Scan tomorrow

Sorry we haven't said earlier: we've got the weekly scan tomorrow morning, followed by a 'where to from here' meeting to talk about expectations for delivery and what's likely to happen after that. 

Pray that the doctors would give us the right information, that we'd ask the right questions, and that we'll all be on the same page. 

Thankfulness #4

One of the questions I'm asked most frequently is whether I'm on bed rest / activity restriction etc. Answer: I'm not, but sometimes it feels like I might as well be. 

The medication I'm on is doing a fantastic job of keeping Baby's heart slow and steady, and it's doing the same to mine. At the moment, this means that I can cope with being up and about for about 5-10 minutes of very light activity (like getting ready in the morning, pottering around the house) or 2-3 minutes of just standing or 1 trip up the back stairs. Then I need a sit down to recover myself before doing a bit more. I can sit and chat pretty easily, but even that wears me out after a couple of hours and I need a lie down. I thought I was tired at the end of my last pregnancy, but this is something else entirely!

I still feel like getting out and about and doing things though. Enter, the power shopper!

 

Image credit

My lovely sister-in-law took SP & I to the shops this morning and the power shopper was fantastic. And surprisingly easy to steer - I was quite scared at the start that I'd knock someone over. Yes, it was quite bulky and made for a considerably more difficult shopping trip than just walking, particularly when there's a pram in the convoy too, but without it I couldn't have even considered wandering around the shops for even 15 minutes, let alone a couple of hours. 

It was so nice to feel like part of the real world again. So I'm thanking God for: 

- power shopping technology
- Westfield providing it free

- the opportunity to see what one aspect of life is like for someone with mobility problems

- the temporary nature of these problems for me. Once Baby is out and I can stop taking the meds, I should be right back to normal :)

A link to share

Click on over to the 'Come Follow Me' blog and read some reflections on the recent twin termination tragedy from the mum of a now-3-year-old that doctors wanted to terminate. I'm horrified to think of how many precious babies there may be who are never given a chance at life.

Come Follow Me: A Question Worth Asking

Hat tip: The Useful Box

Thankfulness #3

Well, obviously I'm thankful for the results posted yesterday :)

But I'm also thankful that God only shows us life one moment at a time. 

A month ago today, I went to Bible Study already feeling tired, wrung out and not-quite-coping, then to what was expected to be a routine scan. If I had been able to see even a few minutes in front of me... well, I'm not quite sure what would have happened, but me falling in a heap probably would have been a large part of it.

As I think back to those first hours after the scan, I thank God that my own understanding of the struggles facing this baby came gradually. That God gave the doctors the words to say, and gave me time to process the implications, from the original 'this is more serious than it was with SP', through 'this is hugely serious and baby is very sick', right to 'it looks quite likely this baby won't survive.'

And although it's tempting to think that knowing yesterday's result a month ago would have been lovely, I know that God has taken me places in the last month that have grown my faith in Him immeasurably, and has given me so many opportunities to share bits of that faith with the people around me. Opportunities that wouldn't have come any other way. 

So as the rollercoaster ride continues, I have no desire to know the future. God does, and He'll give it to us as He always has, just one moment at a time. 

Good news

We had the fortnightly growth scan today, and baby's abdomen is shrinking! :)

While getting smaller is not something to be celebrated in an average pregnancy, for us it means that the fluid inside baby's body is resorbing and baby is getting better. The fluid is still there, and I think the medicos had hoped that it would decrease faster than it is, but we're definitely heading in the right direction. 

The rest of baby's measurements are tracking pretty well. Those that are least influenced by fluid (and thus more reliable indicators of baby's true size) are around the 3rd percentile. So very small, but considering everything else, that's not much of an issue. 

What could possibly be an issue is the amount of amniotic fluid (around baby). It's been hovering around the top of the normal range for the last month, but has now tipped over into the 'mild polyhadramnios' range. Not something of immediate concern, we're not doing anything about it, but a return to the normal range would be nice. 

Baby finally cooperated and gave us a glimpse of his/her face. With markers to aid interpretation :)

 

Thankfulness #2

I am thankful for whoever figured out that chemicals in a mother's body go through her placenta to her baby. It really is amazing that I can take a typical adult dose of a cardiac drug and it can restore rhythm in the baby's heart. 

And so thankful that it worked. The next step was going to be a big needle straight into the cord or baby's thigh, and that just freaks me out. 

Our little conversationalist

It amazes me how kids learn language. I keep thinking of a time, months ago now, that I overheard SP experimenting with grammar. "Kanga hops. Roo hops. Kanga and Roo hop." He could have been writing a textbook. 

Tonight, we were sitting at the dinner table, doing the general 'how was your day?' chat, and he joins in with "What were you learning about at work today, Daddy?"

Totally appropriate. And totally gorgeous :)

Thankfulness #1

Do not be anxious about anything, but in everything, by prayer and petition, with thanksgiving, present your requests to God. And the peace of God, which transcends all understanding, will guard your hearts and your minds in Christ Jesus.         Philippians 4:6-7  

There's so much that we could be anxious about at this time. So many uncertainties, so many difficulties, so many things that just seem wrong.

But the Bible teaches us to be thankful instead.  So over the next few days/weeks, I'm aiming to do a series of posts about things I'm thankful for.

Today, I'm thankful for God, who's plans are perfect and who is always in control. For Jesus, who died and came to life so that, as imperfect as we are, we can know our perfect God.

I can't imagine how we would cope with the stresses of everyday life, let alone a situation like this, without being 100% certain that God is looking after us and everything will always go according to his plan. Even when it seems like life is falling down around our ears, we trust in Him.

Pray that we would keep trusting. 

Update

This morning's scan results were all good.  In fact, baby was annoying the doctors today (just a little) by moving around so much that they couldn't get a detailed look at all the heart stuff.  That's so much better than the sluggish baby of a few weeks ago!


Petrina's observations and ECG are all fine; next scan will be sometime next week.  Yay!

Thanks

Have we said thanks recently for all the prayer and practical support everyone's been giving us?


Thanks.


Next scan is Friday morning.  Petrina continues to feel good movement, so we pray that we'll see continued improvements in heart function and fluid levels.  SP is still a bit upset about me going off to work each morning, but is much happier having mummy around during the days now.

Encouragement

If you didn't already know, music is one of those things that's been a big part of my life. I grew up listening to lots of classical stuff at first, until I discovered the likes of Petra and Whiteheart. I still play at church although I don't keep up with new music as much as I used to... although one could argue that the current manufactured rot is usually not worth the effort.

Anyway, this post is actually supposed to be about sharing a couple of songs that I've found encouraging on many occasions, including our latest rollercoaster ride.

The first song, by a South African band called Tree63, is called Here of All Places. I've often taken comfort in its reminder that even in dark or stressful places, God is at work using it to refine us and increase our trust in Him.

Here of All Places
John Ennis

Here of all places
I'm face to face with
What You began and what I've become
First there was fire
Now, just a flicker
Will breaking my heart lead me back to You?

I shout truth at You
Without love for You
I am blown up beyond recognition
I will sing to You
'Cos You made me to
Won't You help me to mean it?

Chorus:
Hallelujah
Hallelujah
Hallelujah
Better here than nowhere

Something out of nothing
Beauty from ashes
A glorious reign after humiliation
So, I race through
Here of all places
Where nothing is left but my trust in You

You won't give me up
You can't let me down
You'll be standing to welcome me home (one day)
Come sing over me
Come sing over me
Won't You help me to hear it?

Unfortunately it's not up on Youtube, but you'll probably find it on iTunes if you want to know how it sounds.

The other song is by Petra, and is called Thankful Heart. It's taken from part of Paul's letter to the Ephesians, where he encourages them to "...give thanks always and for everything to God the Father in the name of our Lord Jesus Christ..." We've had so much to be thankful for in the last couple of weeks and even though we know there's still a lot to go through, we keep giving thanks to God for the way He sees us through each step of the way.

Thankful Heart
Bob Hartman and John Elefante

Chorus
I have a thankful heart
That you have given me
And it can only come
From you

There is no way to begin
To tell you how I feel
There are no words to express
How you've become so real
Jesus you've given me
So much I can't repay
I have no offering

Chorus

There is no way to begin
To tell you how I feel
There's nothing more I can say
And no way to repay
Your warming touch
That melts my heart of stone
Your steadfast love
I'll never be alone

Chorus

I have a thankful heart
Words don't come easily
But I am sure You can see
my thankful heart

Help me be a man of God
A man who's after Your own heart
Help me show my gratitude
And keep in me a thankful heart

Chorus

This one is up on Youtube if you want to have a listen. And try not to cringe too much at the bad 80's fashion in the clip.

Now this looks good...

It's Australian made, and contains all the essential food groups:

Daintree Estates

Home, sweet home

I've just finished watching the Mythbusters blow up something else. That's nice.

SP is sound asleep. That's nice too.

But what I like best is that as I sit here typing this, my beloved wife is lying here beside me resting. For the next few days at least, she's home!

This afternoon's scan was everything we could have prayed for and more. Rhythm and rate were good and right from the start the sonographer was talking about how Friday's scan was looking a little better but today's looked a lot better.

They didn't do a detailed growth scan but both the sonographer and the staff specialist said that subjectively the oedema and ascites looked better than it had before.

They also said that the contractility (a measure of how much the heart contracts) was getting better, sometimes normal now.

Other notes that Petrina's just handed me:

• Her amniotic fluid level is still a bit high but within the normal range - no more polyhydramnia
• Blood flow through the stomach (another measure of heart function) is improving, to quote the sonographer "1.5! That's within normal range"

Petrina's final comment on the matter: "Being tired and puffed is worth it"

Thank you for all your prayers thus far. Please keep praying for good healing for baby, that SP will enjoy mummy being home without wearing her out in the first five minutes, that Petrina will know her limits, and that we'll keep moving towards a safe delivery of a healthy baby.

Update

Not much to report since Saturday's post. It was lovely for all the family to go in and see Petrina on Sunday afternoon and to pass on the prayers and well-wishes from all our friends. All the weekend observations of baby's heart have been good - sinus rhythm and a good pace, praise God! If this morning's scan shows that the fluid levels are starting to decrease, there's a small chance that they might let Petrina come home. If there's no improvement, we're not sure if they'll just up the dose again or switch to a more direct treatment.

Give thanks:

• That because we live so close to the hospital, Petrina could come home for Friday's leave. Normally they only let patients go as far as Southbank
• For the good obs of baby's heart over the weekend
• For family and friends who are caring and supportive of us all

Pray:

• That SP will cope OK. Each day it's harder for him to see daddy go, which makes it harder for me to leave
• That the scan will show less fluid, so they don't need to increase the dose or change tack
  
• That Petrina will keep coping with the exhaustion that comes from this medication, and other intermittent side effects
  

Leave, wonderful leave

Petrina was able to take a couple of hours leave yesterday afternoon, and it was wonderful! SP was absolutely delighted to have her home reading stories again, and it was lovely for us to just sit together on the couch being in each others' presence.

The higher medication dose is knocking her energy out though, so it's for the best that she's still in and not trying to do things around the house. It'll be interesting to see how things go if they do change to outpatient treatment before baby is born.

For now, please pray that this will be a healing weekend. There's been lots more sinus, but the high fluid levels (a.k.a. hydrops for those with a medical inclination) are still a problem. Pray that there will be long periods of sinus rhythm, giving baby's body the time it needs to clear the fluid and start getting stronger again.

And wouldn't you know it - after my post yesterday about missing parcels, guess what arrived at 1/4 to 5 in the afternoon? That's right! SP may be too young to build it on his own, but he loves helping daddy with it.

The nerve of some people...

A little while ago, I ordered some Lego online from a bunch of yahoos known as Fishpond. Two months later I haven't received the original order, or the replacement I requested when the original was about 3 weeks overdue.

Now what do I get in my email today? A note from Fishpond spruiking their "sell yours" function, and saying how much I could apparently make. Cheeky so-and-sos. Yes, of course I trust you to sell something you can't even deliver!

Further research shows they're not actually an Australian company, despite what the website leads you to believe. If I ever get my order, or a refund, this is one customer who isn't coming back.

In the news that all of you are actually interested in: when I posted this morning I didn't know that there had been quite a lot of SVTs overnight (phone was playing up, but that's another story). A scan this morning showed sinus the whole time, but no improvement in the fluid. So they're increasing the dose, and Petrina can't come home yet. She may still be able to secure a leave pass for a few hours today or over the weekend, we'll see.

Looking hopeful...

Things are looking hopeful today. Although a doppler yesterday morning showed SVTs, by the time they got to the ultrasound scan baby's heart was back in sinus. We don't know how long it was in SVT before that, but the doctors didn't need to change Petrina's medication, which is good.

Even more hopeful is the case conference they're having this morning. The resident told Petrina yesterday that from the Mothers side of the house, they're happy for her to continue treatment as an outpatient. If the Adults cardiologists/physicians agree, she can come home!

SP will be very happy with that. He's coped remarkably well with shuffling from one place to another this week, but "want daddy to not go to work and look after me" when I got him up this morning. Even if Petrina doesn't lift a finger (and I suspect doctors instructions won't allow much more than that) he'll still be so happy that mummy is home.

So give thanks that things continue to look better for baby. We know the doctors will do what's best for Petrina, so pray that the best thing would be for her to continue as an outpatient.

Things you learn in a men's group

Normally our men's Bible study group gets together to study the Bible - I know, that's a stunning revelation. But every now and then we just spend time relaxing together around the BBQ and things like that.

Last night was one of those nights, and for someone short on sleep, the discussions were particularly interesting. For example, did you know:
- Your deer (or other game) will taste much better if taken with a head shot?
- That if you go by surface area rather than mass, men eat much more salad and vegetables than you'd expect?
- Salami is a functional rocket fuel?

After missing Bible studies for the last couple of weeks, it was good to spend some time with the guys again (SP was having a sleepover). Laughter really is a good medicine.

Thanks guys.

Hope and progress

Petrina's just had another scan, and the results are the best we've had since we found out about baby's heart trouble. The rhythm was all sinus - not even any ectopic beats. Praise God for that.

The heart is still enlarged and there is still a lot of fluid around, but we know that takes time to clear anyway.

Please:

• Give thanks for such an encouraging result today!
  
• Pray that the medication will keep working, with no negative side effects as it builds up in Petrina's system
• Pray that as baby's heart gets stronger, the fluid and enlargement will be resolved quickly
  

For those who came in late...

Petrina asked me to do a quick post to fill you in on the number one question that she's being asked at the moment: how did you find out about baby's heart problem?

We had a routine morphology scan at around 20 weeks. During this scan, the sonographer saw some ectopic beats, i.e. every so often it skips a beat. We'd had exactly the same thing with SP, although it didn't start that early. He's a bright, healthy little man, so we left the scan thinking that it would just be more of the same for this baby.

To the best of my knowledge, it's standard procedure if they pick up an ectopic beat to schedule a follow-up scan to check the heart structure. Well, that scan was what we had a couple of weeks ago. Baby's heart structure is fine, but as we know, the rhythm and rate are still needing treatment.

There was a slight change in the treatment plan last night, so Petrina didn't start the new drug until this morning. The scan scheduled for Wednesday might be moved to Thursday to make sure the drugs have had enough time to get into her system.

Back on the rollercoaster

Back on the rollercoaster

I have to admit, I started today with a bit of trepidation. There were no scans or doctor's appointments over the weekend, but with a scan scheduled for this morning there was that growing feeling of "what's next?"

The good news is that although the first scan this morning only showed SVTs, the doctors decided to do a follow-up scan an hour later where they saw some sinus rhythm. Yay! After some discussion, they've decided to change Petrina's medication: she's not going back up to the really potent stuff from last week's visit to CCU, but to a mid-level drug. And she's back on the telemetry unit - hopefully with good contacts this time! There's another scan scheduled for Wednesday afternoon.

Praise God:

• For periods of sinus rhythm over the weekend and again today
• That I was able to bring SP in for some good relatively long times with Petrina over the weekend
• For the love and care our family and our church family are showing during this time

Pray:

• That when the new medication starts tonight, it will be effective for baby with no side effects for Petrina
• That SP will cope with starting a very different routine tomorrow, as some of the mums from church help care for him so that I can keep up with normal(ish) work hours.
• That I will cope with SP starting a very different routine tomorrow, and that I won't worry that I'm failing him as a dad by not taking on all his care myself while Petrina's in hospital. (I'm 99% sure intellectually that I'm doing the right thing, but that doesn't make it emotionally easier)

Crash testing: moments of levity and light

I'm sure that through either work or extensive broadcast education (a.k.a. TV watching), many of you will be familiar with the terms "crash" and "code blue". If a code is called, it usually means that a patient is in cardiac arrest and needs attention right now. As in, RIGHT NOW.

However, I say usually, because occasionally things go a little awry. Like when a code was called on Petrina last night at 10 pm. She was fine, sleeping peacefully after drifting off in front of the TV. But the telemetry unit she had to wear for 24 hours was informing CCU that her heart had stopped beating. Well it was certainly beating strong when she woke with a start to see half a dozen people bursting into her room.

For those who missed it the first time, it happened again at 8 am this morning. There she was, sitting in a chair doing her nails, blissfully unaware that the telemetry unit was again reporting no heartbeat.

Well, an hour or so after that they changed the patches where the electrodes are attached, and as far as I know there were no more codes for the rest of the day. Another downside of wearing the telemetry unit is that its range is restricted, which meant that Petrina was confined to a small portion of the ward. What better way to celebrate than to take a tour of the whole ward again?!

Ahh, like I said, moments of levity.

The moment of light is a second hint that we may be reaching a milestone in the treatment. Petrina felt some increased movement again this afternoon and when she asked for a doppler, it showed that baby's heart was indeed in sinus rhythm at the time. Lots of skipped beats, but that's a relatively minor issue.

Praise God for these signs that the medication is starting to take effect. Pray that it will be fully effective and that baby will grow stronger and be able to clear the fluid in time for delivery.

In other news, if anyone wants to hire a 2 year old mowing and whipper-snipping contractor who knows how to follow previously unseen hand signals, let me know. It's not child labour if his mower doesn't actually cut anything is it?

Tonight on 24...

OK it's not that bad, but sometimes it feels like there are similarities. And the last 24 hours have certainly been eventful.

When I posted last night, they were just about to start the IV infusion for Petrina. That didn't go particularly well. My wife is a wonderful woman, and is able to tolerate a lot of things - needles, vomiting, gastro, fatigue; Petrina wouldn't bat an eyelid for any or all of those things. But she draws the line at crushing chest pains. So when that happened 3 minutes after the IV started, she promptly had it stopped. That wasn't an easy decision, but we already knew that this was not the last treatment option, so I think it was the right one.

In the end, she slept quite well in CCU last night. It seems that the beds there are more comfortable than in the Mothers. And in the morning there was a very positive surprise: Petrina had been feeling a lot more activity, and when the specialist came over to do a quick ultrasound, he saw that baby was in sinus rhythm (that's good) with a heart rate around 130 bpm (that's also good). Still some bigeminiy and trigeminiy arrhythmias, but a lot better than it had been. They watched that for about 10 minutes. Very encouraging.

Since the IV was stopped, they moved Petrina back to the Mothers this afternoon. She's back on the previous treatment plan and dose levels, although it will take a day or so to bring levels back up with the disruption of the last 24 hours.

It's sort of a mixed blessing that a doppler check this afternoon picked up SVTs and high rates again. It's a downer because it's not steady sinus rhythm, but it's good in that we haven't spent the whole weekend thinking "the heart's working properly again". My sister said that on the cardiac ward where she works, it's not unusual for patients to flip between SVT and sinus rhythms during treatment. I think... no, I know God knew that we needed a gentle reminder that it's still a long road, and to keep our hope and our focus in Him.

Meanwhile SP isn't saying so, but he's deeply missing his mum. Playing at a friend's house (a very long-suffering friend today) he was quite upset for a couple of hours, until it was clear that daddy was nearly there to pick him up. I took him to the GP this afternoon just to make sure the last few days wasn't anything serious, and she said it's probably just a virus. I'm pretty sure that some of the night-time wakings are to check that daddy's still around to look after him.

CCU progress

Well, Petrina is settled comfortably into CCU now. Although the original plan was to start the IV line immediately after the transfer this morning, the cardiologist decided it was prudent to give that morning's dose time to work further through Petrina's system before starting the new stuff.

The down side is that the 24 hours in CCU only properly starts now, so it will probably be Saturday morning before she's transferred back to the Mothers. And all mobiles have to be turned off in CCU so if you were planning to call or text during that time, you'll have to wait a little for a reply.

The up side is that we may be seeing the first signs of progress. Baby's heart is still in SVT, but the rate is dropping - it peaked around 250 bpm earlier this week, and was at 210 about 20 minutes ago. Around 4pm this afternoon it dipped to 197. Apparently normal heart rate at this age is about 150 bpm.

We continue to be thankful for everyone's love and prayerful support. We're all pretty tired. SP is still a bit crook, but he's eating and sleeping better than he did last night. Personally, I'm thankful for the effort so many people are going to in order to help us, but at the same time I'm struggling with exhaustion and feeling powerless to do much of anything help the three people I love most on this earth.

At least I can deal with the exhaustion by going to bed. Goodnight all!

Coronary Care

This morning the doctors had a case conference about our baby. It's quite humbling to think that all these specialists are caring for our family: paediatric cardiology, maternal fetal medicine, adult cardiology, adult physician, neonatology.

The outcome of the case conference is that they're changing to the more potent drug. To get it into Petrina (and God willing, baby) as quickly as possible, it's being administered intravenously as well as orally. Petrina's been moved to the Coronary Care Unit in the Adults hospital so they can monitor her health properly while they do this. Ideally it will only be for 24 hours, then she'll be able to go back to the Mothers with a wireless monitoring unit.

There will most likely be a scan tomorrow afternoon to see if there's been any improvement. If there is no improvement by Monday or Tuesday of next week, they'll be moving to direct fetal treatment. That won't be easy, but does give the doctors options to treat baby without affecting Petrina's health so much.

Please keep praying.

Latest Update - Addendum

Please pray that God will be at work mightily in our baby's heart tonight.

Following on from the scan earlier today, there's going to be a case conference tomorrow (Thursday) morning between the paediatric and adult cardiologists to determine the best way forward. Two of the options mentioned are to put Petrina onto the most potent of the drugs that I referred to previously, or to do what I assume (there I go assuming things again) will be some sort of microsurgery so that they can inject something (unnamed but I assume [again!] one of the more benign drugs that she's already on) directly into baby's cord or thigh.

From what I've gathered, part of the issue is that all these drugs take a while to work, and the paediatric cardiologist only has 8 or 9 weeks at the absolute outer limit to find the treatment that's effective in our case. Probably only 1/3 to 1/2 that time to find the treatment so that it's still got time to be effective.

Petrina and I were talking about it earlier this evening and we're in amazingly thankful awe of the treatment that she and baby are getting. We couldn't wish for better care. It wasn't our choice to need it - but we're thankful to have a tertiary hospital only 5 minutes down the road.

The question of why hasn't reared its head yet, but it will in time. Thinking about it for a moment just now, it occurs to me that it may be a case like that of the man born blind, and the purpose is that God will be glorified. Or it could be more like Job, who as far as I know never found out why those things happened in his life.

Latest update

Petrina had another scan earlier today. Once again I've fallen into the trap of oversimplifying the possible outcomes.

The results from today's scan are that the SVTs are still there, unchanged. In addition, the heart is dilating and starting to put pressure on the lungs. And because the heart's struggling so much, the oedema levels are increasing, not decreasing.

But, because the latest blood work wasn't back yet, they're not changing the drugs until they see those results and confirm that the doses are at therapeutic levels. So there's probably going to be another scan tomorrow - that will have given a bit more time for this higher dose to work through Petrina's system into baby.

For those who've been asking: yes, Petrina is probably going to be in hospital for the duration.

Sigh...

I miss my wife.

But I am thankful that after running a temperature since yesterday afternoon and a vomit last night, and after lying in for nearly 3 hours past his normal getting-up time, SP seems to be on the mend.

Petrina's settling in to the ward, starting to meet some of the other mums there and getting over some of the aches and pains that have been interrupting her sleep lately.

I think we're due for another scan today sometime; I'm not certain but I think there are basically two possible outcomes:
- some improvement, stay on the current treatment plan
- no improvement, switch to a different drug

Either way Petrina will be in for a while.

Here's an interesting bit of search engine trivia for you too: I was doing a little reading on some of the drugs the doctors have mentioned - just wikipedia level broad brush-strokes; we have a senior pharmacist at church who can go through the details with me. But anyway, searching with google as usual, it auto-completes some suggestions. Now for the first two drugs, I didn't take much notice, except to realise that about halfway through the spelling was slightly different to what I expected. By the fourth search, google had cottoned on to the fact that I was researching cardiac drugs and gave the correct suggestion after only two letters! A good thing too, 'cause I had no idea how to spell that one properly. Kinda cool, kinda scary at the same time.

Please keep praying.