The Last Word

After thinking about it for an entire year, I realize that I cannot leave an obituary to Janet as the last words on Janet's blog. If we learned anything from Janet, it was the value of life. Obituary's are about death. The last words on Janet's site must be about life which she brightened so much for so many. This will be my last blog on this site. This will also be the first time I will blog on this site without providing a status report about Janet. Instead I am going to give you a status report about me. I am going to talk about how other people have impacted my life over the past year, about the experience of grieving, and some stuff that I have learned from this entire experience. With that as an introduction I will now begin the last blog on Janet's site.

No man could have ever have loved a woman more than I loved Janet. She was the centre of my universe, my soulmate and within hours after she died the daily adrenalin flow and panic of the nine months leading up to her death very suddenly stopped. I was left with a huge emptiness, a state of suspended animation, a feeling that this was not my life but that somehow I was playing the starring role in some horrible nightmare movie that hopefully I would wake up from. I hoped I would wake up soon.

It was hard to believe that less than a year earlier I was half of a successful happy active couple that had found each other in the middle of their lives and spent years together comfortably drifting into the latter part of middle age. We had more hopes and dreams and plans for retirement than even we could accomplish. Our lives together which had seemed so perfect, set and protected had suddenly gone horribly wrong. Our relationship and all of our hopes and dreams had just ended against our wishes. Our lives together had been stolen from us by an incidious form of cancer. I can very easily see how surviving spouses end up combating serious depression after the death of their loved one.

In my case this was not to be. There was no time for depression. First there was the charter sailboat trip with my brother Paul and John Nicholson to St. Vincent and the Grenadines. It was fun, challenging and very interesting all at the same time. There was not a lot of time to feel sorry for myself.

The sailing trip was followed by a return to work with the TELUS Emerging Markets team who had been so supportive during Janet's illness. Most weeks there were at least a couple of evenings where I would sit with one of my male friends and drink beers and have long talks about life, relationships, family and loss. As spring became summer these chats moved to some of the finest patios in Vancouver. At least a few times each week one or more of the ladies at work would pop into my office to ask how I was doing, "I mean really ... how are you doing?" I must have told and retold the story of Janet's diagnosis, illness and death a hundred times. Each time I told the story it seemed a bit closer to reality and my nightmare movie seemed less like a movie and more like the really bad experience it was.

There were also the neighbours who had me up to their homes for dinner and dropped off food. One of my oldest friends made a habit of popping in and checking on me once a week on Sunday nights. She had promised Janet she would keep a close eye on me and she has ever since. There were invites and lunches with Janet's close girl friends and more opportunties for me to tell and retell the story and talk about how it has impacted all of us.

As time went by reality set in more and more. I made some minor changes around the house and what was "our" home became "my" home. I began to see "our life" as the past and "my life" as the present and the future. I think this was an important step in healing. A clear separation of what was from what is. It actually takes quite a while to truly digest the reality that you will never see your wife again. That she will not walk back through the door returning from some business trip or vacation. That she truly is gone forever. It took me months to truly grasp that concept and I had to work at it.

In the first few months sometimes something would happen that would trigger a sudden memory and I would burst into tears. I used to live in fear that this might happen at work or when I was with others. It never did. It took a few months but over time it stopped. Sometimes memories still cause me tear up a bit though. Perhaps that will always happen.

When I look back on the past year, it seems to have two parts. A survival part and a growth part. The survival part is telling the story and realizing that a relationship with a woman that I adored and expected to last a lifetime has converted itself into a decade long experience. A wonderful experience but an experience with an ending nonetheless.

The growth part was when I came to see myself as incredibly fortunate to have had that decade with that special woman. There are many who never even get that much. I also consider myself incredibly lucky to have been surrounded by this incredible support network of family, friends, colleaques and neighbours to help me get through this terrible experience. Many are not that fortunate.

My advice to anyone who loses someone and does not have a support network would be to go get one. Even if that means joining a support group at a local church or whatever. You will need people to listen to your story and you will need to tell it, likely more than once. Catharsis and healing comes from telling people about the experience. I was so very fortunate to be surrounded by people who were prepared to listen and support me as I started my healing journey.

Enough of this though, lets talk about what I have learned from this experience:

With some things in life we have choices, with others we do not. I have learned to pay close attention to (and really appreciate) when I have choices, because I am acutely aware that things will happen where I do not have a choice. Janet being struck with stage iii/iv Ovarian cancer and not responding well to chemo therapy is a good example of something where I did not have a choice. Not having choices makes choices all that much sweeter. As an example I made the choice to dance until the band packed it in at the TELUS Sales Conference. I had a choice, and it was sweet. If Janet were here she would say "when you have a choice ... choose to have fun." I say appreciate that you have a choice.

Express feelings. I am a human not an island and I may have to face things which I cannot get through on my own. There is no shame in sharing with others how I feel and what is amazing is that when I do, they usually respond really well. We used to have a managing director who had this great line for sales people "when all else fails, try telling the truth" I have adapted it to "when bad things happen, try telling people how you feel."

We enter this world with nothing, and we leave it the same way; with nothing. All we have are the experiences in the middle. We all spend a lot of time acquiring stuff that we leave behind. Look at all that you own and consider that the odds are someone else will own it 75 years from now, and if not, shortly thereafter. I now care about experiences and people. I no longer care about stuff. I have got enough stuff to last me a lifetime. Janet left a lot of stuff behind. Most it was related to her looking good (and she did.)

All I have is now. Yesterday is gone, tomorrow may come, but all I have right now is what I have right now. I have learned to love what I have right now because I know from first hand experience that there are no guarantees I will have tomorrow. Yesterday, Janet did not get a tomorrow. When something upsets me I ask myself "would I care if I weren't going to be here tomorrow." Its amazing how that puts things into perspective. I find its a good test of what to sweat and what not to. I am not perfect at this yet. I am still working on it.

A common question I get asked is "has Janet communicated with you since she died." The answer to that is "no". I have not heard her voice, she has not starred in any of my dreams (I really wish she would) and I have had no sightings of her. I often talk to her, sometimes in my head, sometimes out loud. She doesn't answer, but I don't need her to, because I already know what she would say to almost anything I would say to her anyway. I think about her many times each day and I miss her a great deal. Perhaps I always will.

Ovarian cancer robbed my lovely wife of her life. In the name of both of us I will not empower it to take mine as well. My lovely wife Janet would want and expect me to sit out one of life's inning's in her honour. I have done that with great respect and love for my soulmate. She would not want or expect me to sit out the entire game of life. I could not do that and I will not do that.

Tomorrow I will take off my wedding ring and I will officially start a new life once again as Mark Dennis single guy. I am not sure I am completely ready for it, but I fear that if I wait I may never be ready. The year Janet and I bought and renovated our home I said to her "but its not a good time Janet" she said "well, when is a good time?" She had a good point, there is no good time to do reno's and there is also no good time to get back into life.

Janet's last words to me were "so how do we do this Mark?" What she meant was how do we say goodbye. I said, "we don't baby, just lie back and go to sleep, we will talk about it in the morning."

My morning hasn't come yet. I have right now, and I will live that now until morning comes ... and when it does ... I hope that Janet and I get to finish that conversation.

Janet's Obituary

DENNIS Janet Victoria (Thring) September 25, 1952 to February 20, 2008, died peacefully at home holding her husband, Mark's hand and surrounded by her loving family after a short courageous struggle with ovarian cancer. Janet always retained her zest for life despite the many challenges posed by her disease. The final phase of her life was eased by the unconditional love and support of her large circle of friends, especially her support team, TELUS management and employees, family and soulmate Mark.

Janet was born to Cy and Ruth Thring (Sinclair) in Yakima, Washington, USA. Shortly after Janet's birth, the Thring family moved to Cy's native Vancouver where Janet grew up with her two sisters Daphne and Marilyn. Janet joined BCTEL in 1970 and worked there until her retirement from TELUS in February 2008. Janet was a unique and special person whose vibrant, fun loving and vivacious personality, outstanding fashion sense, quick wit, contagious laughter and giant smile brightened many a day and endeared her to all. She will be greatly missed by those who knew and loved her. While we are sad for what never will be, we are grateful for what we have had. Janet was truly a gift who has left her imprint upon our souls.

The family appreciates the efforts and skills of her physicians, Dr. Jones her family doctor of 32 years, Drs. Stuart and Lam of the Burnaby General Cancer Clinic, and the assistance and expertise of the Three Bridges Community Health Centre Pallative Care Team, especially Dr. Anne Hansson and nurses Wanda and Jivan.

A memorial service honouring Janet's rich life will be held Monday March 3rd, 2008 at the Shaughnessy Heights United Church at 1:00 pm, 1550 W. 33rd. Vancouver, light refreshments to follow. In lieu of flowers, donations in her name to the National Ovarian Cancer Association are appreciated. Envelopes will be available at the service. Janet may be watching ... pick your shoes carefully!

The end of Janet's Journey

My lovely wife Janet came to the end of her life's journey at 10:15 pm on Wednesday February 20th. The past few weeks were a struggle for Janet but she passed comfortably and peacefully holding my hand. Her sister Marilyn was present as were my parents Betty and Leslie Dennis.

Tonight ends a nightmare for Janet and me that started last May with her diagnosis of Ovarian Cancer. Unfortunately the nightmare did not have a happy ending.

Janet would not have wanted to spend more than a few weeks living as she did for the past week. She was a strong, independent and vibrant woman. Janet hated being dependent on anyone, even those that loved her the most. She would rather be released from the prison that her body became.

Janet Update (and why it took a long time to publish this blog)

I was chatting with my Dad last night and I found myself commenting on writers block. It suddenly dawned on me why I was procrastinating on updating this blog. I was really having trouble finding good news to talk about. When its good news I have no problem telling you all the details. The writers block occurs when there is no good news. With the progression of Janets Ovarian cancer its not always good news. With that as an introduction let me update you on Janet's condition.

Janet went in for paracentisis on Tuesday at VGH. This was the first time she was drained at VGH and she was very pleased with the medical staff. She had a lady doctor from Ireland who actually did the procedure, which involves inserting a needle into her abdomen to drain fluid. Janet is naturally pretty anxious about this procedure and the bedside manner and compassion of the doctor and nurses have everything to do with how much Janet despises or tolerates the actual process. Karen Corcoran, who has made accompanying Janet for paracentisis her personal crusade since last May, accompanied Janet through entire procedure. The VGH medical staff drained about 2.95 litres of fluid from Janet and she was much more comfortable afterwards. Corco made sure that Janet got her standard celebration meal consisting of White Spot fries and large amounts of triple O sauce for dipping. By the time Janet got home on Tuesday afternoon all was well and after the excellent results from the last paracentisis I had high hopes for similar results this time. I was looking forward to a few days of getting lots of calories into her.

Unfortunately it was not to be. By Wednesday night Janet had thrown up much of what she had eaten. It was obvious that even though she felt more comfortable after the draining procedure, she was having almost as much trouble keeping food and calories down as before the procedure. It has been a struggle all week for Janet to keep any food down. Janet is incredibly thin and each calorie counts. For Janet to lose calories at this time is significant. The past few months have been a battle of calories. Calories retained equals winning, calories lost equals losing. This week we have been losing more than we have been winning.

So we are not getting the same "lift" from the procedure this time that we got last time. Janet is weaker and thinner and requires more assistance with daily living. I won't go into the details and lets not dwell on the bad stuff and lets move on to the good stuff.

We started with the home support staff this past week. We had a home care worker in all day Monday and 4 hours each afternoon on Tuesday through Thursday. This was great for me because I was able to leave the house knowing that Janet's care was in experienced hands. Its also good for Janet to get a rest from me. Janet also likes the back rubs she gets from the home support lady while she is having her bath. Apparently I am too rough (no kidding.) In addition to being able to do some leisurely grocery shopping I managed a bike ride around Stanley Park and was able to have lunch out with both my parents at the same time. It was all good.

Janet and I also spent some time last week getting various business affairs tied up and organized. One of the big highlights from those efforts was that the lovely Janet officially retired from TELUS at the close of business on Friday February 15th. This officially brought to a close a career with BCTEL/TELUS that spanned 38 and a quarter years. A true career achievement in anybody's books.

All of you who read this blog have supported Janet and I in many ways throughout the past 8 months. Your love, laughter, good wishes and fond memories have sustained us through many bad moments and we are both so very deeply grateful for that. I want to share a couple of things with you which I hope will help to sustain you in the years ahead. These are things that I have learned from the past 8 months while intimately sharing a life with the lovely and vibrant Janet.

The first is about our attitude towards death. Those of us who are healthy tend to view death from a healthy persons point of view. We naturally don't like the idea of dying because it will stop us from doing all the stuff we like to do, eating, drinking, laughing, loving, thinking, talking, partying, playing etc. When you are really sick though, death is something else. Very sick people aren't doing any of the fun stuff anyway and just living requires a great deal of effort. It also involves enduring some pain and discomfort even if this aspect is well managed. Its worth stopping to remember that death to a very sick person is not like death is to those of us who are fortunate enough to be healthy. I think if you take the worst you ever felt physically in your entire life multiplied it by two and then asked yourself if I had to live like that for the rest of my life how would I feel about dying. You would be approaching how a very sick person feels about death.

I know that Janet does not look forward to death but she does not fear it either. She will be ready for it when it arrives. Please remember that in the days ahead.

This brings me to another important thing I have learned. Death is a certainty, as one of my friends father once said to him "John, none of us are going to get out of this alive." That is most definitely true. We should all live our lives as though each day were our last, because it may be. One of the reasons why Janet does not fear death is because she has really lived her life. Janet grasped at every opportunity to have fun, to eat, drink, talk, laugh, love, think, party and play that came along. She never said no to a single one. We should all do this, because it really smooths out the road on that last mile of the journey.

Okay enough of this really deep stuff.

We are taking things one day at a time around here right now. There is a chance that if you have a scheduled visit with Janet coming up it will get cancelled. We are going to close off non family visits to Janet after this coming Monday and Tuesday. The core support team (and you know who you are) will be an exception. As life has become more of an effort for Janet the reality is it is more difficult for her to have visitors and I also think that as she is not as much fun to look at and be with as she used to be, its harder on the visitors as well. Those of us who deeply love her do not care how she looks or how much fun she is to be with, our cups already runneth over in that department.

If you have not visited Janet and feel it is something that you must complete in your life's journey please send me an email (marknden at gmail dot com) and I will try and arrange something. I would encourage you first though to picture Janet in your minds eye in one of her finest stylish outfits, wearing a pair of her killer shoes and her perfect white smile contrasted against exactly the right shade of red lipstick and ask yourself if you really need to have that image changed. I know that one day I will be re-inserting that image back into my minds eye and living with it forever.

Thank you for being there for us.

Finally an Update or ... How is Janet Anyway?

Sit down and make yourself comfortable because this is going to be a long blog. To steal a line from Steve Jobs 2008 Macworld Keynote Address "there are four things I want to talk to you about today." Lets start with the How is Janet question, then I will get to the others.

How is Janet?

In general Janet is doing well. The last paracentisis (draining of fluid) produced a much more dramatic result than any previous paracentisis. Janet got a whole week of being able to retain most of the calories that she consumed. This is excellent because at this stage of her disease we are really in a battle of calorie retention. Not the calorie battle most of us are fighting which is to limit the amount we are taking in. In Janet's case we are trying keep in as many calories as she expends each day. After paracentisis this is relatively easy because most of what she consumes stays down. However, the calories she consumes during the week after paracentisis and before she fills up with fluid must sustain her until the next paracentisis which is currently scheduled for Valentines Day, February 14th.

Once Janet starts to fill up with fluid she loses much of what she takes in with the exception of water and clear liquids. This is likely because of a combination of mechanical issues, water pressure on her stomach and diaphram and physiological issues, partial bowel blockages being closed down even further by water pressure. Every now and again there are rare exceptions to Janet losing much of what she takes in. Yesterday was an exception because she kept in one and half boost drinks and a small salad with dressing and some nacho chips and dip while watching the last quarter of the superbowl. This is in stark constrast to the previous two days where nothing except water, ginger ale and gatorade stayed down. Not surprisingly Janet's energy levels fluctuate in direct proportion to the amount of calories she takes in, so she is a bit livlier today than usual.

I do need to point something out about Janet's general state of livliness which I have noticed. Janet is very thin, I suspect that most people by the time they reached her state of disease would be completely lacking in energy, very slow moving and with low levels of mental alertness, slow answers to questions and perhaps some confusion etc. This really was the case with Janet before the last paracentisis. Since the paracentisis she has perked up quite significantly. She is definitely weak. For example she needs to rest for about 5 minutes after climbing the stairs in our apartment. When talking to her though, you would think there is nothing wrong with her. She is as sharp as ever. She also moves quite quickly for a person who is as thin and weak as she is. For instance she moves between our bed and her hospital bed (which she uses as a day bed as it reduces the back pain she sometimes suffers from) very quickly. She sits up quickly. Its almost spooky to watch someone as thin as Janet who is still functioning at such a high level. I think if you take another look at the picture at the beginning of this blog, you will agree it proves my above point, it captures her mental state quite well.

This brings me to the next thing I want to talk to you about which is where we go from here with Janet's health.

Health Tactics

Quite frankly 3 weeks ago Janet did not appear to have long to live. Her physical and mental energy levels were low and honestly her quality of life was not particularly good. Since then she has had a bit of a dramatic turn around. Physically not much has changed except that she has consumed more calories and has therefore increased her energy levels. The most marked change is mentally. She is more alert. She is back to reading books, magazines (something she had pretty much stopped doing). She is watching American Idol and insisted she saw the first episode of Lost (live not recorded.) As a result her quality of life has also improved quite a bit. The objective is still to make Janet's life as comfortable as possible but we are going to try and make some small changes in tactics as follows:

1. Transfer Janet from the Burnaby General Hospital Cancer Clinic to the Vancouver Cancer Clinic so that paracentisis is only a 5 minute cab ride away instead of a half an hour car ride.




2. Try and get the paracentisis schedule moved up from 3 weeks to 2 weeks. There is a risk that Janet may fill up more quickly by doing this but at this stage we may well get more days of keeping calories in, which on balance is a good thing.




3. Try and arrage for bloodwork that needs to be done prior to paracentisis to be collected from home. This saves one of the 2 hospital trips that normally accompany each paracentisis cycle.

In addition I have realized that I am going to have to do a better job of pacing myself as the primary care giver. I can be the 7 by 24 nurse (or butler as I prefer to think of myself) for a few weeks, but I don't think I can keep this up for months. I am going to have to get better at delegating, and getting out of the house, when help is around. Luckily with my parents in town and Marilyn's visits, help is quite often around. Iwill also try and work out some kind of better coverage schedule including home care support with the help of the VCH pallative care team. More to come on that though as I further develop the plan.

Next I would like to give you a brief run down on what Janet has been doing with her new found energy levels.

Janet's Recent Past (the partying is over but she still has fun !)

Much of the past week and a half has been family time intersperced with a few visits from friends. When Marilyn was here, Janet and Marilyn concocted up some nice family dinners. Janet came up with the menu and recipes, Marilyn did the cooking and I did the shopping and we all did the clean up. It all worked out quite well. Saturday was my Mom's xx birthday (I can't put the number in here because she wouldn't want you to know what it is.) We celebrated it by eating beef stew, which Mom brought over, and by having champagne and cake with Janet. Janet's Dad has been over to visit quite often. The twins (our niece and nephew Michael and Chanel) pop by on Friday's (somehow they have managed no college classes on Fridays, who knew.) I usually put them to work around here and they are happy to help out. John Nicholson (the twins Dad) pops by frequently and sometimes John and I just sit and chat for a while. Dave and Stephanie, Marilyn's husband and daughter have also been over for a visit. Its all been high quality family time and we have been really lucky to have had the opportunity to fit all of this in.

So that brings me to my last topic which is what happens next ....

What Happens Next

There are a lot of things that happen in this wild and disorderly event called life that we really don't understand and cannot predict. Janet getting ovarian cancer in the first place is but one small example. Realistically Janet is at high risk for a number of things to happen which could end her life quite quickly. If those things do not happen, eventually she will suffer digestive system blockages that will eventually end her life. It could be weeks or months. No one knows. Its very important that when she is feeling good that Janet enjoy her life as much as possible. Janet needs time for herself, her family and for her friends. Visiting does use energy which is in short supply.

If you haven't visited Janet and would like to, please send me an email with your preferred time and date and I will put it in the calendar. Its best for Janet if we can keep the visits to no more than half an hour as she does get tired quite easily. Please do not bring food or flowers we have enough. If you must bring something bring reading material, magazines or books or even old pictures. Janet loves looking at old pictures of times and parties past. We are going to restrict visiting days to Mondays and Tuesdays only and no more than 2 visitors per day in order to conserve Janet's energy. If this really does not work for you and you need an exception you can let me know.

Thank you to everyone for your love and support through this difficult time. I will continue to use this blog to keep you posted on my lovely wife's progress and Janet and I will both continue to track your messages of support. You do not need to log in in order to leave a comment on this blog. Just tick the anonymous box but your name in the comment so we know who it is from.

Honour Circles and Light, Love and the Warmth of Friends

On Friday, a number of Janet's friends arrived for a ceremony led by Karen Goodfellow called the honour circle. I wasn't actually at the ceremony, but that won't stop me from writing about it anyway.

I left after Karen arrived and returned 2 hours later after getting my spirits lifted at the Frog and Firkin a few blocks away. I returned to find many of Janets friends in the living room and a feeling of warmth and goodwill permeating the atmosphere. I ran upstairs and checked on Janet as I always do and found her energized smiling and very happy with the ceremony. She loved it. My mother Betty and niece Chanel (Daphne's daughter) also attended the ceremony.

Friday was a peak for Janet. She benefited from the paracentisis the day before and was energerized by the love, light and warmth of her friends. Janet rested on Saturday, she had two short visits with friends and slept much of the day. I was a bit worried about her on Saturday as she really seemed really depleted of energy.

That changed today though when she announced to Marilyn (who is visiting us again) and I that she wanted to go to Urban Fare and do some grocery shopping. She got herself up, got dressed in very fashionable brown pants, black top, scarf and a brown beret. Walked to the front door and hopped into Marilyn's green volks beetle and the two of them drove off to Urban Fare. I was totally amazed as this was the opposite of the Janet of the day before. Marilyn and Janet picked up some groceries for Sunday night dinner and stopped in at Whitespot for fries and triple O sauce (Janet's fav) before she returned home for a nap.

I have installed a computer and a decent monitor in the bedroom so that Janet can listen to internet radio stations (a little habit she has picked up from her geeky husband) and watch videos and Internet downloads of American Idol and other favorite programs. I also put a web cam in the bedroom so I can keep an eye on her remotely while I am downstairs.

I will be forever grateful to the women that have worked so tirelessly to help me in my mission to make Janet's life as happy as possible. You know who you are, and you are all truly angels. I realize that we are all frustrated by how little we can do to improve Janet's quality of life but its important to remember that your visits, kind words and efforts have such a big effect on both Janet and I. Thank you.

Big Challenges Big Rewards

Janet went in for her paracentisis on Thursday. Janet hates the procedure which involves a shot of local anesthetic to her abdomen followed by insertion of a needle to remove excess fluid. Typically between 1.8 and 2.4 litres of fluid is removed. The physician uses an ultrasound machine to ensure most if not all fluid is removed. Janet then spends an hour or so in the medical day unit while her blood pressure is monitored and if all is well she is released. She is currently on a three week schedule with this procedure performed every three weeks.

As Janet has become weaker paracentisis has become more a big deal because it requires two trips to the hospital, one for blood tests and one for the actual procedure. Janet has to get dressed and get to the car, sit in the car for at least a half an hour drive and then get out and get to the lab or medical imaging department to have the procedure performed. Its a lot for a person in a weakened state.

On the plus side the procedure does make her feel much more comfortable by reducing the fluid pressure on her stomach Reducing this pressure also significantly increases the odds that any food she eats will be retained by her system.

Janet learned after the second time she had paracentisis that the best way to get through it was to take an Antivan which is a muscle relaxant.

Todays game plan went roughly like this. Janet up and showered and ready to go by 10:00 am (I had to help her get ready). We put Janet in the wheelchair to get to the car and I drove Janet to the hospital where Karen Corcoran was waiting with another wheelchair, borrowed from the hospital. Janet transferred to Karen who wheeled her to the medical imaging department for the procedure and stayed with her until the Medical Day Care Unit released her. Karen then drove Janet back home where I met her with a wheelchair. Its a bit of a hassle but the rewards are as follows:

• 3 litres of fluid removed (a record for Janet)
• Janet feels much more comfortable now and likely will for at least a week, perhaps more
• Janet ate and retained half a turkey sandwhich, a can of Sprite, 3/4 of a Boost drink and a small bowl of Chilli. Its been weeks since Janet was able to retain this much food and calories in a single day. This really helps to put some strength back in her. She actually spent an hour this evening downstairs watching TV and her brother in law John N. commented that she looked much more alert than she has in quite a while. The calories provide immediate benefit.
• As Janet is more comfortable she will likely sleep better and this will contribute to her overall well being.

Paracentisis is definitely in keeping with our objective of making Janet more comfortable and treating her immediate symptons. These days its a big challenge for her, but it does have big rewards at the end of the process. We think its worth it.