tag:blogger.com,1999:blog-30499448.post2358739555540772417..comments2024-02-18T13:53:30.168-08:00Comments on Surgeonsblog: It's Galling: diagnostic dilemmas and the gallbladderSid Schwabhttp://www.blogger.com/profile/14182853083503404098noreply@blogger.comBlogger315125tag:blogger.com,1999:blog-30499448.post-83063813939455274162018-03-09T10:57:58.410-08:002018-03-09T10:57:58.410-08:00desiblm: I can't make any predictions on any s...desiblm: I can't make any predictions on any specific case when I'm not directly involved. But I can speak in generalities: people with symptoms like yours and who, like you, have confirmed stones and, at least at the time of the HIDA, a non-functioning gallbladder have a very high chance of symptom relief.<br /><br />It also sounds as if you're having reflux symptoms as well, and sometimes it's hard to tell the difference. It's often recommended that people with Barrett's and with reflux have an anti-reflux procedure done. That and GB surgery can be done simultaneously, laparoscopically in most cases. <br /><br />These are things best addressed in specific terms by your doctors. If you haven't seen a surgeon, it's certainly a considerationlSid Schwabhttps://www.blogger.com/profile/14182853083503404098noreply@blogger.comtag:blogger.com,1999:blog-30499448.post-74213410804106921282018-03-09T10:41:37.820-08:002018-03-09T10:41:37.820-08:00Dear Doctor sid,
I had a history of extreme bloati...Dear Doctor sid,<br />I had a history of extreme bloating/belching and burping.Initial endoscopy diagnosis was gastritis, but after few years developed dull pain on the gall bladder and hida report said the gall bladder is not working. After few years, i got gallstones and barrets esophagus with non dysplesia.I cannot eat any fatty/oily/protein foods. I still have extreme bloating/belching and burping, will gallbladder removal will give me any relief ? I really like to know your opinion as you are a experienced surgeon who has done so many surgery. Appreciate you response.<br /><br />thank you.desiblmhttps://www.blogger.com/profile/13641484118258176880noreply@blogger.comtag:blogger.com,1999:blog-30499448.post-46508535855703732312017-10-26T13:26:32.460-07:002017-10-26T13:26:32.460-07:00As I've written, B.D., "biliary dyskinesi...As I've written, B.D., "biliary dyskinesia" refers to a situation where there are symptoms consistent with gallbladder origin, but with no pathology (ie, stones or wall thickening) on imaging. If you have stones and suggestive symptoms, you don't have biliary dyskinesia, you have biliary colic. <br /><br />No test we do is 100% accurate. There can be false positives and false negatives. In the case of ultrasound and gallstones, it's pretty clear when they're there. <br /><br />And, no, most people don't have gallstones. Of those that do, most will have the stones remain in the gallbladder, causing symptoms or not. It's when they pass out of the gallbladder that more serious things can happen. It's not rare that gallstones can be present in the gallbladder and not be noticed. It's not common that they remain symptom-free as they pass from the gallbladder. But most gallbladder pain comes not from the stones passing but from a stone plugging up the gallbladder when it tries to contract. I realize there's lots of comments in these threads; but in my<br /> original posts about gallbladder issues, this information can be found. Sid Schwabhttps://www.blogger.com/profile/14182853083503404098noreply@blogger.comtag:blogger.com,1999:blog-30499448.post-84359892597382149642017-10-26T11:41:31.225-07:002017-10-26T11:41:31.225-07:00hello Dr Sid Schwab,
Just want to share an update ...hello Dr Sid Schwab,<br />Just want to share an update from my earlier comment. In 2011 ultrasound showed no stones and Hida scan showed biliary dyskinesia with 0% ejection fraction. Then i did the ultrasound test yesterday and got report i have gall stones. so does it mean that...<br /><br />1) Does the ultrasound does not capture small stones and in the mean time the stones has grown big now to show up in ultrasound, how reliable the ultrasound ? <br />2) In general all folks will have gallstones in gallbladder and it passes to intestine without noticing it or experiencing it ?<br /><br />3)Also now i'm wondering if HIDA scan results in 2011 if i have really biliary dyskensia or not. I know you don't like to get in to diagnosis business, but if you can please let me know your insights it will be great.Anonymoushttps://www.blogger.com/profile/07614643994015540800noreply@blogger.comtag:blogger.com,1999:blog-30499448.post-72219646927719590242017-10-24T16:35:02.846-07:002017-10-24T16:35:02.846-07:00I can't speak specifically to Ensure, Terry, b...I can't speak specifically to Ensure, Terry, but it falls under the general category of substituting a "fatty meal" for CCK to induce gallbladder contraction and to reproduce a person's pain syndrome. <br /><br />In general, fatty meal has been found in some studies to be less effective than CCK. (Cheaper, though, I assume.) So it depends on the results of your particular study: if it showed abnormalities enough to be convincing, that's significant. If it didn't, then the question for your doctors is whether it can be considered reliable. Maybe there's info of which I'm unaware showing that Ensure in particular is better than other forms of fatty meal. That I'm unaware of that info doesn't mean it doesn't exist.Sid Schwabhttps://www.blogger.com/profile/14182853083503404098noreply@blogger.comtag:blogger.com,1999:blog-30499448.post-4460290192956114952017-10-24T16:14:41.067-07:002017-10-24T16:14:41.067-07:00Hi Doc. Thoughts on CCK vs. Ensure drink? Seems li...Hi Doc. Thoughts on CCK vs. Ensure drink? Seems like Ensure is the norm these days. I had a scan today and it was a breeze. I sure hope Ensure gives an accurate reading! Terrynoreply@blogger.comtag:blogger.com,1999:blog-30499448.post-17380684916182711622017-10-09T09:40:36.017-07:002017-10-09T09:40:36.017-07:00Dr Schwab,
some of the Gastroenterologist (Around ...Dr Schwab,<br />some of the Gastroenterologist (Around 5 doctors) ,general physcians(around 4) and 1 surgeon i met gave contradiction answers, hence was checking with those questions to get an insight. But i understood your point. Thank you for answering all my earlier questions.Anonymoushttps://www.blogger.com/profile/07614643994015540800noreply@blogger.comtag:blogger.com,1999:blog-30499448.post-20603374110325325772017-10-09T09:01:28.136-07:002017-10-09T09:01:28.136-07:00B.D.: I like that my blog, to which I haven't ...B.D.: I like that my blog, to which I haven't added new content in several years, is still useful, and I'm happy to answer questions and supply info up to a point. But there gets to be a point where my generosity has its limits. Your questions deserve answers, but I think at this point they're better addressed by your current docs, or a surgeon who can evaluate you in person instead of from the other side of the screen.Sid Schwabhttps://www.blogger.com/profile/14182853083503404098noreply@blogger.comtag:blogger.com,1999:blog-30499448.post-88825665292694893302017-10-09T08:42:41.157-07:002017-10-09T08:42:41.157-07:00Dr schwab,
Thank you for all your prompt reply.
A...Dr schwab,<br />Thank you for all your prompt reply.<br /><br />As you mentioned that the HIDA scan test is affected by various things which can show 0% ejection fraction ratio for gallbladder.<br /><br />1)Can i know some of the scenarios where it can be affect the hida scan results?<br /><br />2)It is better to take the HIDA scan second time to rule out for any false positives?<br /><br />3)Doctor says any non working organ like gallbladder should be removed, do you agree with that?<br /><br />4) What are the side effects other than digestion issues of having a non working gall bladder for a long time ? or what are the health issues that occur when digestion is not good for long time as the body will not absorb all the nutirents, in my case i have low vitamin B12?<br /><br />5)I'm leaving with non working gall bladder almost 7+ years ,their are episodes where my digestion was good and bad, why does the digestion vary though the gall bladder hida scan says 0% ejection fraction ratio?<br /><br /><br /><br />6) How the digestion will get improved after removing the non working gallbladder(Assuming gall bladder is only the issue) as any way it was not working earlier?Anonymoushttps://www.blogger.com/profile/07614643994015540800noreply@blogger.comtag:blogger.com,1999:blog-30499448.post-86435394910110621182017-10-06T16:44:04.722-07:002017-10-06T16:44:04.722-07:00Seems to me your next step is to see a surgeon and...Seems to me your next step is to see a surgeon and get his/her opinion on your situation. Briefly, though: <br /><br />1) Unlikely in my opinion<br /><br />2) As I wrote, when "my" criteria were met the odds of relief were very high. I had many patients in that category<br /><br />3) No current info without looking it up. You could google it.<br /><br />4) I've written about that in my several posts and comments here. <br /><br />5) Not a believer.Sid Schwabhttps://www.blogger.com/profile/14182853083503404098noreply@blogger.comtag:blogger.com,1999:blog-30499448.post-63850169259696382742017-10-06T14:57:41.775-07:002017-10-06T14:57:41.775-07:00Thank you Dr.Schwab for quick reply.
yes, My hida...Thank you Dr.Schwab for quick reply. <br />yes, My hida scan results shows 0% ejection fraction. General physician said its not working at all and recommends to remove the gall bladder. I don't have a severe pain like other who has stones, but lot of burping,belching and bloating is going on. My main concern at this moment is the dizziness,imbalance and extreme fatigue. I want to take a chance, but afraid of the complications after gallbladder removal.But at the same time if i dont go through, i have to suffer like this rest of my life.(already suffering more than 7+ years).If things work out well, then i will be my 2nd innings of my life.Due to this work,family life is heavily impacted as i'm only 36 years old.<br /><br />some questions for you.<br />1) I started getting dizziness and imbalance since i run in to digestion issues from year 2011, If there any digestion issues for long time, will we run in to dizziness and imbalance issues , is there any connection with gallbladder and dizziness/imbalance ?<br /><br />2) Atleast can you remember folks who had biliary dyskensia and no stones who got cured well after gall bladder removal? i have met around 10 folks in person who removed their GB for stones, but never met one who removed for biliary dyskensia, so appreciate your response on this.<br /><br />3) what are your thoughts on Sjogren's syndrome with respect to biliary dyskensia ?<br /><br />4)What are the complications after gallbladder removal?<br /><br />5)Please let me know your thoughts on Probiotic,digestive enzymes and OX bile they sell online, does they really help the digestive system?Anonymoushttps://www.blogger.com/profile/07614643994015540800noreply@blogger.comtag:blogger.com,1999:blog-30499448.post-46753152628536765402017-10-06T13:07:46.388-07:002017-10-06T13:07:46.388-07:00I can't give you the % you're looking for,...I can't give you the % you're looking for, because the diagnosis is such a gray area, meaning many people are told they have it who, in my opinion, didn't. As I've written here, I told my patients that if 1) their symptoms were typical of gallbladder colic and 2) the HIDA scan was abnormal and 3) the CCK reproduced those typical symptoms, then the chances were very high, but not 100%, that they'd be improved by having their gallbladder removed.<br /><br />I'm not sure if you meant to write 0% for your HIDA scan emptying: if it really didn't empty at all, that's a suggestive result. But the test can be affected by various things that could make your gallbladder, at one time or another, not empty properly. As to the rest, you don't fall into my personal criteria.<br /><br />However, my criteria are only mine: I don't claim to have a definite answer. As I said, the diagnosis of biliary dyskinesia is pretty iffy. under the best of circumstances.Sid Schwabhttps://www.blogger.com/profile/14182853083503404098noreply@blogger.comtag:blogger.com,1999:blog-30499448.post-83788472037657683772017-10-06T12:31:06.819-07:002017-10-06T12:31:06.819-07:00hello doctor,
I have done lot of test having indig...hello doctor,<br />I have done lot of test having indigestion issues.<br />1)Ultra sound shows no stones<br />2)Hida scan shows 0% ejection fraction, but CCK induced did not cause me cramp or bloating - Bilary dyskensia.<br />3)I had many frequent episodes of diarrhea , some time it resolves on its own after having bland diet.<br />4)I can't eat any oily,fatty or protein related foods which causes me excessive bloating and some time pain in gallbladder area.<br />5)Nowdays,even a bland diet causes me lot of burping,bloating and indigestion, but no pain<br />6)Colonoscopy was normal and endoscopy showed gastritis.<br />7)My GI doctor feels gallbladder is not the issue but my general physcian recommends to remove the gall bladder.<br />8)Now i need to take a chance either to go with surgery or not. if you can provide % of folks who removed their gallbladder for biliary dyskensia and their success rates that will be great. I have been suffering with this issue for past 7 years and i'm at a point where i need to decide.<br /><br />Anonymoushttps://www.blogger.com/profile/07614643994015540800noreply@blogger.comtag:blogger.com,1999:blog-30499448.post-36336461131958394402017-05-02T06:51:17.445-07:002017-05-02T06:51:17.445-07:00While searching for info on my post-cholestectomy ...While searching for info on my post-cholestectomy problems I found this post. You may be interested to know that I took part in clinical trial of Cholelithiasis. (U of I) A big mistake in my case. I had two stones, largest was 2cm, that were lithotripsied. Consequently this resulted in Acute Pancreatitis, as the shards did not go the proper route! Suffering a few more attacks while continuing in the trial which including pancreatin to help "soften" the shards that were still sitting in my gall duct, I finally begged for a cholecystecomy, much to my surgeon's relief. <br /><br />Needless to say, many years later, I am still having RUQ pain and severe episodes of blocked duct. Upon further investigation UCSF, it was discovered that my gall duct has enlarged sufficiently to support more stone production. And, the spincter of Oddi has enough scar tissue to make it very difficult to pass stones. Even though it was cut to make it larger, I think the scar tissue has re-formed. I tend to keloid on the outside scars. Could it be the same on the inside?<br /><br />This continuing problem makes life pretty miserable at times. <br /><br />I have been through a lot worse, (sarcoma) but I wish I knew if the whole thing could be reconstructed, or conveniently bypassed, or maybe just plain "deleted" entirely.<br />Can you comment on this possibility?<br /><a href="http://forgetfats.com/%D8%AA%D8%B1%D9%83%D9%8A%D8%A8-%D8%A8%D8%A7%D9%84%D9%88%D9%86-%D8%A7%D9%84%D9%85%D8%B9%D8%AF%D9%87/" rel="nofollow">تركيب بالون المعده</a> <a href="http://forgetfats.com/%D8%A8%D8%A7%D9%84%D9%88%D9%86-%D8%A7%D9%84%D9%85%D8%B9%D8%AF%D8%A9/" rel="nofollow">بالون المعدة</a><br /><a href="http://forgetfats.com/%D8%A8%D8%A7%D9%84%D9%88%D9%86%D8%A7%D8%AA-%D8%A7%D9%84%D9%85%D8%B9%D8%AF%D8%A9/" rel="nofollow">بالونات المعدة</a> <a href="http://forgetfats.com/%D8%B9%D9%85%D9%84%D9%8A%D8%A9-%D8%A7%D9%84%D8%A8%D8%A7%D9%84%D9%88%D9%86/" rel="nofollow">عملية البالون</a> <a href="http://forgetfats.com/%D8%B9%D9%85%D9%84%D9%8A%D8%A9-%D8%A8%D8%A7%D9%84%D9%88%D9%86-%D8%A7%D9%84%D9%85%D8%B9%D8%AF%D8%A9/" rel="nofollow">عملية بالون المعدة</a> <br /><br />We seem to have some very unlucky gallbladders in my family, and odd too, maybe. Mother's stones were like sand sludge. Sister had no stones, but only 5% functioning. Niece had Cholecystecomy at age 28. Grandmother died of complications of Cholecystomy, but that was in 1948, so perhaps that was not so unusual.Anonymoushttps://www.blogger.com/profile/02543285756775100691noreply@blogger.comtag:blogger.com,1999:blog-30499448.post-43891946389009335432017-04-22T12:13:45.270-07:002017-04-22T12:13:45.270-07:00Unless your GI doc is pretty old, he or she should...Unless your GI doc is pretty old, he or she should be experienced with ERCP and with sphincterotomy, it that's required. You should ask yours if that's the case.<br /><br />I can't say, without knowing the exact location, whether that thingy could be causing pain. I'd say, absent evidence of obstruction, it's unlikely; but I can't say it's impossible. As usual, your docs are in a much better position to opine than I am.Sid Schwabhttps://www.blogger.com/profile/14182853083503404098noreply@blogger.comtag:blogger.com,1999:blog-30499448.post-21363931005870981242017-04-22T11:28:10.532-07:002017-04-22T11:28:10.532-07:00Thank you for your input. But are saying that thi...Thank you for your input. But are saying that this tiny "thing" shouldn't be causing pain? Also, the radiologist recommended a MRCP but is this sort of redundant when an ERCP would then be needed anyway? I do have GI doc but my original question about a specialist - I meant a specialist who had experience with removal of stones (or tumors) in the CBD - if this needed a specialized dr. not just a regular GI...<br /><br />Yes, the saga continues��<br />GailRebel Chaserhttps://www.blogger.com/profile/01986113532668793263noreply@blogger.comtag:blogger.com,1999:blog-30499448.post-80595888833902555132017-04-21T20:09:01.448-07:002017-04-21T20:09:01.448-07:00The saga continues...
In general I'd say you ...The saga continues...<br /><br />In general I'd say you should address the questions to the doc who ordered the ultrasound. But I can say a few things: <br /><br />it's not uncommon for the bile duct to become dilated after cholecystectomy, and usually it's of no consequence.<br /><br />A 1-2 mm spot is really tiny, somewhere around a 1/16 of an inch. If it were a stone of that size it's likely could have passed on its own. Can't say that for sure.<br /><br />If the duct we're blocked, you'd have jaundice, dark urine, and pale stools. <br /><br />If I'd been your surgeon and you came to me afterward with these symptoms and findings I'd refer you to a gastroenterologist, who'd likely consider doing ERCP, which is passing a scope into and past the stomach and injecting dye into the opening of the bile duct into the duodenum. It might clarify what that object is; and if there's significant narrowing of that opening (known as the Ampulla of Vater and the location of the Sphincter of Oddi) it can be enlarged via that scope.Sid Schwabhttps://www.blogger.com/profile/14182853083503404098noreply@blogger.comtag:blogger.com,1999:blog-30499448.post-53365120819417337842017-04-21T19:37:00.760-07:002017-04-21T19:37:00.760-07:00Hi Dr Schwab,
I hope you are doing well and enjoy...Hi Dr Schwab,<br /><br />I hope you are doing well and enjoying your retirement! <br /><br />So, I had my GB removed in June 2016 but continued to have pain - sometimes excruciating pain - every time I eat. It got so bad that I avoided eating but realized that was going to kill me when weight dropped to 100 lbs. I just had another US and asked the tech if she could take a good look at my common bile duct. I got the results today and it showed a "1-2mm echogenic focus with shadowing near the pancreatic head" along with "prominent dilation of the extrahepatic duct." <br /><br />I have thought I had a blockage of the CBD because everything I eat hurts me...ugh... But where do I go from here? Everything I read sounds so scary and fraught with horrible possibilities - and I've had enough! I know it's most likely a stone but how did it get there (I didn't have stones - just a chronic non functioning GB)? Is this something a surgeon removes? Or a GI doc? Do I need a specialist like Stanford or Mayo?<br /><br />Thank you again for all your help!<br />Gail SeatRebel Chaserhttps://www.blogger.com/profile/01986113532668793263noreply@blogger.comtag:blogger.com,1999:blog-30499448.post-58931110960590307622017-04-09T07:38:02.591-07:002017-04-09T07:38:02.591-07:00The problem with those data is that they include m...The problem with those data is that they include many people who've undergone cholecystectomy for the wrong reasons; i.e, people whose symptoms weren't due to their gallbladder and which, therefore, persisted after surgery. One source reports "5 - 40%," which gives you an idea how vague the whole category is. <br /><br />What can say without hesitation, as one who did around 2,000 cholecystectomies over my career, is that when done for symptomatic gallbladder disease, patients are highly satisfied; and the comment I received more than any other was, "I wish I hadn't waited so long to have it done." <br /><br />It's true that a small number of patients have digestive problems afterward. In many, it's transient. In others, it requires some dietary modification, easily managed. The number who have persisting and difficult-to-manage sequellae is, in my personal experience, extremely small. <br /><br />That's the best I can do for an answer. <br />Sid Schwabhttps://www.blogger.com/profile/14182853083503404098noreply@blogger.comtag:blogger.com,1999:blog-30499448.post-82843462964493625672017-04-08T22:06:32.575-07:002017-04-08T22:06:32.575-07:00Do you have any statistics on how many have issues...Do you have any statistics on how many have issues after surgery compared with those that dont? as a lot on our health boards are claiming the majority suffer with issues and complications after gallbladder removal!NatXhttps://www.blogger.com/profile/14893271523206863246noreply@blogger.comtag:blogger.com,1999:blog-30499448.post-60469147783528714122017-03-21T23:29:45.266-07:002017-03-21T23:29:45.266-07:00"The sad truth is that absent proven gallston..."The sad truth is that absent proven gallstones, or clear signs of inflammation of the gallbladder, our ability to be certain what's going on is imperfect at best." Wise words. Thank you, doctor. <br /><br />I left a couple of comments previously about my removal for low function in May 2016. I'm just back encouraging people to really heed the doctor's caution on removal when you have low function -- with no stones, no sludge, no inflammation. I wish I had studied this blog and had done more research before removal. Retested my HIDA after a few months or something. It's been 10 months since my operation, and I'm miserable most days. I still have all my same pain as before removal, plus new symptoms from temperature control issues to weird headaches to high liver enzymes and exhaustion. <br /><br />Many doctors just treat stones and low function as the same type of gallbladder disease. I found out the hard way that they aren't the same -- and the removal answer isn't as clear cut for those of us with supposed biliary issues. <br />Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-30499448.post-39579341107370921342017-03-11T19:22:50.831-08:002017-03-11T19:22:50.831-08:00I do still respond to questions and comments, but ...I do still respond to questions and comments, but I hesitate to make specific recommendations. For one thing, it's impossible to know enough about a person's situation from this far away. In your case, I don't know on what basis the ulcer was diagnosed, and on what basis it was determined that you had a gallbladder attack. <br /><br />If you've read what I've written about HIDA scans, you know I find them of questionable value. If when you had your gallbladder attack you were found to have gallstones and if your symptoms were pretty typical of biliary origin, then there's not much a HIDA scan would have added then, or, for that matter, now. <br /><br />Itching can be due to blockage of bile ducts; when that's the case, jaundice and abnormal liver tests would be associated. Spleens can become enlarged due to liver disease, but it's usually in the situation of severe cirrhosis causing restriction of flow through the veins that drain the intestinal tract and spleen. Again, that's not a subtle situation. Sid Schwabhttps://www.blogger.com/profile/14182853083503404098noreply@blogger.comtag:blogger.com,1999:blog-30499448.post-13076780967901197792017-03-11T18:49:50.752-08:002017-03-11T18:49:50.752-08:00Hi Dr.,
I'm not sure if you still answer ques...Hi Dr.,<br /><br />I'm not sure if you still answer questions but I'm in the process of deciding if I should get my gb out. I was diagnosed with an ulcer two years ago but was also having right upper quadrant pain. I've had one full gallbladder attack prior to the ulcer diagnosis, but didn't know what it was at the time. I had a HIDA scan with normal ejection fraction rate but the scan was extremely painful and I was nauseous. The past two years my ulcer would not heal on a PPI and I had to completely change to an extremely low fat diet. My gb pain subsided due to the low fat diet, but I still suffered major discomfort every time I ate. Fast forward to today and things have really escalated. I am in constant discomfort, and a recent ultrasound revelead a mildly enlarged spleen that is giving me pain. The past two days my hands and feet have begun to itch. I'm extremely nauseous and have very little appetite. My skin looks darker but my eyes are not jaundiced. My bloodwork checked out ok but I am getting another HIDA scan this week to see if my gb is no longer functioning. <br /><br />Is it possible I have a blockage somewhere causing my enlarged spleen and itchy skin? My liver enzymes were normal two weeks ago but w/ the recent development of itchy skin I'm extremely concerned. <br /><br />I'm hoping the results of the HIDA scan reveal something. Are there any other tests I should request for my situation?Anonymoushttps://www.blogger.com/profile/09871810162366725665noreply@blogger.comtag:blogger.com,1999:blog-30499448.post-63106237067142626962017-01-17T08:05:27.239-08:002017-01-17T08:05:27.239-08:00Thanks, Ms Gutwein. Glad you found the blog, and r...Thanks, Ms Gutwein. Glad you found the blog, and really glad that people continue to find it useful. Come back any time!Sid Schwabhttps://www.blogger.com/profile/14182853083503404098noreply@blogger.comtag:blogger.com,1999:blog-30499448.post-69625580435542406342017-01-16T20:54:40.962-08:002017-01-16T20:54:40.962-08:00I absolutely LOVE your blog! Am getting an ultraso...I absolutely LOVE your blog! Am getting an ultrasound tomorrow to see if there's a problem with my gallbladder and being able to read information about it from an actual surgeon is soooooo comforting! Thank you for sharing... Extremely helpful and comforting! Anonymoushttps://www.blogger.com/profile/06238497989167340971noreply@blogger.com