Inauguration, MS, and caregiving, Oh My!

Raising a child while living with Multiple Sclerosis, you always kind of wonder even worry about what affect it all may have on their future.

While the world watched Barack Obama become the 44th President of the United States. Two of us watched and felt the weight of anxiety lift for there at the center of the world stage stood Michelle (Robinson) Obama, raised by a parent with Multiple Sclerosis.

ONLY a caregiving family would even have noticed much less discussed how former Vice President Dick Cheney and family dealt with what appeared to be your everyday workhorse Everest Jennings Folding Wheelchair with surprising skill.

In this politically diverse household with two Democrats, one Republican, and one Independent it is interesting that only the Republican and Independent voted FOR Obama for President.

“… why a man whose father less than sixty years ago might not have been served at a local restaurant can now stand before you to take a most sacred oath.”

Raised in neighboring Maryland, I believe it was more like 45 years ago when de jure segregation ceased to be. Had President Obama been born in either Maryland or Virginia his parents could have been imprisoned for up to 10 years under miscegenation laws not repealed until 1967.

“… with remembrance, of who we are and how far we have traveled”

From a wheelchair Patti has witnessed two Clinton, two Bush, and today’s Obama inaugural.

"...we did not turn back nor did we falter; and with eyes fixed on the horizon and God's grace upon us, we carried forth …”

Picking her up to view the Inauguration I had to bait the hook with lunch and a trip to Walmart. “Walmart! I like that part, they have good shit!”

Certainly not the kind of ad Walmart could use, but you get Patti’s drift. In our universe we move forward by pushing.


Caregivingly Yours, Patrick Leer
web site: http://caregivinglyyours.com/
videos: http://www.youtube.com/daddyleer
musings: Patrick Ponders ...

profiles in ability: "Christina's World"

Artist Andrew Wyeth died today at age 91.

Christina Olson died at age 74 in 1968.

“Christina’s World” will live forever allowing all to touch the soul of those who face the poignant and heroic line between disability and ability.

“Christina”, Christina Olson was a real person. Born in 1893 she was challenged with an unknown progressing muscular deterioration from childhood. By age twenty-six, she could walk no more than three steps without grabbing an object, her hands were weakening, and she was experiencing exhaustion after ordinary tasks. Doctors were not able to diagnose her condition.

In 1948, Andrew Wyeth sketched Christina as she crawled down the hill to visit her parent's graves. Adding his talent as an artist and his wife Betsy as the model he painted “Christina’s World”.

To say the end result is riveting is understatement.

The thing is “Christina’s World” in one form or another is REAL for so many.

I am reminded of the first time our neighbor across the street stopped me to share that Patti had been pulling herself up our hill on our picket fence and crawling across the side yard to get into our home.

We lived in a Federalist Farm Home located on the high point of our property. You parked by the carriage house and walked up the hill to the house. Patti in the earliest years of Multiple Sclerosis fought, clawed, and crawled if necessary for the fight for independence.

Seeing the painting in the news so much today how can I not be reminded of the courage of so many Christina’s.

Caregivingly Yours, Patrick Leer
web site: http://caregivinglyyours.com/
videos: http://www.youtube.com/daddyleer
musings: Patrick Ponders ...

Pennsylvania Farm Show 2009

If you were to ask Patti her favorite part of the Pennsylvania Farm Show, she would tell you “the Food Court”!!!

(though with MS related dysphagia, caregiver assistance is mandatory to prevent choking)


"The FOOD COURT" is where Pennsylvania’s farms meet the consumer in the most overwhelming, fresh, and affordable menu you will ever find … deep-fried breaded mushrooms, mushroom soup, grilled portabellas, mushroom salad, vegetable soup, batter-dipped vegetables, blooming onions, strawberry slush drink, broccoli-cauliflower salad, chicken corn soup, dill pickles, carrots and celery, broccoli soup, berry pie, pumpkin pie, bean salad, chicken breast sandwiches, turkey barbecue, wings, bucket of chicken, chicken cheese steak, chicken soup, deviled eggs, red beat and mustard eggs, chicken parmesan sandwich, turkey meatball sandwich, chicken chili, trout chowder, tortilla crusted tilapia, cinnamon sticky bun, shoofly pie by the slice, whoopie pies with white or peanut butter icing, fresh apples, apple dumplings with ice cream, apple cider, cider floats, caramel apples on a stick, dried apple snacks, apple or peach sundaes, rib eye steak sandwiches, philly cheese steak sandwiches, beef BBQ sandwiches, beef sticks, peach tea, honey dumplings with ice cream, orchard freeze slushy honey ice cream, honey waffles, maple sundaes, maple yogurt, maple cotton candy, baked potatoes, fresh cut French fries, potato donuts, potatoes and baked sweet potatoes, milkshakes, milk/chocolate milk, ice cream sundaes, deep fried mozzarella cubes with marinara sauce, pork barbeque sandwiches, roast beef sandwiches, lamb stew, ham and cheese sandwiches, beef meatball sandwiches, beef sausage, beef/pork hot dogs, steak salad, ham salad, and pink lemonade.

The flaw to the PA Farm Show Complex is that everyone and everything on wheels or unable to use an escalator needs to converge on too few elevators. Wheelchairs, scooters, strollers, assisted walkers, even catering carts create an epic logjam which can easily consume an hour or more of your visit.

We have learned to take outside all-terrain routes between the 11 buildings housing 24 acres under roof; however this solution takes some extra Patrick pushing and pulling power to successfully maneuver.

Patti ends her Farm Show visits with a nice long afternoon nap to counteract MS fatigue while I abuse Ibuprofren and coat my lower back with Mineral Ice.

Caregivingly Yours, Patrick Leer

web site: http://caregivinglyyours.com/

videos: http://www.youtube.com/daddyleer

musings: Patrick Ponders ...

living with MS / a grant of freedom

THANK YOU National Multiple Sclerosis Society Central Pennsylvania Chapter!

Through their financial assistance program we have been fortunate to receive a 2009 grant that helps pay 15% of our yearly payments on our wheelchair accessible van!

A special shout out to Carla Hecker, Information Resource Center Specialist with National Multiple Sclerosis Society, Denver, CO who ‘was there’ over the holidays to answer questions and get the paperwork started.

And, of course, thanks to the NMSS Central Pennsylvania Chapter President, Margie Adelmann and Director of Programs & Services, Robin Unangst for wrapping it all up and signing the check.

If you ever wonder what Multiple Sclerosis fundraising such as MS Walk is all about … Patti’s freedom is a good example!

Wheelchair confined and unable to transfer Patti’s life would be dramatically different without our van. For whatever reason accessible vehicles are priced comparable to luxury vehicles, living with progressive MS for over two decades does not really leave you economically in the luxury car class.

Between a discounted vehicle loan rate brokered by Pennsylvania Assistive Technology Foundation (PATF) and these grants from NMSS it helps to make freedom a bit more affordable.

Caregivingly Yours, Patrick Leer
web site: http://caregivinglyyours.com/
videos: http://www.youtube.com/daddyleer
musings: Patrick Ponders ...

Multiple Sclerosis & family: wheelchair rollin' 2008

As a caregiver I have never found myself even trying to make a list of New Year’s resolutions. While you certainly must prepare and can ‘try’ to anticipate, the disease progression of the person you care for drives the agenda.

2009 finds me beginning my 19th year as a spouse caregiver, and Patti her 24th year since diagnosed with Multiple Sclerosis.

Captured below in 1 minute and 36 seconds is a look back at 2008 accompanied by "Old Man River".

Multiple Sclerosis & family: wheelchair rollin' 2008

Uploading this I was humbled to discover that Caregivingly Yours videos have been watched nearly 60,000 times since October 2006 when the original Multiple Sclerosis & family: wheelchair rollin’ debuted.

You Tube “insight” feature informs me that our original rollin’ video while most popular in the US, China ranks second, with Sweden and Germany tied for third in views.

Thank you ALL for caring! We will do our best to keep our story of living with Multiple Sclerosis and family, rollin’ on for 2009!

Caregivingly Yours, Patrick Leer
web site: http://caregivinglyyours.com/
videos: http://www.youtube.com/daddyleer
musings: Patrick Ponders ...

caregiving: MS incontinence prophylaxis with Macrobid

Antibiotics, I noticed, are grabbing headlines to open 2009.

Preventive Use of Antibiotics Cuts ICU Deaths

Conventional medical wisdom and antibiotics seems to fluctuate.

Over a decade ago when incontinence first became a part of living with Multiple Sclerosis, it was too often accompanied by Urinary Tract Infections (UTI).

Patti’s MS related physical challenges and wheelchair complicated her ability to deal with her own medical care.

Being a ‘guy’ and her spouse caregiver I found myself in a crash course on female anatomy. Yes, we all have a casual knowledge of each other, but woefully inadequate to be engaged in discussions with OB/GYN’s.

The more I learned the more I discovered it was more than dangerous. It was time to make some noise as her caregiver!

Anyway long story short working along with an OB/GYN who was able to see the more hollistic view of living with MS and caregiving we all decided to try an experiment, prophylaxis with Macrobid® (Nitrofurantoin).

In our story, Patti has NEVER had another UTI since prophylaxis with Macrobid®. It has been almost a decade and yes her doctors periodically like her to ‘take a break’ for a period of time before resuming. Whatever, it works!

When wearing your medical advocate hat, I believe you have to act to protect the patient NOW from the most AT RISK threat. Long term effects certainly must be weighed however first you have to get TO the future.



Caregivingly Yours, Patrick Leer
web site: http://caregivinglyyours.com/
videos: http://www.youtube.com/daddyleer
musings: Patrick Ponders ...

caregiving: incontinence trumps

Incontinence may be intellectualized by doctors but from a caregiver’s perspective incontinence trumps.

With progression of Patti’s Multiple Sclerosis she is totally incontinent both for bladder and bowels. Add into the mix a wheel chair, a non-ambulatory patient with cognitive impairment and you have more than a challenge.

I think it is safe to assume that most people have changed a diaper on an infant. An adult’s diaper is the same concept just on a grander scale.

Incontinence also means whenever. Anything and everything else planned has to accommodate the need to change Depends and usually clothing.

Yes, all manufacturers promote their product does not leak. If your faith is based in US advertising, then bless you. However, I will say after a decade of caregiving for incontinence that Kimberly Clark DEPEND® brand leaks less.

Picking Patti up on Saturday for her parent’s holiday party my nose told me something was not right. Patti claimed that she had just been changed and just wanted a cigarette. I wasn’t buying.

Preparing to change her myself I found myself shortly assisted by 5 aides and a lift. I think operating rooms have less people.

Later driving back she experienced more bowel incontinence. Changing alone was not going to be adequate, a shower was needed.

Timing was bad as aides were all busy getting other residents to bed so I charged forward.

First, dead lifting Patti from wheelchair into bed so I could get her clothing and Depend off, then dead lifting her into a shower chair to roll into the shower.

Soiled clothing and bed linen I quickly tossed in hamper Depends and wipes in trash.

Observing me, the LPN put meds on hold and pitched in finding me extra wash cloths and towels, rounding up fresh linens, and making the bed.

After shower I dead lifted Patti back into bed, whipped on new Depend, nightgown, and rolled her regular wheelchair into the shower as it too needed a cleaning.

All's well that ends well, as Patti was falling into sleep as I turned out the light and sloshed out in soaking wet shoes.

Caregivingly Yours, Patrick Leer
web site: http://caregivinglyyours.com/
videos: http://www.youtube.com/daddyleer
musings: Patrick Ponders ...

A Christmas letter of One Solitary Life

Christmas can be particularly poignant for caregivers and those they care for. Holidays are benchmarks of the past, present, and future.

Reflecting how life does not always fit into a bombastic Christmas Letter, I remembered sitting in Radio City Music Hall with our daughter a few years ago.

Mesmerized with their Christmas Spectacular I felt like a kid.

Yet the scene I remember the most was their living nativity and experiencing for the first time “One Solitary Life”, a 1926 sermon by Rev. James Allan Francis.

In a sense the first modern Christmas Letter …

"He was born in an obscure village,
A child of a peasant woman.

He grew up in another obscure village
Where he worked
In a carpenter shop until he was thirty.

Then for three years
He was an itinerant preacher.

He never had a family.
Or owned a home.

He never set foot inside a big city.
He never traveled two hundred miles
From the place where he was born.

He never wrote a book or held an office
He did none of the things
That usually accompany greatness.

While he was still a young man, the tide
Of popular opinion turned against thim.

His friends deserted him.
He was turned over to his enemies.

He went through the mockery of a trial.
He was nailed to a cross
Between two thieves.

While he was dying
His executioners gambled for the only
Piece of property he had, his coat.

When he was dead, he was taken down
And laid in a borrowed grave.

Nineteen centuries have come and gone
And today he is still the central figure
For much of the human race.

All the armies that ever marched,
All the navies that ever sailed
And all the parliaments that ever sat
And all the kings that ever reigned
Put together have not affected
The life of man upon this earth

As powerfully as this
One Solitary Life."

While there certainly is nothing wrong with pride in winning a soccer tournament, getting all A's, or even just being able to get out of bed in the morning; try to see the love and care at the core of Christmas.

Wishing you all a safe, family filled, and Merry Christmas!

Caregivingly Yours, Patrick Leer
web site: http://caregivinglyyours.com/
videos: http://www.youtube.com/daddyleer
musings: Patrick Ponders ...

caregiving: "Hello! You little brat!"

In a recent study of MS patients, … 62% reported speech and voice impairments. Cognitive problems can be a barrier to communication. … 48% displayed cognitive dysfunction

While pushing Patti through the aisles Christmas shopping, a young girl wearing reindeer antlers and jingle bells was leaping about wishing Hello and Merry Christmas to all ...

… until she was stopped in her tracks by Patti’s, “Hello! You little brat.” Patti was NOT in a bad mood, her MS was preventing her from communicating appropriately.

These are the caregiver moments when I wish I had a big sign “MS Zone” or something. Then again what would that even mean to most people.

Dysarthia, in which the capability to understand, remember words and construct sentences is not lost but the ability to speak clearly becomes affected. Slurred speech, together with impaired mobility, can sometimes lead to accusations of drunkenness or decreased intelligence.

Dysphasia, in which there is a lack of understanding of what is being said and an inability to recall the vocabulary and grammar necessary to build a sentence, hesitant disjointed speech affects confidence and demands patience on the other end.

Disinhibition is one of the rarest behavioural symptoms of MS and linked to MS-related damage in the brain. People experiencing disinhibition may have little or no awareness of others' feelings regarding their actions. Making a hurtful or inappropriate comment is frankly the milder end of a loss of their sense of social rules.

Attempting to defuse the moment by introducing ourselves to the formerly happy child , I hoped that putting names to faces might help Patti.

“Patti, say hi to Laura”

“Hi Laura! You little brat!”

Realizing this was going nowhere, it was easier to offer the child a conspiratorial wink and a whispered aside, “Don’t let her bother you, she’s really the Grinch in disguise.” … Recovering with a giggle she bounced off happily.

Caregivingly Yours, Patrick Leer
web site: http://caregivinglyyours.com/
videos: http://www.youtube.com/daddyleer
musings: Patrick Ponders ...

give us this day ...

A birthday present and an ideal caregiver's home companion!

Caregivingly Yours, Patrick Leer

web site: http://caregivinglyyours.com/

videos: http://www.youtube.com/daddyleer

musings: Patrick Ponders ...

caregiving: multiple sclerosis and cognition

Special thanks to the Multiple Sclerosis Foundation for enabling our story to bridge from the blogosphere to print media.

"A Caregiver’s Perspective: MS and Cognition" will appear in their Winter 2009 edition of MSFocus Magazine. Below is an excerpt:

"Our then elementary-age daughter discovered the first clue: Her mom laughed hysterically at the word “brick.” Then came the day I opened our monthly credit card bill to find $2,000 in charges from a home shopping network. Homecare agencies cancelled our aides due
to incidents involving my wife, Patti’s, verbal and physical outbursts. Finally, I returned home one afternoon to discover our stove top on fire while Patti sat unconcerned or unaware at the kitchen table.

Looking back, were there earlier clues that my wife’s MS symptoms might not stop with the physical? Yes, but who knew to look? We were still reeling from the physical symptoms of Patti’s diagnosis and trying to learn to live with MS as a family. In a few short years, my wife had become wheelchair-bound. We were swamped in physical adaptations, and in the early and mid- 90s, cognitive problems associated with MS were simply not mentioned very often..."

After years of journaling it was fascinating to work with a different medium including submitting copy, editors, revision, and such.

This journal / blog began, in part, four years ago because the challenges of people with progressive and severe MS, their caregivers, and families were invisible to mainstream MS publications.

Thank you, Multiple Sclerosis Foundation for this opportunity.

Caregivingly Yours, Patrick Leer
web site: http://caregivinglyyours.com/
videos: http://www.youtube.com/daddyleer
musings: Patrick Ponders ...

caregiving: nursing home compare

Today the Centers for Medicare and Medicaid Services (CMS) unveiled their new 5-star rating system for nursing homes and care facilities.

NURSING HOME COMPARE

Exhaustive information has always been available through CMS however, this works much like the more consumer familiar restaurant or lodging 5-star systems.

After checking it out this morning, I must offer applause for user friendliness and simplicity.

However, I also must also caution that searching and deciding on 24/7 care is NEVER simple. Certainly use this new tool as a start.

Then visit, visit, and visit again. Your impressions and what you actually see and feel is far more important than data. Care is always about people.

Caregivingly Yours, Patrick Leer
web site: http://caregivinglyyours.com/
videos: http://www.youtube.com/daddyleer
musings: Patrick Ponders ...

caregiving: one third of my life ...

One-third of my life has been spent as a spouse caregiver. I discovered this trivia while playing with a calculator on this last day of my 57th year.


Do I have any pearls of wisdom to offer? Yes, never stop building snowmen!


With 3 inches of snow for an early birthday present it was time to realign the feng shui of kitsch.



Caregivingly Yours, Patrick Leer
website: http://caregivinglyyours.com/
videos: http://www.youtube.com/daddyleer
musings: Patrick Ponders ...

caring bells jingle (or maybe, toll)

While we put lights on our tree last night, Jingle All the Way played on ABC’s 25 Days of Christmas.

As any caregiver knows, “we” means I climbed up and down and all around illuminating our 9’ Frazier Fur. The rest of the cast of ‘helpers’ chomped cookies offering encouragement and compliments.

It was impossible not to reflect on a comedic scene from the movie released Thanksgiving weekend 1996 involving Arnold Schwarzenegger and Sinbad battling their way through a Christmas shopping stampede. Filmed with Hollywood craftsmanship, special effects, and stunt people you get comedy.

Twelve Thanksgiving weekends later, in reality, you get tragedy. I read that a cell phone video posted on You Tube shows a police officer crouching by a man lying at the entrance of the Valley Stream, NY Wal-Mart. Shoppers peer from behind glass doors or stand a few feet away, audio-enhanced chatter captures "They need to shock him," a voice says … another cracks a joke … women laugh.

The coroner ruled Jdimytai Damour, 34 died of suffocation. He could not breathe trampled under the stampede of Christmas bargin shoppers on frugal Friday, black Friday, or whatever.


Valley Stream, NY may not be all that unfamiliar. Snapple Beverage Co., and the drink itself, started there.

Portions of the film “Goodfellas” were filmed in Valley Stream.

Reggae singer, Shaggy, lived and recorded there.

Steve Buscemi - Actor/Director, grew up in Valley Stream

Estimated median house or condo value in 2007: $428,480

Estimated median household income in 2007: $78,829

Sounds more like the fictional Bedford Falls than the kind of town where a life is less valuable than saving a few bucks.

Or is it that we, regardless of where we live have forgotten to care or even what we care about?

What does this entry have to do with caregiving? Everything! One day, EVERYONE will know or love someone who cannot care for themselves. God help us!

Caregivingly Yours, Patrick Leer

website: http://caregivinglyyours.com/

videos: http://www.youtube.com/daddyleer

musings: Patrick Ponders ...

opening December email ...

Opening December email has been like opening an Advent calendar ...

and finding a wonderful award behind each day.

THANK YOU Julie of Julia's New Journal and Amanda of This is me Hugs for your kind remarks and awards.

OUR story as told in Caregivingly Yours is really a story that writes itself. If I could pass along awards it would be to everyone who takes the time to visit here and share our story. Thank You!

Caregivingly Yours, Patrick Leer
website: http://caregivinglyyours.com/
videos: http://www.youtube.com/daddyleer
musings: Patrick Ponders ...

health care: ignorance and fear are deadly

The American College of Physicians, is urging its members to offer testing to all patients older than age 13 for HIV, the virus that causes AIDS, as a way to identify people who unknowingly carry the disease and might pass it to others.

“ACP recommends that physicians adopt a routine screening policy for HIV and encourage their patients to get tested, regardless of their risk factors ...”

The college joined at least three other doctors’ groups -- the American Academy of Family Physicians, the American College of Emergency Physicians and the American College of Obstetricians and Gynecologists -- that have endorsed wider testing.

Ignorance and fear are deadly ALL the time, not just on December 1st, World AIDS Day.

Caregivingly Yours, Patrick Leer
website: http://caregivinglyyours.com/
videos: http://www.youtube.com/daddyleer
musings: Patrick Ponders ...

caregiving: Thanksgiving is not a Norman Rockwell painting

In 1621 the Wampanoag signed an alliance which gave the English permission to use about 12,000 acres of land for Plymouth Plantation.

54 years later the Wampanoags were nearly exterminated in war with the colonists. Surviving male captives were sold to slave traders. Their families, women and children, were used as slaves in the New England colonies.

Thanksgiving eve 1989 Patti (totally able bodied) and I spent the night playing with our then 18 month daughter, taking turns with the butterball turkey on the tot slide.

In the morning Patti awoke unable to walk, see, and barely able to talk from Multiple Sclerosis, spending the remainder of the holiday weekend hospitalized.

On Thanksgiving 2001, I stood on the streets of a resurgent New York City.

Too full of parental pride as my daughter marched by in the Macy's Parade to even notice how cold it was.

On Thanksgiving 2007, I looked across the table into the smiling eyes of my youngest cousin. Premature birth, infantile myotonic muscular dystrophy, liver cancer, and months of chemotherapy and successful surgery had challenged his less than two years of life to sit at that table.

Thanksgiving memories are not Norman Rockwell paintings but rather benchmarks of the life we are given and what we choose to make of it.

Caregivingly Yours, Patrick Leer
website: http://caregivinglyyours.com/
videos: http://www.youtube.com/daddyleer
musings: Patrick Ponders ...

National Family Caregiver's Month ... sleepless in Alaska

Caregivers do not come packaged on shelves, nor are care environments cookie cutter patterns.

While I am thrilled this morning with the first snow here in Pennsylvania, another caregiver up in Alaska wakes to a different view.

from Sandra of Family C.A.R.E.

"I am so tired and overstressed right now I can barely even express it. I'm tired, but I can't keep the house warm for my dad and sleep at the same time because right now our primary heat source is a fireplace. I can't go to sleep and leave an open flame going in the fireplace, and if I let the fire burn out then the house will get down to near freezing levels by morning. This all causes a significant lack of sleep, and that lack of sleep is producing stress and disorientation like you would not believe."

Caregivingly Yours, Patrick Leer
website: http://caregivinglyyours.com/
videos: http://www.youtube.com/daddyleer
musings: Patrick Ponders ...

let it snow ...

Caregivingly Yours, Patrick Leer
website: http://caregivinglyyours.com/
videos: http://www.youtube.com/daddyleer
musings: Patrick Ponders ...

careGIVING: The Smell of Christmas

'Tis the season when the 'giving' part of caregiving begins to occupy the thoughts of family and friends.


Endoresement by demand prompts this entry. Recently the staff at Patti’s care facility has been bugging me to find some of “that potpourri” that we use in Patti’s room.

Previously in an entry entitled “gift shop suggestions” I mentioned that we stockpile a Christmas potpourri to use throughout the year. Let’s face it; a care facility has unique challenges. If Patti’s room is a year round oasis for all then this potpourri is a winning product.

Each year when we go to buy our Christmas tree at a local nursery we find it in their Christmas shop.

So after some recent Internet research …. Eureka!
You can order Aromatique “The Smell Of Christmas” on line or click on their retail locator to find a shop near you.

I even learned that you can buy refresher oil to keep “The Smell of Christmas” potpourri maximized year round. Unaware we have just been replacing, this will save some money … thanks!

Besides the fact that the product absolutely transforms even the most challenged environment I was impressed to learn that Aromatique, Inc is a home grown American success story. Patti Upton created “The Smell of Christmas” at home mixing together some local botanicals and fragranced them with oils and spices. Her larger than life story began with placing some in a friend’s gift shop in Arkansas in 1982 and today leads the decorative fragrance industry.

MORE impressive to me is the “smell of success”. Patti Upton’s commitment to sharing her success has contributed millions to the University of Arkansas for Medical Science and the Nature Conservancy among others.

This is Patrick Leer and I endorse this entry.


Caregivingly Yours, Patrick Leer
website: http://caregivinglyyours.com/
videos: http://www.youtube.com/daddyleer
musings: Patrick Ponders ...