Author Topic: First MRI since radiotherapy with cyber knife  (Read 50454 times)

photog1

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Re: First MRI since radiotherapy with cyber knife
« Reply #60 on: September 12, 2014, 11:07:27 am »
I continue to feel encouraged and happy for my U.K. friend, who is still doing rather well, yet does have periods of feeling tired and slowed down.  Still, he is making it to the gym and getting good workouts done and he puts in long hours at his company.  This is especially important, that he is "at the helm of his ship" and managing it well.  Looking forward to seeing him next week when I travel to the UK to visit him, at long last!  His AN is still swollen, but given the way he has been feeling these past couple of months, he is doing much better than I had thought he would be by this point, 5-7 months post-CK.

Anxious to see, in person, how he is doing and managing things.  He did say his driving is still limited.  It will be a big effort on his part to come to the airport to meet me, as it is a very far distance from his office and his home.

Have any post-CK patients felt at this level only 5-7  months post-treatment?  And, it has stayed that way?  I keep thinking maybe he is doing well because of the anticipation of my coming, then once the time together is over, the bubble could burst and he will be hit hard by the CK side effects again.  I keep these thoughts to myself, of course.  I know the side effects are known to come and go and can hit hard at times.   But, don't they become less intense as time goes on?   

Many thanks!
Tina

Ruthie Mac

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Re: First MRI since radiotherapy with cyber knife
« Reply #61 on: September 12, 2014, 09:52:16 pm »
I'm happy for you that you are finally getting to meet your friend in person...you have been so dedicated to the friendship during his hard time. We should all be so lucky to have someone like you on our side. He is probably nervous about being at his best...and I can just share that at 10 months post radiation for me, I'm still not sure day to day how I'll feel. Sometimes I feel almost back to normal...then some days I still feel wiped out and just want to lay on the couch and watch television. The stress at work can make a big difference. So my advice is to be aware of the roller coaster energy levels and try not to plan to do too much. Go along with whatever he's the most comfortable with. Maybe you can help with some of the driving or help with meals, or do some sightseeing on your own, and just have a good time!
Looking forward to hearing about your trip...
Ruthie

 
4/1/2013  1 cm x 1.6 cm left ear
11/1/2013 SRS Varian Trilogy UMass Medical (4 sessions)
hearing is still good, slight tinnitus, working on balance issues

photog1

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Re: First MRI since radiotherapy with cyber knife
« Reply #62 on: September 13, 2014, 05:04:11 pm »
Thanks, Ruth, for your reply to my last post.  It is true, that he is nervous about being at his best.  This would be true for anybody with an AN and being in this particular situation.  It is a delicate one to be in.  From him, I've learned to understand and respect the situation from his viewpoint.  I do sometimes wonder if I'm making the trip too soon, but he himself asked me (back in early July) if I could come and I don't think he has regretted it.  And, this was even before his 6-month MRI!  I will make sure that he takes it easy, we already plan to just stay in town and rest and get to know each other in his environment, which will be more comfortable for him.  We plan to fix meals together.  His driving is limited, so we will have dinner out just once.  Don't know if I can help with the driving, I have never been to Europe and it will feel so strange riding on the other side of the road!  I won't be there long enough to do any sightseeing myself, but will be content to just hang out with him and relax and get to know him, and more about his AN.  I can understand his work causes him tremendous stress, compounding the healing process all the more.  I didn't think he would ever be able to have me over there as his guest, so this will be special for both of us.   

Thanks again, it was really nice to hear from you.
Tina

photog1

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Re: First MRI since radiotherapy with cyber knife
« Reply #63 on: September 20, 2014, 10:36:19 am »
It's not going well with my friend here in the UK.  He has so many very complicated issues re: his side effects from the CK, continued swelling and needs a new procedure on the 30th, but is now plagued with a bad chest cold which he has to get over before the 30th.  I feel I am in his way being here, yet he wanted me to come.  I don't think it was a good idea for me to come, yet we had such a wonderful meeting at the airport when I arrived here only 2 days ago.  Will be glad to go back home, and yet will also face some very bleak days and months ahead of me.  I am in love with this guy and he told me he can't be the same way towards me.  He is also plagued with very high blood pressure and OCD, issues I never was aware of, or I wouldn't have come, he is going through multitude of complicated personal and health issues, I feel I am in his way.  He has the help and support of a lot of friends here in his hometown, which I was never aware of, so I don't understand why he wanted me to come!!!  Why??????  Why?????? What a terrible disappointment and heartbreak to face after traveling so far and spending so much money to come here, yet he wanted me to come!!!  He hardly responds to any support I am trying to offer.  I am staying out of his way as much as possible.  Can't wait to go back home, but he will be in my thoughts and prayers.  So sorry I don't have a better update.
Tina 

Ruthie Mac

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Re: First MRI since radiotherapy with cyber knife
« Reply #64 on: September 20, 2014, 09:15:22 pm »
Tina,
I'm so sorry to hear your trip is not going well. I have been in similar situations, and as hard as it is, sometimes the reality of a situation is an important awareness to move on to the next chapter, whatever it is, for the both of you.
You have been a devoted friend and you should feel good about that. I'm sure you have helped him, but he is probably not in a position to appreciate it.
When I was 40 and recently divorced, I flew to South Korea (from Boston) to rendezvous with my high school sweetheart who had been a Navy Seal and stayed in the Navy as a career. It was a disaster. He was fat and lazy - had a secret Russian girlfriend. It was a total disaster. But I decided to do some sightseeing while I was there, and now I can say I've been to South Korea and can laugh about it with my friends.
I don't mean to make light of heartbreak...it's really hard...but if there's any way you can turn this trip around into some kind of adventure, I'm sure you'll have the support of all your friends...including all of us on the forum...  your devotion to caring for someone with an AN is inspiring.
Keep shining your light...we need it!!
Ruth
4/1/2013  1 cm x 1.6 cm left ear
11/1/2013 SRS Varian Trilogy UMass Medical (4 sessions)
hearing is still good, slight tinnitus, working on balance issues

photog1

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Re: First MRI since radiotherapy with cyber knife
« Reply #65 on: September 25, 2014, 04:35:26 pm »
Thanks, Ruth for your kind response.  It is so appreciated.

It has been more than shocking for me to have such a heavy dose of reality hit me from behind.  I had thought my guy was doing much better with his continued AN swelling.  He hadn't told me of any complications in many weeks, almost 2 months.  He was all set and greatly looking forward to my visit, which we both had anticipated for months.  He told me that he has a brain tumor.  I know AN's aren't actually brain tumors, or am I wrong about this?  It was evident, rather early on, that he couldn't show any appreciation for my being there.  Maybe the reality of my coming became more than he bargained for and when actually face-to-face with him, he couldn't handle it, feels very inadequate.

I have a terribly heavy heart back home from my first trip to the U.K.  Yesterday morning, I did receive an e-mail from my guy (no, my UK friend, I think), hoping I had a good journey back home.  Then, he apologized left and right for the way he acted during my time with  him, thanked me for taking the time to come visit him, apologized for his health issues.  He said that the most challenging issue for him was having someone in his house with him.  He has lived alone in the large family home since his divorce 8 years ago.   I was the first overnight guest in his house since his divorce, so I know now he couldn't deal with entertaining me.  He also said that I have a true friend in him if I wish to maintain this relationship.  I wonder what his definition of relationship is, because a relationship is deeper than a friendship. 

If only he had told me of the blood pressure issue, that his chest cold wasn't better and if only he had told me of the upcoming procedure on the 30th, I would NOT have made the trip.  I would have cancelled it or postponed it for another time.  He doesn't know exactly what will go on during this procedure for the AN swelling, he said his doctors won't tell him, because they don't want to scare him.  What in the world???

Thank you for your understanding.  I really do need a lot of support regarding this and couldn't think of a better place to vent.  My concentration level is not what it was before and I feel very emotionally battered and scarred.  Now, I feel like I can't focus and enjoy anything.

Thanks,
Tina

photog1

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Re: First MRI since radiotherapy with cyber knife
« Reply #66 on: October 05, 2014, 09:35:52 am »
With the dust still settling since my visit with the UK guy, I am still trying to come to grips about whether his actions towards me, his inability to realize the impact on me and his lack of appreciation for my being there, is mostly related to the swelling of his AN that still persists.  It has him talking much more differently than before his treatments began in February.  Plus, he had 2 separate treatments, 2 months apart.  Most of all, I think the reality of my being there was something he found he was unable to cope with.  After I got home, he said my being there in his house was his greatest challenge.  I was the first person to stay at his house since his divorce 8 years ago.  He has not yet gone through the "mystery" procedure that is supposed to help him with the swelling.  He does not want to take steroids again.

My greatest challenge is going to try to recover emotionally and financially from making this trip so far away. It has been a huge loss for me in both those areas.

So, to everyone out there who suffered and is still suffering from cognitive and emotional issues due to swelling from their CK radiotherapies, my heart goes out to you all and I wish you all the very best in the challenges of your recoveries.  You are all in my prayers.

I haven't been sure if I can send any more posts to the forum about this person, but I just wanted to say these few things.

Thank you.  Wishing you all God speed.

Tina       

photog1

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Re: First MRI since radiotherapy with cyber knife
« Reply #67 on: October 12, 2014, 09:15:02 am »
It is been very tough going since my visit with my UK friend only a few weeks ago.  It feels like it's been months since then.  Knowing even less about him and how he is holding up feels like I know less about him, than ever before.  It's as though he transformed into a different person the day after my arrival.  He never let on to me (from the time I made my trip arrangements in July) that he was not feeling well.  He was very  much looking forward to my coming and our meeting for the first time.    He was always counting down the weeks and the days, even the hours near the end. 

The only crimp in my trip plans came from him when he told me, a week before my coming, that he was coming down with a cold, but he expected to be over it by the time I'd arrive on 9/18.  Once there, he still had what he said was a chest cold, although he didn't sound like it, had no loss of his voice, he didn't even sound nasal.  He just said because of his lowered resistance from the CK radiation, he got the cold and it takes him a while to recover from it.  I am also surprised that he'd told me, in advance, that he feels the cold more easily (so do I, due to a couple of  medications I take for thyroid and psoriasis conditions), and that he would put the heat on his house for us to keep warm. 

Well, he put heat on only in his large solarium off the kitchen, a propane tank in a rolling cart for me to keep warm in there during the day while he went to work, or (on the weekend) when he went out for hours at a time to visit this doctor and that doctor for his cold and blood pressure, plus he visited friends, so to say, and was gone for many hours, leaving me to languish alone by myself in his huge house, locked up inside there with no way to get out.  All doors were locked from the inside out and he had the only remote to disarm his elaborate alarm system and that couldn't be done until he'd get back home!    Even all the doors to the bedrooms (except my little room he moved me to the 2nd night and the bathroom) were closed and locked, including even his room where I was the first night.  There are cameras up by the ceilings in certain places in the halls and in the public rooms downstairs, and even a camera inside his bedroom!  I couldn't go in there, like I could at first, to use the hairdryer he had for me to use at the vanity area in the bedroom.  So, from my 3rd morning on, he dragged out a long extension cord for me to have to use between my little room and the  bathroom and use that dryer in the bathroom. 

I surely wish I knew what was going on in this guy's mind the time I was there with him.  We never did anything together over the weekend like he'd said we would do.  He had specifically wanted me to be there over the weekend so that he would have time for going out and doing t things together,  plus he'd take some time off from work on Monday to spend with me.  This never happened, except for that one dinner out with him on Sunday evening.

He still has his tumor swelling and side effects due to it.  He is desperate to get back to good health, seems he is not at all patient about the time it's taking.  I wish he could just have some faith and believe that everything will turn out okay for him with the swelling, but he's gotten himself all up in a big tizzy, to where even his blood pressure has shot up dangerously high.   My heart goes out to him and I 've found myself in a position where I can't help him at all, whereas I thought I was helping him this past spring and throughout the summer.   He told me he appreciated my help and concern.  He told me he appreciated that I cared about him.

I'm having a lot of trouble dealing with all this and trying to put this puzzle together.  Could this all be just head wonkiness for him?  I hope so, because then he will recover from that in the next months, or many months, maybe 1-2 years, and be back to his old self, the guy I knew to be himself last winter before his CK treatments.

Does any guy here have some understanding about my friend, from a male perspective? Would appreciate any comments and help anyone out there could offer me.  By the way, my friend still has not gone through the certain surgical procedure to help with the incessant swelling.  Being with him, though, as active as he was (even going to the gym almost e very morning and working out for an hour), it was hard to believe that he has an acoustic neuroma at all!

Many thanks!  Hoping for some responses,
Tina

rodneyd

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Re: First MRI since radiotherapy with cyber knife
« Reply #68 on: October 17, 2014, 02:52:30 pm »
Hi Tina,

From what you have said on the forum, I know you are in love with him, or at least feeling like he desperately needs your support.  You had high expectations of your trip, and he did nothing to dissuade them.  But from his behavior (especially locking you into the house and leaving you there alone for hours) it is my male perspective that this guy is not for you.  That is not normal behavior by any stretch of the imagination (M or F) but he may have been sending you a less than subliminal message that he really doesn't care for you.  His hours away from you while you were there is another indication of his lack of concern about you and your relationship with him.

It is possible that he felt no chemistry with you (this can't be determined over the internet or on the phone).  His excuse about having a cold and AN swelling may just be a convenient way for him to avoid you.  His lying about other physical conditions such as high blood pressure and OCD was inexcusable when it was so financially draining on you to make the trip.

The cameras in strategic locations throughout his house is creepy, especially the one in his bedroom.  To me, there is only one reason for this camera and it doesn't have anything to do with security, if you get my drift.

Why didn't he take you with him when he went to his doctors visits?  Why didn't he take you with him to visit friends?  Why didn't he take off from work on Monday as he had promised?  This sounds like he has something to hide (a gf perhaps?).  To leave you alone while he went off is really insulting behavior and totally inexcusable. 

As painful as this is, my thought is that you should cut all ties with him and move on with a productive life here in the US.

Sorry for being a wet blanket, but his behavior towards you, not his words, are the most important gage of his intentions.  And I think they were really unacceptable, and from what you wrote, I think that deep down, you feel that way as well.

Rod
74year old male, 8.3x7.3x6.5 mm AN on 10-28-13.  MRI on 12-30-13 showed no growth.  Imbalance issues and mild tinnitus.  MRI on July 13, 2014 showed no growth.  Still on W & W and taking baby-aspirin regimen.  MRI in July, 2016 show slow growth (1.1 cm).  MRI on July 24, 2017 was 8.2 x 8.6 x 8 mm!

photog1

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Re: First MRI since radiotherapy with cyber knife
« Reply #69 on: October 18, 2014, 10:59:30 am »
Thank you, Rodneyd, for your detailed response to my last post.  I agree with everything you said.  This guy has all sorts of serious, personal issues which I believe he will never deal with and get addressed.  I don't think he believes he has a problem at all. 

I was a little impressed, though, with his sharing with me early this week, that he now knows how bad it was for me being cooped up in his house all those hours over the whole weekend, and he doesn't feel proud at all over how bad it was for me alone in his house, whereas we were supposed to go out and do things together.  He chose to work all day on the Monday I was there (my last full day there) instead of taking some of the time off for us to spend together, as he had told me we'd do.  Instead, I was cooped up in there all day, as well, until he got home about 6:15 that evening.  I had gone mad in that place that day, after a while I was screaming bloody murder, but no one was there to even hear me.  I was confined to the large solarium(sunroom), a glass-enclosed room off the kitchen, to keep warm and in there he had a propane tank inside a wheeled cart to put out heat for me to keep warm.  He never put the heat on in his house to keep us both warm during my time there.  He had told me, prior to my coming, that he would have the heat on because due to his CK radiation, he feels the cold more easily, as I do because of Methotrexate oral chemotherapy I have to take for the parapsoriasis condition I have on my legs.   He has been aware of my condition for a long while.  I didn't keep anything about me from him, I was always open and honest with him. 

Despite his saying (that fateful night when I got banished to the guest room (no camera in there), that he had the "mystery" procedure coming up on Sept. 30th for the AN swelling, and his stress over trying to get over the chest cold he had developed just prior to my coming, he still has not had this procedure done!  That all is still up in the air and I wonder if he really was scheduled for that procedure for the 30th.  And, I wonder if he will ever have it done, or is this something he made up on his own?  Guess I will never know.  Well, the camera that is up on the wall near the ceiling in his room, certainly would show that he doesn't have anything to crow about that first night I was with him in his room.  It actually shows an encounter that looks more like my being raped!  And, I still have bruises on my legs that show it.  Since last week, I have developed hip pain on my right side.  Never have had this pain before in my life and although I have osteopenia, it is not enough to concern my doctor.  My bones are still in good shape.  There are cameras set up in the downstairs rooms and hallways on both floors, so it's not only his room that has one in there. 

I had a huge fight with him this week, a flurry of e-mails we exchanged where I confronted him about this and that, desperately trying to get answers to things he told me there, but gave no explanation.  Finally, I got a confession from him about why he had  moved me out of his room after the first night with him, and that being that he still has not been able to move on since his divorce of 8 years ago, that he can't let go of the memories he has of the blissful 25-year marriage he had.  He is of Indian descent, married an Indian woman 3 years younger than he back in 1980 and he was madly in love with her and felt guilty having me in the room they shared together.  He said I am the first woman who has been in the house with him since his divorce, except for his son and daughter who are grown and on their own.  He also said he is not looking to get involved in any more romances, but if he does end up settling down someday, it would be with an Indian woman younger than he, "in his age group, as he said."  This made me feel very old (I'm 62 and he just turned 57) and I told him how this made me feel.  He apologized, said  that in his culture, men settle down with women 3-8 years younger than they are.  He said he embraces his Indian culture and always was, so he has decided we are not compatible, said we both have vastly different outlooks.  I hadn't done or said anything that would lead him to come to this conclusion!  Plus, way back in the beginning o our relationship, I brought up the matter of our age difference and he told me it didn't matter to him.  I also told him this week that if our relationship had become much stronger, I would have planned to learn all about his culture, learn the language (which he speaks in addition to English) and even relocate to the UK to be with him  He scoffed at this!

In our e-mails this week, I kept asking him WHY did he invite me to come visit him if he still has his ex-wife and blissful marriage on his mind so much.  Man, she left him 8 years ago, had strayed from him with another guy, her personality had changed and he didn't know her anymore, didn't trust her anymore!  He didn't contest the divorce because he'd lost all his trust in her.  I have the e-mail from him (of last March 4th) in which he explained everything about his marriage, what the ex did and what the contentious divorce was like, that it went on for a year and she got almost all his wealth in the end.  He was left with almost nothing and had to start again and rebuild his life, financially, learn to live in the huge family home by himself, manage the place all himself.  I don't know how he does it now, especially with the AN and CK side effects that persist.  And, here he is now, can't get her out of his mind.  By the way, he is British-born, raised and educated there and has lived all his life in the UK.   

I can't help think that a lot of this from him is indicative of perhaps, severe cognitive behavior on his part, due to the continued swelling of his AN and he is at the point where he believes it will be like this for the rest of his life.  He actually told me he has a brain tumor!  I know enough about AN's now to be aware that an AN is not actually a brain tumor, but he apparently has become what he believes.  He believes he will die from this tumor.  If that is the case, then he is going to have to paddle his own canoe from her on, because any attempts on my part to tell him otherwise, and to help him with encouragement, would fall on deaf ears.

It's a dreadful situation, one I couldn't have imagined would ever play out this way!  I don't know how he manages to get up extra early in the mornings, go to the gym and work out for at least an hour, then put in a full day at work as a director of his own manufacturing company!  I think since he had a second round of CK radiation last April, he would be having another MRI (3 months after the one in August) this month.  I guess it will probably show the same results as the one done in August.

This whole thing has left me feeling so drained, my life turned upside down, can't get myself to work on time most days and I have difficulty concentrating, getting things done for myself.  I live alone, too, have been since my husband died in 1993.

Thanks again so much for your comments and concerns.  I so appreciate it.
Tina               

rodneyd

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Re: First MRI since radiotherapy with cyber knife
« Reply #70 on: October 18, 2014, 11:34:55 am »
Hi Tina,

Glad that you thought my response was helpful.  It has clearly been a very difficult ordeal for you, and one that has caused you much anxiety and stress. 

As I said in my previous email, ACTIONS speak louder than words.  He was exceedingly controlling and his behavior was totally unacceptable.  No amount of words now can make up for what he did to you then.  And I don't believe it was because of his divorce 8 years prior.  He has had ample time to deal with those issues.  And how do you know you are the only woman he has had in his house since then?  What is the camera in his bedroom for if you are the first one?  What he is telling you doesn't pass the "smell test".

If you don't mind one more thought, it might be for the best if you broke off contact with him entirely.  I do not believe he will ever change, no matter what he tells you.  The distance between you should make it somewhat easier to do this.  Please don't let his illness become an excuse for his behavior, in my view, it was unacceptable, no matter what. 

Good luck in your future endeavors, whatever they may be.  Let us know how this all turns out.

Rod 
74year old male, 8.3x7.3x6.5 mm AN on 10-28-13.  MRI on 12-30-13 showed no growth.  Imbalance issues and mild tinnitus.  MRI on July 13, 2014 showed no growth.  Still on W & W and taking baby-aspirin regimen.  MRI in July, 2016 show slow growth (1.1 cm).  MRI on July 24, 2017 was 8.2 x 8.6 x 8 mm!

photog1

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Re: First MRI since radiotherapy with cyber knife
« Reply #71 on: October 18, 2014, 12:22:54 pm »
Thanks  Rodneyed, for your latest  response.  I have to confess, I don't know what "smell test" means.

My friend lives in a very wealthy part of town, said the houses on his street are the most expensive in the city.  He said he had to have the security system in his house installed because it is required of everyone in the area to have it done, as there were 6 armed robberies in his neighborhood recently.  I got to take a walk around the block my last evening there and saw homes that were much larger and more expensive-looking than his large, 4-bedroom house.  It has 2 large remote-controlled gates out front, and high fencing all around.  Also, a very large garden in the back, what is known to us as a backyard.

I think he is paranoid.  I told him he has made himself a prisoner in his own home, with the security system the way it is.  He agreed with me.  Even a beeper-type sound goes off as one passes from room to room.       

rodneyd

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Re: First MRI since radiotherapy with cyber knife
« Reply #72 on: October 18, 2014, 04:14:57 pm »
Hi Tina,

FYI, the "smell test" means that I don't think what he is telling you is the truth and it smells like something rotten.

Don't get me wrong, having the cameras around is not the worst thing that was involved with your trip.  However, treating you the way he treated you was horrific and, if it were me, I would have nothing more to do with him.  But I am not a woman and it is not me, so obviously, it is entirely up to you what you do with this situation.

Remember, ACTIONS speak louder than words and in my opinion his ACTIONS were unconscionable. 

Good luck!

Rod
74year old male, 8.3x7.3x6.5 mm AN on 10-28-13.  MRI on 12-30-13 showed no growth.  Imbalance issues and mild tinnitus.  MRI on July 13, 2014 showed no growth.  Still on W & W and taking baby-aspirin regimen.  MRI in July, 2016 show slow growth (1.1 cm).  MRI on July 24, 2017 was 8.2 x 8.6 x 8 mm!

ampeep

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Re: First MRI since radiotherapy with cyber knife
« Reply #73 on: October 18, 2014, 06:31:06 pm »
Hi Tina,

Sorry to butt in, but I totally agree with Rod -- you would be much better off if you forget about your friend.

There are so many things about the way he acts that just don't sound right.  it appears that you're driving yourself crazy trying to rationalize his actions,which don't seem to make any sense.

Take care,
Keith
8/2/13 - diagnosed 1.9 CM right side; 1/13/14 - MRI it got bigger!; 2/10/14 - GK; 8/18/14 - shrinking; 8/17/15 - still shrinking, reduced symptoms

photog1

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Re: First MRI since radiotherapy with cyber knife
« Reply #74 on: October 18, 2014, 08:25:02 pm »
Thanks, Rod and Keith, so much appreciated.  I'm glad to get a male perspective on all this.  It's just what I need to help steer me in the direction of what you are suggesting I do.  And, I have been trying to rationalize his actions, especially since he said his CK effects changed his outlook so much.  In e-mails with him back last early spring, his e-mails sounded very much that way.  When he wrote me in early April and said he couldn't continue the relationship and wanted me to look elsewhere for love and happiness, I never could get him to tell me what happened to cause him to say this.  It was so shocking as he had, just days earlier, told me he would be coming here to visit me. 

When I decided to find out all I could about his condition and all it entails, then I made calls to him to give him support and encouragement after learning about AN's, that was about 6-7weeks after his shocking e-mail.  He appreciated my doing that, said he hoped he could do something nice for me someday.  It brought him back to me.  And, eventually led to his inviting me to come visit him there, as he can't get medical clearance yet from his doctor to travel.  His driving is still limited due to the continued swelling and it causing him the dizziness and vertigo.  I have tried to sort all that out.
Tina