Best Proposal Ever

I happen to think that my proposal to Mandi was pretty awesome, but man, this makes me bow my head in shame. Just kidding, but seriously, this is the best one I've ever seen.

Thankful Thursday: Hubby & Helping Hands

It's thankful Thursday time! We all have so much to be thankful for and we love to take this opportunity just to write down each and everything that comes to mind. Please take this time to share with us what you're thankful for as well. If you have a blog expressing your thankfulness, please share the link! Without further ado, here's what we're thankful for:

Mandi's List:

I'm thankful for a wonderful hubby that is also a phenomenal father. Ronnie has more patience in his little finger than I have in my whole body. Mckenna has been quite the handful since getting home and being jet lagged and Ronnie, the baby whisperer, has been all over it. So sexy to see a man be a daddy!

I'm thankful for a wonderful hubby who is also a great cook. Ronnie has made us dinners since we got home. He makes the best meals, throwing random spices together, that are delish!

I'm thankful for a wonderful hubby who is also a comedian. Life is just funnier with Ronnie around. Period.

Obviously this week I'm thankful for my husband!

Ronnie's List:

I'm thankful for for our successful trip and time with family. It was quite the adventure flying half-way around the world with a 7 month old in tow, but it was also one of the best trips ever. We saw stuff that is generally reserved for dreams and postcards, and got to experience two great cultures while we were at it. Mckenna was an absolute all-star the entire trip and exceeded our expectations big time.

I'm thankful for helping hands. My brothers looked after the house and garden while we were gone and I'm happy to report that nothing died and the house is still standing. It's always nice to have trusted family or friends to turn the keys of the fort over to. Definitely eases the mind while away.

I'm thankful for the chicken we just had for dinner. I marinated chicken breast for about 24 hours in soy sauce, garlic cloves and yellow mustard, and I must say, it turned out great!! We cooked it in tin foil to keep in all of the juices and the flavor absolutely exploded in my mouth with every bite. We also harvested squash from the garden which I over-cooked and over-seasoned. Whoops.

So, what are you thankful for today?

I Need a Vacation

So am I the only one who thinks vacations are a lot more work than day-to-day life? I know I'm not in the majority, but I can't be the only one. Now, please don't get me wrong, I feel truly and utterly blessed to be in a position to even take a vacation, so please don't mistake my question as a complaint. Even though vacations are so tiring there isn't a single part of me that would take back any time I've been able to fly the  coop and check out another place on the map - especially this last jaunt around the world.

Mandi, Mckenna and I recently got back from a trip to visit my in-laws who are currently living in Singapore. While there, we were also able to take a little side trip to Thailand. Both places were two of the most beautiful places I've ever been. Singapore is a cool, hip and happening city while Phuket, Thailand seems like a postcard at every turn. I just so very thankful that we had a camera to capture all of the breathtaking sights!

The purpose of this post isn't to talk about how great the vacation was or how beautiful the sights were. The purpose of this post is to talk about all of the reasons why I need a vacation following a vacation. Maybe some of you can relate, maybe none of you can, but regardless, thought it'd be fun to chat about.

So what was it about this vacation that was so energy-draining? Here are some ideas...

Man was not meant to be on a plane for 11 straight hours. Singapore is really, and I mean really, far away. The 11 hours spent in a plane was only the part in which we crossed the Pacific Ocean. That doesn't count the 2 hours to San Francisco and the 6 hours from Tokyo to Singapore. I'm not math major, but that's 19 hours of flying. Add in travel to and from airports plus lay-overs and now you're talking 27 hours!! Yeah, 27 hours of traveling. It's madness, absolute madness. In a perfect world, I'd be able to sleep like a baby on a plane, but that's made even more difficult since we had our own baby on the plane (and I wasn't even the one with her most of the time, Saint Mandi was). Then, you have the +15 hour time difference and now you're talking a formula that really throws your body for a loop. Ever had jet lag? They need a new name for this as those two words don't do this justice.

Singapore is very, very humid. You feel it right when you exit the plane. It's like Bruce Lee and Chuck Norris got together to give me some swift roundhouses to the chest. I admit that my lungs are a little "soft" due to the ever so dry climate that I'm used to, but seriously, Singapore is like walking in the biggest sauna in the world. I don't know about you, but I find it hard to breathe when there is a ton of humidity in the air. It's tough to get a real deep and giant breath in. We walked around a ton, which was awesome in keeping my lungs going, but I noticed that I didn't cough up nearly as much stuff as normal. What's really strange, is I've been coughing up stuff like crazy since being home. Could be the weather, could be the travel or could be pure coincidence. Either way, I know this much is true - humidity is not my friend and I'm so thankful for the hot and dry Arizona weather.

I'm a schedule/routine guy. I think I've mentioned this before when it comes to being away from home, but I think I'm even more uncomfortable than I realize when thrown off of my routine. The thing is, I thoroughly enjoy the spontaneity the vacations bring and all of the different activities, but subconsciously I think my body is screaming "what the heck is going on!?!?". When I'm at home, I can give you a pretty good idea + or - 15 minutes on how my day will go. I can tell you when breakfast, lunch and dinner will be. I can tell you when my treatments will be done. I can tell you when gym time is. I can tell you when I'll wake and I can tell you when I'll sleep. On vacation however, no matter how hard I do (or don't) try, everything must be a bit flexible. It's funny because that's what I like about vacations, I'm just not so sure my body does.

I'm sure the list could go on, but I'd like to hear about some of your experiences as well. They may jog my jet-lagged mind so I can add to my list. If you've made it through this blog, thank you. I don't want you to think for even one nano-second that I'm complaining. I'm simply observing and starting a conversation. If I had it all to do over again, I do it in a heartbeat. You could double the flight time and cut the vacation in half and I'd still be the first in line. I got to spend some amazing time with my family and see some stuff that I've only seen in the movies, literally. They call this "James Bond Island":

So tell me, am I the only one?

Travels Abroad

Surprise! We were totally holding out on you all!! As some of you have maybe have seen in Facebook photos posted the last day or so, we were in Asia...SURPRISE! We were holding out before posting because we didn't exactly want to let on to the fact that our house would be vacant and we'd be out of the country! So let me back up and give you the whole scoop, now they we're home, settled and we have pictures uploaded to share!

First things, first...why the heck did we go? My parents are living in Singapore now (they were in Shanghai as you may have seen previously). They've been there since February, so we decided it would be a great opportunity to get back to Asian and bring Mckenna for a world adventure.

We set off for Singapore with Mckenna in tow. We were really nervous about the 24+ hours of travel time (one way) and the possible jet lag with Mckenna, but decided to just go for it. Turns out, this kid can travel!! She was phenomenal both ways and jet lag wasn't a problem at all going. It has been a bit of an issue being back, but that's ok! She'll get there.

We had a total blast! We spent time in both Singapore and Thailand. We saw the sites, spend quality family time, and relaxed. We will post pictures and stories over the next few weeks, but I figured I'd put up a few photos and let you know the gist! Here are some pictures from the trip:

We'll post more of our 1,897,609,325 pictures later I'm sure!

Have a favorite of this group?

Hypertonic Not Better Than Isotonic Saline in Young Cystic Fibrosis Patients

SAN FRANCISCO – Inhaled hypertonic saline did not reduce the number of pulmonary exacerbations in infants and children with cystic fibrosis in a randomized trial.

The trial pitted 7% hypertonic saline in 158 pediatric patients against 0.9% isotonic saline as a control in 163 patients. The solutions were nebulized twice daily for 48 weeks, with both groups getting albuterol or levalbuterol beforehand. The patients ranged in age from 4 to 60 months. Adherence was at least 75% in each group, judging from returned study drug ampoules, reported lead investigator Dr. Margaret Rosenfeld at an international conference of the American Thoracic Society.

In the hypertonic saline group, the mean pulmonary exacerbation rate was 2.3 events/person-year (95% confidence interval [CI], 2.0-2.5), and the mean number of total antibiotic treatment days for pulmonary exacerbations was 60 (95% CI, 49-70). In the control group, the mean pulmonary exacerbation rate was 2.3 events/person-year (95% CI, 2.1-2.6), and the mean total number of antibiotic treatment days was 52 (95% CI, 43-61).

No significant differences were seen in secondary end points, including height, weight, respiratory rate, oxygen saturation, cough, or respiratory symptom scores. Adverse event profiles were similar, with cough the most common adverse event in about 40% of each group (JAMA 2012 May 20 [doi:10.1001/jama.2012.5214]).

"There is great interest in the CF [cystic fibrosis] community about developing early intervention strategies to delay or prevent CF lung disease before the bronchiectasis becomes irreversible. From our current evidence, hypertonic saline does not fulfill that role. Based on its inability to reduce the rate of pulmonary exacerbations, we would not recommend that it be used in this age range," said Dr. Rosenfeld, a pediatric pulmonologist and associate professor of pediatrics at the University of Washington in Seattle.

The finding was a surprise because hypertonic saline is known to prevent exacerbations in older children and adults, perhaps by helping the lungs cough out bacteria. There has been hope it would also help very young children, and its use in that population has increased substantially in recent years, Dr. Rosenfeld noted (N. Engl. J. Med. 2006;354:229-40).

"We’ve been scratching our heads about" why that hope didn’t pan out in the trial. "We have a number of hypotheses. The first one is that pulmonary exacerbations may be really different beasts in infants and young children. [Perhaps] they are mostly triggered by viral respiratory infections. Hypertonic saline can’t prevent people from getting respiratory viruses," she said at the conference.

Exacerbations might have been too blunt a primary outcome measure, according to an editorial that accompanied the published study in JAMA.

Very young children with CF have not yet developed the outright lung damage that makes older patients particularly susceptible to exacerbations. Perhaps more subtle markers of early disease onset and progression were needed in the trial, wrote Dr. Elliott Dasenbrook, associate director of the Adult Cystic Fibrosis Program at Case Western Reserve University, Cleveland, and Dr. Michael Konstan, director of the school’s Cystic Fibrosis Center and chairman of its pediatrics department.

"Although the results of the study suggest that inhaled hypertonic saline should not be used routinely in young children, the final verdict on its use for infants and young children has not been rendered. It would be disheartening if a viable therapeutic option was discarded because of negative study results when more sensitive end points might have detected benefit from the intervention. Testing therapeutic agents in infants and young children may require different end points capable of assessing onset and progression of disease," they wrote (JAMA 2012 May 20 [doi: 10.1001/jama.2012.5853]).

There was one "tantalizing" hint in the trial that hypertonic saline may delay structural damage, Dr. Rosenfeld said. Among the 22 children aged 4-16 months in the hypertonic saline group who had pulmonary function tests, forced expiratory volume in 0.5 seconds (FEV_0.5) was a mean of 38 mL greater (95% CI, 1-76) than among the 23 children tested in the control group, the only significant pulmonary function difference.

Perhaps that could be a marker in future trials, but "statistically significant difference does not necessarily imply clinical significance," Dr. Dasenbrook and Dr. Konstan noted. "Even though the results of infant pulmonary function testing appear encouraging, ... these exploratory end points should be viewed as hypothesis generating, and research exploring the clinical effects of these differences is needed."

That research is likely to happen. "We would like to study [hypertonic saline] further and see if we get a signal if we choose more physiologic end points," Dr. Rosenfeld said.

Dr. Rosenfeld disclosed that she is an adviser to Genentech and Vertex Pharmaceuticals, and receives research grants from Vertex. Dr. Dasenbrook is a consultant for Savara and Gilead. Dr. Konstan is an adviser to Aradigm and a consultant for Boehringer Ingelheim, Genentech, Novartis, PARI Respiratory Equipment, Vertex, and several other companies. He receives grants or has grants pending from several companies, and receives speaker’s fees from Genentech and Novartis.

**Original article can be found at http://www.familypracticenews.com/news/more-top-news/single-view/hypertonic-not-better-than-isotonic-saline-in-young-cystic-fibrosis-patients/07c72680a78e0268c8b8eea2b5cf97d2.html