Happy Birthday Asher Noam: The BIG Five!

Happy Birthday to Asher! He's the big five today! Here are a few pictures from this past year of life of our wild child, vilde chai, Lord Asher, lovebug, cuddlebug, sack of potatoes, and most recently, superhero.

We celebrated with a Frosty Paws and a new stuffed toy...

Anniversaries: Turtles, Butterflies and The Number 8

On June 18, I marked the eight year anniversary of getting sick. We know the EXACT day that I got sick.

We never know quite how to 'mark' this date.

This year, we decided to 'celebrate' with a sparkling non-alcoholic beverage and toast to this being THE year of hope and healing. I've already passed through my 20's with this illness, and am really hoping that my thirties are going to be full of healing. Also, eight just happens to be my very favorite number, so I'm hoping that will bring a little luck along with it!

I see the next year as a time of 'cacooning' or 'hibernation'. Both turtles and butterflies seem to emerge over and over in my imagery and in my life. Both speak to me and my journey.

The Turtle: I feel like a Turtle because I must take things VERY slowly. And I must be very PATIENT. So much of what I am learning during these eight years is about patience. I'm reminded by many that the path to healing is NOT a race...and to be the tortoise, and not the hare through the Lyme treatment. Years ago, I began writing a 'book' about my illness experiences and I titled it "From Turtle to Swan." I long ago, set that writing aside for another time, but it is ironic that years later the image of the turtle has resurfaced for me. I feel this is a time to hibernate in my shell, as a turtle does, and let my body have the time it needs to heal. I must let go, surrender and leave the antibiotics to work their way through years of damage to my body from the Lyme spirochetes. I must not keep poking my head out to say, 'Am I better yet?', 'Are the antibiotics working yet?', 'Should I be better yet?', 'Should I be moving 'faster' on the treatment course?'. I need, instead, to give my body TIME to heal, and in the meantime, stay patient and protected in my shell. I feel very much like this part of the Lyme treatment is ENDURING the treatment process and doing that best to survive that while the Lyme dies off. That is why, I feel like I need to hibernate a bit...so if you notice I am more quiet than usual...I'm putting all of my energy into healing so that I can poke my head out of the shell and see the world anew.

The Butterfly: Many of you know, as my 30th birthday approached, I made the butterfly my symbol of hope for this decade. Right now, I may be a turtle, but I feel that when I 'emerge' from my shell I will want to be a butterfly! :) The turtle reminds me how to APPROACH the journey and the butterfly reminds me of the BEAUTY of the journey. And like the turtle, the butterfly must be in a cacoon before it emerges with wings, ready to fly. I always think of Heimlich in 'A Bug's Life'--the caterpiller who wants to be a butterfly! And at the end, he pops out of his cacoon with these little bitty wings on his big body. "Look!" he says, "I'm a beautiful butterfly!" So, right now, I'm a turtle who's a wanna-be butterfly. But, I feel my wings growing little by little.

I find myself, at this moment, although weak in body, strong emotionally and spiritually. I hope that I can hold onto this through the process of treatment.

I hold onto the beautiful words that my dear 'Mommy Bev'--mother figure, friend and fellow Lymie--wrote to me: You might be a turtle presently but with the "kiss" of those antibiotics it is my belief that you will eventually lose that cumbersome shell and sprout those wings to match the ones already in your soul.

Blessings,
Emily

Photo: African Violets blooming, blooming, blooming! I received these as a gift from some of my Mom's colleagues after my gallbladder surgery in January 2005 and they are just this summer, for the first time, blooming again. Gorgeous!

Round Two: The Tortoise and the Hare...

"Do you remember the story of The Tortoise and the Hare?" my Lyme doctor said to me last week. "Well, I want you to be the tortoise, not the hare!"

So, what does this mean in terms of where I'm at with the Lyme treatment?

As you all know, the first round of antibiotics made me so sick that I ended up heading to the emergency room by ambulance for dehydration. I probably just increased the dosage of doxycycline too quickly, had too much 'die-off' of Lyme bacteria, and overloaded my 'sensitive' system.

After stabalizing me with some new meds--and the passage of time, we started antibiotic treatment again.

I am now at dose number 10 of minocycline. I started at the end of April. We started with ONE dose per WEEK, and I am gradually working to decrease the intervals between doses. Right now, I am taking one dose every five days.

The first day after I take a dose of the mino, I feel like a 'wet dishrag'--extreme exhaustion, weakness, tachycardia, achiness, joint pain, sweats, brain fog, etc. By the time I am ready for the next dose, things have settled down a bit. The goal is to be able to tolerate treatment, and not overload my system like I did last time...

My reaction to the antibiotics is consistent with what is called a 'herxheimer reaction', so we have hope that we are on the right track.

I'm feeling cautiously optimistic. During the period that I was off of the antibiotics (after my system had stabalized), I started to have some 'windows' of cognitive clarity where I could do more email or talk on the phone. I had a bit more energy and felt a bit more 'human', which was exciting.

The Swahili saying that my friend Ted taught me remains my motto: Slowly, slowly, that is the way. Quickly, quickly, it gets you nowhere.

Blessings,
Emily

Photo: Taken from our living room window the other day. This bunny didn't even notice me open the window and shoot several pictures of her!

A Rough First Round...

Modified from email sent March 20th, 2006.

Hello My Dear Family, Friends, POTSPals (and now, Lyme Buddies!),

It's been a long while since I have been in touch with many of you and I wanted to get out a little update...

You know when your internet service goes out, the cable goes out or the electricity goes out? You call the company and get a message:

"We are currently experiencing technical difficulties and are working to repair the problem as quickly as possible. We apologize for the inconvenience. Thank you for your patience."

Well, since I didn't get a new body from Harry Hannukah, we are having to work with the body I have and, oh my, are we having technical difficulties! And, I am sorry again for all of the emails and calls I have been unable to return!

I started Lyme treatment with antibiotics, but became so sick on them (think post-surgery last year) that we had to stop them. This is called a herxheimer reaction and in some ways helps us to confirm Lyme disease. As the Lyme bugs die off, they release toxins in the body that make you feel worse.

We (the docs and I) are trying to stabalize my Autonomic Nervous System more before I re-start antibiotics again. It has been a rough start to 2006 and I have been unable to do much of anything other than feel lousy and am in bed a lot. Certainly frustrating. I have very little energy and most of what I do have goes to 'surviving', communicating with docs, or going to the l'hopital to get fluids....

I am armed with the best for the situation:

1. Lots of love from family and friends. Parents who take such good care of me.
2. Lots of Jewish Penicillan (homemade chicken soup) from my Mom
3. Books on tape (when I am able to listen). I just finished Harry Potter and the Order of the Phoenix and am now listening to The Jane Austen Book Club.
4. A gorgeous prayer shawl to comfort me--brought to me by Maxine (massage/PT person) and knitted by women who are part of the Prayer Shawl Ministry
5. LOTS of pajamas to keep me comfy and warm! (I have an obsession with PJs)
6. A comfy bed
7. Kisses and cuddles from Asher
8. Docs who are working super-duper hard for me
9. Music (your suggestions for beautiful music welcome!)
10. All of YOU. Your news brings me such joy--I delight in hearing the details of Payson's first steps or Owen's new words, the details of Carrie's wedding, the adoption of Lianna, Ang's trip to Lake Tahoe--and just the 'stuff' of every day life--both the sorrows and the joys. Thank you.

I wish I had more uplifting news to share...With someone who has been sick with Lyme for as long as I have, treatment will be long and difficult and things unfortunately get worse before they get better.

However, I know of so many 'resurrection' stories of people with Lyme disease, that I want so badly to come out on the other side of this. I want so much to come out of this feeling well enough to come visit all of you! So, while I know it has to get worse, we may also for the first time in 8 years, be on the right track towards healing.

As always, thank you for blessing me with your LOVE and PATIENCE. Know that even during my silences, you are in my heart every day.

Trying to be a patient patient...

Love and Blessings,
Emily

Photo: Crocuses: the first flowers of the year. They bloomed early this year, and still managed to survive a couple sprinklings of snow! Two of my favorite things to do each day (if I am able) are to walk to the mailbox and to take a 'tour' of the yard. I LOVE seeing how it changes every day through the spring, summer and fall.

Antibiotics: The First Go Around

Modified from update sent via email January 29th, 2006 to family and friends....

It has been ages since I have sent out an update. I've been waiting to have some 'news' to share. It's been a busy couple of months...and this update is a bit long! Sorry!

Most developments have happened on the medical front--so I'll sum that up first. (For those of you who are not medically minded just skip over this part!). As most of you know, we travelled to NY in November to see a Lyme doctor.

In short--we have decided to take a leap of faith (as my doctor says) and treat me as if I have Lyme disease. I am getting ready to start high doses of antibiotics.

I feel a mix of emotions: Excited that we finally have some direction for treatment. Terrified about how I will tolerate treatment and whether I will respond to treatment. Frustrated that we didn't think of Lyme as a possibility sooner. Uncertain whether this is the right direction or not. Hopeful that we are at the beginning of finding answers and healing. Grateful that I now have two amazing doctors helping me.

The visit and testing with the Lyme doctor were very extensive, however Lyme testing is a very murky area of medicine. The tests are inadequate and difficult to go on. My test results from the first round came back 'suspicious but inconclusive' according to the Lyme doctor. We then did some repeat testing and got another positive result--making it less likely that the earlier positive was a fluke. However, my 'positive' is not super-strong. I have some bands on the Western Blot, and a reactive Elisa.

In the meantime, I had several MRIs done to rule out a possible anatomical cause for my POTS, such as cervical stenosis or Chiari malformation. These came back clear, which made my main specialist lean more towards Lyme disease. I was able to have a long phone consult with him this month. He uses a wellness scale--and rates me a 20/100. Yikes! In patients like me, who have been unresponsive to all of the treatments available for the POTS, he feels that there is usually something else going on such as the anatomical abnormalities that the MRIs ruled out. Given my level of neurological symptoms (cognitive problems, pain, etc), he felt that Lyme was a possibility. He has had a few other patients who did intensive antibiotic treatment and responded to it.

Typically, my doctor feels that within three months of seeing a patient for the first time, he is able to find something that works to some degree, whether it be PT or meds or eliminating dairy from her diet. It is not an endless trial and failure of meds and other techniques, as I have had over the years. He did not feel, at this point, that there were other medical conditions to look into or rule out. Some doctors believe that any patient with a multi-system illness such as Fibromyalgia, Chronic Fatigue Syndrome, POTS, etc. deserve a shot at long-term antibiotics if they haven't responded to other methods of treatment.

After our conversation, my POTS doctor called the Lyme doctor and they agreed that treating me for Lyme was the next best step. So, while we cannot gaurantee for sure whether or not I have Lyme...we are taking a big leap of faith to treat me as if I do. I am trying very hard to let go and trust in this! Not knowing for sure is so hard!

I have two friends who I met through my support group who are walking me through the Lyme process step by step. I have been so blessed to have them holding my hand and cheering me on every step of the way. I am always amazed by the kindness of others who have travelled the path of illness and reach out to try to make the path of those who follow a bit easier.

Okay...the medical part is over!!! In other news...

I cannot believe that it is the end of January already! We have had such a mild winter--I like the sunny days, but I would like a little more snow! (shhhh....don\'t tell my mom I said that!)

Asher is still wild, but we met with a trainer who helped us with some techniques to see if we can better manage his anxiety. So far, he's been a bit better on the anxiety meter!

The holidays were a hard one for our family, as my 91 year old grandmother (my dad's mom) died in early January. I was very close to her and it was very hard not to be able to be there for the funeral and be with my relatives in Iowa. Grandma always amazed me with her kindness, love, gratitude and goodness. I loved her so much and have so many wonderful memories of my conversations and visits with her.

I had a LOT of visitors for the over the holiday. Unfortunately, I was feeling super-duper lousy...but everyone popped by for little visits anyways which was so kind since I wasn't great company! I saw high school friends Jeannine, Angela, Sarah and Ted (and his wife, Erin).

Ted and Erin brought me the fourth Harry Potter book on cd (which they listened to driving cross-country) and it is 23 cds! So, that should keep me busy for a while. I'm finishing up a mystery right now, Blacklist by Sarah Peretsky, which I am enjoying and getting ready to listen to Friends, Lovers and Chocolate by Alexandar McCall Smith. After that, I'm ready for some good book suggestions--ones you think would be good on tape! I'm thinking of tackling some of the ones my friend Marla-the-reader has recommended as well as some others folks have suggested. It's just so hard to choose!

Otherwise, I haven't felt well enough for much else--not too much email and no movies. I have been able to some knitting which I always enjoy. I've been a bit consumed by the medical stuff and dealing with the death of my grandmother. Mom's getting into the groove of her semester--only two more after this one until retirement! And, I am getting in the groove with a new caregiver, Fay. I really miss Erika, but Fay is great too. Each person is so different.

Well, I know this is a bit long...but I haven't caught up with many of you for quite a while. I owe so many of you a 'real' email my inbox looks like a train wreck...I'm sorry! I hope that your 2006 is off to a wonderful start!

Lots of love and blessings,
Emily

Photo: 'Lord Asher' hanging out in one of his favorite spots--on the ottoman (which he things is HIS). Also, he's looking quite handsome in his penguin bandana after a trip to the groomer.

The BIG 3-0: the birthday report

"Hope is the thing with feathers that perches in the soul and sings the tune without words and never stops at all." --Emily Dickinson--

I asked for a framed print of this quote for my birthday. Our neighbor made it for me and it is GORGEOUS! If I can figure out how to use my NEW digital camera, I'll try to take a picture of it and post it on the blog!

As many of you know, I was having a very hard time with the upcoming big 3-0--not because I was upset about not being married or not having kids, but because I was upset at the prospect of thinking about starting off another decade so sick. I never imagined that I would still be sick this many years later--and in some ways sicker than I was seven years ago. I felt completely overwhelmed and was dreading my birthday...

So, instead I picked this quote by Emily Dickinson and asked for that as my birthday gift. And, I made the butterfly my new 'symbol' of hope. I am trying to turn it around that this is going to be my decade of HEALING. Let's hope...

I ended up having a beautiful birthday. I felt incredibly loved, which made it absolutely wonderful. I still felt lousy all day and especially all week afterwards--so, I didn't get the 'pain-free yuck-free day' that I was hoping for. I think a free pass on birthdays from feeling sick is in order...

First, on Saturday, a high school friend came over to have lunch with me. I sat in my recliner and we ate lunch together. I am finally learning to let go of trying to be a 'hostess with the mostess' when I am so sick...and I just focus on trying to spend time with visitors. Sarah packed her own lunch, did my lunch dishes and came over on my schedule! She started my birthday weekend off with a card and a BUTTERFLY Sculpy. I am so grateful for my friends accommodating to my schedule and needs, just so that we can be together. After about an hour,

I'm toally wiped for the day...so that was Saturday.

On Sunday, my mom cooked birthday dinner, since she had to work all day Monday. The menu included shrimp cocktail, hake, fresh beets, fresh corn...and BIRTHDAY CAKE! Yes, we found a company that makes gluten-free, dairy-free cake blanks. So, for those of you who know me...you know how much I always loved yellow cake with chocolate frosting! I got to have this for my birthday! It was sooo yummy--the first cake I have had in years!

Since there was no mail on Sunday or on my birthday because of Columbus Day...I saved all of my packages and cards that I had received throughout the previous week! So, after dinner I opened my packages...the funkiest, coolest stationary from my Cousin Day (with hopes that I will soon be back to doing one of my favorite things--writing snail mail). A book on cd and new jazz cd from my Uncle Stan. The book: Friends, Lovers and Chocolate...sounds good already, doesn't it? I also got a package in the mail from the Netherlands! A woman I met on my support group sent me a beautiful bracelet which I wear all of the time now as a symbol of our friendship--we're POTSPals, as I like to say.

All this excitement happened before I even turned 30 on Monday!

Sunday night, I could not fall asleep (nothing new for me, of course...) and at 1 am I logged on to my computer to my support group. And here was a post from one of my friends there wishing me happy birthday...she posted it just a few minutes before I logged on! People on my forum have continued to hold me up and support me in amazing ways...one sent e-card the whole week preceding my birthday, another found my address and surprised me with a card and letter.

On Monday, I tried to pace myself to save energy for dinner with Dad and Abbie. I spent the afternoon opening cards from everyone. THANK YOU ALL for all of the beautiful cards you sent! I have them up all over the place so that I can look at them. Your sentiments and great cards were just what I needed to make my birthday perfect. I also got to talk to Ang, Ted and Carrie...and answer the door only to find a delivery of two bouquets of flowers! I was so surprised! One bouquet ALL pinks and purples! And one of cheery daisies. Thank you Marla and Carrie! I couldn't believe that two of my senior year roommates both sent flowers, and from the same flower shop no less! It was a riot! I petered out and missed your calls...Hill, Sarah and Loralea. Loralea wins the prize for her singing of course! :) And hip-hip hooray for Ted because he learned my birthday isn't on November 2!

Dad and Abbie came over here to cook dinner. We had filet mignon! Let's just say, I ate well the whole weekend. I wish my health would follow my good appetite! Dad and Abbie went so far above and beyond to make my birthday special...I was really overwhelmed. They cooked dinner here, we opened presents...and I petered out. So, we had cake in my bedroom! Abbie sang the melody and Dad harmonized (attempted to) on Happy Birthday--wish I had the audio of that to post! We finished the evening with one of Abbie's pampering foot rubs. Yup, I'm spoiled. My big present was a digital camera--which I am so excited about...however I still need to learn how to use it. When I do, though, look out...b/c you'll be getting emailed pics in addition to my verbose mass emails!

I felt like the I got to celebrate my birthday all week because the mail just kept coming...THANK YOU to Dad's family for the shower of cards and gifts and phone calls. I was completely overwhelmed. And to Aunt Joan for the beautiful heart to Aunt Jeanette for the package of yummy smelling things and to Aunt Pat for the surprise phone call...And to all of my friends who showered me with love and cards too! Many of you picked such gorgeous, perfect cards and wrote such great notes...

With all of the love and blessings coming my way this week, I guess turning 30 wasn't so bad after all. Thank you so much for helping me to start this new decade off in a positive way. Now, I just wish my health would follow all the positive vibes you all are sending. To those of you I have yet to get an email out to thank you, I'm sooo sorry...this week has been another rough one in the health department. So, I wanted to update my blog to let you all know 'I'm here...just not too perky!'

I wanted to write this blog to let you all know how much you sustain me and touch my life...all of the love you continue to give me is amazing. I am really hoping that this is going to be the decade for healing...

Blessings and MANY thanks for making my birthday beautiful...

Emily

Why Lyme?: A few "God moments"

Many of you have been asking Why Lyme Disease? Why is this a possibility?

Given my level of neurological symptoms, as well as my not-so-great response so far to treatments, my POTS doctor and I are looking further into both Lyme and Cervical Stenosis.

On the path to deciding whether or not to pursue the possibility of a Lyme diagnosis, I found myself amazed at all of the "God moments" I was having...and wanted to share those with you. If "God talk" bothers you or makes you uncomfortable, I completely understand...so just skip this post on the blog!

As my 30th birthday neared, I found myself despairing about what my life would be. It made me think about HOW sick I have been this past year, how I've gotten worse, not better. I began to wonder more: Would I ever feel better? Was this my life? Would I ever be able to live independently? What about marriage? Children? And everything seemed impossible.

I swore I would never get 'down' about turning 30. But I did. I never imagined that I would enter another decade of my life sick. I had somewhat accepted 'losing my 20's', but I couldn't imagine starting off another decade so sick.

I was also feeling like we were running out of options and strategies for getting me back on track (although, I know in my mind I dramatized this b/c my POTS doc never gives up on me, and never stops pulling tricks out of his hat!). I have tried several new medicines and so far, we haven't had much success. In PT, we have been unable to make progress. So, I felt 'stuck'.

What I wanted most was for God to show me some new hope before I turned 30. Some new hope that just maybe, just maybe my 30's could be my years to improve and have more healing.
I took my despair and really dialogued with my PCP and my POTS doc (as you know from the earlier post). I cried to my PCP! He is such an angel!

As I questioned whether or not to pursue the possiblity of Lyme, I had one "God moment" after another. Here they are...and here is why I feel so incredibly called to pursue the possibility of Lyme. Whether I have it or not, I must pursue this.

• First, about a year ago I began corresponding with a woman on my support group who herself had Lyme disease. She had a daughter my age with POTS. We began corresponding, growing closer and closer, sharing stories, and favorite books on tape. We would often email each other and without knowing, be listening to the EXACT same book on tape at the EXACT same time. I felt so drawn to her, but we rarely talked about Lyme.
• In the spring, my POTS doc raised the remote possibility of Lyme, just to rule it out. I knew nothing about Lyme. But, immediately I KNEW that God had brought this woman in my life for even more reasons! I knew one person in the world with Lyme, and it was her.
• My friend and I began to correspond in great detail about her experiences with Lyme and as an advocate for Lyme. She is AMAZINGLY informed and passionate about Lyme, and I have so many emails from her about Lyme. As she told me her story, we often had very similar experiences--especially not being able to sleep!
• My mom went to dinner with some friends shortly after the suggestion of Lyme disease, and the wife said, "I have always wondered if Emily had Lyme disease!" We had never thought of it before!
• Recently, I posted on my website about how down I was feeling. Another woman, who has both POTS and Lyme emailed me personally to say how much I reminded her of herself and her Lyme experiences. She said that she did not want to push me on the Lyme issue, but offered both her expertise and friendship. We began corresponding in great detail about Lyme and her experiences and I felt so similar to her. She offered to do ANYTHING to help me find a Lyme Literate MD (a VERY difficult thing to do and decide about). Between her and the other woman from my site, I felt so incredibly blessed--although we have never met, these two women did so much to help me with this process. I literally could not have done it without them. And I continue to be amazed by their kindness and support. I felt God through them.
• Just after I began emailing more about Lyme with these women, I saw my PCP and asked him for his thoughts on pursuing the Lyme diagnosis. He was open to it. And then said, "I just had a man in here today who has been sick for four years and they just found out he had Lyme disease."
• When I arrived home from the doctor that day, I found a letter in the mailbox from a dear college friend. After dinner, I read the letter only to find my friend mention that her Dad had recently had a major health scare due to an allergic reaction to antibiotic treatment: He had been diagnosed with Lyme disease! I felt like God was hitting me over the head with Lyme disease! I hadn't heard of it hardly at all...and then all in the course of a few days, I was hearing about it in what seemed like everywhere!
• My PCP appt. was on a Thursday. On Friday, Mom took Asher to the vet for an appt. The vet asked what was going on with me health-wise. At first, my Mom did not mention the Lyme disease stuff, but then thought, 'Oh, I should ask b/c he sees this in animals too, and might know something.' She told him and he said that both his son and his lady friend had Lyme disease! His son had been very sick and was now in medical school. He even had an LLMD for us to possibly see. I ended up scheduling an appt. with the doctor, but ultimately choosing a different doctor.
• Friday evening, I called my friend/adopted Grandma. She asked how my doctor appt. had been the previous day and what we had decided to do. I said, "Well, we are going to look into Lyme disease and..." She interrupted and said, 'You're kidding? I just said to my husband the other day, 'I wonder if Emily has ever been tested for Lyme disease?'" She wanted to suggest it to me, but her husband didn't want her to 'interfere'. She began to tell me the story the daughter (who I know from high school) of their close friends who was diagnosed for many years with bi-polar disorder. Then, a local doc decided to check her for Lyme disease just a short time ago. She came back positive for Lyme, and since beginning treatment has had a great deal of improvment. Her psychiatric problems were CAUSED by the Lyme disease!
• During this time, more and more people on my support group were also popping up with Lyme and POTS, and yet another woman emailed me about having Lyme and POTS.

These are what I call "God moments."

I felt that Lyme was popping up everywhere! I felt that I must pursue it as a possibility. I felt that for the first time in a long time there was new hope and new possibility.

Whether I have Lyme or not...it doesn't really matter. I just need to pursue the possibility.

Right now my quality of life is so poor, I do not want to live my life this way...so I must leave no stone unturned!

Before the Lyme 'stuff' began, I ordered a painting of a butterfly from another woman on my support group. She painted me another one--and titled it 'Butterfly of Hope.' At this point, I wasn't feeling very hopeful, but I made an intentional effort to turn around my thinking and made the butterfly my new 'symbol' for my 30th birthday. I also asked for a print of a favorite Emily Dickinson quote about hope for my birthday (which our neighbor is making for me!).

I feel that God has guided me on this path every step of the way...and that I was given the gift I soooo wanted for my 30th birthday. New hope, new possibilites.

Regardless of what we find--Lyme, cervical stenosis--the path will not be easy--but it is an answer and it does give us more of a direction to travel in terms of treatment.

So, for those of you who have been asking me about my "God moments"--here they are!

Now, I'm just hoping we are going to figure out how to GET me to this appt! That will be the next challenge!

Love and Blessings,

Emily