In the section entitled, "Know Your Illness," I spoke about Avascular Necrosis and how it affects the back and hips. Quoting myself I stated, "Though I do have some deterioration in my hip joints, it currently hasn't interfered with my life at all." I wrote that some time ago, and things have changed.
Over a year ago, I began having significant pain in my right hip. An x-ray was taken and my hips appeared as they did in my last hip x-ray taken two years prior. Over the past many months, pain in both hips have significantly increased and my ability to move around has been severely diminished.
About two weeks ago I saw an orthopedic surgeon about my hip pain. Looking at my newest x-ray, it became very clear that the condition of the bones in my hip is...not what it once was. The ball part of my hip (the femoral head), on both sides, have totally collapsed. Those two parts of my bones are basically dead and at some point, collapsed upon themselves.
The doctor told me I have two options. Option #1) Live with the pain, which will eventually get worse, and wind up in a wheelchair; or option #2) have a double hip replacement surgery. It wasn't the news I wanted to hear, but it was the news I expected to hear. The joys of Avascular Necrosis.
Clearly, my only option is to have the surgeries. They will of course do one hip at a time, about six months apart. With as much pain as I'm in, I'd like to do it as soon as possible and get half of it over with. Unfortunately, to reduce the chance of infection from the surgery, I have to wait until the wounds on my feet heal. I'm hoping, with the mist therapy I'm receiving, that will happen in the next couple months. In the mean time, I need to get my heart, kidney, and Sickle Cell doctors to all okay me for the surgery.
I have always tried to see the positive in things. I know many Sickle Cell patients need hip replacement surgeries when in their twenties. My doctor told about a patient of his who is seven years old and already needs a replacement surgery. However, because the patient is still growing, they can't do the surgery until he/she has finished growing. So what they'll do is remove portions of the hip bone; this will cause new blood vessels to form inside that area, and will help to regenerate the bone until the patient is done growing.
I'm soon to be forty years old. I count myself blessed that I've gone as long as I have without having the hip problems I currently am. Things could always be worse.
Thursday, February 7, 2013
Tuesday, February 5, 2013
Ultrasonic Mist Therapy & Sickle Cell Foot Ulcers
Having a set of wounds for nearly a year that refuse to heal is quite frustrating. However, I've read that some Sickle Cell patients struggle with these wounds for many many years. Though my frustration level is pretty high, I do count myself blessed that I haven't struggled with these wounds for a longer period of time.
For the past six months or more, the two wounds I have on my ankle have literally gone nowhere very fast. There has been no improvement on them. Thankfully, however, they haven't gotten any worse; so that is something.
About two months ago my wound care doctor prescribed "Ultrasonic Mist Therapy." From what I've learned, this is a method of treatment in wound care that is only a few years old, but seems to be very beneficial for most patients. So what is Ultrasonic Mist Therapy?
Three times a week I went to hospital to receive the treatment. The nurse used a handheld device that kind of resembled a wand. Atop of the device was a bottle of saline solution. The nurse held the "wand" directly above the wound. The wand sprayed a steady mist of the saline solution while also shooting out ultrasound waves.
The treatment itself is painless and takes only a few minutes, depending on the size of the wounds. For me, the combined time of treatment for my two wounds was seven minutes. The combination of the saline solution and ultrasounds help to promote blood flow. Since a lack of proper blood flow to the feet and lower legs is the main cause of ulcers, obviously increased blood flow is highly desired.
I received the treatment three times a week for two months. After about two weeks of treatment, I really began to notice: 1) a HUGE reduction in the amount of pain I felt from the wounds; 2) the wounds were no longer deep enough to put a time or a nickle in; 3) the amount of slough on the ulcers was drastically reduced; 4) the wounds began to show slight signs of closing; and 5) "granulation" was greatly increased. "Granulation" is where flecks of fresh skin appear through the slough.
After a month of treatment, my doctor was very excited to see the vast improvement my wounds had made. With another month of treatment under my belt, I saw more improvement and signs toward total healing. Though I think it may take another month or two of treatments before my ulcers are completely healed, I'm encouraged to see them moving in a positive direction rather than staying unchanged.
For anybody who has leg or foot ulcer that won't heal, I highly recommend Ultrasonic Mist Therapy.
For the past six months or more, the two wounds I have on my ankle have literally gone nowhere very fast. There has been no improvement on them. Thankfully, however, they haven't gotten any worse; so that is something.
About two months ago my wound care doctor prescribed "Ultrasonic Mist Therapy." From what I've learned, this is a method of treatment in wound care that is only a few years old, but seems to be very beneficial for most patients. So what is Ultrasonic Mist Therapy?
Three times a week I went to hospital to receive the treatment. The nurse used a handheld device that kind of resembled a wand. Atop of the device was a bottle of saline solution. The nurse held the "wand" directly above the wound. The wand sprayed a steady mist of the saline solution while also shooting out ultrasound waves.
The treatment itself is painless and takes only a few minutes, depending on the size of the wounds. For me, the combined time of treatment for my two wounds was seven minutes. The combination of the saline solution and ultrasounds help to promote blood flow. Since a lack of proper blood flow to the feet and lower legs is the main cause of ulcers, obviously increased blood flow is highly desired.
I received the treatment three times a week for two months. After about two weeks of treatment, I really began to notice: 1) a HUGE reduction in the amount of pain I felt from the wounds; 2) the wounds were no longer deep enough to put a time or a nickle in; 3) the amount of slough on the ulcers was drastically reduced; 4) the wounds began to show slight signs of closing; and 5) "granulation" was greatly increased. "Granulation" is where flecks of fresh skin appear through the slough.
After a month of treatment, my doctor was very excited to see the vast improvement my wounds had made. With another month of treatment under my belt, I saw more improvement and signs toward total healing. Though I think it may take another month or two of treatments before my ulcers are completely healed, I'm encouraged to see them moving in a positive direction rather than staying unchanged.
For anybody who has leg or foot ulcer that won't heal, I highly recommend Ultrasonic Mist Therapy.
Aloe Vera on Sickle Cell Foot Ulcers
Another natural remedy comes from the Aloe Vera cactus plant. There are numerous species of Aloe plants, but it's the Aloe Vera plant that is best known for its medicinal properties. The gel from an Aloe plant can be taken internally and used externally. But the main purpose I'm focusing on here is its healing effects on wounds, burns, and damaged skin.
Growing up, my household always kept an Aloe Vera plant in the house. Whenever I got a scrape or skin injury, I'd apply it to the wound and it would help it heal quicker and with less scaring.
Recently I've tried using fresh Aloe Vera from a plant on my foot ulcers. As I mentioned before, there have been two especially stubborn wounds, and a third that finally healed. Until recently, the amount slough that existed on these wounds prevented the Aloe from reaching the actually damaged skin. However, on this third wound, the slough finally diminished enough that I could start applying Aloe to the ulcer. I was amazed at how quickly this particular wound healed once I started using the Aloe on it.
As of date, I still have two wounds that are taking their time to heal. Thanks to "Ultrasonic Mist Therapy," the slough on these two wounds is diminishing enough to allow me to use Aloe Vera on them. I'm hoping that by using the Aloe, I will see the same improvement on these ulcers as I did on the that recently healed.
If you struggle with ulcers, I would suggest you try using fresh Aloe vera from a plant, if possible. It certainly can't hurt, and it is a pain free method of treatment.
Growing up, my household always kept an Aloe Vera plant in the house. Whenever I got a scrape or skin injury, I'd apply it to the wound and it would help it heal quicker and with less scaring.
Recently I've tried using fresh Aloe Vera from a plant on my foot ulcers. As I mentioned before, there have been two especially stubborn wounds, and a third that finally healed. Until recently, the amount slough that existed on these wounds prevented the Aloe from reaching the actually damaged skin. However, on this third wound, the slough finally diminished enough that I could start applying Aloe to the ulcer. I was amazed at how quickly this particular wound healed once I started using the Aloe on it.
As of date, I still have two wounds that are taking their time to heal. Thanks to "Ultrasonic Mist Therapy," the slough on these two wounds is diminishing enough to allow me to use Aloe Vera on them. I'm hoping that by using the Aloe, I will see the same improvement on these ulcers as I did on the that recently healed.
If you struggle with ulcers, I would suggest you try using fresh Aloe vera from a plant, if possible. It certainly can't hurt, and it is a pain free method of treatment.
Honey and Sickle Cell Foot Ulcers
Sometimes, the best remedy can be found in nature. Many people have found organic honey to be highly beneficial in the treatment of leg/foot ulcers, infections, and a list of other ailments. While many medical professions are open to the benefits of honey, others are not. So far, my doctors have been.
“RAW HONEY”
This kind of honey has not been heat treated or pasteurized like much of the honey that's sold at most grocery stores. As a result, many of the healing properties found in raw honey, aren't cooked out of it.
ABOUT “MANUKA” or “ACTIVE LEPTOSPERMUM” HONEY
The pollen in the Manuka flower (or Leptospermum scoparium) is what bees in New Zealand use to make their honey. "Manuka Honey” has different enzymes and antibacterial properties that honey cultivated from other regions of the world don't have, making it more effective in healing wounds.
As a way of informing consumers about the quality of the Manuka Honey they are purchasing, two different rating systems are used; the UMF or MGO system. The following web page has good information about the difference between the two systems: http://www.aliveplushoney.com/amh-umf-and-mgo-rating-explained.php. Simply put, “both systems seek to measure the antibacterial strength of Manuka Honey.” When buying Manuka Honey, the higher the rating the better. In either the MGO or UMF system, a rating of +10 or more is most desirable; from what I can tell, the rating system stops at +20.
So, if the honey you are thinking about purchasing states its Mankua Honey is rated: MGO+16, UMF+16, or Activity Level +16, then it’s of good quality. Do your research, there are counterfeits out there who mix in true Manuka Honey with standard honey, thus reducing the quality of the product and the amount of healing potential. If a product says it “contains” Manuak Honey, but fails to provide a rating, that might be a red flag.
“WOUND HONEY”
A tube of "Wound Honey" costs anywhere between $15.99 to $19.99 for 80g (or approximately 2.8oz). The product Wound Honey contains Manuka Honey, Aloe Vera, and Pantheno (a common ingredient in skin care). Wound Honey states that it has a +12 activity level.
Wound Honey differs from MEDIHONEY in that it is very thin and runny. It can be a challenge to apply it to my vertical wounds without it running out of my wound and down my leg before I can apply the gauze. Though similar in price to MEDIHONEY, Wound Honey comes in a slightly larger tube; so it lasts a bit longer.
"MEDIHONEY"
This can also be purchased online, costing anywhere from $15.20 to $20.00 for a 1.5oz tube. A 0.5oz tube can also be purchased. It's also available in dressing form. The dressing is like a medicated patch that you can lay on the wound without worrying about the honey melting on your leg before you get the bandage on it. MEDIHONEY contains, "100% active leptospermum honey;" meaning, it has nothing in it but the Manuka Honey and is rated +15. It contains no Aloe Vera or Pantheno like Wound Honey does.
I recently discovered that MEDIHONEY can be bought in gel or paste form. Unaware of having an option, I've only used the gel. The gel is quite thick. This gives you several seconds to apply it to the wound and cover it with a bandage before the heat of your body starts melting it. The "paste"--though I haven't yet used it and from what I've read--gives you more time to dress the wound because it remains thick for a longer period of time. For vertical wounds, this would seem like the better of the two options.
WHAT I'VE EXPERIENCED
When I first learned that honey can help leg/foot ulcers heal, I read that organic honey was best. So that’s is what I first purchased. The first time I used it, I could only keep it on my wound for a few minutes before the burning I experienced was too much. However, when I removed the bandage, in that short time, I was amazed to see how much slough had been removed.
A mild burning sensation for a few minutes is not uncommon in the use of honey on wounds. But what I experienced was...I liken it to pouring lighter-fluid on my foot and setting it on fire; and that intense burning sensation remained present an hour after I removed the honey. What was most likely happening was the honey was doing what it was suppose to, it was removing the bacteria from the wound. Though I tried, I couldn’t endure it.
Next I tried “Wound Honey.” A person suffering from diabetic ulcers told me about it, so I purchased some. I hoped because it contained Aloe Vera, and claimed to have “a soothing effect” on wounds, it wouldn’t burn as bad as the organic honey. Unfortunately, it did burn just as badly. I spoke to a sales representative of "Wound Honey"; she was very surprised at the reaction I had to it. Most customers apparently don't experience the pain reaction I did.
When I told the doctor at my wound clinic that I tried "Wound Honey," he advised me to instead use "MEDIHONEY." Again, I wasn’t able to tolerate the pain. However, since my wounds have improved from the Ultrasonic Mist Therapy, I have been able to use honey on my wounds with little or no burning. At times there will be a mild stinging sensation for a few minutes, but it soon passes; it’s nothing like what I experienced before.
“RAW HONEY”
This kind of honey has not been heat treated or pasteurized like much of the honey that's sold at most grocery stores. As a result, many of the healing properties found in raw honey, aren't cooked out of it.
ABOUT “MANUKA” or “ACTIVE LEPTOSPERMUM” HONEY
The pollen in the Manuka flower (or Leptospermum scoparium) is what bees in New Zealand use to make their honey. "Manuka Honey” has different enzymes and antibacterial properties that honey cultivated from other regions of the world don't have, making it more effective in healing wounds.
As a way of informing consumers about the quality of the Manuka Honey they are purchasing, two different rating systems are used; the UMF or MGO system. The following web page has good information about the difference between the two systems: http://www.aliveplushoney.com/amh-umf-and-mgo-rating-explained.php. Simply put, “both systems seek to measure the antibacterial strength of Manuka Honey.” When buying Manuka Honey, the higher the rating the better. In either the MGO or UMF system, a rating of +10 or more is most desirable; from what I can tell, the rating system stops at +20.
So, if the honey you are thinking about purchasing states its Mankua Honey is rated: MGO+16, UMF+16, or Activity Level +16, then it’s of good quality. Do your research, there are counterfeits out there who mix in true Manuka Honey with standard honey, thus reducing the quality of the product and the amount of healing potential. If a product says it “contains” Manuak Honey, but fails to provide a rating, that might be a red flag.
“WOUND HONEY”
A tube of "Wound Honey" costs anywhere between $15.99 to $19.99 for 80g (or approximately 2.8oz). The product Wound Honey contains Manuka Honey, Aloe Vera, and Pantheno (a common ingredient in skin care). Wound Honey states that it has a +12 activity level.
Wound Honey differs from MEDIHONEY in that it is very thin and runny. It can be a challenge to apply it to my vertical wounds without it running out of my wound and down my leg before I can apply the gauze. Though similar in price to MEDIHONEY, Wound Honey comes in a slightly larger tube; so it lasts a bit longer.
"MEDIHONEY"
This can also be purchased online, costing anywhere from $15.20 to $20.00 for a 1.5oz tube. A 0.5oz tube can also be purchased. It's also available in dressing form. The dressing is like a medicated patch that you can lay on the wound without worrying about the honey melting on your leg before you get the bandage on it. MEDIHONEY contains, "100% active leptospermum honey;" meaning, it has nothing in it but the Manuka Honey and is rated +15. It contains no Aloe Vera or Pantheno like Wound Honey does.
I recently discovered that MEDIHONEY can be bought in gel or paste form. Unaware of having an option, I've only used the gel. The gel is quite thick. This gives you several seconds to apply it to the wound and cover it with a bandage before the heat of your body starts melting it. The "paste"--though I haven't yet used it and from what I've read--gives you more time to dress the wound because it remains thick for a longer period of time. For vertical wounds, this would seem like the better of the two options.
WHAT I'VE EXPERIENCED
When I first learned that honey can help leg/foot ulcers heal, I read that organic honey was best. So that’s is what I first purchased. The first time I used it, I could only keep it on my wound for a few minutes before the burning I experienced was too much. However, when I removed the bandage, in that short time, I was amazed to see how much slough had been removed.
A mild burning sensation for a few minutes is not uncommon in the use of honey on wounds. But what I experienced was...I liken it to pouring lighter-fluid on my foot and setting it on fire; and that intense burning sensation remained present an hour after I removed the honey. What was most likely happening was the honey was doing what it was suppose to, it was removing the bacteria from the wound. Though I tried, I couldn’t endure it.
Next I tried “Wound Honey.” A person suffering from diabetic ulcers told me about it, so I purchased some. I hoped because it contained Aloe Vera, and claimed to have “a soothing effect” on wounds, it wouldn’t burn as bad as the organic honey. Unfortunately, it did burn just as badly. I spoke to a sales representative of "Wound Honey"; she was very surprised at the reaction I had to it. Most customers apparently don't experience the pain reaction I did.
When I told the doctor at my wound clinic that I tried "Wound Honey," he advised me to instead use "MEDIHONEY." Again, I wasn’t able to tolerate the pain. However, since my wounds have improved from the Ultrasonic Mist Therapy, I have been able to use honey on my wounds with little or no burning. At times there will be a mild stinging sensation for a few minutes, but it soon passes; it’s nothing like what I experienced before.
Medications for Sickle Cell Foot Ulcers
There are a variety of medications used to put on top of and treat foot and leg ulcers. The following is a list of medications my doctors have prescribed me.
SILVER SULFADIAZINE CREAM
This is a thick white cream that is generally used for severe burns and leg/foot ulcers. It's an antibacterial cream that helps prevent infections. In my case, I have used this cream each time I cleaned and dressed the wounds, which was usually twice a day.
This has been a very effective medication for my wounds. It causes no pain when applied and is usually very soothing to the wound. It wasn't until I struggled with the two wounds that have refused to heal that other medications were used on my ulcers.
SANTYL COLLAGNS
This is also a thick cream and is almost transparent. My doctor has advised me, when using Santyl, to clean and dress the wound only once a day.
The human body is an amazing and interesting machine. In an effort to protect the wound, the body will cause a mucus like film to form over the ulcer called slough; it's often yellow or white in color. Instead of protecting the wound, it actually prevents it from healing. So, to help the wound heal, the slough needs to be removed; also called debridement.
Santyl helps remove the slough from the wound so it has a chance to heal properly. If the slough and other dead tissue isn't removed, infection can set it. I have been amazed at how quickly an ulcer can turn from bad to worse.
MUPIROCIN
This is another debridement ointment like Santyl. As with any illness, there are a number of medications available for a doctor to use. Due to the sensitivity of my wounds, Santyl and Mupirocin have both been hard to tolerate at times. But has my ulcers improved, I've been able to tolerate them better as of late.
POLYSPORIN
This is a white powder that looks like flour. It's an antibiotic powder that is often used in first aid. My doctor has instructed me to sprinkle the Polysporin in with the Santyl. I put a small amount of Santyl in a tablespoon, sprinkle a little Ploysporin on it and mix the two together. This gives my wound the debridement benefit of the Santyl and antibiotic benefits of the Polysporin to help further reduce the chance of infection. The use of Polysporin with Santyl greatly reduced the amount of discomfort I felt when I used Santly alone.
LIDOCAINE
The process of cleaning and dressing the wound can often be quite painful. The medication--such as the Santyl or Mupirocin--applied to the wound can sometimes cause pain. The kind of Lidocain I use is thin jelly that comes in a tube. I apply it to my wound if the pain gets too severe.
When I clean my wounds, sometimes the pain is at a level where I need to use the Lidocaine. If my wound is especially sensitive on any given day, I will use the Lidocaine before applying the Santyl. This has worked really well to help me tolerate the various medications my doctor has prescribed.
SILVER SULFADIAZINE CREAM
This is a thick white cream that is generally used for severe burns and leg/foot ulcers. It's an antibacterial cream that helps prevent infections. In my case, I have used this cream each time I cleaned and dressed the wounds, which was usually twice a day.
This has been a very effective medication for my wounds. It causes no pain when applied and is usually very soothing to the wound. It wasn't until I struggled with the two wounds that have refused to heal that other medications were used on my ulcers.
SANTYL COLLAGNS
This is also a thick cream and is almost transparent. My doctor has advised me, when using Santyl, to clean and dress the wound only once a day.
The human body is an amazing and interesting machine. In an effort to protect the wound, the body will cause a mucus like film to form over the ulcer called slough; it's often yellow or white in color. Instead of protecting the wound, it actually prevents it from healing. So, to help the wound heal, the slough needs to be removed; also called debridement.
Santyl helps remove the slough from the wound so it has a chance to heal properly. If the slough and other dead tissue isn't removed, infection can set it. I have been amazed at how quickly an ulcer can turn from bad to worse.
MUPIROCIN
This is another debridement ointment like Santyl. As with any illness, there are a number of medications available for a doctor to use. Due to the sensitivity of my wounds, Santyl and Mupirocin have both been hard to tolerate at times. But has my ulcers improved, I've been able to tolerate them better as of late.
POLYSPORIN
This is a white powder that looks like flour. It's an antibiotic powder that is often used in first aid. My doctor has instructed me to sprinkle the Polysporin in with the Santyl. I put a small amount of Santyl in a tablespoon, sprinkle a little Ploysporin on it and mix the two together. This gives my wound the debridement benefit of the Santyl and antibiotic benefits of the Polysporin to help further reduce the chance of infection. The use of Polysporin with Santyl greatly reduced the amount of discomfort I felt when I used Santly alone.
LIDOCAINE
The process of cleaning and dressing the wound can often be quite painful. The medication--such as the Santyl or Mupirocin--applied to the wound can sometimes cause pain. The kind of Lidocain I use is thin jelly that comes in a tube. I apply it to my wound if the pain gets too severe.
When I clean my wounds, sometimes the pain is at a level where I need to use the Lidocaine. If my wound is especially sensitive on any given day, I will use the Lidocaine before applying the Santyl. This has worked really well to help me tolerate the various medications my doctor has prescribed.
My Battle with Sickle Cell Foot Ulcers
In the section entitled "Know Your Illness," I briefly mentioned that foot and/or ulcers are a complication many patients struggle with. I counted myself fortunate that I never had to worry about this problem; that was until June 2010 when I got my first one. My first ulcer was located on the arch of my right foot and was large enough that a quarter could have fit inside it. It took about three months to heal.
Almost a year later to date, I developed another ulcer in the same location. Shortly after that ulcer healed, another ulcer formed on my left foot. This time it was on the top of my foot just below the toes. Before that ulcer healed, my skin began breaking down and two other additional ulcers formed on the same foot. For a time, nearly half of my foot was covered with these painful open wounds. I went many months unable to wear shoes and hardly able to walk.
It took about six months for all those wounds to heal. Unfortunately, since March of 2012, I still have two "left overs," as I like to call them. These two ulcers are the remains of a much larger one. All the other wounds healed. However, for whatever reason, these two wounds are being exceptionally stubborn, and I've had them for almost a year now.
In June of 2011, a blood clot formed in my left leg. They tell me the clot went from about the middle of my shin to the middle of my thigh. Though the clot is now smaller than it once was, a large portion of it is still there. I have little doubt that the clot is interfering with proper blood flow and consequently impeding the proper healing of these particular ulcers. On the Internet, I read of a Sickle Cell patient having problems with leg ulcers for fifteen years! I certainly can't complain about mine.
Almost a year later to date, I developed another ulcer in the same location. Shortly after that ulcer healed, another ulcer formed on my left foot. This time it was on the top of my foot just below the toes. Before that ulcer healed, my skin began breaking down and two other additional ulcers formed on the same foot. For a time, nearly half of my foot was covered with these painful open wounds. I went many months unable to wear shoes and hardly able to walk.
It took about six months for all those wounds to heal. Unfortunately, since March of 2012, I still have two "left overs," as I like to call them. These two ulcers are the remains of a much larger one. All the other wounds healed. However, for whatever reason, these two wounds are being exceptionally stubborn, and I've had them for almost a year now.
In June of 2011, a blood clot formed in my left leg. They tell me the clot went from about the middle of my shin to the middle of my thigh. Though the clot is now smaller than it once was, a large portion of it is still there. I have little doubt that the clot is interfering with proper blood flow and consequently impeding the proper healing of these particular ulcers. On the Internet, I read of a Sickle Cell patient having problems with leg ulcers for fifteen years! I certainly can't complain about mine.
Saturday, February 2, 2013
"7th Sight" - September 15, 1999
I can’t see Him
but I feel Him.
I can’t hear Him,
but I listen to His voice.
I can’t see His face,
but I see His hands.
I can’t see His brush,
but I see His canvas.
Though I cannot hug Him,
I fee His love.
Though I can’t behold His glory,
I feel His power.
but I feel Him.
I can’t hear Him,
but I listen to His voice.
I can’t see His face,
but I see His hands.
I can’t see His brush,
but I see His canvas.
Though I cannot hug Him,
I fee His love.
Though I can’t behold His glory,
I feel His power.
"Renewed" - December 27, 1998
Drowning in the water,
Flooded by my tears;
I see a pierced hand
Calming all my fears.
Though my sorrowed heart aches,
And my weakened body pains,
It's through Him that my strength regains.
Flooded by my tears;
I see a pierced hand
Calming all my fears.
Though my sorrowed heart aches,
And my weakened body pains,
It's through Him that my strength regains.
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