Ah, vacation

I am on vacation this week of 3-17-2013. The first two days were beautiful days in Arkansas, 70's and a lot of work done outdoors. I am trying very hard to limit my snacking and to record calories in order to lose weight. It works, it has in the past and it is pretty much a tried and true method for me.

I have noticed some results that I thought might be there but wasn't sure. The less I eat, the longer space I get between eating something the more regular my bowels seem to become. The last two days I have not gone BM until the evening. I have not gone as frequently and I have had greater volume of output. I think there are two things at work here. First is I've cut down on the amount of snacking. Second the stress level of getting up and going to work is reduced and my days have pretty been my own to start. I've gotten a lot done and have been more physically active in the last couple of days than normal. All of that is good. 

In addition I've stayed away from an excess of chocolate, fatty candy bars. That also seems to be a trigger. So right now, the early indications are good, I am relaxed, work at my own pace, don't have too much in the way of obligations and my system seems to be functioning quite nicely.

My wife always says, moderation. For a person who has most often lived a life of excess that is tough to follow, but the proof is hard to ignore.

Paragould, Arkansas 3-17-13

Update: 1.5 years.

It has been approximately a year and a half since I had my second bowel resection. This morning I had my forth Flex-Sigmoidoscopy. This is a modified colonoscopy to check the sigmoid region of the colon. This is where the cancer was located the last two times. It has been a procedure on two levels. Preparation and procedure.

The preparation is different than a colonoscopy. The preparation has consisted of me taking two enemas at home in the evening and then one at the hospital right before the procedure. The idea is to clean out the the lower part of the colon so the Dr. can see the area clearly. In a colonoscopy you drink a prep that is a powerful laxative and flushes the colon all the way to the small intestine so the Dr. can get a clear view of the entire colon. Both are effective procedures for what they are intended.

The procedure is nothing. The prep is a pain. The last time I had a flex-sig my system did not react well. I soiled myself in the recovery room, I soiled myself on the way home and had to hit the shower and take my clothes off. My system does not seem to tolerate invasive inspection and I have a heck of a mess. Plus for a day maybe two I can have accidents and it is humiliating.

This time I prepped a little differently. I took a whole bottle of laxative, I think the name is Magnesium Calcitrate. It is a fairly strong laxative but not of the flushing variety. I stopped eating any solids at noon the day before the procedure. I took the laxative in two doses one at 4 PM the other about 5:30 PM. It worked, I went quite a bit and was fairly comfortable except my lower abdomen felt bloated and crampy. I took the first enema about 8 PM. I ended up going until about 1 in the morning and wore adult paper diapers because I don't have control when I am prepping.

Had one funny incident. I had plumbed the hot water heater in our trailer that afternoon before the prep. I was going over to check on the repair so I did not end up with water on the floor. I went over there about the time I thought the trips to the john had slowed down. However upon trying to return I couldn't take ten steps without heading to the toilet. I was wearying sweat pants and briefs on the bottom. You learn to wear clothes you can pull down easily when you prep. Also, tuck your tee shirt into your sweats. That way you don't waste any time fumbling with a long tee trying to get you pants down. Well, anyway, I had a couple of accidents. Soon I was reduced to nakedness on the bottom and it was raining cats and dogs out, it was cool, in the 40's and I'm stuck in the trailer. Finally my situation eased to the point I thought I could make it back to the house. It is a short distance, some 30 feet, but with few clothes on, and heavy rain and cold air on you butt the trip back was rather stimulating.

I was finally able to go to sleep about 1 AM. I figured on getting up at 3 to take the second enema. I slept in until 4, Terry woke up and started the morning ritual so we could be off to the hospital. I was supposed to be there at 5:30 AM. I got up, did the enema with good results I felt no cramping of bloating so I think my prep from the day before was paying off. The drive into the hospital was uneventful.

After checking in I was taken directly to the procedure room. No stop in the prep room, the hospital was overflowing with patients and in fact the procedure prep room was half full of regular patients because they had no more rooms. So the nurses that participate in the procedure helped in the prep. Everything went well and I was feeling good. Now usually I have to take one more enema, but because everyone was out of procedure it was overlooked and I was not going to say anything. I've had some pretty disastrous episodes in the prep room when I take that enema and I did not want to repeat. Especially since I was so far from the bathroom and so many people I had to walk/run/scamper past.

I do not take any drugs for this procedure. During a colonoscopy they give you amnesia drugs so you don't remember the discomfort. 
The flex-sig is only going up a short distance and is not uncomfortable. Well, if you are a guy and had a prostrate check you know the feeling and it isn't even that bad. I was awake, the Dr. and I carried on a conversation. He did go up the colon some and ran into a dirty area. He asked if we did a prep and I said yes, I told him what I had done and asked if it wasn't enough. He said it was OK for our purposes. 

The procedure concluded and I am fine. The surgeon did have an observing Doctor. Terry said she looked Indian, (SE Asia) and was quiet. I was in the same room as my doctor dictated his findings. He went on to explain to the visiting doctor my situation. I learned a few things. First the procedure shows no indication of recurrence and everything looks fine. There are some titanium stitches working their way out but no cause for concern.

The biggest information I learned from the conversation between the two Dr.s. follows. My surgeon explained that I had had an initial resection in 2007. The tumor recurred on the anastamosis which is the surgery point of the initial surgery. This type of recurrence is very infrequent. That I knew. What I did not know was that the Dr.s considered this case to be complicated and were maintaining an above average monitoring of the situation. On one hand that made me feel good. On another level it was scary. I also learned that which I suspected that the "rectum cavity" is for all intents and purposes gone. He showed me where the outer skin had been brought around into the anus to make up for the lack of internal material. The rectum cavity is a collection point. Most fecal material accumulates in the rectum and when it is full we feel that need to evacuate and so we have a BM. I don't have any storage facility so I end up going a lot. I also don't have the normal warning system. When I get that feeling I'd better get to a bathroom. That is good to know, I suspected that was the reason for my frequent BM's it also explains the low level of control I have. The sphincter muscles have been weakened by surgery and it becomes difficult to hold back the tide so to speak. 

After all I learned today I am happy that recovery seems to be going well. I am happy that there are mechanical reasons for some of the issues I face. I am happy to be pain free and to feel somewhat normal. However, like many cancer victims I have times of apprehension and concern. Every time you feel a pain or a swelling you spend endless amounts of time figuring out the cause so you can convince yourself you do not have stage four cancer and only six months to live. It is a common mental state we survivors end up putting up with. I am happier than I have been in years, I feel better than I have in years. My wife notices a big change in my willingness to get projects going and to make repairs around the house. I  am deeply in love with my wife. She has really been a strong support through all of this and has not shrunk back once but done things I know she has a great distaste for just to help me. She is one fine partner.

Over a year out.

It has now been over a year since I had the reversal surgery to hook my small intestines back to my colon. It has not been the easiest year but I feel so good I can't complain too much. The year has not been easy because I have to go to the bathroom so much. I have had days where 25 BM's was the challenge of the day. On the other hand I have had days when I did not go at all, but that is very rare. Lately however, it seems to be settling down to around 10 maybe. Seems like after I have breakfast I have to go a few times, lunch will have the same occurrence and evening after supper and while lying in bed I more go a few more times. They are all pain free. The consistency varies and that seems to depend upon what I eat, or how much. Our diet consists of meats for most meals, some starch, some veggies, and some sweets. I think the sweets are the biggest contributor. I can eat some vending machine pastries and if I do too much I end up with frequent trips to the bathroom and glue is the consistency making cleaning yourself a difficult, messy task. 

I do wear a pad during the day, if I am at work. I do not have accidents, but I have had and a pad just provides some insurance. If I am at home I am usually just a few steps away from a bathroom so it is not a big deal.

I feel great. My enthusiasm for living has returned. I have been engaged in remodeling our back hall and stairway and it is a great deal of satisfaction to watch it come together. I do not work very fast, and I don't work in the evening so work days kill the work days at home. The project is coming along fine. I am delighted with the tools I have acquired over the years and now making use of so much. Life is great.

If I still continue to go to the bathroom quite frequently I'll be fine. I'm learning to adjust and am thankful for the health I have.

Reversal Part 6

The reversal will require a hospital stay. I go through the usual pre-op blood work, discussion with a nurse and if I understand the procedure being performed. It goes well. I am anxious to have this procedure as the illeostomy is such an aggravation. The skin erosion hurts and looks like hell, the bag still gives us some problems with coming loose, and the routine is fatiguing.

We show up at 5:30 AM and I go into the pre-op room. The nurses are kind, the nurse anesthesiologist is nice and they remember I do not react well to morphine. Seems like even the surgical people are getting to know me. That is not good. Dr. Jones comes in and we discuss what is to take place and that is is a fairly simple procedure as the small intestine has not actually been cut in half but more butterflied and one section poked up through my side. I'm looking forward to having this over with.

I wake up in the recovery room. Once again everyone is nice. Terry comes in to sit with me and I actually begin to feel quite good. No bag, no bags to replace, a sense of freedom. To think that a few months ago I was praying for the bag to get relief from the inflammation and pain of radiation treatments. It seems so long ago.

In the hospital room I really begin to feel good. The Dr. comes to check on me and says he might even let me go home in the morning if I continue to do so well. This is a Friday. Terry goes home hoping that when I call on Saturday she will come and get me. However, things take a downward turn in the evening. I begin to experience diarrhea and it burns my bottom. I go about every fifteen minutes and do not feel well at all. The nurse comes in and explains that diarrhea is a normal reaction to the reversal surgery and helps as best she can but there isn't much she can do. I am up and down most of the night with very little sleep and a real pain in the ass. The acid in my stomach and small intestine is not moderated by the large intestine and burns the rectal area.

Long about morning is starts to lessen but I do not feel good. Being Saturday the Dr. on call is Jones partner. He takes one look at me and says, "You're not ready to go home today." Damn, but he is right. I hurt and don't feel well. By the time he comes in it is Sunday noon and Terry and I decide that she should stay home and we'll see about Sunday. I spend the entire day alone in the room, TV is a distraction but when you don't feel good just having someone there is better. However. Terry has had enough of sitting in hospital rooms and I do not want her to go through that discomfort.

Sunday, I feel a little better. The diarrhea has stopped and I am eating some semi-soft food. I get some ice cream from the nurse, it feels and tastes good. Terry comes and the day passes without too much discomfort.

Monday comes, I'm ready to go home and I am discharged. Hopefully I will not be back to the hospital for a long while. At home I do not have any BM;s because the system is empty. So I enjoy some days of peace and quiet and recover some strength. Pretty soon at night have I have these long, low sounding farts. They are great. They should be recorded. I guess the material is working its way through the large intestine, and pushing a long tube a gas out. It takes several days before I have a BM and it doesn't hurt to go. It doesn't hurt to go for the first time in about a year and a half. This is wonderful.

I fart, I go to the bathroom, frequently and I encounter no pain. I go back to work, but the stool is very soft and I encounter accidents which necessitates putting the pads back into my underwear. It is a small price to pay for not have a painful BM. However I do run into some problems with control and experience numerous occasion when I am with my friends at work where I have an accident as we are standing talking in the hall. No one knows it, but I can feel it and sometimes it is no small amount. I end up having a change of clothes at work and I feel that if I explain my problem to my co-workers that they will understand my strange coming and goings. They do. I recommend for anyone experiencing this type of problem  let you coworkers know, you can describe in terms that are not gross. If they know they understand and have sympathy for your plight. Not that you want sympathy, but they come to take your actions as normal for you and you don't have to suffer the feeling that your coworkers must think you an odd duck.

The condition I experience is chronic diarrhea. The stool is not loose but I go frequently. I go some times as much as 25 times a day. It is a frustrating routine. The accidents I encounter are call incontinence. We associate that with the urinary tract, but it also happens with the digestive tract. I have a prescription drug called Limodal, and I also us Immodium, but I am reluctant to use too much. I'd rather go quite often than plug up.

So long term recovery begins. It is now December and I am back at work full time.

Part 5 Time to Reversal

Kristi arrives in the middle of the night and we talk for a while. One thing I can do with my two daughters is talk, we have some great conversations.

I sleep for a while then wake up in pain, and get another shot. It is not too bad, and I get some rest. The morning brings more meds and a Dr. visit, not the regular surgeon but his associate and that is who is on call during the weekend. It is Saturday. Kristi goes out and gets breakfast, I eat hospital fare as they don't want me to take in too much food until they can make a better determination as to the cause of the pain. The surgeon who did the work has already said he does not want to have to go in there now as it is too much of a mess and it might just really complicate matters. 

Kristi comes back with some cards and a cribbage board. I have not played cribbage in years. I call Terry, she is rested and in better spirits and we talk about her not coming to the hospital. Kristi is with me and she will be staying until Thursday. So Terry stays home, gets some much needed peace and quiet and can nap when she wants to and I'm not underfoot.

Kris and I while away the day playing cribbage, reminiscing about the days when we played cribbage as a family and traveled to the U.P. of Michigan for vacations. It is easy talking with my daughter and I am much comforted. The pain seems to ease and the time grows between injections. In the afternoon they move me to a pill and everything is better. I still have bouts of pain as the meds wear off but they seem to becoming less frequent. 

Sunday comes and the pain is eased quite a bit. Kris and I still seem to find a lot to talk about and we play cribbage, It is the most relaxing time I've had since the start of chemo/radiation. She is a knowledgeable nurse, is constantly critiquing the nursing care at NEA and is frankly impressed with the attention the patients received. Kristi is an RN on a cardio ward in Valparaiso, IN and their nights are so busy they often do not have time to just tend to their wards. NEA nurses seem to make time and have a nice way about them. They instill confidence that things are going OK.

Finally Monday morning, the Dr. comes in, a urologist and they decide they cannot pin point the source of the pain and seeing it has gotten much less intense I am released to go home. 

Home, home, home. You just do not know how good that sounds when you are not feeling good. There is my wife, my dogs, my bed, my stuff and Nurse Kissy. That name comes from her nieces and my grandchildren. My other daughter Jenny's children.

So a pleasant week begins with the attentions of my own personal RN and my wife sharing the burden of care instead of carrying it alone. Kristi does not like the process of changing the bag, at one point she comments, "God, Dad, that is your intestine sticking out." She looks a little white around the gills. Terry and I smile, Terry has learned to tolerate the little devil.

However, all good things must come to an end and Kristi returns home and I miss her terribly. The load is now on Terry, but I am feeling better. 

After a bit I go back to work for a while. I still do not like the rustle of the plastic bag under my clothing. I still have leakers, and Terry is much better at replacing the bag than I am. When I stand my tummy has too much of a bulge, lying down the skin lies flatter and is easier to work with.

I am still suffering skin erosion from the acidic output. It really burns some times and even may bleed a little. No one seems to have a solution. We go back to the Wound Clinic for follow up on the butt wound which is now completely healed. Still the nurses aren't able to make any great headway on appliance attachment. I now start looking forward to the "reversal" surgery in October as the skin irritation is sometimes quite annoying.

The one thing I am grateful for is I have no bowel issues with the illeostomy. The bag is one thing, but I empty it when I want, I do not have an urge to go to the bathroom, I have no pain in the anal area, no inflammation, and am at ease for the first time in four years. I am having should I keep it, should I reverse it talks with myself, but I lean more and more toward reversal as time goes by.

Days run together. I am working much of the time and still having bag problems. However Terry and I seem to have grown at ease with the issues and while neither of us like it we handle it. Terry has become quite good at handling bag replacement and has developed a method that is most reliable even though I still encounter leakage. It seems as if the stool erodes away the adhesive and will literally tunnel an escape route. When we remove the appliance we can follow the track of the leak.

Nothing we do seems to make much difference although once an a while we get one that stays for the full three days. Emptying the bag is my job. It opens and empties through an tunnel into the commode. I use a spray to flush it and rinse it out then reseal it with some clamps. It works until I forget to apply the clamp and then I am the creator of the leak. The initial odor upon releasing the content is quite over powering at times. It is job best done in private and by yourself as it is the nastiest part of the illeostomy. However neither Terry or I notice odors when the bag is sealed and works correctly. Like I said earlier, not having to go to the bathroom with the same frequency I did before surgery is a relief. At least I feel almost human when I'm out and about.

Other than the skin erosion and the cleaning of the bag four or five times a day time passes and I am quite comfortable. October approaches and the date for the illeostomy reversal is soon at hand.

End of part 5

Part 4 Between Surgeries

I have come home, only to have to go to the wound clinic two days later to have my wound evaluated and treated. Then comes the ugly events at IHop. Back home and days of recovery begin, but with the added burden of having this plastic bag attached to my side. It isn't so bad at night, I wear it under my sleep shorts and other than the rustle of plastic is is not uncomfortable.

The visiting nurse comes and helps us understand more about how to attach the "appliance." I will be wearing this appliance for about 10 weeks until the inflammation and incision heal from the resection surgery. For some reason recovery this time is not such a big issue. However, I've been through this before. I do not have the anxiety issue with pain pills because I watch what I take and only take them when I feel some fair amount of discomfort or pain. It isn't too long before I'm taking one in the morning, one in mid-afternoon and one early evening and not taking one when I go to bed because they do not knock me out but put me in la-la land where I don't sleep but just feel good.

The appliance is another thing. We don't seem to master the ability to make it adhere for very long. Plus the output is acidic and I start having skin issues within the appliance. We have ointments to put on, we have antiseptic medications but nothing seems to work. The acid just keeps eating the skin and keeping it irritated. Pretty soon we resort to me lying on the couch when we are going to change the appliance and letting it be exposed to the air for as long as I can stand it. I say stand it because the output from the stoma is not predictable, nor can I feel anything. It just seems to come and I have to blot it with paper toweling. We are going through a lot of paper toweling and it is tiring to lay there and watch you small intestine belch forth waste.

As my strength returns we start to make excursions to stores and shops. For the most part it isn't too bad as long as the appliance doesn't leak but occasionally it does and we have to leave early to come home. About a week after surgery I was lying on the bed in the morning relaxing and thinking about getting up when I noticed a pain in the lower back, right side. It wasn't too bad and considering the surgery I did not think too much of it. It is a Friday. As the morning progresses so does the pain until about 10 AM I am gasping from the intensity of the pain. It now feels like someone has shoved a knife through my back and it is coming out the front. It does not feel like a intestinal blockage, I've had that and the sensation is entirely different. This is powerful and intense.

I tell Terry we need to go to the Dr. We pile in the van, she is driving and I have taken a pain pill but it has not touched the pain. As we go into Jonesboro I am gasping in pain and poor Terry is equally upset. We go to the Dr.'s office, he looks at me and sends me to the hospital for a X-ray and blood work to check for infection. We bundle in the van, down to the hospital and it is excruciating. The attendants can tell I'm in distress and hurry along but still it is over an hour and a half before we have the results and head back to the Dr.'s office. We get there early afternoon and I am really suffering. There is no sign of any cause for the pain, no infection, the blood counts are normal and the X-ray reveals nothing. Then my bag leaks, and I mean it is full and leaking and they have no replacements at the Dr.'s office. The nurse cleans me as best she can and uses adhesive tape to make a temporary repair in the meantime no pain meds. Terry is starting to get upset with the suffering I am going through and starts adding her voice to the urgency.

Finally I am sent back to the hospital and admitted. This is now about 4 PM Friday afternoon. Over eight hours of pain, no pain meds. I am admitted and put on the third floor med/surg area. Nurses are coming in, a RN comes in to take my history, Terry has to do much of the talking as I am in too much pain now. The nurses initially are not able to replace the bag, finally Terry tells them certainly in this hospital there is someone who must know how to properly change the bag. Finally they get two nurses from the oncology ward to come up and they are successful so at least one part of the dilemma is solved for the time being. I am taken down for a CT scan and the pain is so intense I get sick and vomit while in the room only there is nothing to throw up but I have to go through the convulsions. At one point the young nurse tries to help me up from the table I was lying on to have the scan and we can't make it so I inadvertently grab her inner thigh to give me some leverage. I am embarrassed and apologize, she understands and says it is no big deal. I got off the gurney though, back into the wheel chair and back up to the room. By now it is about 7 PM. I am convinced I have passed (a or some) kidney stones. The Dr. says there is no evidence of kidney stones and I finally get Dilaudid to ease the pain. However instead of a drip I am allowed one shot every two hours. A compassionate nurse comes in to put the drug in the IV and says let's see, here is one shot for the first two hours you've been here, here is one for the second two hours, and in forty-five minutes you'll be able to have a third. The pain starts to subside, but it is still pretty powerful.

In the meantime Terry is looking distraught. She has been with me every step of the way, pretty much powerless in the drama except as an empathetic observer. She looks like she would just like to sit down and cry. We have called my daughter Kristi to let her know and about the time I have received the first meds Kristi calls and says she is on here way from Chicago and will be there about two or three in the morning. It is as though an angel has responded. I talk with Terry and we decide she should go home, I am fairly settled and while still experiencing some pain it is milder and she needs to go home and rest. 

She goes home, I'm left to the tender mercies of the nurses and they are great. About 2:30 AM I hear Kristi's voice asking for directions. Here she is, smiling, tired but in my room. I am so relieved I am in tears, along with old "Misty Kristi."

There ends part 4.

Part 3, Resection

After the chemo/radiation work I had about six weeks before surgery so the inflammation and drug effects would lessen and heal For about two weeks after the cessation of the chemo/radiation I was still feeling bad side effects but pain medication seemed to make it tolerable. The problem I had with the pain medication was instead of making me sleepy and groggy I got wired, I fell in love with the world, and had a mellow buzz. It actually got to be quite enjoyable a few hours before bed to take a Vicodin and mellow out watching some favorite TV episodes. I did recognize the signs though and started limiting my intake of the pain meds as I could see a need starting to arise. Having been through that with alcohol I was not going to allow that to start with pain meds.

About week three after c/r I started to note some relief in the anal area as I guess the inflammation was lessening. I still had painful BM's and some bleeding but after week four the bleeding stopped.

The last two weeks before surgery I was actually quite comfortable. It almost made me think, couldn't we stop here. A few days before the surgery the doctor did a flex-sig which stands for Flexible Sigmoidoscopy. It is a short version of a colonoscopy designed to look at only the lower end of the colon. He said while the destruction looked quite complete the damage had to be cleared away and a new beginning made.

I had felt for some time that I would end up with a permanent colostomy because of the previous resection. Both areas of surgery were very low in the colon and I wasn't sure how much was left to reattach. However after four years of bowel problems I was really resigned to a colostomy and actually looking forward to the relief from having to pass a BM through my anal area. The doctor, however, said that if the margins were clean and he could get a little extra movement he would resection. I wasn't worried, either way would be OK, but he was pretty adamant that I should not have a colostomy if I did not need to. His words proved to be correct.

The week of surgery the flex-sig, a CT scan and blood work. This time I had my blood typed and had to wear a wrist band with that additional information in case I needed blood during surgery. That was new.

The day arrived, I was perfectly OK. I talked with the Dr. before and when the anesthesiologist came I told him that last time my experience with morphine was not good. Was there another drug that I could have that would not wire me up so much and cause the severe anxiety attack I had shortly after I got home. The anesthesiologist said there was a drug called Dilaudid that was used if morphine caused a bad reaction. So they switched me to that in the prep room and it worked well. There is a real reason for you to be involved in your care as your preferences or wishes may not be known and you have to speak up. So I went under. The OR was schedule for the max time 5 hours, it went over 6. I had quite a few adhesion and scar tissue from the previous surgery not to include the massive amount of burned scar tissue from the radiation. So I woke in the recovery room with a bag on my right side and a piece of my small intestine poking through my side. It is called an illeostomy as opposed to a colostomy. I guess I did not know what I was going to end up with.

Soon after I ended up in the oncology recovery ward with some fine nurses taking care of me. Terry was there and God love her she was there all of the time during recovery. This recovery went quite smoothly except for the illeostomy bag which plagued everyone even the nurses. It would leak, it did not feel too uncomfortable, but I sure knew I had something stuck to my side. One night nurse, a lovely lady named Michelle, was going to change my bag and went into the lab and got a class A work suit that has a mask and head piece not to say she was covered from head to foot with a plastic outfit, booties and gloves. She will always be known as the "blue smurf nurse." She changed the bag and by this time I was beginning to pass material, but it comes out as a liquid. It is the large intestine that is the water reduction unit, the small intestine is small because everything is like thin pudding. Ah the descriptions.

After five days of recovery, blowing up a lung capacity machine, and enjoying the attentions of pretty nurses I was forced to leave. However, during the transfer of my body from the gurney to the surgical table my left hip had suffered a rug burn. It was quite painful and somewhat bloody. So two days after I came home from surgery I had to go back to a Wound Clinic to have that taken care of. During that time my bag began to leak and the nurses there were experts in bag replacement showed Terry and I some things to look out for. 

When we left, I was famished. So we went to IHop. As I got out of the van the bag ruptured. So here I am with liquid running down my leg, Terry has a low sugar reaction and in we go. I sat through a good breakfast with my bag held so it wouldn't leak and I was afraid that I might smell but apparently the clothing protected me. All in all we made it, but that was the first of many episodes at home and in public with "the bag."

More to follow.