Early Spring Edition

In the big picture, things are definitely better.  There's no comparison in Liam's condition now against several weeks ago.  Now she's almost back to her old self.  She's getting her appetite back, her spirit is good, she jokes, she enjoys the company of people (as oppose to almost everything reversed just a few weeks ago).  There's no question in our mind that dialysis brought the big improvement. This is all good and we couldn't be happier. We got our Liami back!!!  

Unfortunately, within the big picture there are the smaller pictures. 
1.  She's still a very sick and vulnerable girl.  Anything could happen at any time.
2.  While dialysis works well (so far) as a whole, the individual sessions bring tough side effects on her: nausea, pain.  She always come back not feeling well.  That is the situation so far.  Hopefully things will improve in the future.  (But again, just to put things in perspective, it's better to not feel well 3 times a week than not feel well ALL THE TIME.)
3.  We're watching her digestion closely.  Not much to add here as we're still in the assessment period.  But we know from the past about her poor motility.  Will that change now that the rest of her is a bit better?  I guess time will tell.


The Laundry Basket Guide to Jewish Holidays
(I'm apologizing in advance for (a) the lame humor, and (b) the poor translation.  I wrote this segment originally in Hebrew.  In Hebrew it's almost funny (to my taste, at least).  I'm not sure I was able to translate everything in a meaningful and-maybe-funny-too way.  Oh well, learn Hebrew, you gentiles.)

Passover came surprisingly early this year (as you might know by now, I'm not a fan of this holiday.  I think we would have ended up better staying in Egypt.  For one, we would have been Africa's champions by now (football, eh, soccer);  Rachel and I remember well the excellent falafel we had on the street in Cairo - full of desert send, dust, and pollution from the unbelievable traffic; plus, Rachel already has some good connection with a no-name pita bakery in downtown Cairo).  Suddenly, just a day or two before it came, I heard that it's passover (it's strange how they move such an important holiday without prior notice).  Anyhow, on Monday Liam had dialysis so it was uncertain in what condition she'd made it back - see above.  We-I-mean-Rachel-who-even-cares-about-my-opinion decided to push it to Tuesday.  But on Tuesday there's the European Champions League (football, eh soccer).  Yooo-hoo, Rachel....you didn't check the sports calendars (because I'm absolutely sure that she checks the golf tournaments....it's only UEFA matches she's not use to - yet). 

And then, as if this is Hanukkah (if I ever learn how to spell it) and not Passover, a true miracle happened:  I heard, I mean, I'm pretty sure I heard, an "OK" (which means one of two:  either she doesn't care for me any more (DOH!!!) or I was folding laundry so superb in the past several months.  Really, there can be no other explanation).  Spontaneously, a chant came out of my throat...the same song Jews everywhere sing in Passover to celebrate the told freedom - now we're free, now we're free. 

I promised myself I'll have only one glass of wine - instead of the traditional 4 (but ended up drinking 5 - I'm soooo happy to be free).  From the bitter herb we had plenty of in the past several month - we don't need another bite.  The whole thing lasted less than an hour.  And so well fed and "hydrated" I left for the game (in which Manchester United lost).  Can there be a better way to celebrate this holiday?  (On a serious note, I never liked this holiday anyway.  Since childhood I'm trying hard to avoid it.  Only when we started celebrating it in our house it became fun.  But that is a different story.)

Walking the thin, tight rope

On Friday Liam had her second dialysis out of the house.  Rachel left her in the hospital with Savta (grandmama) and ran some errands.  As soon as I stepped into the house the phone rang:  "Liam doesn't feel good in dialysis....they're not sure what to do....maybe she needs her shunt to be x rayed.....etc."  So what do you do at a time like this:  Do you go to the ER, which means staying there for several hours until the scan/check/diagnose?  Or, do you go home, risking who-knows-what and a possible trip to the ER anyway at night?  It's a tight rope to walk on. 
After a few back-and-forth we decided that they return home.  Sure enough, the next two-three hours were hell.  She screamed out of pain.  We weren't sure what to do.  Then, suddenly and completely unexpectedly, she fell into a deep, deep sleep.  Go figure.  We didn't ask too many question, though.  Just fell asleep as soon as we could.

And this, in a nutshell, is our current life.  Swinging sharply between good periods and bad ones.


The Laundry Basket Guide to Feeling Stuffed
This week was the first time in many, many months that we lived at home like a "normal" family.  It's difficult to call it "normal" life with everything that goes on around, but occasionally the simplest things turns out to be life's greatest pleasures:  to eat a hot meal at home as a family (even though Liam doesn't eat yet), hearing the girls breathe at night as they sleep, coming home from work (instead of driving to the hospital). 
And everything feels full, stuffed, whole:  the house is full of hospital "stuff", that didn't make it yet to its designated destination;  it's full of family, of course; and visitors and friends; and my plate, which fills up (twice...) with home made food (home made food, hard to believe!!!), and following it the belly that fills up too much (but is so happy that everything else around is full that it fills just like that, without paying much attention); the dish washer, the trash and of course - I know, you couldn't wait - the laundry basket, which can't find a way to empty itself.  Ahhhh, home sweet home.

Home Again

To those who don't know it yet, Liam is back home.  She returned on Tuesday, 3-23-2010.  So far so good.  She's pretty stable.  In good spirit most of the time.  Asks for food and takes small bites.  She's tired and ooowie occasionally, but overall it looks good.

Three times a week she will go to Egleston for dialysis.  Her first visit (our of the house) was yesterday.  In previous visits (from the hospital) she almost always came out exhausted and nauseated.  But yesterday she came out pretty well and survived the ride home.

Work
While at the hospital, Rachel didn't "have to" do any job except for being mom (in reality, she always helped the nurses and even did the work for them).  At home, however, she's extremely busy.  Beside being mom, she's also the head nurse, often the Dr, and of course, my wife (hey Rache, one beer and a snack, please...sports is starting soon...hey Rache, I'm hungry....)  We do get the help of  professional nurses several times a week, but they are all still learning everything so Rachel is a teacher too.

The compact guide to being a couple
Yesterday, for the first time in I-don't-know-how-many-years, Rachel and I spent time together without kids....for 20 minutes - while we drove to the airport to pick Meitav up.  20 minutes....oh, how I LOVE I-85 south.....

The Laundry Basket Guide to Spirituality
The most efficient way to wash the sheets is to remove them from the bed, wash, dry, and put them right back on.  Within one hour I have the bed re-made with the same sheets all cleaned.  This work, on paper, includes wash, dry, ironing, folding, and making the bed.  Five for the price of one (wait, that didn't sound right...oh well, you know what I mean...).  That's the credit I'm receiving, which is all that matter.
But wait, there's more:  since I'm so efficient, that leaves me all this time to pray that all the unidentified items at the bottom of the basket - the unmatched socks, not-my-bras, etc. - will soon disappear.  But apparently something ain't right.  I'm either not praying correctly or I'm addressing the wrong gods.  Because the lonely socks are still there.  The entire world prays for their gods and they sure that they're being heard.  Me, nada.  Strange.....

But today belongs to Meitav

Today our blog will not mention Liam, but rather Meitav.  After several months of hard work she had her spring performance today.  Jazz, modern (dance), and ballet.  As I'm looking at her very professional performance on the stage, I'm thinking to myself:
Is this really the girl I see off to school and off to bed every day, the one I help with homework (less and less, I must admit), the one I mentor and stand behind?  It's hard to believe.  She looks so independent and mature up there.  (My only suggestion for the performance organizers is to have the girls' names on the back of their customs, so we'd know who's who.  Like in professional sports, you know.) 

The Laundry Basket Guide to Modern Dance
And as we sitting there watching Meitav, Rachel leans over and whispers in my ear:  "psst, your T-shirt stinks."  Another lost battle.

The Laundry Basket Guide to Desired Gardening
On a "normal" basis (a term I'm not sure what it means to our family), I don't do laundry.  I just fold it - and only during eligible sporting seasons - football, baseball, golf (some), soccer (NONE!).  But now that I'm sort of a single parent, I'm forced to do a few loads of wash  every week.  The problem is that what do I know about all these special cloths?  As far as I'm concerned, there's only one cycle (Normal) and all the cloths go from the washer to the dryer.  End of story. When Rachel, in a rare visit at home, discovered some ruined cloths - the result of my ignorance - my line of defense is always the same:  There's no war without its casualties.  Which, coincidentally or not, is the very same line I mumble out after pulling out an exotic plant during my once-a-year weeding (must be in a time there's nothing good on TV).  All I'm doing is building un-trust.  And that, in a nutshell, is my retirement plan:  I'm waiting for "them" to tell me:  Please don't load the washer-dryer no more and don't weed the garden.  That would be the rubber stamp that would officially send me to the couch.

Hold the champagne on ice, still

(But keep drinking your beer...)

Maybe all the celebration of Liam's miraculous recovery was a bit premature.  The fact of the matter is that she's still very sick and very fragile.  Us giving her solid food may not have been the smartest thing to do.  Last night was another difficult night for us.  Today, though, she had a "fair" day.  Not as bad as last night, not as great as the previous two days.  So why all the back-and-forth swings?  Hard to tell.  What I can say is that there are too many variables.  The type of medication and the way they are being delivered to her is under constant changes.  Maybe they changed things too early (??).  We mentioned many time before that Liam is a special case.  The Drs can't open a book and know what to do.  It's all sort of trial and error - again and again and again.


At the same time and with all the difficulties of the last 24 hours, there's no question that her condition improved.  Even when she's under pain-discomfort, Liam still talks more clearly and at times when she's relieved from whatever-it-is, she's in good spirit.  We're looking forward with hope to the next few days.

Volcanic Eruption

Suddenly....
Much like the sudden eruption of spring in Atlanta, Liam had amazing last two days.  It started yesterday, when Rachel cried three times:

1.  When Liam asked for water.  We thought to give it to her very gradually - suck it from a sponge.  But NO, she demanded water.  So it was given to her from a cup with a straw.  And she gulped.  Now this is something Liam used to do on a regular basis until several months ago when this whole ordeal started.  But since then, not a drop of liquid or any food came into her mouth.  So Rachel cried.  Then the Missy asked for yogurt.  Amazing.

2.  She picked up a little toy that somebody brought over - a small revolving-lights flashlight.  And started playing with it.  Again, something she hasn't done in months and months.

3.  Hospital staff - Drs, nurses, others - were amazed to see Liam driving her wheelchair in the hallway all on her own.  Most of them don't know that this is what Liam used to do on a regular basis.  The only Liam they know is the one laying in bed with her eyes closed, the one that screams out of pain, the one that is helpless.

Later last night she asked for chicken.  CHICKEN????  Are you out of your mind?  The GI Drs' recommendation was for Liam to return very gradually to food - first with liquid food through her feeding tubes.  Only later soft food through the mouth - maybe.  But NOOOO, she wants Chick-Fil-A and she wants it now.

So how is this sudden improvement explained?  Are the prayers really work?  I guess there's always 50% chance that they do.  But since I personally don't pray (except when it's 11 seconds to go and the Falcons need a touchdown), I'm crediting the dialysis.  Ok, you don't need to be a human gnome scientist to figure that one out.  So the question is then, if this such an easy answer, how come they waited such a long time before starting dialysis?

It's easy NOW, in hindsight.  But for all those months Liam was not "sick enough" (whatever that means) to get dialysis - per the Drs.  And we trusted them, `cause what do we know about life beyond laundry basket wisdom?
Secondly, despite the great news, Liam is not out of the woods yet.  It's not like she's jumping up and down.  She's still very sick and is hooked to many hoses and such.  She still doesn't feel good more than she does, 
Additionally, her blood is under the microscope - literally.  They discovered two things, which might be linked:
1.  Aluminum traces in her blood.  Probably from a medication she received.
2.  She produces enough red blood cells, but they disappear somewhere.

Nevertheless, these are the first good news in months so we are thrilled - to say the least.


And now it's a beautiful Friday afternoon, but instead of drinking beer on my porch, I'm here with my little vomiting buddy.  Rachel got the night off.  Well deserved and needed, but also a strategic move.  You see, she doesn't know yet that Arsenal FC plays Barcelona on Passover night.  I've gotta soften the blow somehow. 

Meanwhile Liam isn't sleeping.  Beside the nausea from the dialysis, her days and nights are reversed.

The Laundry Basket Guide to Cryptography
Back in the kibbutz everybody's cloths were tagged with numbers.  Moishe is 56, Sarah is 33, etc.  Every Saturday you through your dirty cloths into the appropriate bin in the central laundry facility.  Every following Friday you picked them up from the shelves with your number on it in the main distribution facility. 
My cloths are no longer marked with a number, but the old number is still with me,  And every time I need to enter a password somewhere, I encrypt it with my old laundry number.  So now the hackers among you know how to break my code.  All you need is to get my old laundry number.  This is easy.  Somewhere in Atlanta there's a homeless wearing my old shirt - the one I lost in the battle for my financial freedom, remember?  Now go get it.


But  now I jinxed it all once again since Liam's having a shitty night. 

Ahhhhh, sweet, sweet sleep

Two days ago the Drs changed strategy with regard to the type of medication Liam gets and the way these meds are being administered.  Rather than inject a few meds directly, they are now dripping them into her through the IV.  This seems to be working well.  Liam is no longer in severe and continuous pain.  She sleeps a lot - which is good.  while the drips are not a long term solution, it allows for her body to hill from [speculated] internal wounds.
So next to her bed is a medication skyscraper (that a few geeks, who think they know better, insist on calling an IV pole).

Other positive signs:
Dialysis seems to be working well.
Blood pressure is good.
She's peeing on her own (so they don't need to cathe her that often).
She's a lot more interactive and aware of her surrounding.

One not so great item - and an important one:
Liam is producing red blood cells, but mysteriously losing them.  They're trying to figure this out.

Another difficult night

Pain journal

Saturday 1-2 pm:Liam is retching non-stop.  Medication helps for 1 hour; then  it's all back and she can't get the med until 5-6 hours later.

3-ish:  we take Liam downstairs in hope to distract her a bit, change atmosphere.  It's too windy outside and Liam asks to go back to her bed.  Rachel leaves. Of course, the minute I open a double-door with my back, pushing the medication tower in one hand and driving her wheelchair with the other - all while Liam is retching - exactly at that very moment, they called me from work (I'm on call this week).  Somehow with the help of the nurse I put Liam back in bed and somehow she allowed me to go on the computer for 10 minutes to take care of the incident at work (false alarm, BTW).

4-ish:  Liam finally fell asleep for about 2 hours.  Retching stopped.  Then nurses came in to do stuff and she woke up.  The retching resumed.

8-or-9-or-sometime-then:  They started blood transfusion (which was in the plans all day), since her red blood cells count is too low. 
Mysteriously, the retching stopped.....but instead, she now complains about pain.

10-ish and into the night:  more and more pain....no medication helps.

1-2-3 Sunday AM:  Liam screams out of pain.  We give her any and all medication available and permitted.  Nada.

NO, NO, NO.....
That's what she screams.
IT HURTS....MOMMY....NO, NO, NO

My eyelids are heavy, my nerves are recked, my heart is achen (for her), and I'm frustrated.  But what is my suffering compares to hers?  Got to move forward.  Easier said then done, but what other choice do we have?

3-which-is-now-4-somebody-moved-the-clock-forward:  They give her Morphine.  Still nada.
4:40 AM:  Liam finally relaxes - at least momentarily.  As if there's a devil sitting and watching us, at that very moment they called from work again.  Can you believe it?  Lucky for me by the time I got on the bridge call they got it resolved.

5 AM:  Liam is quite, but we decide to cath her now so that maybe she'd fall asleep and nobody would mess with her for several hours.  The gamble works.....for 20 minutes.  Then it all comes back.

5-6:  more screaming out of pain, more unhelpful meds.

6: A resident comes in to ask questions she already knows the answers to and give comments I already know.  But somehow, her touch calms Liam for just a few minutes.  A feminine touch, a Mommy touch - that's what she needs.  And horse-size medicine too, maybe.

Sometimes later they gave her Benadryl.  It calmed her down for an hour, that's all.

My initial purpose in this writing was to describe a routine night in the hospital.  Little did I know what a hellish night I was to face.  While this night was extreme (with the degree of how uncomfortable Liam was), Rachel spends many such nights - maybe just ab tad easier - in the hospital during the week.

To whoever is looking for a happy ending to this post - there's none.  Between 8-9:30 Sunday AM Liam was quite for a bit.  But now it's all back.  I'm intentionally posting now and not waiting for the conclusion (if there will be any) for the authenticity.

Our favorite Dr is on his way here for consultation on his day off.  The situation is not good.  A new strategy was discussed.  To be continued....maybe.

Fifteen

Sweet & Sour
So far Liam had two dialysis sessions.  They are still ramping it up gradually. 
Sweet: Some of the "bad" numbers are coming down - quite substentially.  In her 2nd session, they removed more than 1 Liter of "extra fluids".  That is 1 L that should have gone down through to the urine and out.  But since the kidneys don't do their job, fluids are accumulating.  Indeed, before dialysis started, she was very puffed up.  Now the puffiness has subsided.
Sour:  She vomits and gag a lot.  More than before dialysis started.  Her blood pressure is still too high.

Fifteen
And there she was.  Tiny tiny.  Straight black hair.  Rachel didn't see her at first, only I did.  Three hours later, the Dr came into the room and said that something might not be right with her.  That was fifteen years ago - today.  (Three days later she was rushed to the NICU in Egleston hospital, and the rest is history - but you can scroll back to the beginning of this blog to read a brief summary of Liam's life.) 

So today a few friends, family members, and medical staff folks all gathered to celebrate Liam's 15th birthday.  Liam slept through most of it, which is good since she badly needs the rest.  Thanks, everybody who came, thanks, everybody who brought gifts, and thanks for the rest of you well-wishers. (and THANK YOU whoever brought those killer cupcakes....it took me two weeks of hard labor to get rid of 2 ounces of fat....now it's all back, and then some....yeah, THANKS A LOT...alright, back to the treadmill...)

From right to left:  Meitav, Rachel, Rudra (Rachel's boyfriend and the son that I never had, and still doesn't...you'll find him in every photo), Chuck (Rachel's original boyfriend and the neighbor that ran away from us to a snobby neighborhood), Dr. Cooley (the coolest Dr, by far), Sage (one of our favorite nurses - but they all are), Savta (grandma).

It's good to be king (a rare moment with her eyes open)

Zebras, etc.

A bit of as belated update.

Since the weekend Liam is not in good shape.  She's in discomfort/pain/nausea/who-knows.  She complains a lot, not sleeping enough - under stress, in short.

Yesterday, Monday, 3/8/10, Liam had yet another surgery, in which they installed a port for dialysis, plus corrected something with the shunt from the last-week surgery.  It was quite upsetting to hear that Liam needs this port.  Well, we sort of knew that it was coming soon, but when Rachel asked the Drs to install it in last week's surgery, they said it's not time yet.  Only 2.5 days past since when they said "now".  ARRRRRRGGGG!!!!   You see, a surgery is a trauma to the body, no matter how minor it might be.  For a sick body like Liam's it's exponential.  Anaesthesia is really hard on her, not to mention the new scars etc.  So the fact that the nephrologists didn't get their act together on the expense of Liam's well being, is more than just annoying.  But oh well, it's behind us now.

Today Liam had her first dialysis.  More to come, of course.  3 times a week from now on.

At the Safari
On Sunday, after a 3-hours sleep at night and combined with the fact I was a bit under the weather, I was completely exhausted.  But I could not ignore the first signs of spring.  So I hopped on my bike and strolled to Piedmont Park.  The entire city was there, mind you.  People of all colors and all sexes and all sex orientations (you know, when Rachel and I are at the park together, she's eying the gay men, while they're staring at me....but that's just a side note...), kids, dogs, families.

I strolled on the main path, looking in amazement at the people grazing on the lawn.  Playing ball, lounging, picninc'ing, etc.  Doing what normal people should do on a sunny Sunday afternoon.  The people, just like zebras and water buffalo in the safari, raised their heads, looked at me with my strange bike, and returned to their activities.  This was UNBELIEVABLE!!  Who knew that there's such a world out there and that life goes on as usual in the world while we're buried in the hospital?

I thought about the route I was to take on my way home and didn't feel like leaving the park.  It was soooo good there, to be among "normal" people.  One thing was very noticeable:  they all either smiled or just looked very calm.  There were no signs of stress, there were no sounds of heart rate and blood pressure monitors.a

Two important guides you don't want to miss

Friday evening.  Liam is finally asleep - temporarily at least - after two miserable days-and-nights.  Rachel's getting a much deserved and badly needed night at home.  Since her surgery on Wednesday, Liam is not well.  Many of the old numbers, which previously stabilized (kidneys, blood pressure, etc.) are high again.  In addition, she has a mysterious wound on her left thigh.  At first they thought it's a bed sore, but it doesn't look or acts as such.  It bothers Liam a lot.  And let's not forget:  this "minor" procedure was a brain surgery, none less.  So she has plenty on her plate.  And things are not well.

In addition, some of the medications are not as effective as they were earlier, which adds to her discomfort.  I'm aware that I reported about her high spirit earlier this week.  Unfortunately this is another perfect example of this crazy roller coaster we're riding the past several months.  It keeps rolling and rolling and rolling.

I need to finish this post soon so I can catch some sleep.  There's no telling when Liam will wake up in pain again.

The Laundry Basket Guide to Financial Freedom
Like most men, I too have several old T-shirts that I love dearly and wouldn't let go of.  My explanation, naturally, is a practical one:  "but why get rid of it?  it's only 15 years old...I could easily get 15 more out of it....it's just a waste of money to throw it away."  But with Rachel it's not that easy.  The shirt is just coming out of the dryer, looks and smells clean, when I hear the yelling from the other side of the house (where she can't even see me):  "get rid of this shirt...it's too old...it smells bad even after the wash".  All based on her sense of smell alone (she knows what I had for lunch when I'm pulling into the street).  I sniff but I don't smell a thing - only the good scent of the detergent.  "Throw it over there, on the floor....I will donate it". 
And just like that 15 years of love and bond are coming to an end.  No ceremony, no funeral.  And now I have to pull money out of my 401K to finance a future shirt for the homeless.  Which brings us to....

The Laundry Basket Guide to Social Justice
But Rachel, why would some homeless gets to wear it?  First of all, why let him suffer the smell (what smell, Rachel? Really.  I still can't smell it)?  What did he do wrong to deserve it?  Secondly, I'm sentimental about this shirt.  This is the shirt I was wearing when I buried our old cat (oh, so it's not the money...it's an emotional issue....but SSHHHHH, quite please).  But the educated reader knows already that social justice is something only the naive ones believe in.  In other words, this is a lost  battle.  The shirt is gone.

Plumbing 102

Yesterday, Tuesday, was a good day for Liam.  She joked and talked almost like the good, old Liam.  She's still in pain in between medication, still complaining, but for a while she surprised everybody and was her old self - talking about food, restaurants, etc.  We find it quite amazing that after all she's been through, her spirit is so high the minute she gets a break from the pain.

"Asher", that's what she calls me when she wants to laugh at me.  Not Abba, Asher.  She knows I will "get angry", and that's exactly what she's after.  So when I got to the hospital yesterday and sat down, all of the sudden I hear a soft 'a-s-h-e-r', and a shadow of a smile extends from the corners of her mouth to signal just that - that she's kidding me.  THIS IS SOMETHING SHE HASN'T DONE IN SEVERAL MONTHS!!!

Then I lowered my head to her bed.  Back when Liam was healthy, she loved hitting my bald head.  Her hand went up and....tap, tap,tap....ever so slightly, but hit me she did.  And there's no greater gift in the whole world!!!

Last night, though, was miserable.  Liam was in pain and restless all night long.  No medication was able to relieve her from her discomfort.  Neither she nor Rachel got any sleep.

Wednesday, 3/3
Today Liam had a surgery to internalize the shunts.  They pulled the right side shunt altogether for it wasn't draining anything.  The left one they inserted into a vein, rather than dumping it in the belly.  The surgery went well.  Back from the OR Liam was resting now comfortably the entire afternoon.  In the evening she woke up in severe pain again:  from the surgery itself (I don't know how many surgery scars she has on her head by now...many), and from new IV needles stuck in her arm.  Hoping for a good night.

Stabilization?

Liam is more stable now - and we hope that with this line we don't jinx everything again.  The truth is that she lives in between medication doses.  We became a bit more observant.  Rather than wait for a certain medication to lose affect and for Liam to be in pain again, we noticed that the pulse and respiratory rates on the monitor are on the rise just before she's OOWWWie again.  So we keep one eye on the monitor and ask the nurse for medication accordingly.  So far it works well.  We'll see.

When she's not drugged out, Liam is more of her old self:  speaks, jokes, focused.  Even her hand is moving under full control of her brain again (which is good news/bad news:  she's pulling on the many wires and hoses that hook to her body everywhere).

The Mobile Laundry Basket
I never had any motivation problems when it comes to exercise.  If I'm healthy and has the time, I'm out and about.  But I always insisted exercising in my own certain conditions:  outdoors, leaving from the house and returning there, for free.  That was never a problem - until Liam checked into the hospital.  Suddenly I didn't have any time left. 
But I noticed that I do have the time when I'm at work - at lunch time.  However, I hated exercising away from the house or indoors.  I hated having to change in a public locker room and to shower there.  I hated the need to take cloths in a bag and to return the sweaty ones home.  So for a while I didn't exercise. 
Until I realized I was being a baby.  And I realized how lucky I am that the office provides for several FREE exercise facilities (fitness room, basketball court, racket ball).  So I made the little switch in my head and now I'm schlepping clean cloths to work and sweaty laundry back home every day - and I'm happy.  A little switch - that's all that it took to free me from myself.  Now I'm exercising indoors on all those devices I always hated - and I'm a happy camper.  I still prefer to ride my bike on the bike path, but now I feel free with all these new options.