John had an exhausting day with OT, PT and Speech therapy putting him through the ringer. Speech therapy worked with cognitive tests and OT works with ADLs (activities of daily living). John did so well they may sign off in the next day or so. He is still a little unsteady on his feet, so PT worked the better half of the session on balance. The doctors, nurses, and therapists will meet tomorrow to determine a discharge date. I am optimistic he will be home by the end of the week.
I was remembering the other day when the Lord promised me a prince (1Samuel 25) and then John came into my life. I love him so much. Caren

Blog analytics

On Wednesday the 25th I activated some analytics on the blog to see how many people are viewing the blog and where they are coming from - just for fun. Here are some of the results (through yesterday, 4 days worth of data).

The people:
Number of unique visitors that have come to the site: 253
Daily average number of visitors: 150
Average time on site: 1 minute 27 seconds
Total number of web page views: 1,134

Geography:
Number of countries: 2 (USA and New Zealand)
States (in order of most views):

1. Minnesota
2. New York
3. Florida
4. South Dakota
5. Ohio
6. Illinois
7. California
8. Alaska
9. Nevada
10. Wisconsin
11. District of Columbia
12. Missouri
13. Arizona
14. Pennsylvania
15. Iowa
16. Massachusetts
17. North Dakota
18. Colorado

Top 15 cities (in order of most viewed):

1. Minneapolis, MN
2. Saint Paul, MN
3. Circle Pines, MN
4. South Saint Paul, MN
5. New York, NY
6. Hugo, MN
7. Brandon, SD
8. Burnsville, MN
9. Ft. Myers, FL
10. Rollingstone, MN
11. Bemidji, MN
12. Hopkins, MN
13. Chicago, IL
14. Munroe Falls, OH
15. Dilworth, MN

Computer operating system

1. Windows
2. Macintosh
3. iPhone
4. Linux
5. iPod

Therapy

Yesterday in talking with the nurse we got a bit of an understanding as to what his days were going to be like beginning Monday. In the mornings he will get dressed, eat breakfast in the common area (by the nursing station in the middle of the center room), then have his PT (physical therapy). The rest of the time is up to him (sleep, walk, socialize, etc). In the afternoon he has lunch, again in the common area, and then a dose of OT (occupational therapy) which I think is what he needs the most of. Since the surgery (and it was noticable before surgery) we've noticed the tumor seems to have effected his frontal lobe function including spontaneity, initiation and other non-verbal abilities. Having some OT help learning to adapt to these difficulties will be beneficial not only for him, but Caren and the rest of the family.

Visiting update
The nursing staff suggested that if family or friends want to come visit, late afternoon (between 4 and 7) might be the right time. She did mention that once the full time therapy begins he is going to be pretty wiped out. Getting a hold of Caren first might be the best thing before dropping in.

Caren

Caren will now be posting to the blog since I will be heading back to work. I suspect this will be a nice outlet for her and she will enjoy giving updates on John progress.

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Up to 8

Today he's been resting/napping the whole time since I've arrived. Earlier this morning John is officially off all his tubes/IV's and has been moved from neuro on 7 up to rehab on 8.

For the first time he has been placed in a double room with an older guy that likes a loud TV. Tonight is supposed to be my night for spending the night but I'm not sure where I can sleep.

The nurses on this floor seem to not know a thing (single room availibility, when PT begins) and are acting boarderline incompetent. I'm hopeful he can get out of here soon.

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Cards and rest

Today has been another light day with a few visitors so John has been able to rest. He did his first physical therapy session today walking around the nurses station. He made two laps but felt weak which was to be expected. His appitite is still not completely back yet but he is at least on solid foods. There is talk of him being able to go home this weekend yet into Carens care, which he is really looking forward to.

Jamie, Caren and I played card (Uno) this afternoon to pass the time. Jamie apparently like to hold as many cards as possible in her hands at all times. :)

This evening we have been invited to Johns brother (Jeff) house for dinner. We got a "sitter" to stay with John while we are gone to keep him company.



John says thanks for all the thoughts and prayers!

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Two bits

I brought in my hair shears and cut Johns hair down to a number 2 (1/4 of an inch). It's the shortest his hair as been since he was a kid.

What he doesn't know is I'm invoicing him for $50 for my services.

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Visitors

See the prior post and visitors are welcome.

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Friday visitors

I think John will be up for seeing people tomorrow, I'll post in the morning around 9am when I am sure. I'm guessing there will be a fair number so don't be suprised if the room gets busy. It if is busy or if John gets overwhelmed please try to be aware and try to manage your "in-room time".

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Thanksgiving

So our grandma, aka Mimi, bought a thanksgiving dinner from Rainbow Foods. When I called to pick it up they said it was "precooked and ready to go". I went to go get it today before noon the lady at the deli said it was precooked but in order to eat it needs to go into the oven for two and a quarter hours. With that great news I dropped Jamie off at the hospital and headed back home to prep and cook the food.

(precooked pictures)






About 4 o'clock everything was done. I packed everything up and headed in to the hospital.

When I got in John was in his chair alert, talkative, and in much better shape than yesterday. I dished up some food and everyone ate - and John even had two helpings! It's by far the most he's eaten since before they surgery.

He's been up most of they day and hasn't really taken any naps so he's pretty tired. Right now it's 6:25pm and he's already crawled into bed and drift off to sleep. I think he's going to need it since there seemed to be a bit of interest in all of you blog readers wanting to visit tomorrow.

Jamie is taking a shift sleeping at his side to keep him company tonight giving Caren a much needed break.

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Each day is a gift

I dropped Jamie off at the hospital while I am preparing some things at home. In talking to Jamie, dad is doing much better today. He's eating a little bit and his pain is more under control.

A unanimous poster reminded us that everyday is a gift. It's such a true statement and it's easy to forget as we busy ourselves in the daily chores of life. I for one am thankful my father has been given a few more.

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Turkey day

We sure have a lot to be thankful for this year. My dad has had a rough couple of weeks and although he is still in the hospital is able to be with family. More on that coming soon...

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Another days end

Today has been another day off on and off sleep. His headache seems to be better under control and a constant ice pack on his head certainly seems to help. For us (the imediate family), with John being stable we've actually been able to take some breaks in the evening and get away from hospital and eat out for dinner. A little shout out to our other family members that have joined us at the resturaunt and made that little bit of time away a healthy distraction.

Caren continues to be a trooper watching over John. She also has been helping the nurses keep track what meds he's been on, what's working for him, what different test results have been, etc. Tonight she's even staying the night because he does better with someone around.

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The Jeffersons

Moving on up!

We just finished moved up to 7. It's actually the same room we were in presurgery. I think John will appreciate the move - it's quieter and a larger room and for the visitors, a better view out the window.

John has had a few visitors today consisting of family and pastors. There hasn't been too much chatting since John has really been trying to sleep.

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Turban

He doctors decided to take his incision dressing off today, which caught me a little off guard this morning. Earlier in he day they got him out of bed for a few hours into a chair here in the room. He's now back in his bed sleeping as that type of movement is very draining.

One of the nurses said they are waiting for a room to open up on 7 (neuro) and that they are hoping to get him up there later today.

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Headache

They have been asking John, if 1 is very very mild and 10 is the worst you could possibly have, rate your headache. Before the surgery he said he was a 1. Post surgery he has been a 10.

The good news is late last night they gave him another drug (Dilaudid) which seemed to do the trick. Apparently it's a trial and error type of methodology to determining how to rid the pain. I believe this was their 5th attempt!

A small update: last night he slept really well which I'm sure is exactly what he needed. His appetite has been poor but his fluid intake has been constant.

Visiting update

Thanks for the requests. At this point he is still really, really fatigued and if everyone comes now he will really be overwhelmed/exhausted. They are looking to move him hopefully tomorrow out of the ICU back up to the neuro floor. So with all the movement plus commotion Caren is thinking Friday might be a good day. Thanks again!

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What's next?

I've gotten sone questions as to, what is going to happen next? Is he cured? Does he just go home?Is there another surgery? The short answer is, kind of.

What we do know is once he leaves the hospital his incision will have to heal. He should be able to get out of here in a week. Once his head heals in 3-4 weeks he will have radiation and chemo treatments for 6 weeks. Once they're done they will reassess and figure out the next steps.

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Tremors

I forgot to mention that one of the PT staff came in to do an assessment on how he is going. One of the tests was to hold his arms out and for those 10 seconds there were no tremors! Hopefully that is a sign of a good recovery upcoming!

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Post op

John looks better today, less swelling and his color is back (not that it wasn't that bad yesterday). He still has a turban on his head and all the needles and lines in him. He has three cups in front of him with Sprite, water and ice chips. The left side of his body is functioning but at a slower pace which isn't out the ordinary. He's been drifting in and out of sleep in-between drinks, conversations and nurse checkups. His headache is still there and they are working on getting the proper drug mixture to help take it down. You can tell he's pretty fatigued today and is in need of his rest.

So far so good.




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This morning

We have yet to make it in but Caren said she has made it in. John has a splitting headache which oddly enough is pretty rare after this type of surgery. They brought him down for another MRI about a hour ago to see how things look.


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A miracle!

9:05pm:
We were just able see John in the ICU. At first glance he's not as swollen as I thought and had his head wrapped. Jamie, Caren and I reached out to hold his hand, legs and arms which made him slowly open his eyes (squinting through his swollen eyes). He was able to squeeze our hands and move his arms and legs. He then by the grace of God was able to say all of our names!

We didn't want to stay long and right as we are leaving we got a sign that "John" (and his personality) is going to be ok. He said "So has my hair grown back yet?" (sort of an inside joke) - which was everything we could have asked for.

What a rollercoaster day. Thank you, thank you, thank you from all of us. Your prayers for strength WERE felt!

Praise and thank God for watching over John, for guiding Dr. Greggory, for giving us strength, and for allowing John to live and see more days on this earth.

Now the long road to recovery...

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Visitors on 11/24

Tomorrow we would like to limit the number of visitors. If possible please refrain from unannounced dropins while he recovers. Thanks for your continued support and prayers.

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Surgeon recap

The surgery is over. The Dr. Gregory came out and gave everyone in the waiting room all the time we needed to ask questions after he gave us a detailed recap of how things went. In short, he got 90 percent and things looked real good. They then did the fourth MRI and decided they could go in and get a little more out of the tumor out. There were no suprises and John did very well. They were no signs of a stroke so he believes he should be able to move and talk. He did say there is a chance of him not being able to move his left side but only time will tell.

Next: In just over a hour he should be waking up and then they will move him to the ICU for some much needed rest.


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Still stitching

The surgeon is still at it.


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Stitching

20 minutes ago they finished and are now stitching him up. In a hour he should be out of surgery and then a hour after that he should be in his room. We don't know yet how everything went.

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Crowd

Nothing new to report, but the army of well wishers is growing.




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Nothing new to post about

No news has come.

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MRI #4

So they are done for the moment. They have taken most of the tumor out and have reached a cross road. The surgeon doesn't know if they are going to close him up or take out more. He has called for another MRI and make a decision based on those results.

The bad news: we have heard that he tumor is malignant, but have yet to hear the surgeon officially state that to us.

Keep the faith and keep sending out prayers!

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No update yet

Nothing new to report.


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1:05pm

My wife and I ran into the anesthesiologist in the hallway on our way back from lunch. He said everything was going well. He estimated it was about a third of the way removed.

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12:20

They are in.

(graphic)

When they took a plate of his skull off the tumor bulged outwards because of all the built up pressure.

So far so good.

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Nothing new

We continue to sit in the waiting room with no new news.



We're shoehorned into the corner of the room.

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MRI

We just got news that the reason for the delay was because they had him doing one last MRI. He has now just gone into surgery. The next update we are told will be in a hour to a hour and a half.

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Update?

We've been told that the surgery still hasn't started and that they are still doing prep work. Some here are comparing it to a carpenter - measure twice, cut once. Sounds good to me!

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No update

9:30am - No new information.

10:15am - still no new info. Not sure if the surgery is even underway...


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Waiting room

The waiting room is surprisingly small compared to the amount of active surgeries. There also isn't any cellular or wireless coverage which makes it difficult to get the word out and receive phone calls. I'm going to try to be diligent in getting updates out but please bare with me if there are gaps between posts. Keep praying!


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KO'd

John is officially knocked out. We got a few moments to see him one past time before he went into the OR. He was in a very light slumber (and was snoring) and vagly responded to loud talking. The nurse said that they expect they'd be in active surgery in about a hour.


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Early morning

We got to the hospital at 6am this morning and were able to see John in the room. To our suprise there were three pastors already there and were just finishing up a round of prayers. Around 630 John was finally moved to pre-op. It's now 745 and we had to leave for a few minutes while they put some additional lines in him to prep him for the anesthesiologist. We will be able to go see him again in a few minutes before he goes in for the surgery to begin.


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Tomorrow

So tomorrow is the big day. His surgery starts at 730am and will go till 5 or so we are thinking. He is heading to pre-op at 530am and I will be at the hospital at 6am. It's going to be a long day. Please keep everyone in prayer especially John and the hospital staff.

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Life savers or fruit loops

Earlier today a technition who is going to be working on a computer during the surgery (overlaying 3D images of all the scans) came in do to some prep work. He placed these round sponge type things on his head that will assist with his early morning cat scan. They look a lot like life savers or fruit loops that are stuck on his head. It reminds me of a one year old child that eats his cereal and gets little messy.


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Outpouring

We just got a visit from the pastor and a "few" attenders from Encompass church that felt called to pray.








Everyone then huddled in to lay hands and pray. Lots of emotion and the Lords presence was felt.

John says, "Thanks, Caren and I are overwelmed from your prayers, email and support."

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Vikings

We arrived this afternoon during the Vikings game. It's nice to see my dad in good spirits watching the Vikes take it too Seattle. He seems to be a little distracted though, which isn't suprising knowing tomorrow is the big day. I think we all will feel better once we get past the surgery and know a little bit more. The tention of not knowing and waiting is sure slow and arguious.


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Dr. Richard S. Gregory

http://www.allina.com/ac/homepgs.nsf/fhomepage/542

Dr. Gregory is the surgeon that will be doing the operation on John. He has over 20 years of experience as a neuro surgeon and comes very highly recommended.

Please pray for Dr. Gregory. Pray he get rest this evening. Pray that his hands will be steady and his mind will be sharp. Pray the God will sustain him during the 10 plus hours of work he will be doing.

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Day five

John had another rough night last night. If you're thinking of coming to visit please come in the afternoon or call first.

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Commenting

Just a FYI, I have opened up commenting to everyone so you don't have to register with a bunch of services. Feel free to leave comments; John gets copies of them in his email.

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Day four

Last night John had a rough night sleeping. It was nothing in particular that caused it, rather a combination of things like new room, the beeping of the IV pump, and of course all the needles. Jamie and I decided to stay home all morning to let him get some rest and arrived early this afternoon. John is in good spirits today and is actually busy showing some folks how to cover some of his church responsibilities on his computer - with the football game on in the background.

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End of the day

It's the end of the day and John has had so many visitors since this morning I have lost track. Earlier he was given a folder with over 75 printed out e-mails of prayers from people all over, most of which are from people he doesn't know. The prayer responses for him and our family has truly been an amazing blessing. Thanks.

Tomorrow is a pretty slow day, nothing really planned which will be nice. John is looking forward to watching the Notre Dame game tomorrow and getting some rest in preparation for Monday.

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Moving on up

John is all situated in him new room on the 7th floor. The room is seemingly larger, mostly because of the lack equipment. There are two CCTV cameras in the room so he can be monitored all the time. The view from the room is much improved with a view of the James J Hill house across the way.

It sure looks like a nice day outside. The setting sun is making a nice burnt red color on the low horizon. I guess that means tomorrow is a good day for sailors.

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Moving day

We've gotten some pleasant news, John is being moved up to the seventh floor which is where the neuro folks are. Very exciting, all we need is for him to get back so the transfer can happen.


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MSI #2

So after the doctors had some time to evaluate the scan results they needed another run on a MSI. Apparently the testing results had some incomplete parts to it so they just grabbed him and are redoing just a couple parts which should take about a hour and a half.


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Scheduled

So Monday morning is the day for the surgery. Pray for him, pray for his surgeon, and pray for His wisdom and grace.


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Back

John is now back in the room and is pretty tired from the testing. He's not hooked up to any of the machines and is out of his bed for the first time sitting in a chair.

It's hard for him though. He feels the same as he did a week ago and now he has to be in a hospital room and up until today was laying in bed all day.


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Day three

Jamie and I have arrived here at the hospital to an empty room since John is still getting his MSI testing. His razor is still here so it looks like they haven't moved him out of the ICU yet. Rumor has it he may be moved up a few floors today to the neuro area, we shall see. I can't wait to see my dad today, I hope he slept well.


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E-mail blast

I created an e-mail blast where you can sign up and get updates as they are posted straight to your inbox. Just fill out the box on the main page, upper right, then confirm your e-mail address when you get the confirmation e-mail. These updates will be delivered to you between 3 and 5pm CST each day.

(I'm hoping this works - let me know if it isn't or if there is another way to do this)

YOUR prayers

James 5:13-18

Is anyone among you suffering? Let him pray. Is anyone cheerful? Let him sing psalms. Is anyone among you sick? Let him call for the elders of the church, and let them pray over him, anointing him with oil in the name of the Lord. And the prayer of faith will save the sick, and the Lord will raise him up. And if he has committed sins, he will be forgiven. Confess your trespasses to one another, and pray for one another, that you may be healed. The effective, fervent prayer of a righteous man avails much. Elijah was a man with a nature like ours, and he prayed earnestly that it would not rain; and it did not rain on the land for three years and six months. And he prayed again, and the heaven gave rain, and the earth produced its fruit.


Thanks to all those who have sent us notice of prayer and uplifting e-mails. We all appreciate it - and especially John. They bring a smile to his face.

From all of us close to John, a most sincere thank you.

Evening and prognosis

After a long day we finally left around 9pm and came back home. In the morning John has his MSI scan which should last most of the morning. I'm guessing I'll head back in short of noon. That reminds me if you'd like to visit, in the afternoon would be best (text me or e-mail if you want to know if it's OK just to be sure).

Earlier this today the surgeon did give us an estimated prognosis based on what he believes the tumor to be ... which wasn't great news. Without discussing exact details, since I want to wait till we have a little more clarity, having the operation is almost a non-option. Doing nothing at all is essentially fatal in 6 months. Doing the surgery will give the fighting chance he needs. I'll expand on these thoughts as we learn more.

Shepard of His flock

No matter the dificulty we can always rely on His strength and have confidence in Gods grace.

Psalm 23
1 The LORD is my shepherd; I shall not want.
2 He maketh me to lie down in green pastures: he leadeth me beside the still waters.
3 He restoreth my soul: he leadeth me in the paths of righteousness for his name's sake.
4 Yea, though I walk through the valley of the shadow of death, I will fear no evil: for thou art with me; thy rod and thy staff they comfort me.
5 Thou preparest a table before me in the presence of mine enemies: thou anointest my head with oil; my cup runneth over.
6 Surely goodness and mercy shall follow me all the days of my life: and I will dwell in the house of the LORD for ever.

AMEN!

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Surgeon

The surgeon came and had some no so great news. He is not 100% sure but with his 25 years of experience and if he were a betting man this is what he believes John has:

glioblastoma (GLEE-oh-blas-TOH-muh)

A fast-growing type of central nervous system tumor that forms from glial (supportive) tissue of the brain and spinal cord and has cells that look very different from normal cells. Glioblastoma usually occurs in adults and affects the brain more often than the spinal cord. Also called GBM, glioblastoma multiforme, and grade IV astrocytoma.

More info can be found here:
http://www.abta.org/index.cfm?contentid=262&glioblastoma-GBM

There is still a chance that it could be another type and/or benign - only time will tell.

Keep on your knees folks - miracles happen.

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The man, the myth, the legend.

Meet John Phillip Nicholson.

Genuine prayers requested. Good karma, well wishes and the like need not apply.

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MSI - the next step

The surgeon has yet to swing by but we did get a visitor that was a sort of assistant for a specialist. The specialist is going to be bringing John down for another brain scan tomorrow morning. Unlike the MRI machine which uses magnets, this procedure (MSI?) measures the brain activity by measuring the brains electromagnetic field while responding to various stimuli. The stimulious they test the brain for is sensory, motor and speech. The idea behind doing this is so they can determine where the mass ends and active brain begins. Once this is determined they will use this data along with the MRI information and be able to make more educated decisions if and when he goes under a knife.

A fun fact about the MSI machine, apparently there are only 15 of these machines in the country and the technology is pretty cutting edge even though it's 10 years old.


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Back

Well he just got back from the second MRI and we are waiting for the surgeon to swing by at some point today. John looks worn out and in need of a nap - he's has a busy day. Lots of people coming in and out, lots of needles, lots of evaluation, lots of fluids and meds to control any swelling. No rest for the weary I'm afraid.

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Us

Like any hospital visit we are "enjoying" a lot of free time. New news is slow to come and we are just buckled in waiting to hear anything different - good, bad, or indifferent. Everyone is in good spirits though all things cosidered.


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The tumor

The tumor is located in he front of his brain in between his scull and right frontal lobe. It is about the size of a baseball which has the doctors a little concerend. They are very suprised about how well John is physically and mentally functioning since it is compacting his right hemisphere so much. Last night we were able to see the cat scan results/pictures. It was very odd seeing something of that size being so out of place is someone head.

As for the surgery, they say this type of brain surgery in the location that it is in is pretty routine. Reading between the lines, the location seems to be best case as far as tumor in the brain goes.


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This morning

Last night I picked my sister up at the airport around midnight, who flew in from LAX. We went to my house and crashed.

This morning we woke up and got into the hospital around 930 and found John in good spirits and being his typical joking self.

After I left last night around 8pm he went in for a MRI. This morning we were told that they need to do a second MRI to see some more detail of the tumor before they can make any decisions.

From the preliminary coversation we did have with the surgeon yesterday it's looking like surgery is emminent, it's just a matter of when. He thought, off the cuff, it would be next week some time. The reason for the delay is because they need the MRI equipment booked for all day for use during the procedure. The earliest it's available for all day is next week.


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What happened - the short version

A few weeks ago we began to notice more pronounced changes in the way John was acting. We noticed partial loss of control of his face, slight memory loss, constant fatigue, an ongoing headache and stronger than normal tremors.

After a brief discussion it was decided to bring him in to the doctors office for evaluation. This was yesterday morning. The doctors office recommended to go straight to the ER even before he came in so at 9:30am he was in the ER. After an initial evaluation they wanted to do a cat scan. The results came back at 2pm - they had found a tumor in his brain.

He was then transferred from St. Johns to United hospital where they have a top notch neurosurgon department (best in the Twin Cities).

John is in good spirits all things considering and at this point we are waiting to hear more information.

I'm off to the hospital - more updates to come.

Thanks in advance for all the prayers for John.

Test post

Test post from my iPhone.


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