Quietly Freaking Out - Lung surgery

Saw the Urologist today. It was the one month post op check.

I had my left kidney out on Sept. 6.

I had a pet scan 2 weeks ago. I have a 1-1/2 cm nodule in one of my lungs.

The doc says that the scan shows no cancer activity but, he says, the nodule should come out.

I guess this is being discussed by a tumor board (of doctors) next week. He says that I am young (54 years old), and that he feels confident this surgery will be approved.

My lymph glands are clear. He says to take the nodule out is to make super sure they got everything.

Now the freaking out part.

Could someone just kind of calm me down? I'm not scared to have another surgery. He said it was an easy surgery.

Is it an easy surgery? Could someone tell me what to expect?

I have anxiety. I am not chicken to do it. I can do it, I just have the nervous stomach right now. I found out about 3:00 p.m. I don't know why it's hitting me now.

Any advice, ANYTHING - I appreciate. TALK TO ME!

 

Comments

  • cran1
    cran1 Member Posts: 139
    Well Hand I do not have much

    Well Hand I do not have much to offer you in terms of knowledge of mets. Alls I can say hang in there. I freak out too sometimes when I think about not making it to my boys high school graduation. I'm sure tomorrow Texas will be on to give you some valuable data. 

  • handpuppet64
    handpuppet64 Member Posts: 29
    cran1 said:

    Well Hand I do not have much

    Well Hand I do not have much to offer you in terms of knowledge of mets. Alls I can say hang in there. I freak out too sometimes when I think about not making it to my boys high school graduation. I'm sure tomorrow Texas will be on to give you some valuable data. 

    Yeah, I'm just working thru

    Yeah, I'm just working thru an anxiety attack.

    I told the doc I didn't really remember much about the nephrectomy. I am reading info on how it is to get these nodules out - it's an easy surgery. The doc said it's easy.

    I didn't panic when I had the kidney out. I don't know why it's happening now. It's a quiet type of panic - I'll be o.k. I'm trying to visualize things like tropic islands and doing deep breathing.

    I appreciate your comapny, cran1. Your kids are cute. I have a 13 year old and a 23 year old. I just had the 23 year old talk to me like I was an idiot and he told me to calm down (he did so nicely).

     

  • handpuppet64
    handpuppet64 Member Posts: 29
    cran1 said:

    Well Hand I do not have much

    Well Hand I do not have much to offer you in terms of knowledge of mets. Alls I can say hang in there. I freak out too sometimes when I think about not making it to my boys high school graduation. I'm sure tomorrow Texas will be on to give you some valuable data. 

    Yeah, I'm just working thru

    Yeah, I'm just working thru an anxiety attack.

    I told the doc I didn't really remember much about the nephrectomy. I am reading info on how it is to get these nodules out - it's an easy surgery. The doc said it's easy.

    I didn't panic when I had the kidney out. I don't know why it's happening now. It's a quiet type of panic - I'll be o.k. I'm trying to visualize things like tropic islands and doing deep breathing.

    I appreciate your comapny, cran1. Your kids are cute. I have a 13 year old and a 23 year old. I just had the 23 year old talk to me like I was an idiot and he told me to calm down (he did so nicely).

     

  • cran1
    cran1 Member Posts: 139

    Yeah, I'm just working thru

    Yeah, I'm just working thru an anxiety attack.

    I told the doc I didn't really remember much about the nephrectomy. I am reading info on how it is to get these nodules out - it's an easy surgery. The doc said it's easy.

    I didn't panic when I had the kidney out. I don't know why it's happening now. It's a quiet type of panic - I'll be o.k. I'm trying to visualize things like tropic islands and doing deep breathing.

    I appreciate your comapny, cran1. Your kids are cute. I have a 13 year old and a 23 year old. I just had the 23 year old talk to me like I was an idiot and he told me to calm down (he did so nicely).

     

    That's funny my 7 yr ole

    That's funny my 7 yr ole daughter talks that way to me all the time! When I get bent outta shape I good drink sets me right. Not sure if you drink though.

  • handpuppet64
    handpuppet64 Member Posts: 29
    cran1 said:

    That's funny my 7 yr ole

    That's funny my 7 yr ole daughter talks that way to me all the time! When I get bent outta shape I good drink sets me right. Not sure if you drink though.

    Maybe I should start.
    The 23

    Maybe I should start.

    The 23 year old - he gets this look in his eye . . . there she goes again.

    I probably could use a few glasses of wine. I don't know - he was telling me last night, "MOM, nothing can be as bad as the nephrectomy . . . "

    He's right. Truthfully, I don't remember that entire week, really.

    I don't know why I am freaking out over the lung nodule - I was really panicky last night. I am o.k. now, it's weird.

    One thing I notice about the posts on this board is, everybody has a kind of "what the heck . . ." attitude. I guess that's the way to be.

    Before and after the nephrectomy, they were giving me shots of diladud and I had these dreams that giant lemurs were throwing mud at me. These giant lemurs had eyes that glowed.

    You probably don't want to talk to me anymore, after that bit of too much information (TMI).

    Maybe I have to learn to quit taking life seriously. Maybe the gian lemurs reprented cancer? Who knows?

  • Djinnie
    Djinnie Member Posts: 945 Member

    Maybe I should start.
    The 23

    Maybe I should start.

    The 23 year old - he gets this look in his eye . . . there she goes again.

    I probably could use a few glasses of wine. I don't know - he was telling me last night, "MOM, nothing can be as bad as the nephrectomy . . . "

    He's right. Truthfully, I don't remember that entire week, really.

    I don't know why I am freaking out over the lung nodule - I was really panicky last night. I am o.k. now, it's weird.

    One thing I notice about the posts on this board is, everybody has a kind of "what the heck . . ." attitude. I guess that's the way to be.

    Before and after the nephrectomy, they were giving me shots of diladud and I had these dreams that giant lemurs were throwing mud at me. These giant lemurs had eyes that glowed.

    You probably don't want to talk to me anymore, after that bit of too much information (TMI).

    Maybe I have to learn to quit taking life seriously. Maybe the gian lemurs reprented cancer? Who knows?

    I am sorry you have certainly

    I am sorry you have certainly had a lot to deal with! I should think you were experiencing some delayed shock, you were suddenly on overload. That is probably what your dream was about, you must feel you have had so much thrown at you! and you probably weren't freaking out so much at the lung nodule but at the whole issue! 

    I know that Danbren has had a lung op so maybe she can give you some advice! When it comes down to the metal we are all scared, everyone has a melt down from time to time. You will get through this though! If you get anxious again, there is always someone on here to talk you through it! All the best:)

    Djinnie x

  • twinthings
    twinthings Member Posts: 409
    Keep Calm

    I know you must be scared silly and rightfully so!  I would be too!  But, try to look at the bright side.  Yes, I said there's a bright side.  It sounds to me like you are getting excellent care from doctors who are on top of their game.  What a blessing that is! 

    If you are familiar with my story, then you know I have a doctor with a less than aggressive attitude who considers me 'healed' because my cancer was removed.  God forbid I should have mets to the lungs (I'm not implying you have lung mets), I'd probably not know till it's too late for treatment, thanks to his laid back way of thinking. So, knowing is half the battle! 

    You will find the strength and courage to fight this battle, just as you did when initially faced with kidney cancer.  I am a firm believer in, what doesn't kill us makes us stronger.  And, if you believe in God then you already know, if He brings you to it He will bring you thru it! 

    So, keep your chin up, keep calm and keep thinking positive thoughts.  I have two 28 year olds (hence 'twinthings') one of which is a boy.  One thing I know for certain, if your boy is a mama's boy like mine is, he will say and do just about anything, even if it's stupid, just to make me feel better and calm my fears.  Gotta love those mama's boys!!

    Keep us posted and I'll keep you in my prayers!

  • handpuppet64
    handpuppet64 Member Posts: 29

    Keep Calm

    I know you must be scared silly and rightfully so!  I would be too!  But, try to look at the bright side.  Yes, I said there's a bright side.  It sounds to me like you are getting excellent care from doctors who are on top of their game.  What a blessing that is! 

    If you are familiar with my story, then you know I have a doctor with a less than aggressive attitude who considers me 'healed' because my cancer was removed.  God forbid I should have mets to the lungs (I'm not implying you have lung mets), I'd probably not know till it's too late for treatment, thanks to his laid back way of thinking. So, knowing is half the battle! 

    You will find the strength and courage to fight this battle, just as you did when initially faced with kidney cancer.  I am a firm believer in, what doesn't kill us makes us stronger.  And, if you believe in God then you already know, if He brings you to it He will bring you thru it! 

    So, keep your chin up, keep calm and keep thinking positive thoughts.  I have two 28 year olds (hence 'twinthings') one of which is a boy.  One thing I know for certain, if your boy is a mama's boy like mine is, he will say and do just about anything, even if it's stupid, just to make me feel better and calm my fears.  Gotta love those mama's boys!!

    Keep us posted and I'll keep you in my prayers!

    The onocologist told me that

    The onocologist told me that there is low cellular activity in the lung (based on the PET scan) and not to worry about it.

    The urologist is the one who is bringing my case to the tumor board and saying the lung nodule is to be removed.

    I left the onocologists office feeling cured. Now I do not.

    My husband had this - we were both railroad workers in the early 1980s. Over the years, many of his friends have died very young - stomach, kidney, esophogheal cancer.

    I am wondering if I was exposed to something carcinogenic.

    My husband had his kidney removed and was disease free for 180 months, then it spread to his pancreas, then he had the whipple procedure, then he had clean scans for 6 weeks, then the cancer spread rapidly and there was nothing they could do.

    so what I am saying is - the onolcolgist's position for my lung nodule was to leave it alone.

    Now, on this web site, I am reading, that scans are not always accurate. Then, the urologist tells me, scans - are not always accurate.

    I have a 13 year old daughter. I told the urologist - GET THE NODULE OUT.

    So I'm going to get the lung nodule out.

    My son's thing is he heard what the onocolgoist said, and in his young mind, all is well. I told him last night, -- that's not how it played out with your father.

    I was a basket case when my husband was going thru this. Now, strangely enough, I am functioning better.

    I do want to say, based on the findings - the urologist said, I was very close be being classified stage 3, why I wasn't given "targeted therapy." I'm not a doctor, but I can read, you know what I am saying?

    Well, yesterday, the urologist started explaining to me about targeted therapy and such.

    Now, I think your cancer, when they found it was early, and I think that's a good thing, but I certainly understand your position on and your concerns with your doctor. Sometimes, I have asked a doctor a question - sometimes I think I get a patronizing answer - you really have to be educated and watch for cues.

    I do think - 100 years ago - if this was happening to me, I'd be gone already (to heaven).

    So it's good the medical knowledge has evolved, but I think they put a "formula" to many patients - where your cancer measuers this size - we did surgery, "boom, you are cured."

    I'm trying tokeep  busy and not think about things.

    Thank you for support,I'll take it. I appreciate it.

     

  • GSRon
    GSRon Member Posts: 1,303 Member

    The onocologist told me that

    The onocologist told me that there is low cellular activity in the lung (based on the PET scan) and not to worry about it.

    The urologist is the one who is bringing my case to the tumor board and saying the lung nodule is to be removed.

    I left the onocologists office feeling cured. Now I do not.

    My husband had this - we were both railroad workers in the early 1980s. Over the years, many of his friends have died very young - stomach, kidney, esophogheal cancer.

    I am wondering if I was exposed to something carcinogenic.

    My husband had his kidney removed and was disease free for 180 months, then it spread to his pancreas, then he had the whipple procedure, then he had clean scans for 6 weeks, then the cancer spread rapidly and there was nothing they could do.

    so what I am saying is - the onolcolgist's position for my lung nodule was to leave it alone.

    Now, on this web site, I am reading, that scans are not always accurate. Then, the urologist tells me, scans - are not always accurate.

    I have a 13 year old daughter. I told the urologist - GET THE NODULE OUT.

    So I'm going to get the lung nodule out.

    My son's thing is he heard what the onocolgoist said, and in his young mind, all is well. I told him last night, -- that's not how it played out with your father.

    I was a basket case when my husband was going thru this. Now, strangely enough, I am functioning better.

    I do want to say, based on the findings - the urologist said, I was very close be being classified stage 3, why I wasn't given "targeted therapy." I'm not a doctor, but I can read, you know what I am saying?

    Well, yesterday, the urologist started explaining to me about targeted therapy and such.

    Now, I think your cancer, when they found it was early, and I think that's a good thing, but I certainly understand your position on and your concerns with your doctor. Sometimes, I have asked a doctor a question - sometimes I think I get a patronizing answer - you really have to be educated and watch for cues.

    I do think - 100 years ago - if this was happening to me, I'd be gone already (to heaven).

    So it's good the medical knowledge has evolved, but I think they put a "formula" to many patients - where your cancer measuers this size - we did surgery, "boom, you are cured."

    I'm trying tokeep  busy and not think about things.

    Thank you for support,I'll take it. I appreciate it.

     

    Handpuppet.. I just re-read

    Handpuppet.. I just re-read your last post and went holy crap..!  You worked in or around the rails..??. geeesh.  For those that do not know, those steel train wheels on steel tracks wear and give off what is called "rail dust."  Rail dust can be airborne for some distance, not sure how far. In the car biz, that rail dust eats through car paint... the particles rust..  Imagine what damage that can do if inhaled or injested..? 

    Ron

  • handpuppet64
    handpuppet64 Member Posts: 29
    GSRon said:

    Handpuppet.. I just re-read

    Handpuppet.. I just re-read your last post and went holy crap..!  You worked in or around the rails..??. geeesh.  For those that do not know, those steel train wheels on steel tracks wear and give off what is called "rail dust."  Rail dust can be airborne for some distance, not sure how far. In the car biz, that rail dust eats through car paint... the particles rust..  Imagine what damage that can do if inhaled or injested..? 

    Ron

    I called an attorney

    I called an attorney yesterday for a claim against the railroad.

    I started working in the railroad yards when I was 22. I only worked there 4 years. My husband had 30 years in.

    I only found out I had kidney cancer on Sept. 6. I'm still processing all this - including how'd my husband and I get the same cancer ? ? ? ?

    And I know what I'm in for.

     

     

  • NanoSecond
    NanoSecond Member Posts: 653

    I called an attorney

    I called an attorney yesterday for a claim against the railroad.

    I started working in the railroad yards when I was 22. I only worked there 4 years. My husband had 30 years in.

    I only found out I had kidney cancer on Sept. 6. I'm still processing all this - including how'd my husband and I get the same cancer ? ? ? ?

    And I know what I'm in for.

     

     

    Be careful

    I realize you may be in shock and confusion over all this. But I would hate for you to add the additional stress of a lawsuit on top of more pressing health concerns.

    There are only a few "officially recognized" risk factors that are thought to lead to kidney cancer.  The most prominent is if you were a heavy (or light) smoker.  Another is exposure to Agent Orange.  Considering these kinds of factors it makes perfect sense to assume that exposure to other airborne carcinogens (such as Rail Dust as pointed out by Ron) or other toxic substances might also be high risk factors (as there sure seems to be a lot of kidney cancers amongst fire-fighters and other "first responders").

    Still, I suspect that you will have a very tough time "proving" what actually caused your or your husband's RCC.  And, in the end, who would really "win" in this kind of case?  I suspect only the lawyers.  They always get paid no matter what.

    Regardless, the most important thing that you (or any of us cancer fighters) can do is to reduce our stress level as much as possible.  Acute stress releases at least 3 hormones vital to the "flight or fight" response: Cortisol, Adrenaline, and Epinephrine.  They are life-saving when deployed in the short term.  But if that acute stress becomes chronic (long term and sustained), these hormones can also promote tumor proliferation.  In particular, always remember that Cortisol weakens the immune system.

    And remember that there is hardly anything more constantly stressful than a prolonged lawsuit.

  • handpuppet64
    handpuppet64 Member Posts: 29

    Be careful

    I realize you may be in shock and confusion over all this. But I would hate for you to add the additional stress of a lawsuit on top of more pressing health concerns.

    There are only a few "officially recognized" risk factors that are thought to lead to kidney cancer.  The most prominent is if you were a heavy (or light) smoker.  Another is exposure to Agent Orange.  Considering these kinds of factors it makes perfect sense to assume that exposure to other airborne carcinogens (such as Rail Dust as pointed out by Ron) or other toxic substances might also be high risk factors (as there sure seems to be a lot of kidney cancers amongst fire-fighters and other "first responders").

    Still, I suspect that you will have a very tough time "proving" what actually caused your or your husband's RCC.  And, in the end, who would really "win" in this kind of case?  I suspect only the lawyers.  They always get paid no matter what.

    Regardless, the most important thing that you (or any of us cancer fighters) can do is to reduce our stress level as much as possible.  Acute stress releases at least 3 hormones vital to the "flight or fight" response: Cortisol, Adrenaline, and Epinephrine.  They are life-saving when deployed in the short term.  But if that acute stress becomes chronic (long term and sustained), these hormones can also promote tumor proliferation.  In particular, always remember that Cortisol weakens the immune system.

    And remember that there is hardly anything more constantly stressful than a prolonged lawsuit.

    NanoSecond,
    I appreciate your

    NanoSecond,

    I appreciate your wisdom.

    It doesn't cost former railroad employees any money to do this. I like the distraction aspect of it.

    I have a 23 year old son, he told me EXACTLY what you are saying now.

    I am getting the contract from the lawyer in the mail and I am going to read it carefully.

    I'm just considering it.

    I like what you said about stress. That's true. My husband died of kidney cancer in Dec. 2007. He was my whole life. I find my situation - well, strange. I may not sound rational at times, I appreciate your common sense approach. I may chuck the whole idea - I do want to read the contract from the lawyer.

    Your probably right - it's just that the urologist told me about removing the lung nodule yesterday - and the railroad idea kept my mind off the lung nodule, if that makes sense. It only did for a while because I had a panic attack late at night.

    I'm just processing and figuring it out. Thank you for your level headedness - thank you.

     

  • handpuppet64
    handpuppet64 Member Posts: 29

    NanoSecond,
    I appreciate your

    NanoSecond,

    I appreciate your wisdom.

    It doesn't cost former railroad employees any money to do this. I like the distraction aspect of it.

    I have a 23 year old son, he told me EXACTLY what you are saying now.

    I am getting the contract from the lawyer in the mail and I am going to read it carefully.

    I'm just considering it.

    I like what you said about stress. That's true. My husband died of kidney cancer in Dec. 2007. He was my whole life. I find my situation - well, strange. I may not sound rational at times, I appreciate your common sense approach. I may chuck the whole idea - I do want to read the contract from the lawyer.

    Your probably right - it's just that the urologist told me about removing the lung nodule yesterday - and the railroad idea kept my mind off the lung nodule, if that makes sense. It only did for a while because I had a panic attack late at night.

    I'm just processing and figuring it out. Thank you for your level headedness - thank you.

     

    More . . .

    Isn't that the beauty of these discussion board because I am looking for answers or maybe somebody to talk too (heck I need somebody to talk too), and you can get a friend out there who knows what you are going thru?

    If you know me long enough, I do obsess over things, I had my 23 year old son tell me that last night "QUIT OBSESSING," which is hard becuase I get a feeling that our roles are changing as well as my own life plan.

    I dont' think cancer is fair. I don't think I am getting my full life. I think we have to live each day to the fullest. Hell, I am procesing and obsessing - will try to get busy doing something.

     

  • NanoSecond
    NanoSecond Member Posts: 653

    More . . .

    Isn't that the beauty of these discussion board because I am looking for answers or maybe somebody to talk too (heck I need somebody to talk too), and you can get a friend out there who knows what you are going thru?

    If you know me long enough, I do obsess over things, I had my 23 year old son tell me that last night "QUIT OBSESSING," which is hard becuase I get a feeling that our roles are changing as well as my own life plan.

    I dont' think cancer is fair. I don't think I am getting my full life. I think we have to live each day to the fullest. Hell, I am procesing and obsessing - will try to get busy doing something.

     

    More...

    I am very pleased that you found my comments helpful.  What is interesting is that I did not for a moment consider that your engaging in a lawsuit might - just for you and just in this particular situation - actually work to reduce your stress.  If that were true then I might change my advice and say "go for it".

    It truly should be about what we can do to reduce stress whenever possible.  Being fully engaged in an activity is certainly one way to do that.  So, if your motivation is not dependent on the outcome of the case, it might very well prove to be therapeutic.

    Regardless, it is always a good idea to first take your time and think very clearly about what it is you hope to achieve in any legal proceeding.

     

  • GSRon
    GSRon Member Posts: 1,303 Member

    More...

    I am very pleased that you found my comments helpful.  What is interesting is that I did not for a moment consider that your engaging in a lawsuit might - just for you and just in this particular situation - actually work to reduce your stress.  If that were true then I might change my advice and say "go for it".

    It truly should be about what we can do to reduce stress whenever possible.  Being fully engaged in an activity is certainly one way to do that.  So, if your motivation is not dependent on the outcome of the case, it might very well prove to be therapeutic.

    Regardless, it is always a good idea to first take your time and think very clearly about what it is you hope to achieve in any legal proceeding.

     

    Not clear

    Sorry I should of been a bit clearer in my comments..  I was thinking about your lung Met with the rail dust.. not the Kidney Cancer.. it may be a bit of a stretch to link rail dust and K.C.  But then I am no expert.  But if your lung Met turned out not to be KC related, then you have some good info.  Also I wanted to make the point that sometimes we just do not always recognize environmental risks..

    Again I agee with Neil, reduce the stress as much as possible..

    Ron

  • handpuppet64
    handpuppet64 Member Posts: 29
    GSRon said:

    Not clear

    Sorry I should of been a bit clearer in my comments..  I was thinking about your lung Met with the rail dust.. not the Kidney Cancer.. it may be a bit of a stretch to link rail dust and K.C.  But then I am no expert.  But if your lung Met turned out not to be KC related, then you have some good info.  Also I wanted to make the point that sometimes we just do not always recognize environmental risks..

    Again I agee with Neil, reduce the stress as much as possible..

    Ron

    When I got on this board, I'm

    When I got on this board, I'm typing away , not thiking - just stream of thought.

    Guys - I worked at the diesel ramp - (engine house).

    Furthermore, over the years, my husband's friends have been dying of stomach, esophogheal, pancreatic cancer.

    Furthermore, if a worker wanted to sue, there are systems in place.

    Do I think I was exposed to something YES PROBABLY. The criteria is, did I work there during certain years 1975-1990. My husband and I  have THE SAME TYPE CANCER. That's too coincidental.

    Will I sue - I don't know.

    Is it right to reduce stress - absolutely.

    All of these ideas are good things. I think I just got on this board and was so happy to have someone to talk too, I just didn't think about it (happens frequently).

    Thanks guys.

     

  • dhs1963
    dhs1963 Member Posts: 513
    Lung surgery is minor compared to the Nephrectomy

    The lung surgery is not a big deal.  I had a similar sized tumor removed.  and was feeling good quickly.  Realy, after the first day, the only issue was the chest tube.  That kept me in the hospital.  And it damaged a nerve, which is still healing after 10 months.  But the surgery itself was nothing.

     

     

  • handpuppet64
    handpuppet64 Member Posts: 29
    dhs1963 said:

    Lung surgery is minor compared to the Nephrectomy

    The lung surgery is not a big deal.  I had a similar sized tumor removed.  and was feeling good quickly.  Realy, after the first day, the only issue was the chest tube.  That kept me in the hospital.  And it damaged a nerve, which is still healing after 10 months.  But the surgery itself was nothing.

     

     

    Chest tube: (shudder)
     
    thank

    Chest tube: (shudder)

     

    thank you.  -- sigh.

     

     

     

     

  • garym
    garym Member Posts: 1,647

    Chest tube: (shudder)
     
    thank

    Chest tube: (shudder)

     

    thank you.  -- sigh.

     

     

     

     

    You'll be fine...

    Tubes aren't a big deal either, more of a nuisance than anything, but it does sting (for only a few seconds) when they are removed.

  • danbren2
    danbren2 Member Posts: 311
    Lower Portion of Lung Removed

    Dear Handpuppet64,

         In March of 2013 I had 1/3 of my lower right lung removed (after having right Kidney removed in August 2011).  It was a smooth surgery and I was back at work full time on April 29.  The anxiety that I had was miserable and I finally had to get some help (I am taking meds) with it and am feeling so much better about everything.  I do have my 7 month CT Scan on Friday Oct. 11 and I am nervous and a little anxious about it.  We all get nervous and anxious, if we did not we would not be human.  For the most part I do a lot of praying and am thankful for everyday

         You have come to the right place for support.  The people on this sight are just fantastic and they are the ones that have helped me through.  They have taught me that yesterday is gone, today is a gift, and tomorrow is not here to worry about!  I come to this sight everyday, I may not post everyday but I do come to the sight every day, the loving caring feelings here are worth so much to me and make me realize just how lucky I am to know these people!  Keep your spirits up and your worries down!

                                                               Love and prayers for good health!

                                                                Brenda