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January 22, 1993 – The calm before the storm
Rumors have it that we will be going home today or tomorrow. Heather has only had a couple of small contractions over the last couple of days. She has been allowed to lay flat on her bed and has been on a liquid diet since Thursday night. The nurses have hinted that she just needs to get back to eating a solid diet and have a portable pump set up so that she can have the magnesium sulfate administered at home.
I am all for going home. I haven’t spent a night in a hospital since my own birth until this little escapade. I have learned that hospitals are bearable at best, and this is only when you are in desperate need of attention, but quickly become a form of prison when one is in a ‘wait-and-see’ situation. That’s where we are at, “Let’s wait and see what the doctor says when he looks over your charts”. It was only three days ago that we began this journey but in hospital time that is just this side of eternity.
My thoughts are interrupted as a nurse walks into the room, “Ok, dad, let’s get you trained on how to use the Terbutaline Pump!”
“Great, what do I have to do?”
The nurse is busy unwrapping a small device, tubing, and what looks like a small first aid kit. She doesn’t pause to answer me, “It is pretty simple. There is a pump that will inject a maintenance level of medication into mommy to keep her from going into contractions. The pump is connected to a pad that has a needle which is placed on the thigh. Your job will be to clean and place the needle when it needs changed. ”
“Uh, I have to stick a needle into her?” I have to admit that the thought of inserting a needle into my wife gives me the heebie-jeebies. I have no problem with blood or needles. I have actually slaughtered my share of chickens, cleaned fish, and even given myself stitches with a needle and sewing thread. But for some reason, purposely sticking a needle into another human being just gives me the creeps.
The nurse seems entertained by my question, and light-heartedly answers, “Well, she can’t do it herself. She has to remain lying down even if she goes home. You’re a big boy.”
Heather joins in with the nurse, “Yeah, Tony, it’s just a little needle. You can do it.”
The nurse has been swabbing a spot on my wife’s thigh with alcohol in preparation for the needle to be inserted while I have been going over what it is that I will have to do. I don’t get much more time to think on it before the nurse waves me over.
“Ok, put these gloves on,” she hands me a pair of latex gloves which I slip on my hands.
“Good, now hold the needle pad in your right hand like this”, she has it clasped between her thumb, index, and middle fingers much like you would do if you were holding an egg up for inspection. I take the needle pad into my hand mimicking the way the nurse had held it.
“Now for the easy part. Just stick it into your wife’s leg right here where I have already swabbed it. One quick motion and it will stop when the pad touches the skin.” She moves her hand through the air in the motion that I should copy. It is just an easy swing of the hand towards the target – nothing too forceful.
I think about it for a second trying to build up the nerve. “C’mon, Tony. Just do it.” My wife encourages me. I think she likes the fact that I am not enjoying this procedure. I decide that I have to get this over with so I take the needle, and copying the nurse’s technique, I stick it into my wife’s leg. It felt ‘gritty’ and it causes me to jump back and bounce around the room. I start shaking my hands trying to make them forget what that felt like.
“That is so gross!!”
Both the nurse and my wife enjoy a laugh at my expense.
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We really were ready to go home on that Friday evening so many years ago. And, yes, I did get the heebie-jeebies and dance around the room after sticking a needle into my wife’s leg. I still remember what it felt like and I still don’t like it.
Friday was a quiet day. Things almost seemed ‘normal’ besides the fact of being in the hospital. We would experience that type of day many times over while raising Lauren. And like that Friday, many of those days would be the quiet before the storm.
Tomorrow I will take you through the day that Lauren was born. I may have to do it in two installments… in actuality, I could probably write a book on that day alone, but I will keep it short for this purpose.
January 21, 1993
Dr. Chaparro has just stepped into the room. Again, it is early morning. It is starting to seem like everything either happens very early or very late in the day so that rest is always far away and not enough. Heather is still being pumped full of magnesium sulfate and the contractions seem to be under control. As the doctor takes a seat next to my wife’s bed, I remember back to when we had first met him.
My wife and I had already ran the gamut of genetic specialists for first, second, and even third opinions looking for hope. They had all confirmed the results and prognosis of the ultra sound and so it was with no enthusiasm that we kept the appointment that had been made for us with a neurosurgeon at the Childrens hospital in Dayton, Ohio. We had already been told that in vitro surgery was not an option for our child. Technology just wasn’t far enough along for the delicate procedure that would be necessary to make any difference in our situation. So why were we here? Maybe somewhere deeply veiled by all the pain and despair, a small spark of hope was waiting to be fanned.
As we walked into his office that morning, we didn’t see what we had expected. Dr. Chapparo was a young man, maybe early 30’s, dressed in a shirt that contained bright purple colors and around his neck was a bolo tie. He bounced out of his seat and introduced himself as he ushered us to chairs on the other side of his desk. Once he returned to his chair he seemed to continue to bounce as he wiggled back and forth in his seat. This guy had a lot of energy. My wife and I shared a quizzical look as we both tried to figure out what it was we were supposed to be getting from this hack.
He immediately fell into doctor speak as he regurgitated all of the same fancy medical terms we had heard a dozen times since December 23rd.
“Myelomeningocele…. yada yada yada… hydrocephalus…. more yadas. Microcephalic…. shunts…”
The messenger may have been different, but the message seemed to be moving along the same lines that we now knew by rote. But, then Dr. Chapparo said something that caught our attention.
“Science is great but it doesn’t know everything. I think we should wait and see what happens.”
Was that hope? Had he really seen the same things that everyone else had when they held the images up against the x-ray lights? Was he just as a crazy as he appeared to be as he sat there and bounced in his chair?
Thinking back to that meeting, it was easy to see a change had occurred in how my wife viewed the pregnancy. She had stopped talking to the baby in her belly after we had been given the news following the ultra sound. We no longer had late night discussions about what to name our future child or how to finish decorating the nursery. In short, the spark had gone out of her where the baby was concerned. But after that meeting with Dr. Chapparo, some of the spark had returned – it was very guarded – but it was there none-the-less.
And here he was for our second meeting with him. This time he had come to see us in our ‘office’ though neither of us was doing any bouncing.
“How you guys holding up?”
How do you answer a question like that in the middle of the situation that we found ourselves?
“Uh, ok, I guess.”
“I hear it has been an exciting couple of days but you guys are in the best hands. I stopped by because I wanted to let you know that we have a team prepared to respond as soon as anything changes. You guys have opted for the C-section, right?”
We answered, yes, that was the case.
“That’s important. We will need to keep the baby’s back as sterile as possible until we can close it up. Once you deliver, we will transport your child to Childrens where we can treat the opening in her back and take pressure off her ventricles by draining the excess fluid that is building in her head. Have you decided on a name for you daughter?”
My wife answered that question, “We chose the name Lauren Alexis.” I followed quickly on her answer, “But we are going to call her Alex.” We had decided on that combination before we even knew what sex the baby was going to be.
“OK, then the next time I see you all, we will be taking care of Alex.”
And with that, Dr. Chapparo was standing up and heading towards the door. My farewell followed him out, “I hope its not too soon, doc.”
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That was the beginning of day 3 in the hospital. I still hadn’t left to get a shower or change out of my work clothes since we had shown up on Tuesday, so Heather’s mother was going to stop by and give me a break to take care of that and to get some things from home for my wife. Thursday was a day to settle down and wonder how long a haul we were in for. The longer that our daughter stayed in my wife’s womb, the more time her body would mature and be able to survive outside of my wife’s uterus. However, each day that passed was also more time for the Hydrocephalus to continue to destroy brain function. Were we supposed to hope for a premature birth that would put her on a path to treatment for her medical condition but could most likely kill her because her body was too frail? Or were we supposed to hope she remained where she was while her medical condition robbed us even more of the chance of having a child with some mental function but increased her odds of physically surviving?
18 years ago on January 21st we had officially entered some strange form of limbo. It was only apropos that one of the things that I would bring back with me from home was a book that I borrowed from my brother by an author that I had never read before. I opened the pages of The Stand by Stephen King that evening in the hospital. I don’t know why I figure you would care about that detail but that is one of the things that I remember from that day long ago.
January 20, 1993
It’s Wednesday morning. I am not sure what time since time has lost meaning inside the dimly-lit, drab walls of the hospital room.
Heather, my wife, had been hurriedly admitted to an intensive care unit within the labor and delivery ward yesterday morning and had been under constant care all that day and well into the morning. It took that long for the medications to take their course and stop the labor from progressing. That struggle had come at the cost of my wife suffering the worst case of nausea that she had ever experienced – not to mention the back pains that were actually signs of the contractions that her body was initiating as it tried to force our 24-week fetus into a world that it was not prepared for.
This morning we were reminded just how unprepared our unborn child is for this world by a visit from a doctor who specializes in premature births. The baby that is impatiently trying to escape my wife’s womb is somewhere between 1 and 2 lbs. She is about half the length of a full term baby and she has yet to build the fatty layer below the derma that will give her the warm pink tone that she would have if she were to be the full 40 weeks of gestation. The biggest concern though is that her lungs are not fully developed. She will not be able to breathe on her own if she comes today. We are given an option to be part of a clinical study in which they would inject my wife with surfactant made from calve lungs and other steroids that would increase the odds of our daughter surviving if she were to come today. We had agreed to the study and my wife had been given the additional medicines.
But these were measures to deal with the possibility of a premature birth not the birth of a child with myelomeningocele dysplasia (severe form of spina bifida). Our daughter’s spinal column was open to the amniotic fluid that she was surrounded by within the sterile environment of the amniotic sac. My wife had lost the mucus plug that keeps the cervix sealed during pregnancy and the bag that was the only defense against an infection that could kill our daughter was already beginning to ‘fall’ outside the uterus through the open cervix. The doctors had made it clear that natural birth would be a death sentence for a fetus that was facing such a premature birth with these medical considerations. If my wife progressed any further with her labor, she would have to be rushed to the OR for an emergency C-section.
We are still waiting on a visit from a neurosurgeon who is a specialist at the Childrens Hospital that is about 30 minutes down the road. We are anxious for this visit because he will have to perform surgery on our daughter the day that she is born to close the opening on her back and to treat the hydrocephalus if she is to survive beyond her first day of life.
We haven’t slept or ate. My wife has spent the night vomiting and I spent the night catching it in a pan. I am still in the work clothes that I had meant to wear to work the day before. All of this information is coming at us so fast and we are making decisions that we don’t fully understand.
Can I share something with you?
I am scared. I don’t know what is going to happen or how things are going to turn out. I don’t know if our baby is going to make it. I don’t know how all of this is going to impact our young marriage. I don’t know how we will financially make it.
Everything is outside of my control. Everything just seems to be happening to us.
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As I am trying to recall the events from 18 years ago, I am trying keep a balance of detail and length of post so that I can bring some understanding of what my wife and I faced without completely boring the reader. January 20th was a day of discovering how big the hill was that we faced in trying to give our daughter the best chance at living. Every time we turned around it seemed we would get more bad news. My wife would have contractions from time-to-time during that day and each time we would brace for ‘is-this-it?’ Her nausea would continue but would stabilize so that she wasn’t so sick by the end of the day.
I will continue with this series tomorrow.
January 19, 1993
I am dressed in clothing that is suited for working construction in the winter – old jeans, work boots, and some heavy flannel. Just 4 months earlier I had walked out on an office job where I was able to stay out of the elements while wearing clean jeans or dockers with an oxford shirt. I gave up a steady paycheck with benefits to slog it out building houses in the middle of winter where the pay was based on how many days of work that could fit in the ‘good’ weather days. Oh, and I had no benefits with the new job. No insurance. No pension. No nothing.
Of course, I made this move when my wife was pregnant with our first child.
‘Smooth move Exlax.’ Those are my thoughts as I scrape ice off the two vehicles that we own as they warm up in the early winter morning. One vehicle will take me to work and the other will be used by my wife to make the trip to Dayton, Ohio for a high risk pregnancy check-up. Yeah, I guess I should catch you up on that particular point. On December 21st, my wife went in for her first ultra sound and discovered we were having a little girl and that she was 4 months along. Two days later on December 23rd, the doctor called us both back to the office to inform us that we had a non-viable fetus. She, the doctor, had wanted us to schedule an abortion.
In the 27 days that had elapsed between that moment and this one, my wife and I had learned what an emotional hell the decision process is for contemplating ending the life of a child we had dreamed over. Three genetic counselors had given us the same news as the doctor who had reviewed the ultra sound with us. Our ‘fetus’ had a severe neural tube defect generically known as Spina Bifida with Hydrocephalus (water on the brain) secondary to that condition. If an infection didn’t kill her, the Hydrocephalus would destroy most if not all of her brain function. If she somehow survived through childbirth, our best hope was to have a child who would never be self aware. She wouldn’t know us. She would never give us a hug or say I love you. She would just be a body where the dream of our daughter was supposed to be. That was if she survived.
We had talked over our options with family members and some thought we should have the abortion, some supported us whatever decision we made, and then there were those who told us that they could never forgive us if we went through with an abortion.
I’m 21 years old as is my wife. I am working a construction job with no benefits while my wife makes a few bucks working at a local pizza shop. We barely have two nickels to rub together and we are facing the prospect of giving birth to a baby which will need extensive medical support if it survives the pregnancy.
What would you do if you were me?
Well today I am going to go hand mix some mud for two brick layers while my wife heads off to the appointment by herself.
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It’s funny. Not ‘ha ha’ but strange. For some reason I decided at the last minute to call off work, which I can’t afford to do, and go with my wife to her pregnancy checkup. I am actually sitting in the examining room, still in my work clothes, watching the doctor as he does his thing.
The doctor’s expression just changed.
Something’s wrong.
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18 years ago my wife and I were in a hospital room for a high risk pregnancy checkup when she was almost 5 months along with our first child. The doctor looked up at us during the checkup and told us that my wife had gone into labor. She was 4 centimeters dilated and the amniotic sac was protruding from the cervix.
My wife would be rushed from that room and admitted into the hospital where she would be given Magnesium Sulfate to stop the contractions and placed on an inverted bed in the hopes of having gravity work to pull the amniotic sac back inside the womb. This would cause her to become very nauseated with the inevitable outcome of upchucking while hanging upside down.
That was January 19, 1993. Our daughter would not be born until January 23rd.
I am going to try to recall some of the events of that week over the next few days as our family prepares to celebrate the 18th anniversary of Lauren’s birthday this coming Sunday.
Death and Children
Six years ago I took my oldest daughter to our current church for the first time. She fell in love with the choir right away and on Wednesday nights, she would skip out on her class in order to just sit in the back of the auditorium while the choir practiced for Sunday morning. She was 10 years old and her wheelchair made it easy to spot her.
That’s probably why Ron noticed her that first night.
Towards the end of the practice that evening six years ago, he stepped off of the stage and came over and introduced himself to Lauren. There was an instant connection between the two. She was 10 and he was in his late 60’s – she was in a wheelchair and he was bent over at the waist unable to straighten his back to stand up fully. That night started a pattern of the two looking each other up at church to see how each other was doing. They would talk about life and how God was good even though they both had to face several surgeries.
Lauren came to recognize Ron’s car because it was a PT Cruiser with a Tasmanian Devil on the front wheel wells and she would make it a point to look for him so that she could give him a hug. There were times she would call him on the phone to check up on him when he was doing poorly and he would do likewise.
As a parent, it was comforting to see the compassion that they each had for the other. That compassion has defined Lauren’s response to people around her – especially people who are suffering through health problems. At church, she always is on the lookout for Ron and for another lady, Millie, who is suffering with Alzheimer disease. In school, she looks for the lady that used to work in the nurses office who has been battling cancer for years now. Those three persons are in Lauren’s heart.
Last night we received a call that Ron had passed away. I sat with Lauren and told her the news and she cried in my arms as she said, “I didn’t get to talk to him one last time.”
Today we found out that Millie passed away a few days ago while we were out of town. My wife and I have decided not to burden Lauren with that news at this moment – or the news that her friend from school is doing poorly.
As a parent, I am finding myself trying to comfort my children with the same platitudes that my parents used with me as a child. The words feel no better coming out of my mouth than they did going into my ears as a child. As adults we have become desensitized to the harsh reality of death. We lean on the understanding that there is a better life after this one as a way to placate our knowledge that death is a curse. We may giggle at the platitude, ‘everyone wants to go to heaven, but nobody wants to die’, but there is truth in those words. God did not create us for death but for life. Death is unnatural but we repeat the words that its just part of life.
What? Death is part of life? Since when? Death is no part of life.
Children feel that deeply.
Our Christian faith teaches us that death is not the end for those alive in Christ but just the beginning of an eternal reality – life everlasting. However, we as adults should not be so quick to forget the heinous act of death for what it is – it mirrors in small, through physical separation, what eternal damnation is in large from a spiritual separation. Its a reminder of the judgment that God has placed on all sin.
We can thank God for those lives that leave this world in Christ, but we should weep bitterly for those who don’t.
Southern Hospitality
Today I booked a get-away weekend for my family to Nashville, Tennessee. While booking the hotel room, we discovered that the CMA Music Fest was in town for the same weekend that we had decided to travel there. We were super excited to find out that Reba McEntire was playing at the LP (home of the Tennessee Titans football team) on the first night that we would be in town. My oldest daughter is a huge Reba fan so I went to the ticket site and tried to purchase seats for the concert.
That is where my trouble started. My daughter, Lauren, the one who loves Reba McEntire, is 16 years old and paralyzed from the chest down. She uses an electric wheelchair to move around this world so I selected the icon which was provided for purchasing accessible seating. I received an email within minutes from TicketMaster stating that I would have to book the seats directly through the CMA Music Fest site so I looked up the number and called them.
I spoke to a nice young man who informed me that there were no seats left in the wheelchair seating section but that there were plenty of seats available elsewhere. I asked him if I could purchase regular seats and just transfer my daughter from her wheelchair to a regular seat once we were inside the stadium.
That was when I was informed that if a patron came into the stadium in a wheelchair that they had to remain in their wheelchair. He suggested that I speak to a supervisor to see if there was something else that could be done. I accepted his offer and went on to explain what had occurred to the young lady that came onto the line after I was transferred. She confirmed what the young man had told me, but had some helpful advice.
If you want to carry her from the parking lot to her seat that would be fine.
I know she was trying to be helpful so I tried to explain that my daughter weighed around 125 pounds and that carrying her would be quite a feat from the parking lot to a seat through the crowds.
I have to admit that I was a little disappointed that my daughter’s wheelchair was going to keep her from going to a concert in a stadium that can seat nearly 70,000 people for a football game but couldn’t find a way to let her have a seat unless she could get to it without her wheelchair.
It weighed on my heart all afternoon. She didn’t know that she was going to miss out on an opportunity because of her handicap but I did. For better or worse, I made a decision by the end of the afternoon and called the CMA Fest ticket line.
If you happen to be at the LP field on Thursday, June 11, you may see a father carrying his 16 year old daughter through the ticket line, through the hallways, and finally to her seat. I don’t know how much longer I will be able to do these types of things for her, but I wasn’t going to let a little bit of Southern Hospitality stop her from having the opportunity this trip.
This World; Downside Up
Earlier this week, I wrote this post about one of the humorous lessons we learn from parenting. Today’s installment is a little more serious. I need to give you a few details before I get into the actual post.
My eldest daughter, Lauren, was born 4 months premature and has a neural tube defect known as Spina Bifida which is further complicated by Hydrocephalus (water on the brain). At 1 pound 8 ounces and needing emergency surgery, she wasn’t expected to make it through her first day (or the pregnancy for that matter). She is paralyzed from the chest down and requires a wheelchair to get around. There are many complications that have required surgery since her birth some 16 years ago – 47 or 48 surgeries to date.
My post today will be about a lesson that I learned during a hospital stay following a surgery that didn’t go as expected. She was about 10 years old at the time and this was a period in my life that I was learning to stop running from God.
Tired. Driving to the hospital that is all that I can think about. Its so hard to balance the real world with the one that I will be entering in just a few minutes. The Childrens hospital is a sterile world where time weighs like an iron mountain on the backs and hearts of parents who wait. We are all waiting on a hope that seems so slippery. Like a bar of soap in the shower, it manages to spring from the hands that grasp at it too hard. Tired. Yeah, I am tired from wrestling with a hope that doesn’t cast a shadow in either of my worlds. Pulling into a parking spot, I resign myself to the fact that for the next 24 hours I will have to hold up that iron mountain so that my wife can have her shift in the real world.
Walking down the claustrophobic hallways, I reflect on the fact that its Saturday evening. People my age are at home having dinner with their healthy sons and daughters while my daughter fights through the after affects of a surgery that almost took her life. Just days before my knees had almost buckled when the doctor had come out too early from the operating room and called my wife and I into a private counseling room. There he had told us that they had inadvertently poked a hole through the main artery that goes into the heart while prepping her for surgery. They were trying to stop the bleeding but they may have to crack her chest open to save her life.
We had been fortunate. They had been able to stop the bleeding without diving into her chest cavity. Now she would need several months of healing before they could retry the surgery. I had to put that thought out of my mind and instead just focus on the here and now. At least tonight I would have a love-seat to ‘sleep’ on since Lauren had been upgraded from the Intensive Care Unit to a regular room while I was in the real world.
I take one last mental breath before walking into her room.
She is tired. She is my wife and I can tell that its been a long night and longer day for her. I ask, “How is she doing?”, while I glance over to the bed that is surrounded by machines that monitor her oxygen saturation, heart rate, breathing, blood pressure, and give her fluids. Two tubes run from her body to take away fluids. One is a catheter and the other is a chest tube that keeps the pressure from building up on her lungs and heart because her body is still trying to heal from the puncture to her artery. My daughter is a small-bodied girl lying asleep in the mix of tubes and cables. Her eyes look bruised and puffy in her sleep and her pale hands seem too fragile for the IV’s that are taped there.
“She’s been in a lot of pain”, she answers me quietly not wanting to wake Lauren. “Mostly from the chest tube. They just gave her some pain meds so that she would be comfortable and she fell asleep.”
“How about you, how did you sleep?” I already know the answer but its the type of conversations that are mandatory in the hospital world.
“Not much because Lauren didn’t want me to leave her side. Hopefully you will have a better night. At least it will be quieter in here.”
“Well, why don’t you go home and get some sleep.” It was more of a command than it was a question. “I’ve got it from here.”
I watch as Heather gathers a few things before putting on her shoes. As she readies to exit the room, she looks to Lauren and then to me, “Call me if anything happens.”
“You know I will, but it looks like its going to be a quiet night.”
“Lucky you”, and with that she slips into the hall looking for her escape into the real world.
I take the seat that she had just been sitting in and prepare for my time of bearing the load. The room feels stale and some how it carries off a muggy-cool temperature. Everything seems to scream that this is a sick place, even the painted butterflies on the ceiling seem to be fighting to escape upward away from this room. I close my eyes hoping to shut out this world but its sound drones on me even more now that it has more of my undivided attention.
Forty-five minutes pass in this manner as I try to find a way into the world of sleep where these machines and smells can’t follow me. My attempts are interrupted when one of the alarms starts to sound loudly. As I am looking over to see which one is the culprit, nurses rush into the room.
“What’s going on?”, concern coloring my question.
They are busy checking machines so they don’t look at me when they answer, “Her blood pressure has dropped too low.” Then looking at my daughter, they begin to shake her slightly, “Lauren, sweetheart, we need you to wake up. Take some big breaths for us.” During this episode her oxygen saturation has also slipped below the limit that they have set on the machine.
But I look at the blood pressure reading: 32 over 18. I am instantly converted to full panic mode. All I can do is watch as they continue to work with Lauren. I am scared.
A resident had entered at some point but I hadn’t realized it until he turned to me and said, “We need to move her back to the ICU because we are not set up down here to watch her closely enough. We don’t know what is causing her BP to fall so low but we have called her doctor and we are going to move her now.”
Machines are unplugged from the walls and allowed to go on battery backup as they pull her bed out into the hall. I follow and watch my daughter. Her eyes are so sleepy – barely open but watching. Her hair is a blond mess slightly pulled back beneath her head and her skin has a sallow glow to it. She looks as if she has visited death’s door and brought some back with her. And now it wanted to return, taking her with it.
Her bed is pulled into an ICU ward and I am allowed to stand beside her bed next to her head as they hook up the machines and pass off information.
Lauren looks at me as I take her hand in mine and she whispers, “Its Ok, Daddy.”
Her words stabbed me in the chest because I am the parent. I am supposed to comfort her. She is the one that is sick and hurting and I am daddy and I am supposed to make it all better. But I can’t!! Instead I am a scared mess.
I want to pick her up and take her away from this upside down world where little, sick girls try to comfort daddies.
Its been years since we went through that little bit of hell on earth. Lauren pulled through that night but it took several days for her to get well enough to come home… and we still don’t know why her blood pressure kept falling during that time.
One day, years later, God reminded me of that night and what Lauren said to me. And He had this to say to me, “Why do you keep telling Me its Ok?”
He has a way of making this world look Downside Up – where He is in complete control.
“For the least of these”
30 Second Rule 
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