Wednesday, January 30, 2019

Chuguexa, Tomas and The Silver Bullet

This morning we set out for Chuguexa and we arrived without any problem. When we arrived, we noticed that Tomas was not there to greet us.  Another Tomas, told us that he was there since the other Tomas had fallen and was not doing very good.  We made a mental note to visit him.

The clinic went well but it was a diabetic clinic.  Most everyone was out of control and it was for a variety of reasons. Some people had not come for a few months to refill their medicines and others just were not watching their diet.

This mother brought her baby to see us and she was precious. She is only 3 months old but the parents do not have a photo of her so I told the mother that I will print a couple of photos for her.  She is a very content baby.

When we finished clinic, we went to visit Tomas. I was very sad when I saw him. He had fallen and had scraped his shoulder. He was very weak and tearful.  We sat and listened as he told us about his fall. He had been bathing in the tuj and fell as he was getting dressed. Now, all he can do is shuffle and his family helps him a lot.

We gave him some medicine that he needed and then we prayed with him and his family. When we finished, the family served us lunch.

When I arrived in Chichi, I ran a few errands and then it was time to meet for dinner.

Since Jennifer owns the wheels, also known as The Silver Bullet, she sweeps through town and picks us up.  Shes lives next door to her so that is her first pick-up, then they came to my house and then we proceeded to Carol's house.  Chichi does not have many restaurants to chose from so we decided to live on the edge and leave town.  We drove a few minutes down the highway to what us to be an old mill.

It has been very cold, so we stayed pretty chilled through dinner. The food was decent but the company was a lot of fun. The peacock asked us for a photo so we could not turn it down.

Shes and Jennifer are physical therapists at ASELSI, close to where I live.  Carol was the director there at one time, but now she is working some with us .  We are not all here at the same time very much.  Shes goes to Xela every weekend.  Jennifer will be leaving for the states and then I will be leaving a week after her. Carol will be going to the states this fall for several weeks. So, we take advantage of these rare opportunities.  Our main focus is to keep The Bullet in shape!  It is ALL for The Bullet!

Tomorrow, we will have clinic in Lemoa. It should be a busy clinic and I look forward to it.

Monday, January 28, 2019

Clinic in Lemoa and Class in Quiche

This morning, I met Carol on the way to Lemoa and we headed to clinic.  Last year, Carol went with me to Montellano for a surgical clinic and enjoyed it.  Since then, she has signed up for several surgical clinics and has expressed an interest to also help us in Lemoa.  Today was her first day with us and we tried to break her in gently. She started by counting and bagging medicine and then helped to vital signs. The team welcomes her anytime that she wants to help!

We had about twenty-two patients so it was not a busting clinic.

I talked to Fernando, who arrived with Armando the first time that we met him.  Armando is the gentleman that had the mass on his back and he had surgery to remove it a few weeks ago in Montellano. Fernando called to tell me that he had gone for his post-op visit and all is well!  He is healing and not showing any sign of infection. We are so thankful and for that and we always give God the glory!

After lunch, Ana, Carol and I went to Quiche to have a IVAA and Pap Class.  There were about twenty-five ladies present and all went well. They had good questions and there is interest in us returning to do a clinic for them.

When it was time to leave, we had a list of about seventeen names. They also want to speak to the other ladies who were not able to be present today.  We then were invited to have coffee at a nearby coffee shop.

It was a very good day, with positive outcomes!

Wednesday, January 23, 2019

Clinic in San Jorge and Meet Manuel Junior!

This morning, I stopped and picked up Manuel before heading out to San Jorge.  I have not introduced your to Manuel yet, who is our newest employee!

I met Manuel the first time in Montellano, when he was helping with some surgical clinics. Manuel lives in Xepocol, recently finished nursing school in Xela and now is working with us.  When he and Manuel Sut work together we refer to them as Señor Manuel and Manuel Junior.  It is kind of funny watching their response!

I think that Manuel Junior will wear many hats with us, as does Señor Manuel.  Manuel Junior is a nurse, working as a promoter, is learning the pharmacy, does dental cleanings and now is learning how to drive................we appreciate him a lot and his willingness to do what is asked of him.

Since I was just riding, it was a good time to take a photo of the drive back to Chichicastenango.

San Jorge is much different than Chichicastenango, where I live. Chichi is about 6,500 ft. in elevation.  San Jorge is only about 700 ft. and is very hot and dry.  They harvest corn twice a year and primarily use their water to keep their crops alive.

We had a small medical clinic today and we expect that.  Dental won the competition with about eleven patients.

Tuesday, January 22, 2019

Clinic in Patzite

A couple of weeks ago, I blogged about Led Zeppelin and the Stairway to Heaven song in Patzite.

Today, we had a great clinic.  Medical had fifteen patients and I am thankful that these patients came to see us today!

Several people had urinary tract issues and infections. I hope that the antibiotics work well and when they return, they are feeling much better.

One one young lady has mass on the side of her neck, that she has had for five months.  Hopefully, she will return with an ultrasound next clinic. 

We talked with a family who attends the Church of God in Patzite.  They are very interested in us coming and presenting an IVAA/ Pap class, followed by a clinic for the ladies.  We will see what happens there.

This was my view of the Stairway to Heaven today! They had recently washed white clothes and hung them in the wind to dry.

It reminded me of two things.  First, the transfiguration of Christ, as recorded in Mark, chapter 9.  I like the NIV translation that says, "and his clothes became dazzling white, whiter than anyone on earth could bleach them."  I like using bleach and have ruined many clothes by accidentally making a splash.

The other thought was from Revelation 7:14, "These are the people who are coming out of terrible suffering.  They have washed their robes and made them white in the blood of the lamb."

It was a very good clinic with Tomas, Brenda, Aura and Martina.  On the way home, we stopped and had some ice cream........a perfect way to conclude the day.

Tomorrow, we will head to San Jorge.  We are just thankful that the bridge has reopened and I am not expecting to drive five hours again.  :) 

Monday, January 21, 2019

Forward with Chuchipaca Ladies Class

Last year, I began a series on Proverbs, chapter 31, on the Virtous Woman.  This was a class requested by the ladies and we needed to postpone it for a few months. Now, we are up and running again and have a class planned for every month of this year.

I was encouraged since it has been awhile since we met. When I asked a question, they responded with good memories.  What is the name of the virtuous woman?  Where did she live?  Who was being given this advise?

I like to use a lot of examples when I teach, of ways that they can apply what we read. To tell someone that they need to be virtuous, is not enough. How do you lead a virtuous life? What  characteristics are present?  What do I need to change in my life to make this occur?  Examples here in Guatemala are sometimes difficult since the culture is different, but no less important.

There were around 30-35 people present.  This photo is one fourth of the seating in Chuchipaca.

The Power Point that I am using for the class.  Maria translated for me into K'iche' and she did a great job!

Lisa holds a clinic here every Saturday and that clinic continues to do very well.

We will meet again in two weeks and I look forward to our time together.

Saturday, January 19, 2019

Weekend Fun in Panajachel

Once and awhile we get out of Chichicastenango and have a little fun........a little diversion!

Jennifer was in Panajachel for the weekend so Carol and I drove over on Saturday to have lunch with her.

We parked the truck and started walking to the restaurant, which is quite well-known in Pana. It is called Smokin' Joes and it is awesome!  He starts grilling steak, burgers and ribs in the afternoon on Saturdays. If you plan a trip to Pana, be sure it includes a Saturday aftenoon!

Before we ran into Jennifer, Carol and I ran to a little supermarket and pretty much wanted everything in the store. I found this raspberry jam and it looked so good..............yes, I now own it :)

We went back to the restaurant and found a table.  The restaurant was pretty full.  We all ordered the same thing, BBQ ribs................sitting down to a feast.

You are allowed to select different sides so this was Jennifer's plate.  She had a baked potato, green beans, salad and garlic bread.

If you can see Carol's plate, she had the famous macaroni and cheese.  We loved every minute of it and every bite!

It was good to get out of town and have some fun. It was warmer at the lake than it has been in Chichi, so that was an added pleasure.

We offered to take back a plate for Kemmel and Lisa but they had visited Smokin' Joe's the weekend before.  As I mentioned, it is a HOT SPOT!

Friday, January 18, 2019

Mactzul I Clinic, Competition and Driving

On Friday, we had clinic in Mactzul I. I was with Tomas, Aura and Martina.  As always, there is a little competition between dental and medical. Well today, I blasted away and took the win!!  Eleven medical and ONE dental...............ONLY ONE!!  As we were loading the trucks, we were all joking around and then I started feeling bad.  Why??  I know not.  But it use to happen when I would compete with my dad. I always felt bad if I beat him................oh well, I do not think I would make a good professional gambler.

When we finished packing the trucks, I asked Martina if she wanted to drive.  She said yes, so away we went.  We will continue to practice....................Good job Martina!

It is Friday.....and I have big plans for the weekend!! I may tell you about them in another post!

Thursday, January 17, 2019

Guatemala or Alaska?

The last few days in Chichicastenango have been very cold.  Did I say VERY??

This morning, Manuel picked me up and we went to Chichi to have clinic in the church building there.  We had 18 medical patients and it mainly was a diabetic clinic.  It has been quite awhile since I have seen such high glucose readings.  Possibly some is due to the holidays but I do not think so.  Some have not been to clinic for several months.  Did I say SEVERAL??

For lunch, we all ran to a nearby restaurant.  I could not drink my coffee fast enough to get warm. The others had hot chocolate or hot tea.  It was a good lunch with grilled steak, salad and rice.  It had a grilled onion on the side and it reminded me of when JoLee came to visit us in about 2008 or 2009.

I was living in Quiche and often I ate at a house where they grilled steak on the street.  We both enjoy the grilled onion that they usually put on the side of the plate so we ran to the market and bought several of them.  The lady who owned the house was very kind and grilled them for us.  They had flavorful chili and salsa and we were just as content as we could be!

This is Andrea, as she was trying to stay warm though lunch! Andrea loves her hot chocolate made with milk.

We had a good day but it was nice to get home and be a little warmer.

Tomorrow, we will head out to Mactzul I.  I will have clinic with Aura and Martina and Tomas.  We will have another day of competition.......will the winner be medical or dental??  We shall see..........

Wednesday, January 16, 2019

People Continuing to Give

When I was in Montellano with Gaspar and his family, there were other good things happening.  Many dolls were made and brought down by JoLee, who has been working with Health Talents for many years.  These children enjoyed getting a doll when they were close to being discharged.

The children loved the dolls and they brought a smile to their faces.

Thank you JoLee for making the dolls and bringing them down to be distributed!

The beds at Clinica Ezell have been around for a few years. Last year, Health Talents began a bed drive and people donated money to purchase a bed.  The donar was able to have a plate placed on the bed and have it dedicated to someone.

Many of you have met Carol. She is a friend of mine who lives in Chichicastenango and recently retired from working with another clinic, ASELSI.  She accompanied me on a surgical clinic when we were short nurses and she loved her week with us.  She since then has donated her time for several other surgical clinics and purchased a bed.  As you can see, she dedicated it to her aunt and we look forward to Carol being with us in different clinics this year.  Thank you, Carol!

It was exciting to see all of the beds with messages of dedication.  Many know Dennis and Elaine who have worked with Health Talents for many years.

Well, it is time to head back up to Chichi and do a few clinics and some classes.  The Chuchipaca ladies wanted to start classes again this year and we will be having some IVAA and Pap clinics.

Tuesday, January 15, 2019

Armando had Surgery!

I can't describe emotional level at the clinic today. Armando had his surgery on he is ready to return to Jalapa. If you have not seen the story as it has progressed, this is Armando and he gave me his full permission to share his story and photos. Such a very difficult situation for twenty years and now it has been resolved.

He had the mass removed on Sunday afternoon. He was one of the first cases done and he did very well.  During his surgery, Gaspar spent a lot of time talking to his son at the entrance of the clinic.  His son is also very appreciative and thankful. He could have been discharged on Monday but due to the long travel, they waited until today.

This is Armando post-op with Barb. He wanted to express his appreciation and have his photo taken with many of the staff.

He asked me to take a photo so he could see what the back of his neck looked like. It is a very emotional time for him and this surgery will change his life. He has been limited in his movement and how he sleeps for so many years.

Armando ready to escape the clinic. One more photo with Jenni, who works in recovery and Rita who works with patients pre and post-op.

We wish Armando the best and I am sure that we will see him soon.

Last night, we celebrated Ashley's birthday.  She lives in Ohio and this is her first surgical trip to Montellano.  We hope that she enjoys her time with us and will want to return in the future.

Many thanks to Rick and all of those in Montellano, who have come and donated their time.  During the week, you touch more lives than you are aware of. May God bless you during the remaining of the week. May you have safe travels back to the states and find your family and friends well.  Thank you!

Saturday, January 12, 2019

Burden of Armando

A little over two months ago, I received a message from Jody, who had seen my blog or a posting of Health Talents. She left a message, asking me to contact her since she knew of a man in Guatemala that needed some help. I responded to her message but she did not have a lot of information on this gentleman.  She and some others had recently been to Guatemala and saw this patient but were not able to help him.

Jody did not know his name or where he lived, just that he was in Guatemala. First, I want to let you know that I have asked this patient if it is alright that I share his story and photos and he was not hesitant at all.

So, this man's name is Armando and he lives in Jalapa.  Jalapa, according to the Google map is 4.5 to 5.5 hours from Chichicastenango. He unfortunately has had this mass growing for twenty years and has not been able to find help.

This is the photo that were sent to me.

I was at the coast when I received the photo. I spoke to Rick about the possibility of doing the surgery in January. He told me that Dr. Scott would be there and to contact him to see what his thoughts were. Dr. Scott and I shared emails and he thought that this patient would be a good surgical candidate.

Jody had a contact in Guatemala, who knew someone else and eventually we found Armando.  He traveled to Chichicastenango and was accompanied by Fernando.  This was the first time that either one of them had been here. I gave them directions to our clinic in Lemoa and we met with them around mid-morning on a Thursday.

I was thankful that Lisa was with us that day. We examined him and spoke with him about having surgery in Montellano in January but the schedule was pretty tight and we did not know if he would be seen or not. We gave him papers to have his lab work done and when I heard that there was space for him, I called and told him to go ahead and complete the lab work. He returned to Chichi with his results and we signed his surgical consent papers.

Tomorrow morning, Gaspar, his family and I will be traveling to Montellano. Armando will be leaving Jalapa around 3 am, with his son, to arrive in Montellano.  Gaspar drew them a map the other day in clinic since this is all new territory to them.

What a blessing this will be if Dr. Scott is able to proceed with the surgery!

Tuesday, January 8, 2019

Clinic in Patzite

Today we had clinic in Patzite. Martina and I met in Chichi and took a different route than usual due to a bridge being closed.  We met Aura, Brenda and Tomas where we hold clinic. We unloaded the trucks and began our day.

We usually have a lot of competition here and I always lose.  Aura is competitive and I enjoy that and I do not mind losing to her on patient load.........I do prefer to win but I know when the odds are stacked against me.

It was a chilly day so it was nice when they called us for lunch.  We had beans, rice, tamalitos, chili and coffee. We used the tamilitos as hand-warmers before we ate them.

As many areas around Guatemala continue to grow, up go the houses, buildings, offices and different constructions.  This is my view from where I see patients. The building has recently been painted lime green, I think that is the color :) :) and the stairway was added on.

Right away, I thought of the Led Zepplin song, Stairway to Heaven.

There's a lady who's sure
All that glitters is gold
And she's buying a stairway to heaven.
When she gets there she knows
If the stores are all closed
With a word she can get what she came for.
Oh oh oh oh and she's buying a stairway to heaven.

So anyway.........medical finally tied with dental, each having eleven patients.  For the first time, I could have won but I did not charge last the patient that arrived after lunch.  She was the daughter of the lady that helped prepare that wonderful lunch. No, it was just a sidewalk consult :) :) :)

While Revelations gives us an idea of what heaven will be like, I am sure that it is something even more beautiful that the writer of  this song imagined. It is not something that I spend a lot of time thinking about. Our human mind, directed only by human experiences can not fathom eternity. We are too time oriented. It can not understand being face-to-face with God Almighty. Being in total light with no darkness or in a sinless existence, is not something we can comprehend.

I only trust that God will make it as perfect as He has promised.  I would rather spend my time preparing myself and helping as many who would like to make that journey. I want to be sure that I will be climbing that stairway to heaven.

Monday, January 7, 2019

The Babies Are Ready!

It is seems that February and August roll around quicker each year!  In just a few weeks, we have three babies who are returning to Montellano for their palate surgery.  We pray that God will continue to bless those that sponsor children and those who come to Guatemala to help during the surgical week.

Jesus had a heart for children.  Even when his disciples tried to turn the children away, Jesus brought them close. 

Matthew 19:14-----Jesus said, "Let the little children come to me, and do not hinder them, for the kingdom of heaven belongs to such as these."

This was Dilon last year before his surgery. His surgery touched many of us, since it was sponsored BY a child.  Ava, had heard about helping others and wanted to do the same.  She made bracelets and sold them to sponsor Dilon's surgery.  Yes, inspirational!

This is Dilon, a year later! His parents are very thankful and appreciate the future that Dilon has.  Thank you, Ava!

This is Brayon and one of my favorite photos from last year!  I apologize the latest photo did turn out well, so I will post another as soon as I can.  Brayon and his parents are doing well.  Brayon is running and will hardly sit still.....hence, no photo update.  His surgeries are sponsored by Angie and his family thanks you!

Nelson, use to have head-light eyes but he has changed!!  He could have won any staring contest last year........but he has mellowed!!

I actually bored Nelson and could not keep him awake for the exam. His surgery is sponsored by Beverly, Wayne and Doris from Lenoir, North Carolina.  I am working on getting Beverly and Wayne down here later this year. Hope to see you guys soon and thank you for helping Nelson!

It was a good clinic today!  We have hired a new guardian for the clinic.  As you can see the path is worn from the road up to the clinic porch.........we do not need lawn mowers or machetes, just cows and lambs.  We are still in the dry season so we are surrounded by dust and allergies.

Tomorrow, we will have clinic in Patzite and a little competition between medical and dental.  Of course, I am accustom to losing to Aura and Martina and I am sure that I will again tomorrow.

Sunday, January 6, 2019

Worship in Chichicastenango

This morning, I decided not to go to Quiche where I usually attend worship. The bridge between Chichi and Quiche has been closed by the government for about a week. Well, they say a week.....we will see what happens. It will cause some difficulty for us, as we travel to different communities.

Around 2009-2010, the bridge collapsed and they rebuilt is.  As the work was being done, we would take a minivan to the bridge, climb down the embankment, cross the river on some planks, climb up on the other side and then hop another minivan to arrive at our final destination.  Now, about ten years later, we will relive the same adventure.

The lesson today, was as many lessons have probably been world-wide since the beginning of the year.  It is a common time when people make new resolutions or goals. His scripture of focus was taken from Psalms.

Psalm 121

I lift up my eyes to the mountains—
    where does my help come from?
My help comes from the Lord,
    the Maker of heaven and earth.

He will not let your foot slip—
    he who watches over you will not slumber;
indeed, he who watches over Israel
    will neither slumber nor sleep.

The Lord watches over you—
    the Lord is your shade at your right hand;
the sun will not harm you by day,
    nor the moon by night.

The Lord will keep you from all harm—
    he will watch over your life;
the Lord will watch over your coming and going
    both now and forevermore.

We see beauty all around us. Even those who do not believe in God enjoy the mountains, sunsets, sunrises and refreshing rains. The creator of the universe makes himself available to us, if we accept him. That is where our help and our strength comes from.

I ask patients when they are hurting or when they have a sick child, "What is one of the first things you do when you have struggles and are concerned?" The majority of the time, they respond with, "I pray." It is natural for us to seek God since we know there is a higher power. We may not totally understand it but we believe that there is something greater than ourselves.

I find comfort in that. I know that I do not have all of the answers. I know that I am powerless. I know that I need his daily guidance. He watches over us...........constantly. He does not sleep, he keeps us from harm and he will never leave us.

Let us rededicate our lives to the True God and study to know what he demands from us.

Thursday, January 3, 2019

First Clinic of 2019

Our first clinic of the year was outstanding! At the end of the day, I was so thankful for the events that had taken place.

I was preparing a few things this morning and Gaspar asked if I had time to speak to someone.  I responded, "Of course!"

Gaspar returned with a gentleman that I knew, but could not remember how...........and then the gaps in my memory began to fill. This gentleman, Rigoberto, had brought his daughter Nancy to see us late in November of 2017. She was seventeen years old and showed all signs of being in severe renal failure. She did not have any significant history, so it was a real concern for many reasons. We referred her to the national hospital in Quiche and she was admitted.

Rigoberto and I would speak by phone at least once every day. For three weeks, Nancy was in the hospital and her dad never left the bedside.  Sometimes he would call me twice a day and I would go visit as I could.  Eventually, the physicians in Quiche wanted to transfer her to the national hospital in Quetzaltenango, since they have better services for kidney patients.  Rigoberto did not understand all of this and kept asking for help. I asked him to listen to the physicians.  When Rigoberto agreed to have her transferred, there were no ambulances to take her. I spoke to Kemmel and then went to talk to Gaspar, to see if he could take her.  He agreed and that afternoon they went.

The last few times that I spoke to him, he said the physicians were talking about doing a kidney transplant.  He was told that her kidneys had failed and without a new kidney, she would die.  We did not hear anything for a few weeks and then when I called, he did not respond.  Well, Gaspar and I both thought that Nancy had died.

Today, Rigoberto was flying high and tearful and he told me how well Nancy is doing! They started dialysis on her and she remained in the hospital for several weeks.  She returns to the hospital once a month to have her labs checked.  She finished 2018 doing dialysis 4 times a day, at home, but now they are reducing it to three times a day! He is one thankful father!

Gaspar and I talked to him until it was time to start our devotional.  We talked about how hard illnesses are and sometimes we do not fully understand everything.............but sometimes, illness can be a blessing. Sometimes, it can shake us enough to reconsider our relationship with God.  Life can be painful and there is nothing more painful than losing a child. A parent would rather die themself than to see their child suffer. But sometimes, we are given another chance or more time to make better decisions that improve our relationship with God.

As we know from Isaiah 55:8-9---------For my thoughts are not your thoughts, neither are your ways my ways, declares the Lord.  As the heavens are higher than the earth, so are my ways higher than your ways."

This is where our trust and confidence in God are so important........important but not easy. But we do have his promise, that if we are his children, he will never fail us.

Thank you, Lord!


Wednesday, January 2, 2019

Back on the Radar!

I arrived in Chichicastenango today........the three weeks in the states went so quickly but it was a good time.

Mom and I made a quick trip to Freeport Bahamas for a week. We had a really good time.  Someone from the Church of Christ came and picked us up on Sunday. Everyone was very welcoming and friendly.  Our accommodations at the hotel were nice and the food was excellent. The pool was huge and it was not crowded.

This was our last breakfast before we headed to the airport.

One last minute to play.

Mom loved it and we had a relaxing time.

Mom, Dad and I had dinner out with some friends and this was a couple of days before I returned to Guatemala.

Returning was an adventure.  As I have said many times, I do not have a boring life.

As I was in Miami, ready to catch the flight to Guatemala, one teenager was entertaining his family with the white mints, Tic-Tacs. He would stuff one up his nasal passage, snort it a few times and then open his mouth to show how it had travelled down so they could see it on his tongue!  What talent!  I help back my applause.

The flight was delayed twice but they never let us know why. When we finally were able to board the plane, there were no crew members to push us away from the gate so we had another 45 minute wait on the plane.

I arrived in Guatemala City, two hours later than I should have. I was frustrated since it was after 10 pm so I called the hotel to let them know that I was going to be late. I did not want them giving my room away since it was New Year's Eve and Antigua was packed.

I quickly found a taxi and we headed out to Antigua.  After about driving ten minutes, the driver pulls into a station to buy gas.  He waits and waits and finally gives up on being served.  We then drove to another gas station and he put a couple of dollars of gas in the tank.......big spender!

Antigua was busting! The streets were packed and I just wanted to eat lunch/ dinner or whatever was quick. I stopped into Burger King since I thought it would be the quickest. All of the restaurants had lines out the doors of people waiting for a table. 

There was a group of about eight people that were not able to control their friend, who obviously had been partying all evening.  They could not get him to sit down, so some of his friends just forced him to a table..............then his girl friend followed them with all of the cokes and then as she reached the table, all of them fell on the floor and flooded the area around them.  But no worries..........the food was still intact on another tray so they sat there wet and started their meal.

The park was full of people releasing Chinese Lanterns or Floating Lanterns.  It was beautiful. I wish that I had taken my good camera and tripod.

A little after midnight, someone started a fire near the arch in Antigua.  I saw it when I walked to breakfast and then it made the CNN News that night.  So fire trucks available and it burnt eight stores on the corner.

Finally back in Chichi and ready to start clinics tomorrow. It should be a busy day.  Several patients who are hoping for surgery in February will be there, with their lab results.  I will keep you posted.