Surgery plus 2 months

I couldn't be more satisfied with the results of my POEM surgery!!  Two months after surgery.  Zero symptoms of heartburn which is the most common side effect of the surgery.  I did have some gas in my stomach a few weeks ago that led to some burping for a week or so but that went away.  The only time I have had any sensation is after I eat lentils.  I think they produce a lot of gas that feels funny in my chest.  I had that sensation twice and both times were after eating lentils so no more lentils.

My swallowing is 99.9% perfect.  Large bread bites are still slow to pass into my stomach but that's easy enough to fix by chewing those bites a little longer.  That's it!!!  Perfecto, FIXED.

I would add this piece of advise if you have this surgery.  DO NOT swallow any water to try and get food that is being stubborn to go into your stomach after surgery.  Dr. Swanstrom says that in his post operation instructions.  It was not a large problem for me but a couple of times in the first 3 weeks or so I had some bites that were being a little slow so I drank a little water to help them go down.  Nothing major happened but I did feel a little tender for a day or so.  I would think it could be possible to do a little damage to the surgery site if you really forced a large piece of steak through or something like that.

I have gained about 9 lbs. in 2 months.  Tipping the scales at 147 lbs. Not a bad weight for my frame.  It would be interesting to see how much weight Achalasia patients gain back on average after surgery.  I think it would be very easy to get fat.  I prepared myself for the fact that I would be able to eat much more than I had been for the last couple of years and took this opportunity to eat much much more fruits and veges.  Mt. biking a lot this spring (we are off to Utah for 2 weeks, leaving Sat.).  It sounds crazy but there have been so many positives that have come from having Achalasia.

Totally Fantastic trip to France
Becoming friends with Joelle and Claude
Artisan Cheese making (worthy of it's own blog, it definitely started in France)
Healthier diet
Which led to more Mt. biking

Amazing.

1) Emmental (swiss), 1)Tomme (alpine style) 1) Cheddar 1) Blue 2) Gouda's
That's approximately 17 lbs. of cheese aging.  It's so fun.

I will post in a month or two unless something changes.  I have all my follow up tests at the end of August.  I am still waiting for copies of my post operation swallowing X-rays.

Back to Work - Surgery + 3 weeks

Back to work...and an 18 mile Mt. Bike ride.  All is well physically at this point and eating continues to be a joy.  I have been surprised by how much better I feel in general, more energy and I had not realized how I constantly had that low blood sugar feeling before my surgery.  Mostly fruits and vegetables is what I eat and it is wonderful although I do miss the foie gras, cheese and chocolate mousse diet I was following in France.  I have found that I need to chew my bites a few more times than normal to make for easy swallowing, especially bread and meat.  There have been about 5 times in the last 3 weeks when food has hesitated at the bottom of my esophagus before going into my stomach.  I have to remember that I have a permanent swallowing disorder and that the surgery simply helped with the symptoms and did not cure me.  Swallowing is easy and I feel normal again.  No signs of heartburn only occasional burping which is new to me,  I assume since my LES was clamped shut before no air could possibly escape.  Not enough burping to be inappropriate or awkward only very small amounts many times throughout the day, definitely more than normal but not something that affects my day in any way.

I have gained 7 lbs. since my surgery 3 weeks ago.  Now topping the scales at a whopping 145 lbs.

Riquewihr, France.  We saw a few stuffed foxes here and there around Alsace.

A teacher Kelly worked with (Kelly and I went to school with her son and she lives just around the corner from us) at Griffin Creek Elementary who retired a number of years ago was just diagnosed with Achalasia (affects 1 in 100,000 people) and had an appointment with a local surgeon when we found out and turned her on to Dr. Swanstrom.  She has an appointment to see him later in February and I am so happy for her to have the opportunity / privilege  to be under his care.  Yesterday I discovered a video conference on Youtube in which my Dream Team Dr.'s Swanstrom and Perretta were leading a discussion on the POEM surgery that was being attended by surgeons from John's Hopkins University, Mt. Sinai Hospital, Dalhousie medical school, Cleveland clinic and a few others.  These Dr.'s are the ones teaching the other Dr.'s around the world.  I still can't believe how fortunate I was to have such a fantastic opportunity.

Sunrise in Trincomoli Channel B.C. Canada, July 2012

We rode our bikes last weekend and I felt much better than on my first ride.  Normal but not conditioned.

First bike ride - surgery + 14 days

I did not have to walk last night but a short rest
was in order at one point.

I went on my first bike ride since surgery last night.  A night time mountain biking ride with a group from the local bike shop.  UGH I think Dr. Swanstrom accidentally removed one of my lungs!!  I thought with all the skiing before we went to France that I would be in better shape for the ride but no way.  I have not been on my bike since October and it felt like it.  No legs, No lungs.

I did some serious huffing and puffing with no unusual pains or sensations anywhere.  My chest felt completely normal during all the heavy breathing and nothing is sore in that area this morning.  I suspect the anesthesia sets you back a little as well as all the sitting around eating french cheese and foie gras.

Tonight is my last Nexium which I have been taking as a precaution to control acid reflux after the surgery.  Historically there has been about a 30% occurrence  of acid reflux in POEM patients but I think Dr. Swanstrom may have tweaked the technique a little to
try and reduce that likelihood. I will ask him at the next visit.  He told Kelly after the surgery he thought acid reflux would be unlikely but did not elaborate. 

We are still waiting for our illegal unpasteurized cheese to arrive in the mail.  Interestingly Louis Pasteur was a professor at Strasbourg University when he invented pasteurization.

Surgery + 13 days

Almost two weeks after my POEM surgery I can report that I have gained 2 pounds from my pre operative weight of 138 lbs..  Swallowing feels as if there were never any problem at all and my energy level is much more even since I can take in more calories and eat a more balanced diet of fruits and vegetables along with my proteins.  Some large bites of bread are still a little slow to pass into my stomach but the sensation is not the same as it was before the surgery.  I am reluctant to flush the bites with water at this point as it seems like it would only put more pressure on the surgery site so I simply wait a minute or two and it usually passes.  I can say that the times I have had the slow passages of food have been when I have been less diligent about taking smaller bites and chewing more.  I do not need to consider the bite size or chewing for most foods any more only thick substances such as bread.  The eating is so fantastic, to lay into a full plate of salad is so satisfying since salad was a forbidden food for me not long ago.   I do not have a single sensation which would lead me to remember I had surgery just two weeks ago.  I don't think that would be the case had I had the laparoscopic myotomy.

Cheese in France is quite a bit different that in the USA.  Yum.  Next trip we will get a book that explains all the different types.  The variety is astounding.   In Strasbourg not far from the Cathedral is La Cloche a Fromage which has a restaurant serving tons of cheese as well as a Fromagerie (cheese store) across the street.  

The rampart in Riquewihr.  One of the most beautiful villages.

Road to Andlau 20 min. south of Strasbourg.  The wine route must be stunning in the summer.  There definitely was a certain beauty to it in January.  This picture is actually lower in the valley towards the Rhine river where more vegetables are grown.

I purchased a few more Tylenol for the trip home which I did not need.

IRCAD tour. Surgery + 8 days

We are home in Oregon now.  It has been 8 days since my POEM surgery and all signs are still pointing to a very positive outcome.  I am happy to be eating lots of fruits and vegetables which I have not been able to enjoy for quite some time as they did not offer me the calories I needed and I also found them very difficult  to swallow.  When I did manage to get down an apple or banana, it would require so much water that I would be full after only a small amount of fruit, therefore limiting my caloric intake (starving) which made maintaining  my energy and weight that much more difficult.  For the last 8 months I have been eating very high calorie foods, it works, I fluctuated between 137 and 140 lbs for the last 8 months.  Upon our return from France I weighed 138 lbs. but that will soon change.  It takes me a couple of weeks to see weight gain or loss after a change in diet and/or exercise.  I am eating pretty much whatever I want with the exception of hard sharp foods like tortilla chips.  Small bites, lots of chewing.  Looking forward to enjoying a healthy diet of fruits and vegetables.   I have had the sensation of food not passing directly through to my stomach 2 maybe 3 times since surgery always while eating bread products.  I simply waited several seconds and it would eventually pass.  Not anything which concerned me in the slightest.  No Tylenol since day 4 only the Nexium to help eliminate any acid reflux for the first couple of weeks and then I will be medication free. 

I have some hesitations about eating certain foods right now but I have to say my entire esophagus, stomach etc. feels as if nothing ever happened and all of my swallowing functions are exactly as they were 5 years ago.  Amazingly successful.  I am not sure if the typical POEM patient experiences such a flawless outcome but I am sold.  

I believe my exceptional outcome is directly related to Dr. Swanstrom's expertise.  Perhaps my outcome is not exceptional simply typical for the POEM surgery.  I feel exceptional :)  

Dr. Perretta gave Kelly, Joelle and myself a tour of IRCAD last Tuesday.   What an interesting facility. It was started in 1994 and has grown into one of the world's leading centers for minimally invasive surgical research, development and training.  They offer onsite training as well as Web Based Courses.  

IRCAD is directly next to but not connected to the New Civic Hospital in Strasbourg.  So, my surgery was not technically performed at ircad since it is exclusevely a research and training facility.  I was operated on at the hospital next door which has HD links to ircad for recording surgeries and I suspect may be used for telesurgery but perhaps not.

In the above picture this lady is doing artwork on an esophagus which must be part of some type of upcoming course or Websurg.

This is a training room where there are 6 - 8 surgical stations.  I think she said there are teams of two surgeons at each station during a training course and they are permanently accompanied by a senior surgeon for the duration of the course which is not typical I was led to believe.  It is more typical for a senior surgeon to float around the room and help as needed.

The Da Vinci surgical robot is part of the modern surgery room.  The above surgeon from Denmark is actually performing surgery on a live pig in the background during a training session.  The screen below shows him sewing up something inside the pig.  I got to walk over to the patient and saw a cute pink belly with a few laparoscopes entering it's abdomen from different angles (no pics allowed of the pigs) all connected to the robot being controlled by the joysticks in the surgeons hands.

The robot is superior to a human since it's hands (tools, cameras, knives etc.) are only 5mm in diameter and have a far greater range of motion than ours do.  Therefore, the surgeon can reach into tiny areas without disturbing the nearby tissue.  It seems like a pretty intuitive device. $2 million is the number I remember.

So, cool web technology, amazing robotics we got to see in person, but the pigs!!  Dr. Perretta says prior to opening a set of doors, "I apologize it might be a little smelly in here because of the pigs".  I was thinking flesh type of smell not unlike a butcher shop or something. . . then the aroma of a barn enters my head.  We raise all the pigs onsite she informs us.  Piggy condominiums and an ethics board which must clear each and every decision prior to any changes.  They are the best cared for pigs and when they get too large they are sent to an upscale farm in the country to live out their life.

There are a number of pieces of art throughout the ircad building, a reflection of Prof. Marescaux's appreciation of the arts.  Time zones of the world are in the background as well as a door to a Mosque for Muslims which may be visiting and need to pray.  Thoughtful.

Nouvel Hospital Civil photo taken from outside ircad.  I think the hospital opened around 2006.  It is very modern.  Both were about a 4 minute walk from our Hotel.  The distances looked farther on google maps but the hospital, hotel, petit france and all of the old part of Strasbourg were with in a 10 minute (very pleasant) walk of each other.

I was asked to do a short interview on camera for ircad to edit into a statement of sorts on my experiences with the POEM procedure.  I always thought an interview involved an interviewer.  Not in France.  It was fun, I just told my story and how I felt.  Awkward.

Saying Goodbye to Dr. Sylvanna Perretta.

What a great experience and outcome.  Thank you again.

I will be posting occasionally or as needed to log progress, Dr.s visits etc.

Please feel free to contact me if you have any questions at all or if you want to chat a little about my experience or what to expect.  Leaving a comment with your contact info. is the easiest way.

Ircad and Choucroute. Surgery + 5 days

Ircad was intensely interesting!! Will do proper post once we get home.

Love Alsace, France
Love eating
Love Joelle and Claude
Could not have asked for a better final day. Thank you Joelle, Sylvanna, Kelly and the nice couple we sat next to at de tirbouchon restaurant.

Bought illegal cheese. Cheese monger said mail it home you have a good chance of getting it. Post office lady said put it in an envelope not a box you will have a better chance of getting it. We will see.

Small bites, lots of chewing equals zero problems!

Surgery plus 4 days

I took a tylenol around 9 am and now it is 530 pm with zero hint of pain all day

We awoke to another beautiful breakfast at Joelle and Claude's.

Yesterday we had breakfast with Dr. Swanstrom at our hotel where he is also staying. Chit chat what a great guy. Zero ego, thoughtful, considerate conversation. Good vibes emanate from him.

I am released from their care. I have a couple tests in a few months to check ph for reflux as well as manometry to test esophageal function.


Joelle kindly took us to several old villages nearby, perhaps within 10 miles of Andlau where we are staying. Really nice Hansel and Gretel kind of villages which are so much more interesting than I had anticipated. I really enjoy looking at the buildings. Everything is closed in the villages on Sunday and Monday but we did find a hotel with a restaurant open for lunch in Riquewihr.

Foods introduced:
French onion soup
Tart flambé
Escargot
Cheese bread with bacon in it
Double cream brie cheese


Joelle told us of a restaurant in Barr which opens at 7 pm on Monday. She sets a pretty high bar when it comes to all things Alsatian. Her and Claude were raised here and she prides herself on offering a genuine Alsatian experience. She is an expert on the regional cuisine, architecture, history, language, antiquities and traditions. Joelle says this restaurant is pretty good at authentic Alsatian cuisine. Mmm mmm mm.
Baekeoffe? Foie gras? Spaetzle? Choucroute? More cheese? Mousse?

Time to go to dinner.

POEM surgery detailed

Mostly for the benefit of future Achalasia patients considering the trip to Strasbourg for the POEM surgery, I thought I would detail my 30 hours at the hospital so you can understand a little of what to expect.

5 am. Awake after falling asleep at 2 am.

6 am. We were taken in a taxi from the hotel to the hospital where Dr. Swanstrom greeted us in the lobby and showed us up to the admissions area where I put on a gown, said goodbye to Kelly and relaxed in bed.

630 am. I was rolled in my bed down the hallway into an elevator down another hallway into a large empty staging room and left to rest again, soon there were many others brought into the room and it was obvious we were the surgical patients for the morning.

720 am. A gaggle of giggling french nurses ( expectation realized ;)) arrived to sort and export. They seemed to enjoy the fact I only spoke English and took the opportunity to practice the language. Hello. What is your name? How are you? Where do you come from? All with much laughter and discussion in their native tongue regarding my rugged good looks and handsome physique (approximate interpretation).

I transferred to an operating table from the rolling bed just outside the operating room and successfully kept all my parts inside the gown during the process. Hurray. I was rolled into the OR which looked very sophisticated with many large flat screen monitors, huge cool looking operating lights, some other equipment and a handful of folks prepping for surgery. Dr. Perretta was there and put her hand on my chest and consoled me while I explained my concerns of aspirating when they put me to sleep. She has the skill and professionalism of the highly trained surgeon she is while at the same time the genuine heart of the kindest nurse. A rare combination. The anesthesiologist said she would be putting me to sleep now so I tried to stay awake for as long as possible when I felt the slightest hint of drowsiness because It seemed like a pretty fun thing to do at the time. 1 second.

8 - 830 am operation begins.

1030 am. I awake (do not recall).

1031 am. Dr. S. called Kelly and reported all went well, I had a super tight sphincter
and he expected a full recovery with great results and a small chance of reflux.

1130 am. I awake in a large room filled with lights, people, desks, more lights chapstick and some lights. Retreat.

1140 am. Arrived in a regular hospital room with apologies for the need to share it with another patient. No worries.

1141 am. Kelly says hi kisses me on the cheek, lovingly caresses me for a while then quickly realizes I will be no sort of entertainment anytime soon and leaves me to sleep it off.

1200 pm. My first french lesson. My bunk mate's nurse is using the word catastrophique repeatedly. Loosely translated this means your bunk mate has loose stools which have run all over his half of the room and this room will be uninhabitable in 4 seconds. catastrophique

1200 and 10 seconds pm. Freaking out.

1205 pm. Moved to own room. Much sleeping. No pain. I don't remember much of the afternoon but I know Kelly and Joelle came and visited several times into the evening. Modern, clean, basic hospital room with what I swear is the most comfortable mattress I have ever been on. Very comfortable.

?? pm. Dr. Perretta arrived. We chatted and I took notes which seemed like a good idea. The answers I wrote down were:

2nd poem surgery at ircad

No h20 until friday.

No

Probably soft/liquid until sunday

No

Will see Dr. S. saturday

Maybe walk 4-5 pm no need to tell nurse

Surg. went well woke up well

I need to ask her about the two questions which correspond to the two NO answers to see if any apologies are in order. I was pretty intoxicated.

300 pm hot hot. Push button for nurse to take my temperature because i have internal bleeding, infections, almost drowned in a tsunami and will soon die. Temperature confirmed 37.1 which I gather is pretty good based on the smile on the nurses face.

430 pm. Walked around the hallways for 10 minutes.

Afternoon and evening. Periodic temp and blood pressure checks. I connect faces to the nurses which speak some english, a little english and no english. Mostly no english which leaves more time for resting. If I push the red button I know a nurse will show up with which I can communicate reasonably well.

As far as I know I was on I. V. meds for nausea and mild pain along with sugary saline solutions for hydration and some energy. No drinking until friday (surgery was thursday) according to my notes.

700 pm. Walking

800pm. Nurse says goodnight see you at 2 am and 5 am.

900 pm. Nurse walking in hallway singing a lovely french song. Serious.

1000 pm. Walking

Pretty good sleeping very comfortable.

400 am. Mild chest pain. Push red button and she tells me she will mix something up for me. Returns with small I. V. bag which she connects to my system of bags and tubes. No narcotics needed I am pretty sure. All of the pain was very mild and I asked lots of questions about what was in the I. V. Bags.

405 am. Walking the halls.

Sleep

830 am Kelly arrived.

930 am. Dr. Perretta arrived for a check up and to let me know that if the swallowing X-ray was acceptable I could eat, drink and leave that afternoon as planned

1000 am. Prof. Marascaux arrived to introduce himself and wish me good luck.

1230 pm. Taken to radiology.

1240 pm. Radiologist looks at first X-ray and no kidding he turns to me and says this grapefruit sized gray area in your abdomen is not normal, not something he has seen before. Catastrophique I think. I had my initial swallowing X-ray done in Medford and they were a little confused so there was not a previous abdominal X-ray to compare to. He continued with the swallowing part of the procedure. This was my first chance to swallow since my surgery and I had no idea what to expect. It was beautiful!! Awful toxic tasting liquid but beautiful man oh man it slid down so easy, way better than I had ever remembered. Short lived glory because I had a tumor the size of a grapefruit in my chest.

130 pm. Dr. Perretta arrived, had reviewed the X-rays and assured me that what the radiologist saw was the CO2 gas bubble they used to inflate something or other inside my abdomen to allow easier access for the surgery. This is a new technique for them and the radiologist had not seen it before. She said the swallowing looked fantastic and I could have some water and soup which arrived in seconds from somewhere. Released.

I was given some Tylenol, nausea meds and 15 days worth of Nexium.

230 pm. taxi to hotel, sleep, eat yoghurt, drink water, yoghurt, juice etc. pretty tired.

I experienced mild esophageal pain friday and saturday which was completely controlled with tylenol. No nausea ever. Today is sunday and the pain is basically gone and I feel very normal as you can tell by the length and spunk of this blog post.

Today is post op day 3 and even if there were no further improvement in pain and ease of swallowing ( which there will be as swelling and irritation subsides over the next many days) I would rate my POEM surgery a 100% SUCCESS. What a relief.

Food introduction timeline:

Surgery day. No food or water.

1st day post op. Yoghurt, soup and juice.

2nd day. Scrambled eggs, goat cheese, crepe with 3 cheeses, foie gras, fried potatoes, mushroom gravy, creme brûlée. Small bites chew a long time.

3rd day. Added firm cheese, lox, soft pretzel, liver pate, prosciutto and cookies.

My goal before we leave Alsace, France is Choucroute. Not charcuterie. Google it.

We are back at Joelle and Claude's

Happy

Breakfast. Surgery + 2 days

Scrambled eggs, goat cheese, two cups of coffee, two glasses of apples juice and yogurt. No puking, spitting, sweating or water bottles involved. Miracle!!

Hello

A quick note with more details later tomorrow.
Surgery went well according to both surgeons. Recovery is ok, feel like I have been punched in the chest by Mike Tyson but it gets a little better each hour. Only taking some non narcotic pain meds which seems to be doing the trick.

We are back at the hotel. Our friend Joelle has contacted us to let us know she has postponed her trip to the French Alps to work with her friend who owns an ambulance company. She has done this so we can stay at her place Sunday to Wednesday. She is such a sweet lady I can not even tell you.

Swallowing is easy again. Still missing a bit of spunk. DEFINITELY on the mend.

Dr. Swanstrom is coming to see us at the hotel tomorrow and Dr. Perretta has offered to show us the entire ircad facility on tuesday. Prof. Marescaux (ircad was his dream) came into to introduce himself before we left this morning. Really nice people.

Last Breakfast Alone?

Need someone to share this pot of coffee with. And to return this blog to Scott's hands.

Will walk to hospital now. Barium swallow at 9:00 to see if Scott's able to eat and drink.

Separated by a Mile

I'd say the distance from our hotel to the hospital is one mile. I've ridden a taxi for one leg, a car for two and walked five in slush and snow. Scott spent the day recovering from they muddiness of anesthesia. Lots of sleep. Lots of boredom.

He does a barium swallow in the morning at 9:00. If it shows he's swallowing well he'll be allowed to eat and drink. Most POEM patients go home the next day, so scott tells it. He won't have to trek the mile. Part of the deal is a taxi ride back.

I've Seen Scott

Memory a little slow from the anesthesia still. Asked me the same questions over and over. Wanted to sleep so I left. Meeting Joelle at 3:00. Will go back with her.

Dr.'s orders: sit up, no eating, no drinking all day. He's super thirsty, too.

Walking alone in the snow. Unbelievably beautiful!!

Out of Surgery

Dr. Swanstrom just called. Surgery went well. He said the esophageal sphincter was so tight he could hardly get the scope in. He said it looks like he was able to correct it so that he won't have reflux. Hooray. I think he used the words "poor guy" in regards to how tight it was. I'm so happy for "Lawrence" as Dr. Swanstrom called Scott. He's in the recovery room now. He said about an hour and a half there which is at about noon. I'll walk to the hospital at 11:30.

Kelly Alone

We caught a taxi this morning at six (actually it was sent for us) and we were met in the hospital lobby by Scott's surgeon from the US. I had to leave him right after he got to his room and I wasn't allowed to stay because he must share his room with another man. Privacy reasons were cited.

Too dark at 6:30 to walk alone so I went to the lobby and sat and read. At nearly 8:00 felt like I could walk. Just headed out in the right direction and ended up right at the hotel.

Last hurdle...breakfast. Not sure if it came with the room but thought it did. Called reception and asked. Yes. Thank goodness because I couldn't handle walking around to find some. Also, the breakfast was 22 Euros. That's $29.86 to you and me.

Achalasia is fantastic!! Stinky Cheese and the Richie Rich's

Our new very good friend Joelle decided to come with us to Strasbourg to show us around a little before I had to go to IRCAD for a consult with the anesthesiologist. She was raised in Strasbourg and we learned quite a bit from her in the short time we were together about the history and the traditional ways of Alsace, what a treat!

We were met in the lobby by Dr. Perretta. She escorted us to the connected hospital (which is affiliated with Strasbourg University) to meet with the anesthesiologist for a brief consultation. They did an EKG, drew some blood, asked basic medical and health questions, proclaimed me fit for surgery and sent us on our way.

Today my diet is liquid only!! and nothing at all after 7 pm. Liquid Hmm. So I emailed the wonderful Lisa L. back in Portland to see what Exactly the parameters were. Liquid includes such things as creamy soups Hmm?? That was last night around 9 pm (noon Oregon time). At that point Kelly typed out a note on her phone, translated it to french and wrote it down for Joelle to see so she did not make quite so much food in the morning that might not get eaten. Claude saw the note first and informed Joelle of the situation. A communication glitch led Joelle to believe I had already had surgery prior to arriving at her house so she thought something must be wrong and was concerned when we saw her this morning. Joelle had no less than three types of soup for me to choose from for breakfast. Blended rice and chocolate soup, blended tomato vegetable and the most delicious blended fish soup ever. Kelly is emailing with her right now and they are meeting for dinner tomorrow while I am in the hospital for the night, cute cute.

So, I asked Dr. Perretta what she would have for dinner if she were on the same dietary restrictions as myself. Dr. Perretta is a very well respected surgeon at IRCAD and knows Exactly what is allowed. "You should find a very large Chocolate Mousse". Dr.'s orders, back to the Chocolatier for dinner. You can not tell by the pictures below but the mousse was filled with vanilla creme brûlée (bar NONE the best meal I have EVER had!!). For dessert I had a dark chocolate caramel (gooey) topped with sea salt. Kelly had stinky cheese, salami and Joelle's bread, i would have loved that for a starter course.

Life is good and you don't know the half of it.

Let's just say we were waiting in the lobby of Cour du Corbeau for our taxi to IRCAD, a television film crew arrived and interviewed Kelly because our hotel has just been chosen today as the "Best hotel in ALL of France". We are in a Jr. Suite from which the first photo on their website slideshow was taken (looking down an exterior walkway). The normal rate for our room is posted in the lobby, $510 per night. Swank

If you have smelled ripe munster cheese (Joelle does not allow the stuff unwrapped in her house) you can appreciate the fact that our packs were filled with the stuff as we sheepishly made our way with the porter to our room in the best hotel in France. It smells very similar to Durian, the spiny large fruit the Thai's love that is so freakin' foul, shivers down my spine yuck. The munster tastes delicious however. Same same but different.

Taxi at 6:00 am to IRCAD for surgery after which I will get a list from Dr. Perretta and Dr. Swanstrom of what they would eat for the next week if they were me. Dr.'s orders!!


The iphone app does not let me post links or move photos.

The photos below are:

1) hotel courtyard
2) dinner
3) walking in Petite France, Strasbourg
4) Kelly and Joelle taken from her garden
5) our room with the bay window
6) strasbourg cathedral
7) ircad
8) dr. Perretta
9) the classic french way. A bowl of coffee
10) fish soup

Le temps des choses B&B

Well we made it! 26 hours of traveling 1.5 hours of economy section airplane sleep, which is the same type of sleep the good guys get after they are stuffed into the trunk of a sedan by the Mob prior to getting a pair of concrete boots.

Rented a itsy bitsy thing of a Renault which zips around just fine. We were directed to the Autobahn at which point we were introduced to an entirely new level of engine noise which sounds more like a high speed drill than a car. Somehow we drove right to our B&B, passed it, turned around, passed it again, one more time, saw it, passed it again, pulled over to let the people who didn't realize they left the Autobahn 10 miles ago go around us and finally found a spot to park. Looked up to see the main cathedral in town 18 feet in front of the car. There were no smiling duos of young men dressed in black approaching us and I realized we had escaped Utah and finally made it to France!!!

Joelle (like noel but with a sh sound at the beginning) welcomed us like old friends into her home. Joelle is the most fantastic hostess you could imagine, her house is 400 years old this year, built in the classic style of Alsace which is the name of this region of France. Timber framed mortise and tenon is the style with some sort of cement mixture filling the voids in between the timbers. Joelle says they chose this style long ago so the wooden dowels could be driven out, the timbers taken apart and the entire house moved to another location. It is BEAUTIFUL inside. Joelle and Claude remodeled it 12 years ago and she has been renting out a couple rooms and making wonderful breakfasts for the last 10 years. She bakes all the bread, all the sweets, made the 3 types of jam on the table, made the rice pudding, made the applesauce served it all on 100 year old dishes from Alsace and placed the entire show on a 200 year old dining table. All the while talking, laughing and goofing around in a crazy American accent that sounds like Morgan Freeman with a mouth full of socks. Joelle is great.

We visited several old towns today and realized Sunday and Monday are the days of the week many shops and restaurants are closed so we walked around Obernai for a couple of hours being medical tourists and thoroughly enjoying ourselves. We found a chocolatier, I had some espresso and an eclair, a very very good eclair. Spent the next half hour trying to keep my hands from shaking while I took 45 pictures of the same door knob. Too much chocolatier. I need some charcuterie. Closed on Monday. We did find a place to eat and Kelly devoured some steak and fries while I choked down a puff pastry filled with chicken and mushrooms in a cream sauce, yummy.

Now we are home. Snacking on Joelle's sweet treats, painting, writing, laying around.