End of Life Issues
My mother is 86 years old and has esophageal cancer which has spread to an area of her chest between her lungs.
My mother’s doctor told us that she cannot be cured since the cancer has spread to her lymph nodes. But the Doctor said that he can “sustain her.”
Over the past few months, I’ve gradually learned, and I’ve reluctantly had to accept the fact that the cancer will eventually take her away from us.
I wanted to ask a few questions about her condition.
1. What is the average length of time a stage 4 patient can survive? 1 year? 2 years? 3 years? 4 years?
2. What is the average length of time a stage 4 patient can survive after she has decided to stop treatment? 1 month? 2 months? 3 months?
3. When you decide to stop treatment, where do people generally go for the last month or two of their life for care? A nursing home? Hospital?
4. I read on the internet that a person will suffer quite a bit after stopping treatment before passing away, that he or she will vomit frequently, will have to endure a lot of pain, etc. Does anyone know what a person has to endure before passing away?
If anyone has some knowledge about any of the above issues, I would greatly appreciate hearing from you.
I know this is not a pleasant subject to talk about, but it would greatly help me to know what to expect, and to see if it’s possible to prepare in some way for what sadly seems inevitable.
Thank you very much for your kind help!
Tom
Comments
-
Part 1 where do they go and will Mom suffer?
Tom,
MOST people stay at home, and call in HOSPICE as I have done. DO NOT wait until the end if she stops treatment (as you cannot start Hospice with treatment ongoing in most places even if it is not curative) but instead call Hospice at ONCE. I signed up with them today and I, like many people, plan to stay at my home until the very end, with Hospice and family at my side. I do NOT wish to be in a hospital for the end of my life so unless there is some unforeseen problem before I go, I will not go back to the hospital again, period. You can have Mom put in an Hospice HOME, or in the hospital or she can stay at home. THAT is totally up to you and Mom and whomever is in charge of her care.
As for suffering in the end....There is NO reason that her pain cannot be thoroughly managed very well, right up to the very end. There is absolutely NO need for undue suffering and this is usually not the case. With good Hospice and good end of life care, you mom should not suffer in any pain, and the vomiting and other things that you mentioned are very person-specific and not in any way a normal or expected thing. While she MAY have trouble swallowing or the like in the end, they have many many many ways of managing her pain and suffering that she may have a very peaceful passing and that it is not traumatic and horrible for you, or for her, or for the family! Don't believe everything you read as there is a lot of scary stuff out there. I have read that, too. It is not what I have learned to be the honest truth.
I hope this helps, and that many others will now reply in kind!
-Eric0 -
Part 2: Would tell you how long if anyone could...
TOm,
I am stage 4 with the same type of spreading and no treatment possible except "extension of life" as palliative, and I am receiving NO treatment except pain management.
NO ONE can tell you how long Mom will live with or without treatment!
ANYTHING anyone says is a mere GUESS!!
They tell me I have 4-6 months (from August 18th) and that is a total guess.
May be a year, may be 3 months.
You mom may live for a year or two with chemo and radiation, and maybe a year or less without, but this is a total GUESS too. Based on what I have SEEN over time reading so far.
Each person is SO different, and there is no way to know or tell how any one person will react or NOT react to chemo drugs! Also the same with radiation. She may respond GREAT to Cisplatin or not at all and the same goes for each, and that will totally change what line of chemo she would get and then how long she will sustain.
Some last for months without treatment, some for years. There is NO way to compare two different tumor, two different metabolisms, etc etc etc etc etc add infinitum!!
I WISH I could give you concrete answers, but anyone who does is just blowing smoke. I am in the SAME boat and would (kind of) like to know how long do I have?? But then again, maybe not. I understand your questions but I cannot answer them any more directly without lying. That, we do not do here!!
Anyone??
Wishing you ALL the best. I will post more as I think of it. Welcome aboard, as much as I hate to say THAT too.
-Eric0 -
End of Lifechemosmoker said:Part 2: Would tell you how long if anyone could...
TOm,
I am stage 4 with the same type of spreading and no treatment possible except "extension of life" as palliative, and I am receiving NO treatment except pain management.
NO ONE can tell you how long Mom will live with or without treatment!
ANYTHING anyone says is a mere GUESS!!
They tell me I have 4-6 months (from August 18th) and that is a total guess.
May be a year, may be 3 months.
You mom may live for a year or two with chemo and radiation, and maybe a year or less without, but this is a total GUESS too. Based on what I have SEEN over time reading so far.
Each person is SO different, and there is no way to know or tell how any one person will react or NOT react to chemo drugs! Also the same with radiation. She may respond GREAT to Cisplatin or not at all and the same goes for each, and that will totally change what line of chemo she would get and then how long she will sustain.
Some last for months without treatment, some for years. There is NO way to compare two different tumor, two different metabolisms, etc etc etc etc etc add infinitum!!
I WISH I could give you concrete answers, but anyone who does is just blowing smoke. I am in the SAME boat and would (kind of) like to know how long do I have?? But then again, maybe not. I understand your questions but I cannot answer them any more directly without lying. That, we do not do here!!
Anyone??
Wishing you ALL the best. I will post more as I think of it. Welcome aboard, as much as I hate to say THAT too.
-Eric
Hi: I recently cared for my husband at home who passed away June 3 2011. I am a nurse and did not have any difficulties caring for him, but it is not a job that everyone can handle and you shouldn’t feel bad if you are unable to care for your mom at home. Some things to consider are do you have some help. You do need to sleep, so if there are other siblings who can help, it makes it a lot easier. There is no need for pain and suffering. I suggest, as Lee did, that you get hospice involved ASAP. They are wonderful in supporting patient and family through this journey. They are available 24 hrs a day.
As far a survival every person is different, but cancer patients are evaluated with a tool called a PPS (Palliative Performance Scale). I am including a link for you to peruse. You basically follow across the scale and find out what number your mother is( at the present time based on activity, bedridden, etc) and there is a general time frame on how many days she will survive. My husband was right on and lived exactly to the day as was stated in this tool. Now everyone is different, but you might find it useful to see how they rate a patient’s condition http://www.eperc.mcw.edu/fastFact/ff_125.htm
My husband did not suffer at all. No vomiting and his pain well controlled. One item that a lot of people don’t understand is that if the loved one does not want to eat or drink, do not force or encourage them. At this point, nutrition does very little. Their bodies do not need a lot of food and when the organs are shutting down, it is very hard to digest food and fluids. If you force liquids and the kidneys for example are not working at 100%, this will cause excess fluid throughout the body (edema) which can be uncomfortable. So the rule of thumb is let the person decide when and how much they want to eat and drink. I hope this helps some and if I can answer any more of your questions , I would be glad to. Patti0 -
Hi Tom,chemosmoker said:Part 2: Would tell you how long if anyone could...
TOm,
I am stage 4 with the same type of spreading and no treatment possible except "extension of life" as palliative, and I am receiving NO treatment except pain management.
NO ONE can tell you how long Mom will live with or without treatment!
ANYTHING anyone says is a mere GUESS!!
They tell me I have 4-6 months (from August 18th) and that is a total guess.
May be a year, may be 3 months.
You mom may live for a year or two with chemo and radiation, and maybe a year or less without, but this is a total GUESS too. Based on what I have SEEN over time reading so far.
Each person is SO different, and there is no way to know or tell how any one person will react or NOT react to chemo drugs! Also the same with radiation. She may respond GREAT to Cisplatin or not at all and the same goes for each, and that will totally change what line of chemo she would get and then how long she will sustain.
Some last for months without treatment, some for years. There is NO way to compare two different tumor, two different metabolisms, etc etc etc etc etc add infinitum!!
I WISH I could give you concrete answers, but anyone who does is just blowing smoke. I am in the SAME boat and would (kind of) like to know how long do I have?? But then again, maybe not. I understand your questions but I cannot answer them any more directly without lying. That, we do not do here!!
Anyone??
Wishing you ALL the best. I will post more as I think of it. Welcome aboard, as much as I hate to say THAT too.
-Eric
Well, Eric pretty well summed it up. No one can tell you the answers to your questions. However, there are many things that can indeed make her more comfortable until the very end.
As Eric stated, Hospice is a great place to start. We are just getting started next week with it, so I really can't tell you much about it, but on this site, it seems to come highly recommended. Depending on your mom's situation, for example, does she live alone, is there someone there to be her caregiver? If she has someone in the home to help her out and support her, she can likely live out her days at home, if she chooses. If she does not have such a person, there are hospice homes where she could go to receive wonderful care, when she comes to the time of not being able to live independently.
We also have a home care nurse that comes every couple days. They are a palliative care/pain management team. So far, they basically clean Lee's feeding tube incision, take his vitals, and ask a few health related questions. I imagine as time goes on, they may be more helpful with personal care, counselling, medication administration etc, as needed.
We also have a Palliative care doctor, who works out of our cancer clinic. We just saw her for the first time yesterday, and she was very adamant that Lee does not suffer ANY pain, EVER. These doctors will work with your mom to treat all her symptoms as they occur. For example, Lee has these odd 'hiccups' that cause him pain. Well, who knew? There is a prescription for that!!! They can also treat nausea, vomiting, constipation or whatever else may plague her.
As we are in Canada, I'm not sure exactly where you are, and what services are available to you, but I'm sure it's similar. I know you have posted before, but I don't remember..... Does your mom have a feeding tube in? This may be something to look into if she does not. I know that in our case, it saved Lee's life. His esophagus is almost completely closed up now, and he can only swallow liquids. If it is not needed yet, perhaps she may want to consider one as an insurance policy for the future? Maybe she'll never need it, but it's great to have, and even handy to make sure she does not become dehydrated, which is of utmost importance during and after treatment.
I wish we all had a crystal ball, and could predict the future for our loved ones, but unfortunately that's not possible. Please don't read too many stats on the internet, they are very misleading and dated. Everyone is different, everyone handles treatment differently, everyone's disease progresses at different speeds. I think last time you posted, I told you what Lee's mother's doctor told us about how elderly people have slower growth rates than young people do. The cells just don't generate as fast as they used to, which is an advantage to her hopefully.
Hope that helps, be well,
Chantal0 -
Hi Tom
My dear husband, just 55, passed away just last month. Stage IVb Esophageal cancer, mets to lungs.
I can tell you that he had a most comfortable and peaceful and even productive and joyful last year, all in all (not counting the side effects of chemo, which weren't too bad but not great).
He decided to enter Hospice House about 3+ weeks before he passed away. It was a great decision for him; he could relax, paint, work on the computer, have friendly and compassionate nurses who became his friends and who were only concerned with his plan, his level of comfort.
He could entertain visitors, and he did!
He ate and drank right up to two days before passing away. He enjoyed his meals. He did have a stent.
He did not suffer since the nurses kept managing his symptoms right away. His big issue was the lungs--he could become very short of breath, but they managed THAT very well.
Hospice is all about making the client comfortable. They are experts, and they have a calling for this sort of work. You will be well served by them.
Hope this helps,
Jo-Ann0 -
Hello Eric,chemosmoker said:Part 1 where do they go and will Mom suffer?
Tom,
MOST people stay at home, and call in HOSPICE as I have done. DO NOT wait until the end if she stops treatment (as you cannot start Hospice with treatment ongoing in most places even if it is not curative) but instead call Hospice at ONCE. I signed up with them today and I, like many people, plan to stay at my home until the very end, with Hospice and family at my side. I do NOT wish to be in a hospital for the end of my life so unless there is some unforeseen problem before I go, I will not go back to the hospital again, period. You can have Mom put in an Hospice HOME, or in the hospital or she can stay at home. THAT is totally up to you and Mom and whomever is in charge of her care.
As for suffering in the end....There is NO reason that her pain cannot be thoroughly managed very well, right up to the very end. There is absolutely NO need for undue suffering and this is usually not the case. With good Hospice and good end of life care, you mom should not suffer in any pain, and the vomiting and other things that you mentioned are very person-specific and not in any way a normal or expected thing. While she MAY have trouble swallowing or the like in the end, they have many many many ways of managing her pain and suffering that she may have a very peaceful passing and that it is not traumatic and horrible for you, or for her, or for the family! Don't believe everything you read as there is a lot of scary stuff out there. I have read that, too. It is not what I have learned to be the honest truth.
I hope this helps, and that many others will now reply in kind!
-Eric
Thank you very
Hello Eric,
Thank you very much for your kind reply.
Sorry, for being so late in thanking you for your help. I’m struggling with all sorts of serious health problems myself. I’m also desperately trying to hold on to my job. And since my mother lives with me and I’m trying to take care of her, I often have very little energy left. But, again, thank you so much for your time and help.
My mother is still doing chemo every 3 weeks but it is getting harder, much harder for her to do chemo. Since Stage 4 cancer is not curable, and as she will eventually have to stop chemo, I am very worried and nervous about the future.
Thanks for the information about Hospice care. I have no friends or relatives to turn to, and no knowledge about these issues so all the information you provided is very new and helpful.
Based on what you told me, I plan to keep my mother at home since I’m sure she will be more comfortable here. But I definitely will call hospice! It’s great to know that Hospices are providing such a valuable and important service. Thank God they are there to help!
It is very, very reassuring to know that one does not have to go through much pain and suffering at the end. I thought that pain and suffering were unavoidable, and I’m glad you told me that that’s not necessarily the case.
I’m really amazed at the courage and dignity you are showing. It is so, so kind of you to reach out and help others. God bless you!
Thanks again for your thoughts and prayers. I greatly appreciate your thoughtful advice and kind assistance.
Tom0 -
Thanks Againchemosmoker said:Part 2: Would tell you how long if anyone could...
TOm,
I am stage 4 with the same type of spreading and no treatment possible except "extension of life" as palliative, and I am receiving NO treatment except pain management.
NO ONE can tell you how long Mom will live with or without treatment!
ANYTHING anyone says is a mere GUESS!!
They tell me I have 4-6 months (from August 18th) and that is a total guess.
May be a year, may be 3 months.
You mom may live for a year or two with chemo and radiation, and maybe a year or less without, but this is a total GUESS too. Based on what I have SEEN over time reading so far.
Each person is SO different, and there is no way to know or tell how any one person will react or NOT react to chemo drugs! Also the same with radiation. She may respond GREAT to Cisplatin or not at all and the same goes for each, and that will totally change what line of chemo she would get and then how long she will sustain.
Some last for months without treatment, some for years. There is NO way to compare two different tumor, two different metabolisms, etc etc etc etc etc add infinitum!!
I WISH I could give you concrete answers, but anyone who does is just blowing smoke. I am in the SAME boat and would (kind of) like to know how long do I have?? But then again, maybe not. I understand your questions but I cannot answer them any more directly without lying. That, we do not do here!!
Anyone??
Wishing you ALL the best. I will post more as I think of it. Welcome aboard, as much as I hate to say THAT too.
-Eric
Hello again Eric,
Thank you once again for taking the time to reply to my questions.
I guess I’m not surprised by what you mentioned about no one being able to tell for sure how long a stage 4 patient will live with or without treatment.
I’ve read over the internet of stage 4 patients who have been receiving treatment and have lived 6 years whereas others lived only a few months with treatment. I was hoping I could get a more definite time frame but I guess that’s not possible.
I hope you are with us for a long, long time. I sincerely wish you longevity with a good quality of life.
Thank you once again for your kind advice and assistance. God Bless you.
Tom0 -
Thank youhobbssy said:End of Life
Hi: I recently cared for my husband at home who passed away June 3 2011. I am a nurse and did not have any difficulties caring for him, but it is not a job that everyone can handle and you shouldn’t feel bad if you are unable to care for your mom at home. Some things to consider are do you have some help. You do need to sleep, so if there are other siblings who can help, it makes it a lot easier. There is no need for pain and suffering. I suggest, as Lee did, that you get hospice involved ASAP. They are wonderful in supporting patient and family through this journey. They are available 24 hrs a day.
As far a survival every person is different, but cancer patients are evaluated with a tool called a PPS (Palliative Performance Scale). I am including a link for you to peruse. You basically follow across the scale and find out what number your mother is( at the present time based on activity, bedridden, etc) and there is a general time frame on how many days she will survive. My husband was right on and lived exactly to the day as was stated in this tool. Now everyone is different, but you might find it useful to see how they rate a patient’s condition http://www.eperc.mcw.edu/fastFact/ff_125.htm
My husband did not suffer at all. No vomiting and his pain well controlled. One item that a lot of people don’t understand is that if the loved one does not want to eat or drink, do not force or encourage them. At this point, nutrition does very little. Their bodies do not need a lot of food and when the organs are shutting down, it is very hard to digest food and fluids. If you force liquids and the kidneys for example are not working at 100%, this will cause excess fluid throughout the body (edema) which can be uncomfortable. So the rule of thumb is let the person decide when and how much they want to eat and drink. I hope this helps some and if I can answer any more of your questions , I would be glad to. Patti
Hello Patti,
Thank you very much for your kind reply.
Sorry, for being so late in thanking you for your help. I’m struggling with all sorts of serious health problems myself. I’m also desperately trying to hold on to my job. And since my mother lives with me and I’m trying to take care of her, I often have very little energy left. But, again, thank you so much for your time and help.
My mother is still doing chemo every 3 weeks but it is getting harder, much harder for her to do chemo. Since Stage 4 cancer is not curable, and as she will eventually have to stop chemo, I am very worried and nervous about the future.
I’m sorry to hear that your husband passed away. It is good that you are a nurse and knew how to care for him. I’m glad he did not suffer or experience much pain.
Unfortunately, I don’t’ have any siblings or anyone else who can help. I have no friends or relatives to turn to, and no knowledge about these issues so all this information is very new and helpful. From what you and others have mentioned, hospice care seems to be the best thing for her. It’s great to know that Hospices are providing such a valuable and important service. Thank God they are there to help!
Thanks for the link to the Palliative Performance Scale. What an interesting tool.
I’m glad you told me not to force her to eat. I’ve been very worried since she has no appetite but, based on what you told me, I won’t force her to eat anymore since my insistence angers her and, apparently, it doesn’t help her when I keep encouraging her to eat.
Thanks for offering to help out if I have any more questions. That is very kind of you, and I greatly appreciate your kind help!
Tom0 -
Thank youDaisylin said:Hi Tom,
Well, Eric pretty well summed it up. No one can tell you the answers to your questions. However, there are many things that can indeed make her more comfortable until the very end.
As Eric stated, Hospice is a great place to start. We are just getting started next week with it, so I really can't tell you much about it, but on this site, it seems to come highly recommended. Depending on your mom's situation, for example, does she live alone, is there someone there to be her caregiver? If she has someone in the home to help her out and support her, she can likely live out her days at home, if she chooses. If she does not have such a person, there are hospice homes where she could go to receive wonderful care, when she comes to the time of not being able to live independently.
We also have a home care nurse that comes every couple days. They are a palliative care/pain management team. So far, they basically clean Lee's feeding tube incision, take his vitals, and ask a few health related questions. I imagine as time goes on, they may be more helpful with personal care, counselling, medication administration etc, as needed.
We also have a Palliative care doctor, who works out of our cancer clinic. We just saw her for the first time yesterday, and she was very adamant that Lee does not suffer ANY pain, EVER. These doctors will work with your mom to treat all her symptoms as they occur. For example, Lee has these odd 'hiccups' that cause him pain. Well, who knew? There is a prescription for that!!! They can also treat nausea, vomiting, constipation or whatever else may plague her.
As we are in Canada, I'm not sure exactly where you are, and what services are available to you, but I'm sure it's similar. I know you have posted before, but I don't remember..... Does your mom have a feeding tube in? This may be something to look into if she does not. I know that in our case, it saved Lee's life. His esophagus is almost completely closed up now, and he can only swallow liquids. If it is not needed yet, perhaps she may want to consider one as an insurance policy for the future? Maybe she'll never need it, but it's great to have, and even handy to make sure she does not become dehydrated, which is of utmost importance during and after treatment.
I wish we all had a crystal ball, and could predict the future for our loved ones, but unfortunately that's not possible. Please don't read too many stats on the internet, they are very misleading and dated. Everyone is different, everyone handles treatment differently, everyone's disease progresses at different speeds. I think last time you posted, I told you what Lee's mother's doctor told us about how elderly people have slower growth rates than young people do. The cells just don't generate as fast as they used to, which is an advantage to her hopefully.
Hope that helps, be well,
Chantal
Hello Chantal,
Thank you very much for your kind and detailed reply.
Sorry, for being so late in thanking you for your help. I’m struggling with all sorts of serious health problems myself. I’m also desperately trying to hold on to my job. And since my mother lives with me and I’m trying to take care of her, I often have very little energy left. But, again, thank you so much for your time and help.
My mother is still doing chemo every 3 weeks but it is getting harder, much harder for her to do chemo. Since Stage 4 cancer is not curable, and as she will eventually have to stop chemo, I am very worried and nervous about the future.
From what you and others have mentioned, it appears that hospice care is the best thing for her. I don’t have any family or friends who can help, and I really don’t know how to take care of her. So it’s truly reassuring to know that hospice care is available.
It’s great to know that pain is not inevitable and can be controlled and managed. I’m glad Lee’s Palliative care doctor has made sure that he does not suffer any pain and that there is medication for keeping everything under control.
My mother does not have a feeding tube. She started chemo treatment in March and was eating okay until about a month ago when her appetite decreased quite a bit.
She doesn’t have much pain when swallowing (it comes and goes and it’s slight pain). Most of the time, the pain she gets is around the chest area which is where the cancer has spread to. The pain in the chest area is a little stronger than the pain in the esophagus but that pain also comes and goes. My main worry is her appetite since over the past 4 weeks, she eats very little.
From what you and others have told me, it is impossible to tell how long she can live with stage 4 disease. I was hoping I could get a definitive answer to my question but I guess that’s impossible.
What you told me about older people having slower growth rates than younger people was very useful. I had no idea this was true and recently someone else confirmed what you told me. I’m glad that it may grow at a slower rate for my mother.
Thanks once again for your thoughtful advice and ideas. I greatly appreciate your kind help! I hope Lee is doing better and continues to be pain-free.
Thank you,
Tom0 -
Thank youjojoshort said:Hi Tom
My dear husband, just 55, passed away just last month. Stage IVb Esophageal cancer, mets to lungs.
I can tell you that he had a most comfortable and peaceful and even productive and joyful last year, all in all (not counting the side effects of chemo, which weren't too bad but not great).
He decided to enter Hospice House about 3+ weeks before he passed away. It was a great decision for him; he could relax, paint, work on the computer, have friendly and compassionate nurses who became his friends and who were only concerned with his plan, his level of comfort.
He could entertain visitors, and he did!
He ate and drank right up to two days before passing away. He enjoyed his meals. He did have a stent.
He did not suffer since the nurses kept managing his symptoms right away. His big issue was the lungs--he could become very short of breath, but they managed THAT very well.
Hospice is all about making the client comfortable. They are experts, and they have a calling for this sort of work. You will be well served by them.
Hope this helps,
Jo-Ann
Hello Jo-Ann,
Thank you very much for your kind reply.
Sorry, for being so late in thanking you for your help. I’m struggling with all sorts of serious health problems myself. I’m also desperately trying to hold on to my job. And since my mother lives with me and I’m trying to take care of her, I often have very little energy left. But, again, thank you so much for your time and help.
My mother is still doing chemo every 3 weeks but it is getting harder, much harder for her to do chemo. Since Stage 4 cancer is not curable, and as she will eventually have to stop chemo, I am very worried and nervous about the future.
I’m so sorry that your husband passed away recently at a fairly young age.
I’m so glad that he passed away peacefully. It’s great that he was able to have a productive and good time in the Hospice House and get so much done.
Thanks for the information about Hospice care. I have no friends or relatives to turn to, and no knowledge about these issues so all this information is very new and helpful. It’s great to know that Hospices are providing such a valuable and important service. Thank God they are here to help!
Thanks again for your kind help!
Tom0 -
YOU are welcome...TomM1956728 said:Hello Eric,
Thank you very
Hello Eric,
Thank you very much for your kind reply.
Sorry, for being so late in thanking you for your help. I’m struggling with all sorts of serious health problems myself. I’m also desperately trying to hold on to my job. And since my mother lives with me and I’m trying to take care of her, I often have very little energy left. But, again, thank you so much for your time and help.
My mother is still doing chemo every 3 weeks but it is getting harder, much harder for her to do chemo. Since Stage 4 cancer is not curable, and as she will eventually have to stop chemo, I am very worried and nervous about the future.
Thanks for the information about Hospice care. I have no friends or relatives to turn to, and no knowledge about these issues so all the information you provided is very new and helpful.
Based on what you told me, I plan to keep my mother at home since I’m sure she will be more comfortable here. But I definitely will call hospice! It’s great to know that Hospices are providing such a valuable and important service. Thank God they are there to help!
It is very, very reassuring to know that one does not have to go through much pain and suffering at the end. I thought that pain and suffering were unavoidable, and I’m glad you told me that that’s not necessarily the case.
I’m really amazed at the courage and dignity you are showing. It is so, so kind of you to reach out and help others. God bless you!
Thanks again for your thoughts and prayers. I greatly appreciate your thoughtful advice and kind assistance.
Tom
Tom,
You are so welcome, and please lean on ALL of us as much as you can. We are ALL here for you no matter what!
-Eric0
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