friend... yeah right. This friend is an A-hole who goes by the name of "Wart" and he will not get the hell off my foot.  I have had 3 laser treatments and even a small surgery to remove him, but with the immune suppressants that I take, he will not go away!  He laughs at banana peels, duct tape, and salicylic acid.  I could cry.  I just want a damn pedicure.  Hopefully he will be gone by my next update.  

Because of the increase in skin symptoms, I have decided to go back to the injectable Methotrexate (MTX) since I now know that it is better absorbed into the system.  
To [hopefully] avoid the shot anxiety that I had before, I have established a new routine for shots.  

1. Replace ice pack with popsicle or ice cream bar to attempt to form a positive connection to shot time.  If this doesn't work, then I guess it will help me to not eat so many popsicles and ice cream bars.  LOL
2. Move shot day to Monday so I can still drink on Sunday if I want to.  Is more explanation needed?  Haaha!
3. Take shot in the morning to get it over with so I don't spend the entire day dreading it. 

So far, so good!  I have a few weeks under my belt and I am not freaking out quite yet!

My Dermatologist also gave me another topical cream to apply to the sores that I have been getting on my face.  It's called Desonide 0.05% and it works like a charm!

For DM friends, I wanted to share that Cetaphil Gentle Skin Cleanser followed by CeraVe Moisturizing Lotion have really helped to sooth and as well as avoid any issues.  I also use the new Cetaphil Gentle Skin Cleansing Cloths to remove makeup.  

Currently Cetaphil's Gentle Cleansing Bar and Aveeno Baby Soothing Relief Moisture Cream has been working for my body.

If things continue or get worse, my Dermatologist said that we can do some official skin allergy testing, since some preservatives and aromas can aggravate auto-immune skin conditions.  I have found though, that if I just stick to my beloved Aveda hair care products, that the reactions around the hairline subside or are eliminated completely. 

Aside from rashes, a few sores and a little panic, I'm doing pretty great.  Might not sound like it, but you probably know by now that I wouldn't lie to you.  I have been so damn busy that I haven't had too much time to focus on my symptoms; so although my body hasn't been feeling great, I have been able to move my focus elsewhere, which is a good thing.

In case you needed a laugh today, I recently Googled something related to "Dermatomyositis" and when I switched over to the images offered, this is what I saw... 

I never realized that Hypertrichosis was a symptom of DM (It's not, Mom - I'm kidding!) but apparently if my current job doesn't work out, I may have a future in the "Bearded Lady" business.  

Look for me in a circus ring near you! 


Hope that you're all safe and warm today.  As always, thank you for supporting and loving me.

Maren