fever up and down
Comments
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If he is still running aPumakitty said:Sorry
I am sorry your husband is having such a hard time. I hope things soon get better for you. Please try to take care of yourself. Let us know how things go.
Kathy
If he is still running a fever in the morning, we are going in. I am not going to wait for it to reach 101. He told me, he does not know whats wrong but he said he is not well.0 -
Hydration ~ Tenting
Is he taking in enough water....de-hydration will really make you feel like crap and just want to sleep all of the time.
One way to help realize if he's getting hydrated enough is called "tenting". Gentley lift the skin on the back of his hands, a soft pinch and lift...
If it is elastic and goes back to the original shape very quickly, he is probably good to go.
If it "tents" up and stays that way for any period of time, he probably needs to get more fluid in....honestly, I don't think you can get enough fluids in during treatment...LOL.
Best,
John0 -
I agree that he could bearndog64 said:If he is still running a
If he is still running a fever in the morning, we are going in. I am not going to wait for it to reach 101. He told me, he does not know whats wrong but he said he is not well.
I agree that he could be dehydrated. With pinching the skin; pinch your own; then pinch his & see how different it is. If it's not bouncing back the way yours does; he needs an IV.
The feeling like crap could be due to pain medications. This is why I mentioned reading side effects; so that you can decide if it may be medication related or something else. When I was on meth I was feeling horrible; felt flu like; couldn't get off of the couch plus I felt like a zombie.
Good luck. Let us know how you make out. If you're not far from MD Anderson; I would go to their ER. Doesn't sound like his doctors are listening to you.
~Hugs0 -
Arndog64Skiffin16 said:Hydration ~ Tenting
Is he taking in enough water....de-hydration will really make you feel like crap and just want to sleep all of the time.
One way to help realize if he's getting hydrated enough is called "tenting". Gentley lift the skin on the back of his hands, a soft pinch and lift...
If it is elastic and goes back to the original shape very quickly, he is probably good to go.
If it "tents" up and stays that way for any period of time, he probably needs to get more fluid in....honestly, I don't think you can get enough fluids in during treatment...LOL.
Best,
John
From my experience with the Onco's and ER Drs- I was told anything under 100 is NOT untypical and is expected during treatment with what the body is dealing with. Was told if it got to 101, and stayed there for awhile- get to a hospital ASAP. The reason was that 101 was their breakpoint that the struggle was getting too great for the body to handle.
And, I did live this experience after my 2nd two-pump chemo session. Too sick for any rads in week #5, my condition got even worse the following weekend, so that on Monday morning it was staying just above 101. On the phone with the Onco Nurse- she insisted that I get to a hospital immediately, which I did, and where I stayed for 4 nights with antibiotic drips.
So, it might be possible anything under 101 is typical, if he's getting the hydration and meds and Nutrition needed, but that rightly is the Dr's call. Most of us do go thru times like this, so don't get too anxious about it. 101 and above, though- get thee to a hospital ER or the Onco's office.
kcass0 -
Oh my...Kent Cass said:Arndog64
From my experience with the Onco's and ER Drs- I was told anything under 100 is NOT untypical and is expected during treatment with what the body is dealing with. Was told if it got to 101, and stayed there for awhile- get to a hospital ASAP. The reason was that 101 was their breakpoint that the struggle was getting too great for the body to handle.
And, I did live this experience after my 2nd two-pump chemo session. Too sick for any rads in week #5, my condition got even worse the following weekend, so that on Monday morning it was staying just above 101. On the phone with the Onco Nurse- she insisted that I get to a hospital immediately, which I did, and where I stayed for 4 nights with antibiotic drips.
So, it might be possible anything under 101 is typical, if he's getting the hydration and meds and Nutrition needed, but that rightly is the Dr's call. Most of us do go thru times like this, so don't get too anxious about it. 101 and above, though- get thee to a hospital ER or the Onco's office.
kcass
No better advice, but sending positive thoughts your way!0 -
He hasn't taken any painKareGiver said:Oh my...
No better advice, but sending positive thoughts your way!
He hasn't taken any pain meds since 4:00. He has been sleeping. He just left the hospital yesteterday and received plenty of fluids. Today he has not had anything to eat and very little to drink because like I said he has been sleeping. His temp is between 100.5 - 100.7 for the past 5 1/2 hours. I asked him if he is still running fever, did he want to go to the ER in the morning and he said yes. For him to say yes, he must be feeling pretty bad.
We shall see what the morning brings us. Night all..Thanks for the advice.. You guys are great..0 -
If in doubt, go to the ER!arndog64 said:He hasn't taken any pain
He hasn't taken any pain meds since 4:00. He has been sleeping. He just left the hospital yesteterday and received plenty of fluids. Today he has not had anything to eat and very little to drink because like I said he has been sleeping. His temp is between 100.5 - 100.7 for the past 5 1/2 hours. I asked him if he is still running fever, did he want to go to the ER in the morning and he said yes. For him to say yes, he must be feeling pretty bad.
We shall see what the morning brings us. Night all..Thanks for the advice.. You guys are great..
If in doubt, go to the ER! Those were my mom's words to me on Monday after a weekend of feeling really awful and running a fever of 100.7 for about 4 hours. I didn't want to over-react but finally relented just because I felt so darn bad. An hour in the ER and I was shipped up to the floor in an isolation room with low WBC (1.5) and RBC (6.8) counts. 4 days in the hospital, too many antibiotics to count, a couple units of blood, and one not so pleasant shot to bring my WBC's up... and I feel 100% better than I did last weekend! If your caregiver instincts tell you he needs to go, I would definitely listen to them.
Good luck to you guys! Sending positive thoughts that he feels better soon.0 -
Hoping he stops running a fever.arndog64 said:He hasn't taken any pain
He hasn't taken any pain meds since 4:00. He has been sleeping. He just left the hospital yesteterday and received plenty of fluids. Today he has not had anything to eat and very little to drink because like I said he has been sleeping. His temp is between 100.5 - 100.7 for the past 5 1/2 hours. I asked him if he is still running fever, did he want to go to the ER in the morning and he said yes. For him to say yes, he must be feeling pretty bad.
We shall see what the morning brings us. Night all..Thanks for the advice.. You guys are great..
That has to be so stressful I'm sorry. I will say that one of the added benefits about having my peg tube is that even tho I was soundly sleeping, I was able to take in all the water and nutrients I needed, cause I just had to hook up to the pump, and pass out asleep.
It doesn't take long to get dehydrated. Especially if he was sleeping all day and didn't take in much. I was taking in tons of water and liquids and was still getting dehydrated. It's just so taxing on your body. I also had to take in 2400 calories just not to lose any weight. My normal was only around 1200-1400 a day back before cancer. It's so tough on your body.
Thinking of you guys,
Sweet0 -
On Firesweetblood22 said:Hoping he stops running a fever.
That has to be so stressful I'm sorry. I will say that one of the added benefits about having my peg tube is that even tho I was soundly sleeping, I was able to take in all the water and nutrients I needed, cause I just had to hook up to the pump, and pass out asleep.
It doesn't take long to get dehydrated. Especially if he was sleeping all day and didn't take in much. I was taking in tons of water and liquids and was still getting dehydrated. It's just so taxing on your body. I also had to take in 2400 calories just not to lose any weight. My normal was only around 1200-1400 a day back before cancer. It's so tough on your body.
Thinking of you guys,
Sweet
I recall have a terrible time near the end of treatment. I was burning up something fierce for day at that time and no idea why.
I was hospitalized and I had a stack of those liquid coolant pads they use for sprains stored in the fridge in my room. I would rotate them on my forehead and neck. It gave some releif. It was awful but it did pass. It may be the body reacting to the radiation.
He is going through a very difficult phase now and I know it is easy to say but patience is required.
Measure improvements by the week not the day for now and let him understand this is the toughest time for many, but it will improve.
Hope he get through this part quickly.
Best wishes
Scam0 -
Withdrawal & side effectsarndog64 said:He hasn't taken any pain
He hasn't taken any pain meds since 4:00. He has been sleeping. He just left the hospital yesteterday and received plenty of fluids. Today he has not had anything to eat and very little to drink because like I said he has been sleeping. His temp is between 100.5 - 100.7 for the past 5 1/2 hours. I asked him if he is still running fever, did he want to go to the ER in the morning and he said yes. For him to say yes, he must be feeling pretty bad.
We shall see what the morning brings us. Night all..Thanks for the advice.. You guys are great..
Just looked up his medications- I also looked up the patch withdrawal symptoms & will paste it in. How long was he on the patch & how long since he's had one?
This is all copied & pasted in. When he sleeps like that; you should try to get him to take some sort of pain med to keep it in his body. I noticed my hub going into withdrawal after morphine; so I used to dose him every 4 hours for the 1st 24 hrs; then it got spaced out longer. Their body is so beat up from treatment
Fentanyl withdrawal is a very real problem caused by the physical tolerance and dependence built up by the drug in the human body. It takes as long as 17 hours for the Fentanyl concentrations in your blood stream to decrease by 50%, after one dose. If the drug has to be discontinued, it is absolutely essential that it should be done in a gradual manner of progressively reduced dosage. Symptoms associated with fentanyl withdrawal may include any of the following symptoms:
• anxiety
• muscle aches
• back pain
• joint pain
• diarrhea
• rapid heartbeat
• rapid breathing
• fever
• tearing from your eyes
• runny nose
• sneezing fits
• chills
• sweating
• yawning
• anorexia
• nausea
• vomiting
• a feeling of your hair standing on end
• nervousness
• irritability
• shivering
• stomach cramps
• insomnia
• weakness
======================================================================================
Dilaudid side effects- Constipation; dizziness, drowsiness; dry mouth; flushing; lightheadedness; nausea; sweating; vomiting.
Seek medical attention right away if any of these SEVERE side effects occur when using Dilaudid:
Severe allergic reactions (rash; hives; itching; difficulty breathing; tightness in the chest; swelling of the mouth, face, lips, or tongue); fainting; fast, slow, or irregular heartbeat; hallucinations; mental or mood changes; seizure; severe or persistent dizziness or drowsiness; severe or persistent headache or vomiting; shallow, slowed, or difficult breathing; tremor; trouble urinating; vision changes.
This is not a complete list of all side effects that may occur.
================================================================================
Liquid Vicodin- SIDE EFFECTS: Nausea, stomach upset, headache, drowsiness, and constipation may occur. If these effects persist or worsen, notify your doctor. Tell your doctor immediately if you have any of these serious side effects: vision changes, mental/mood changes, dizziness. Tell your doctor immediately if you have any of these unlikely but serious side effects: excessive sweating, muscle twitching. Tell your doctor immediately if you have any of these highly unlikely but very serious side effects: trouble breathing (e.g., slow, shallow breathing), extreme dizziness, fast heartbeat, trouble urinating. If you notice other effects not listed above, contact your doctor or pharmacist.
=================================================================================
Methadone side effects- Constipation; dizziness; drowsiness; dry mouth; headache; increased sweating; itching; lightheadedness; nausea; vomiting; weakness.
Seek medical attention right away if any of these SEVERE side effects occur when using Methadone:
Severe allergic reactions (rash; hives; itching; difficulty breathing; tightness in the chest; swelling of the mouth, face, lips, or tongue); confusion; decreased sexual desire or ability; excessive drowsiness; fainting; fast, slow, or irregular heartbeat; hallucinations; loss of appetite; menstrual changes; mental or mood changes (eg, agitation, disorientation, exaggerated sense of well-being); seizures; severe or persistent dizziness or lightheadedness; shortness of breath; slow or shallow breathing; swelling of the arms, feet, or legs; trouble sleeping; trouble urinating; unusual bruising or bleeding.
This is not a complete list of all side effects that may occur.0 -
Was he on fentanyl? If so,Daddisgrl said:Withdrawal & side effects
Just looked up his medications- I also looked up the patch withdrawal symptoms & will paste it in. How long was he on the patch & how long since he's had one?
This is all copied & pasted in. When he sleeps like that; you should try to get him to take some sort of pain med to keep it in his body. I noticed my hub going into withdrawal after morphine; so I used to dose him every 4 hours for the 1st 24 hrs; then it got spaced out longer. Their body is so beat up from treatment
Fentanyl withdrawal is a very real problem caused by the physical tolerance and dependence built up by the drug in the human body. It takes as long as 17 hours for the Fentanyl concentrations in your blood stream to decrease by 50%, after one dose. If the drug has to be discontinued, it is absolutely essential that it should be done in a gradual manner of progressively reduced dosage. Symptoms associated with fentanyl withdrawal may include any of the following symptoms:
• anxiety
• muscle aches
• back pain
• joint pain
• diarrhea
• rapid heartbeat
• rapid breathing
• fever
• tearing from your eyes
• runny nose
• sneezing fits
• chills
• sweating
• yawning
• anorexia
• nausea
• vomiting
• a feeling of your hair standing on end
• nervousness
• irritability
• shivering
• stomach cramps
• insomnia
• weakness
======================================================================================
Dilaudid side effects- Constipation; dizziness, drowsiness; dry mouth; flushing; lightheadedness; nausea; sweating; vomiting.
Seek medical attention right away if any of these SEVERE side effects occur when using Dilaudid:
Severe allergic reactions (rash; hives; itching; difficulty breathing; tightness in the chest; swelling of the mouth, face, lips, or tongue); fainting; fast, slow, or irregular heartbeat; hallucinations; mental or mood changes; seizure; severe or persistent dizziness or drowsiness; severe or persistent headache or vomiting; shallow, slowed, or difficult breathing; tremor; trouble urinating; vision changes.
This is not a complete list of all side effects that may occur.
================================================================================
Liquid Vicodin- SIDE EFFECTS: Nausea, stomach upset, headache, drowsiness, and constipation may occur. If these effects persist or worsen, notify your doctor. Tell your doctor immediately if you have any of these serious side effects: vision changes, mental/mood changes, dizziness. Tell your doctor immediately if you have any of these unlikely but serious side effects: excessive sweating, muscle twitching. Tell your doctor immediately if you have any of these highly unlikely but very serious side effects: trouble breathing (e.g., slow, shallow breathing), extreme dizziness, fast heartbeat, trouble urinating. If you notice other effects not listed above, contact your doctor or pharmacist.
=================================================================================
Methadone side effects- Constipation; dizziness; drowsiness; dry mouth; headache; increased sweating; itching; lightheadedness; nausea; vomiting; weakness.
Seek medical attention right away if any of these SEVERE side effects occur when using Methadone:
Severe allergic reactions (rash; hives; itching; difficulty breathing; tightness in the chest; swelling of the mouth, face, lips, or tongue); confusion; decreased sexual desire or ability; excessive drowsiness; fainting; fast, slow, or irregular heartbeat; hallucinations; loss of appetite; menstrual changes; mental or mood changes (eg, agitation, disorientation, exaggerated sense of well-being); seizures; severe or persistent dizziness or lightheadedness; shortness of breath; slow or shallow breathing; swelling of the arms, feet, or legs; trouble sleeping; trouble urinating; unusual bruising or bleeding.
This is not a complete list of all side effects that may occur.
Was he on fentanyl? If so, I have experienced fentanyl withdrawal and thought I was dying. It sucks! The first time it happened I didn't know what the heck was wrong with me. I had everything on that first list. I was so out of it that I didn't realize that I needed to change my patch. Actually, that may have happened to me twice and then I figured it out the third time.0 -
Fentanyl...sweetblood22 said:Was he on fentanyl? If so,
Was he on fentanyl? If so, I have experienced fentanyl withdrawal and thought I was dying. It sucks! The first time it happened I didn't know what the heck was wrong with me. I had everything on that first list. I was so out of it that I didn't realize that I needed to change my patch. Actually, that may have happened to me twice and then I figured it out the third time.
Going to copy a few of her posts where I got the information from
Post- Need some advice-
You are right about the methadone, he does not like it. But, his pain doctor told him to keep using it, it's good stuff and said his body will know what to do with it. His pain meds have changed sine the hospital visit. He is on Dilata, Methadone and liquid vivodin. No more pain patches. I will watch him over the weekend and if his fever gets over 100.4 and stays up we will go back.
I got this from another post- He has the pain patch, liquid vicodin, liquid methadone. But they wear off in 2 hours and his dose says only take at 4 hr intervals. So, needless to say his pain is not managed well at home.0 -
Found it- 2nd paragraphsweetblood22 said:Was he on fentanyl? If so,
Was he on fentanyl? If so, I have experienced fentanyl withdrawal and thought I was dying. It sucks! The first time it happened I didn't know what the heck was wrong with me. I had everything on that first list. I was so out of it that I didn't realize that I needed to change my patch. Actually, that may have happened to me twice and then I figured it out the third time.
Post- At the hospital - He has the pain patch, liquid vicodin, liquid methadone. But they wear off in 2 hours and his dose says only take at 4 hr intervals. So, needless to say his pain is not managed well at home. Trying to get a prescription filled before the time is up. They treat you like drug addiscts. LOL Anyways, the hospital is working on the pain mgt. meds every 2 hours. I am going to be aggressive with him at this point. It has been a good 6 weeks of eating a shake 2-3 times a week and that's it.I am going to have a talk with his doctor's today if he does not speak up..
http://csn.cancer.org/node/218255 - My husband does not care for his oncologist -My husband does not care for his oncologist and staff. The oncologist is very young and her onco nurse is not very friendly and the front desk staff are not very professional. I talked to the doctor today, my husband is in alot of pain and was taking more than prescribed and she basically talked down to me. I understand that they have to be cautious about the pain meds.. He ran out of morphine in 3 weeks instead of the 4. I realize he is taking more than instructed but the pain meds only last for like 4 hours and they have him taking meds one every 8 hours. I am sorry but that does not do anything for my husband.
he has the low dose fent patch and hydrocodone and he just ran out of morphine. He ran out of morphine 3 1/2 weeks out and his doctor was kinda rude about the refill thing... Needless to say, she did not refill the morphine. She wants to send him to pain management instead. What do you guys think of that?0 -
pain management centerDaddisgrl said:Found it- 2nd paragraph
Post- At the hospital - He has the pain patch, liquid vicodin, liquid methadone. But they wear off in 2 hours and his dose says only take at 4 hr intervals. So, needless to say his pain is not managed well at home. Trying to get a prescription filled before the time is up. They treat you like drug addiscts. LOL Anyways, the hospital is working on the pain mgt. meds every 2 hours. I am going to be aggressive with him at this point. It has been a good 6 weeks of eating a shake 2-3 times a week and that's it.I am going to have a talk with his doctor's today if he does not speak up..
http://csn.cancer.org/node/218255 - My husband does not care for his oncologist -My husband does not care for his oncologist and staff. The oncologist is very young and her onco nurse is not very friendly and the front desk staff are not very professional. I talked to the doctor today, my husband is in alot of pain and was taking more than prescribed and she basically talked down to me. I understand that they have to be cautious about the pain meds.. He ran out of morphine in 3 weeks instead of the 4. I realize he is taking more than instructed but the pain meds only last for like 4 hours and they have him taking meds one every 8 hours. I am sorry but that does not do anything for my husband.
he has the low dose fent patch and hydrocodone and he just ran out of morphine. He ran out of morphine 3 1/2 weeks out and his doctor was kinda rude about the refill thing... Needless to say, she did not refill the morphine. She wants to send him to pain management instead. What do you guys think of that?
Initially, it worked well for us. The refill routine now, however, is onerous: can't call them ahead on Monday and say a refill will be needed on Wednesday and expect them to honor the need to mark that down somewhere. Instead, you call on Tuesday, they tell you it takes up to 48 hours for a refill so it is often Thursday or Friday before you get it - by then, you have done without it for at least 24 hours since you ran out on Wednesday!
Talked to the doctors there - rather, the nurse practitioner because we NEVER see the doctor - and he just shrugs and says that is their system.
Well, it sucks.
Our family physician has offered to work with us on this and I think we will have to take him up on his offer. It's a shame you pay for speciality services and they are less than stellar.
If you go the pain center route, make sure they clearly define their refill procedure.
And regarding the need to be careful with pain meds for cancer patients: it isn't true. It has been carefully been explained to my husband, who had a fear of addiction, that as long as you are taking the medication for pain, you won't become addicted. Not something you have to worry about. Don't know why your oncologist would intimate such a thing, Daddisgrl. That's unfair to your husband and to you.0 -
Noellesmom- the posts were by arndog64 not mineNoellesmom said:pain management center
Initially, it worked well for us. The refill routine now, however, is onerous: can't call them ahead on Monday and say a refill will be needed on Wednesday and expect them to honor the need to mark that down somewhere. Instead, you call on Tuesday, they tell you it takes up to 48 hours for a refill so it is often Thursday or Friday before you get it - by then, you have done without it for at least 24 hours since you ran out on Wednesday!
Talked to the doctors there - rather, the nurse practitioner because we NEVER see the doctor - and he just shrugs and says that is their system.
Well, it sucks.
Our family physician has offered to work with us on this and I think we will have to take him up on his offer. It's a shame you pay for speciality services and they are less than stellar.
If you go the pain center route, make sure they clearly define their refill procedure.
And regarding the need to be careful with pain meds for cancer patients: it isn't true. It has been carefully been explained to my husband, who had a fear of addiction, that as long as you are taking the medication for pain, you won't become addicted. Not something you have to worry about. Don't know why your oncologist would intimate such a thing, Daddisgrl. That's unfair to your husband and to you.
Noellesmom- the posts were by arndog64 not mine. I was replying to one of her posts yesterday when she made a new one. I don't like just jumping into a post without knowing some history; so I did some reading & found the posts about his pain medication.
Pain Management here in NJ is not like where you are; they do not call refill in for narcotics & will not write a script without seeing the patient. I get an appointment every 30 days for my back pain. I've been on a lot of pain meds myself; so have an idea of what they can do to a person. I've been on all that the OP's (original poster's) hub has been on; so when my dad & hub were diagnosed with cancer; it was a huge help so that I wasn't running around like a lunatic because of side effects. Some of the side effects are the pits & can make you think the cancer patient is on their death bed.
Generics verses brand- there is a huge difference between brand percocet & generic. Once you build up a tolerance to the generic; it's like taking Tylenol & you need to take 2 to 3 pills to equal the pain relief of one brand pill. My hub is at this point with generic where 1 isn't doing much
Generic Oxycontin- thankfully they took it off of the market because it made people vomit. I learned this with myself as well as my dad. I ended up giving him a brand & his vomiting stopped.
Oxycontin brand- back in November the formulation was changed so that drug addicts can't crush & snort. It is not an 8 hour lasting pill any more & does not work for some people; myself included.
Fentanyl patch- it was decent for pain but I couldn't sleep with it; so I had to stop it. My hub was vomiting during treatment; turns out he could not tolerate the patch either.
I always suggest Actiq pops; they are Fentanyl based & really good for throat cancer pain. My hub likes these better then percocet because he can eat a small amount & it will take care of his pain.0 -
couple thingsDaddisgrl said:Noellesmom- the posts were by arndog64 not mine
Noellesmom- the posts were by arndog64 not mine. I was replying to one of her posts yesterday when she made a new one. I don't like just jumping into a post without knowing some history; so I did some reading & found the posts about his pain medication.
Pain Management here in NJ is not like where you are; they do not call refill in for narcotics & will not write a script without seeing the patient. I get an appointment every 30 days for my back pain. I've been on a lot of pain meds myself; so have an idea of what they can do to a person. I've been on all that the OP's (original poster's) hub has been on; so when my dad & hub were diagnosed with cancer; it was a huge help so that I wasn't running around like a lunatic because of side effects. Some of the side effects are the pits & can make you think the cancer patient is on their death bed.
Generics verses brand- there is a huge difference between brand percocet & generic. Once you build up a tolerance to the generic; it's like taking Tylenol & you need to take 2 to 3 pills to equal the pain relief of one brand pill. My hub is at this point with generic where 1 isn't doing much
Generic Oxycontin- thankfully they took it off of the market because it made people vomit. I learned this with myself as well as my dad. I ended up giving him a brand & his vomiting stopped.
Oxycontin brand- back in November the formulation was changed so that drug addicts can't crush & snort. It is not an 8 hour lasting pill any more & does not work for some people; myself included.
Fentanyl patch- it was decent for pain but I couldn't sleep with it; so I had to stop it. My hub was vomiting during treatment; turns out he could not tolerate the patch either.
I always suggest Actiq pops; they are Fentanyl based & really good for throat cancer pain. My hub likes these better then percocet because he can eat a small amount & it will take care of his pain.
So sorry your hubby is feeling so bad. You've got the right idea to take him to the hospital tomorrow if he doesn't improve.
I would not advise going to a different hospital than the one his treatment is associated with. I can tell you from working at a hospital for 27 years that they are not going to transfer his care under those circumstances. He will get emergent treatment only. He will be able to transfer care when he's not in emergent need of medical care.
Also, don't make any changes to his pain medication without the explicit guidance of his physicians and they absolutely should be available to you to discuss this daily if necessary. He may very well need help changing meds or dosages but please, seek help with this.
Best of luck
Lisa0
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