Thursday, January 31, 2013

Post #91: holla holla holla

Here, a brief update told in picture and song:
 
 
BNL was my JAM in college. That's right, I call them BNL. We're tight like that.
 
Do you know what's keeping my awake? Prednisone. I didn't sleep last night, and despite halving the dose, I am still wide awake and kind of jacked up, but not in a productive way. Sigh.
 
SOUP......SO MUCH SOUP
 

Also, I have become a soup vampire. My prey? That bowl of loveliness above. I add extra water and eat around the noodles (or sneak a few, if I'm feeling extra adventurous), leaving nothing but a sad pile of noodle carcasses and chicken (should I say "chicken") chunks in the bottom of the bowl. Gross AND unsatisfying! Wheeeeeeee I'm so tired.
 

Haha, me too! Just kidding.
Perhaps because I am so tired, these dog shaming memes are cracking me up. Like, seriously, I just snorted. I <3 dogs, especially hilarious, naughty dogs I don't have to clean up after.

Finally:

Mmmmm, expensive yuppie goodness
Odwalla, I salute you. Your grown up chocolate milk protein drink has been keeping me afloat for the last week.

That is all-I am going to get in bed and try to sleep.

Tuesday, January 29, 2013

Post #90: Spa day!

I have a mani/pedi at 11 followed by a deep tissue massage at noon......
 

JUST KIDDING! Actually, I have a week long dose of steroids (the real kind! non of this corticosteroid bullshit) and an all liquid diet (for the foreseeable future).
 
When I hear "all liquid diet" a few things come to mind:
 
1.) SPRING BREAK BABY
2.) weird diets celebrities go on to lose weight for big events like the Oscars
3.) jaw surgery
4.) fancy spas. Soups! Cucumber water! Beetroot/ginger/kale/worm dropping smoothies! In between mud wraps, detox like you mean it!
5.) fancy-ass yippies who periodically "cleanse" their systems with home delivered organic juices (I'm looking at you, Mistress GOOP)
 
I was going to list nutrisystem (a shake for breakfast, a shake for lunch) but I forgot about the sensible dinner part. Foiled! At any rate, I don't think about Crohn's, and I don't think about drinking diluted apple juice like it's your job in order to stay hydrated. Suprise! Yet another fun facet of the rollercoaster ride that is my Crohn's.
 
When last I posted, I had just returned from the ER, dehydrated, SOBER (the first rule of Crohn's club is ALWAYS TAKE THE PAINKILLERS. wtf), and freaked out. It's almost a week later, and while improving, the symptoms have not fully resolved themselves. No one is really sure what is going on, but in a bid to buy some more time for the new scary injectible medicine to kick in (yes, I took the plunge), my doctor has decided to put me on steroids for a week, have me do the all liquid diet thing, and hope that my AAC calms the F down.
 
The all liquid diet is, I must say, kind of demoralizing. Nothing says "I'm sick!" like eating drinking BROTH. Ugh. Also, side note, store bought broth is foul-tomorrow I'm going to go all Martha Stewart on broth's ass and make it myself (bouquet garni for the win). I am also going to go buy some Ensure. So far I have been eating drinking watered down fruit juice, watered down Gatorade, watered down soup (like tomato soup, nothing fiber-y), and organic protein smoothie things that taste like the chocolate milk I used to get in grade school. I'm not hungry-I'm actually pretty nauseous-and the one thing I want when I'm nauseous are carbs. Crackers and bread. As you may have noticed, these cannot be consumed through a straw.
 
I feel like these major shifts come on suddenly. Last Wednesday-day, I was fine-I enjoyed a lovely turkey sandwich and went about my business. Last Wednesday-night, I was doubled over and sweating through the sheets. These quick deviations from the expected leave little time to do anything but adjust and plod forward.

So that's what I'm doing-plodding forward, distracting myself with Pinterest, and swimming through a sea of liquids. Cocooning myself in my quilt and constantly checking in with my body for any sign of things that are different-good or bad. Watching endless episodes of "Diners, Drive-ins, and Dives" (don't judge me) and wishing, not for the first time, that I could eat 1/10th of the food they present on the show, or eat food in general with 1/10th of the enjoyment and gusto of the people sucking down greasy chili dogs in some Baltimore hole in the wall.

But before I conquer the chili dog (shudder), I first have to conquer the egg, and the saltine, and if I'm feeling wild, the plain pasta. I miss you, solid foods. I can't wait for us to be friends again. 

Thursday, January 24, 2013

Post #89: Calm, rational, appropriate

mmmm, fluids.
At 1:30, you wake on the inhale; the pain is so sharp, so sudden, it has literally taken your breath away. In the hazy early morning border between awake and asleep, you consider for a moment the possibility that you are having a very disturbing, realistic dream.

Until you try to move your body.

Unthinking, you tried to flip over and glance at the clock, but the pain in your abdomen is so intense, so deep, that any movement feels like ripping. You are frozen, stuck-your breath is shallow, your body quakes. Your hands shake and your body sweats.

This is a pain you have never felt before. You whimper and consider the objects at hand that you might bang against the wall to attract the attention of your housemate. You are afraid.

In your old car, the one with the leather seats, sometimes during the summer you would forget to put down a towel, and your thighs would stick to the warm hide. This is what it feels like, except with your intestines-pulling and ripping away from something hot and painful, sometimes sticking, pulling and stretching and tearing again with each inhalation. You force yourself to breathe, and unfurl, even as your body wants to curl into itself in agony.

Eventually, slowly, you turn onto your back. And then your side, and then you sit up. Glance at the clock. Realize this is not a dream. Force yourself onto unsteady legs, feeling nauseous and hot and shaky. Go to find help.

The tears come, because in the quiet dawn it is all too much. You call the nurse hot line and the doctor on call. They ask you a barrage of  standard questions. You are asked to rate your pain: 10 when you woke up, 6 now. The fact that you are even calling the nurse hot line at this point is a testament to the lessening of your pain. A half hour ago, you would have had to call 911, because you couldn't have made it down the stairs.

They tell you to "come in." You get dressed, your housemate gets dressed, and you drive into the city in silence. It is dark and the freeway is nearly empty.

You make it to the emergency room and your housemate cruises into the ambulance bay, backs up, parks in police only parking, backs up, and finally parks directly in front of the sliding glass doors, the nose of the car nearly touching the glass. At each turn, the security guards half rise from their seats, ready to enforce parking rules in an empty lot. Up and down, like traffic puppets. You walk in and check yourself in to the ER.

As you wait, a young man harasses the intake nurse, badgering her for information about his girlfriend, who he insists "IS FAMILY" and apparently has a head wound. The same security guards warily circle and observe his behavior and as the nurse calls your name, they have moved in tandem to confront the man. You hear raised voices as they take your vitals in a small vestibule that smells like takeout Thai food.

They take you to a large room and measure your vitals again. You explain your symptoms, again. You've never been in the ER of a large, urban hospital (for yourself, anyway) and it occurs to you, as you shiver on a gurney amidst cabinets of scary looking equipment (gauze, suction hoses and buckets, intubation tubes, something called a cut down kit) that this is where people come when they are shot. You and your aching abdomen feel like ER impostors.

You are prodded and a nurse comes in to insert your IV. You offer up your one good vein, and as she tightens the rubber tourniquet and slaps your skin, you worry about the size of the needle. You already feel like throwing up and your last IV insertion was painful. The nurse sticks you, and you feel the needle thread up your vein....until it stops. The room spins a little. "Come on, come on" the nurse whispers, and keeps pushing. The room spins a little more. You feel a trickle of blood drip down your arm, and the course gauze against your skin and the nurse wipes it away. Wipe wipe wipe. Finally, she's in-you can feel her relax. She tries to take blood, and tightens the rubber band on your arm; it digs into your flesh. She flushes the line and secures it to your skin. You both exhale.

She cheerfully explains that because this is the vein they always use for blood draws, there is some scar tissue she had to "push through." You smile even as the room starts to tilt again, because all of this talk about blood and veins is making you sick.

They offer you some Zofran, which you take, because you don't want to vomit into one of the large teal basins they keep stacked in the cabinet. Another line, crossed-you remember that when your family member was dying, they would give him Zofran after the chemo. Throughout all of your IBS/IBD adventures, you refused to take the "cancer drug"-but your family member is dead, and it's 3 in the morning, and you don't care. The medicine works quickly.

You put a gown on over your yoga pants and are thankful you remembered to wear a sports bra, so you're not waving your boobs all around the ER. You pee in a cup, and wait. You wait for blood results, and you wait. You wait for a pregnancy test so they can send you to CT. All of this waiting makes you feel less guilty for peeing on the floor a little when you filled your cup in the bathroom down the hall, pulling the IV behind you and trying not to pee on your gown. It is an ER after all, and you're sure the floor will see much worse fluids before the shift is over.

The nurses, and doctors, are unfailingly kind. They bring warm blankets and offer you pain meds, which you stupidly decline. Somewhere in the back of your mind, you're afraid that if they offer you the meds, and you take them, then your pain will go away and they will never believe you had it in the first place. You enjoy  not wanting to hurl and absent-mindedly rub small circles over the tender spot on your side.

They tell you there is blood in your urine. Kidney stones?

Finally, they wheel you into CT. The nurse who fetches you is almost courtly in his demeanor; there is something old fashioned and respectful about him. He straightens your blankets and makes sure you are comfortable. As you pass through the corridors, you joke about getting the one gurney with the squeaky wheel, like the one grocery cart with the squeaky wheel, and his laugh is quiet and musical. He offers you a purple gloved hand to help you raise yourself up and leads you to the machine, carefully depositing you and securing your legs against a bolster. He and the tech make small talk.

Someone injects you with dye, and sends you in and out of the giant whirring donut machine as they take detailed pictures of your abdomen. The dye courses through your veins, igniting them, making your lips tingle, making you taste pennies in your mouth. The dye makes you hot, like your entire body is blushing. Your hands, above your head, drip with sweat. When it is over, the tech flushes your IV because the dye is "sticky" and she doesn't want it clogging the line. You think of the dye floating through your body, coating your organs like a sticky BBQ sauce. You wish she could flush it out of your whole body, not just your IV.

You wait for the results. Feeling guilty that you dragged your housemate to the ER, you try to make jokes, but she passes out asleep against the case containing a day's worth of discarded needles. You have a lady nurse, and then a male nurse with old-timey mutton chops. Another male nurse with tattoos on his arms tells you about his service in the military, and how he travelled the world, ticking off the various countries on his finger tips. He is from another state, and says when he is sick he wants his mom more than anyone else. You smile, and he says, "Dudes need their moms more than anyone! In the military, everyone is so hard. You just want your mom. It's like, you're soft, you're my mom, you'll take care of me." Even though you are probably roughly the same age, you immediately want to mother the muscular ex-military nurse and make him a lasagna.

You wait, and feel thankful for the kindness of the nurses and the fact that you have medical insurance. You wonder how much this trip is going to cost you.


There is a shift change, and nurses and doctors flood the hallway outside your room, talking animatedly about dates and patients and motorcycles. Out of the corner of your eye, you see a young woman walk by with a giant bandage on her head, telling the nurse to discharge her to her waiting boyfriend, who you assume is the guy who tangled with security hours before. It feels like a completed ER vignette. She stalks by in high heeled galoshes, even though it is not raining.

You wait.

Five hours after you have first been admitted, a new doctor comes in to tell you the results of all of your testing are unremarkable. Seeing your face, he tries to make you feel better by telling you that 3/4 of cases involving abdominal pain go unresolved. Again, you feel like you have failed ER 101. You are still in pain and there is no reason. There are also no more chances for painkillers. You are discharged, less nauseous but still in pain, with no explanation for your sudden, scary pain.

The sun is up now; you decide to walk over to your gastro's office in the adjoining building and see if you can talk to his nurse. She sees you and says the doctor may want more testing. She describes all the ways Crohn's can make your guts feel like yours feel. On her computer, she scrolls through your test results from the ER, when you see this description:
 
31 yr old female presenting with UQR pain. Calm, rational, appropriate demeanor. Seems mildly distressed.

You rub your side, again. The pain is still there, present with the slightest touch. Calm, rational, and appropriate: the title for your  new memoir. Unfortunately, you feel anything but.

Sunday, January 20, 2013

Post #88: Taking care of business

Yup. Still pissed about this.
Get it?! Stall? Like a BATHROOM!? Oh CCFA, you're so clever. (sarcasm!)

I am feeling super tired and gross today (partially my fault, partially my colon's fault); it's been a busy week of crossing stuff off my to-do list, and it's like I'm in an end of the week energy slump. Some stuff I did:

1.) Got through the first appointment with my doctor without crying.
This is big. I met him pretty much a year ago, and have always done the ugly cry in his office. Perhaps it was getting over the hump (ha, hump) of having him meet my AAC in person (goodbye, last vestiges of dignity!) but I felt like this was the first time I was able to have a calm, rational discussion about my situation without being emotional or reactionary.

Since it was my one year anniversary, I really wanted to ask him if he was SURE, really sure, that this was Crohn's. As I didn't want to seem like a complete moron, I may have phrased it like, "Are you sure you didn't find a magical tape worm up there? This is definitely Crohn's?" but the answer would have been the same: yes. It may seem odd that I'm still questioning this, but (and this is difficult for me to believe) Crohn's has only been on my radar for a year. I have only had this diagnosis for a year. It's not like a pregnancy test-you don't pee on a stick and have a little blue colon pop up, like, congratulations! It's IBD! So, after two colonoscopies, as assload of testing, a few flares, and a couple dozen handfuls of steroids later, I guess my stick finally turned blue.

2.) Got scanned
Since I am steroid free (woooo) I finally got a DEXA scan. Basically, they scan your spine and hip to make sure your bones aren't disintegrating due to prolonged steroid use or lack of calcium absorbsion. Sexy! This was the least invasive procedure I've had this month. (see #3)

3.) Got probed
And then learned this bit of intel: did you know that if you have an autoimmune disorder, you need yearly PAP smears? I mean, if you're a lady. I DID NOT KNOW THIS.

4.) Exercised, and felt ambivalent about it
I am so tired of being tired. Every time I work out-something I convince myself is in my best interest-I need a 2-3 hour nap. After a tough work out, I used to like the feeling of sore muscles-a little reminder of all the ass you kicked at the gym. Now, as my butt muscles protest when I climb the stairs, it just makes me cranky. Like, great, I'm exhausted and now I'm sore too. DAMN YOU TOTAL BODY CONDITIONING! It just makes me question the point of working out at all, right now-I started this because I thought it might give me more energy, or some kind of mental boost, or calm my AAC, but it just makes my ass tired (and not lifted). Sigh.

5.) Donated blood (to the lab)
A quick AMP story: for whatever reason, the phlebotomists at the hospital are uniformly hilarious. After my appointment, I went to get blood work done, and as the guy was cinching my upper arm with rubber tubing I peeked at the number of vials (4) he was about to fill. He was a pretty quiet guy, and when he saw me looking at the tubes he kind of smiled and handed me the packet with the needle in it. "Did you want to draw the blood? Go for it." I laughed and said I was just seeing how much blood he was going to take. Without missing a beat, he replied, "Just the 4 the doctor ordered. And then of course the extra 2. For Craigslist." He was so matter of fact about it, my eyes got big and I kind of looked at him in horrified confusion before it registered as a joke. We both started laughing and then we talked about how weird it is that some doctors are squeamish about their own blood. Good times.

That's all I've got for now. Over and out.

Sunday, January 13, 2013

Post #87: #Escapethestupidity

So....I was doing my usual perusal of IBD blogs, when I came across the CCFA's (that's Crohn's and Colitis Foundation of America, to you people with functional colons) latest add campaign, winningly titled "Escape the Stall." Here are some of the images from the campaign:
 

Wow! Don't these images just scream DIGNITY and RESPECT?

No. They are actually horribly, horribly offensive and insensitive. Huzzah, CCFA! I can't wait for these ads to become PSAs, so more people can continue to NOT understand this disease!

Look, I read the article in the NYT; I understand the reasoning behind the ads. I think the push to spread awareness about IBD is great, but I cannot think of a more poorly executed campaign to accomplish this goal. When I first saw these ads, I honestly thought they were some sort of tasteless parody. Alas.

Despite what you may understand from the ads (or from this blog!), Crohn's is not just a poop disease. It's not all about spending time in the bathroom, although that is certainly a reality for people with IBD. It's about fatigue, pain, malabsorbtion, surgery, increased risk of cancer, inflammation, blood tests, doctor's appointments, scary drugs, missed work, missed life experiences....it's a multifaceted physical, mental, and emotional clusterfuck of symptoms and experiences. Take a look at these ads: do they convey any of the complexity of this disease?

Some of the ads contain a small, written post script that address some of these issues, but the visual impact of a person stuck in the bathroom-and the name of the campaign, "Escape the Stall"-overshadow these nuances. This is about poop. Embarrassing, embarrassing poop. Shameful poop. If the goal was to bring awareness to IBD, to take it "out of the shadows"-it has only succeeded in pushing the sufferers back into the stall from which they should, as the ad encourages, seek to escape.

If you knew nothing at all about Crohn's, these ads would lead you to believe it is a disease relegated to the bathroom, a dirty place for a dirty disease. Worse, these IBD sufferers are in public bathrooms, inflicting their dirty disease into a public space. To suggest through this imagery that Crohn's is a dirty, embarrassing, shameful thing is inexcusable. These images do not encourage hope; they perpetuate hopelessness.

I can appreciate that creating an ad campaign around IBD would be difficult. It's a complicated, ugly disease. But then again, so is breast cancer, diabetes, colon cancer, or the myriad other diseases that have a presence in drug commercials, public service announcements, or magazine ads. And yet-those diseases are treated with a respect that is entirely absent from the CCFA campaign.

The "Escape the Stall" images seem to be attempting a light-hearted tone, a kind of "reel them in with humor" approach. Hey asshole marketing team that developed these ads: there is NOTHING FUNNY ABOUT CROHN'S. You know what I think of when I see the bride stuck in the bathroom? That scene from "Bridesmaids" where the bride gets food poisoning and shits herself. Santa? I think that dude ate too many cookies. The girl in the high heels? I think she drank too much and is in the toilet to upchuck her cosmos. NONE OF THESE THINGS ARE RELATED TO IBD.

The CCFA is an advocacy group. It is their job to educate people about IBD. They have utterly failed and managed to insult their constituents in the process.

We deserve better.

Sunday, January 6, 2013

Post #86: A day in the life (of an AAC)

After an exhaustive search, it was determined that I have no candy up my butt.
Oh, colonoscopies. First thing's first-everything is pretty much the same, which is still not normal, but (pending the biopsy results) also not worse. Hooray!? Now, let's make a pro/con list of this most recent procedure:

Pro: The morning of, a friend sent me the following encouragement:

"For tomorrow, because I have no idea what to say before someone goes in for a roto-rooting: [pounds fist against chest then raises it in salute]."

AWESOME.

Con: Prep. Even though the pill prep was less vomit inducing than drinking the "jug of fun" (as a pharmacist called it the other day), it still required swallowing 32 giant salty horse pills and then, you know, cleaning house. And by house I mean colon. And by cleaning....well, you get the picture.  

Pro: It's over!

Con: For whatever reason, they wheeled me into the treatment room 45 minutes early and left me there, giving me ample time to stare at the apparatus that would soon be introduced to my AAC. It is really, really long, and the controls look like a video game joystick. Also, I couldn't really explore the room (extra blankets and emesis basins and extra lube, oh my!) because my "tether" (whatever you call the tube connecting me to the IV) was too short. Not that I tried....

Pro: The nurses there are SO FREAKING NICE. The nurse in the procedure room was joking that I had really come in for a day at the spa, and when I left I would have a spray tan. My doctor joined in: "let me go get the cucumber slices!" I'm not sure what prompted this, or why everyone thought it was funny at the time, but I appreciated the attempt to bust out a little humor pre-butt scope.

AMPs for the win!

Con: This is kind of a big one. For a number of reasons, I wasn't able to be fully sedated for the procedure. I was high, sure, but also aware that there was a pokey foreign object in my colon. I kind of floated in and out, but I remember being uncomfortable and kind of panicked about being awake, but also too drugged to really panic, if that makes sense.
In a last ditch effort, they gave me some benadryl, but the problem wasn't a mosquito bite, but more a giant flexible hose in my AAC. At one point, I must have closed my eyes, and I heard my doctor say, "Oh good, she's finally asleep" to which I replied, "NO ACTUALLY I'M STILL HERE."

Good times!

Pro: Even with the SURPRISE! discussed above, I am still not scared of having a colonoscopy. Nothing truly terrible happened, and I won't be developing a complex over this. The benefits far outweigh the downsides, and awake or not, I'll still have another when I need one.

So-colonoscopy? Check. Follow up appointment scheduled? Check. Back to eating delicious solid foods? Checkcheckcheck. Decision on whether to start the new scary medication? TBD.  

I feel like this was a hurdle (a hurdle I asked for, to be fair) that I had to clear to start off 2013. One way or another, that happened, so now it's on to the next.

Tuesday, January 1, 2013

Post #85: Extreme sexiness ahead

Hahaha, this made me  laugh. And I haven't really been laughing today.

So. I am a year older. It's now been exactly a year since my diagnosis, and to celebrate, I am going to have my innards roto-rooted on Friday. I don't want to write some depressing, introspective review of the last year, because I have been composing that particular essay in my head for the last two weeks. For the most part, the things that stayed the same have been frustrating, the things that have changed have been scary, and a healthy dose of uncertainty has added fun to the mix. Now you're all caught up.

A very funny, wise friend from college wrote on my FB wall "Congratulations on another turn around the sun!" and for some reason, that seems like the perfect attitude to adopt at this time in my life. I usually have some angst around my birthday, as I mentally tabulate all of my successes/failures to date, but this year I wanted to skip the angst and take a nap. Something about having a birthday so close to New Year's creates a  double whammy of existential pondering, but again, I only have so much energy for that kind of mental flogging.

I've postponed having a birthday party, again-when you have an AAC, why bother planning a celebration with food you can't eat, drinks you can't drink, and activities you don't have the energy for? It seems like adding insult to injury. I keep promising myself that when I feel better, I am going to celebrate the hell out of these two birthdays, but I would settle for a smaller affair where I just didn't feel like crap.

Speaking of feeling like crap, I am gearing myself up for the super fun time that is colonoscopy prep (I told you there was extreme sexiness ahead!). This is not my first rodeo, so to speak, but it is my first time using the pill prep (32 pills! yikes). While I'm SO FREAKING GLAD that I don't have to drink a gallon or two of hurl inducing salty lemon lime colon explosion juice, I am always wary of trying something new. My doctor will also be meeting my colon in person for the first time, and I have to say I'm feeling a little awkward about the whole thing. In the past, my colonoscopies were performed by a specialist I didn't really see clinically; I feel like I spend a lot of time with this current doctor, and now all mystery will be removed from our relationship. I know this is a stupid thing to worry about, but when you're constantly sobbing in front of your doctor and discussing sexy topics like malabsorbtion, painful gas, and the quality/quantity of your bowel movements, it's nice to think you have a little dignity left. Then again, if you spend the 18 hours before the procedure having explosive diarrhea like I did last year, you would pretty much let the mailman preform the exam if it meant getting hooked up to some fluids and getting a little sedation. So there's that.

After this procedure, I will have to make some treatment decisions, something I've alluded to in previous posts. I've been delaying it, and delaying it, and it's finally time to nut up (such a gross expression, but it makes me laugh every time) and take a long, hard look at my life and decide if I can tolerate how things are or if I am willing to add more medications to the pile for a shot at better quality of life.

I talked about finding a motto for 2013, and while I didn't settle on one, I've been thinking a lot about something my yoga teacher said a few classes ago. My leg was splayed to the side in some sort of super sexy deep groin stretch. Everyone else in class was groaning, and I felt like I could release my leg all the way to the floor, but I didn't because I was worried that it might hurt and no one else was doing it. My teacher walked over, grabbed my heel and repositioned my leg, stretching me farther than I thought I could go. "How does that feel? Is it ok?" I thought about it, and there was no pain, no stress. "Yeah, actually." As she moved to the next student, she replied, "Good. Never settle for less when you can do more."

That stuck in my mind. When it comes to my Crohn's, am I setting for less, or just settling in general (that last sentence felt very Carrie Bradshaw-esque. Like if she were writing about Crohn's, she would say that, and then go cheat on/with Mr. Big and cry about it over appletinis in between bathroom trips)? I've felt like crap for the last few days-a combination of eating like crap (it was Christmas! and then my birthday! and there were treats EVERYWHERE), sleeping too much, and going off my exercise schedule. My stomach is hard and bloated. I'm in pain, and my AAC is not pleased. I haven't really left the house in two days. Is that what I want the next week, the next month, or the next year to look like?  

I don't have answers to all my questions, and I find myself, yet again, waiting and dwelling in uncertainty. All that aside, I made it through a year with Crohn's. I should focus on that. I made a full lap around the sun, and I have some momentum as I start my next turn.