Skin appears better so I guess it
was the right thing to do. <shrug> Yesterday-
Wiping itchy areas down with a wet washcloth- sides,
chest, neck, hips. Much less scratching.
He's now going without a shirt/jacket.
Played outdoors with Emm, Darb and Buck.
Doing well.
Thoughts... the spray helped to hydrate his skin
some... but unsure whether it also caused itching on
his shoulders. Diluted Douxo rinse may help
keep bacteria in check. Higher protein, less startch
(potatoes), higher oil (1 1/3 tbsp), and added
zucchini, green beans, etc. to help move things
along. I guess that's the plan. Note:
Back on Tufts prescribed diet from before
Chylothorax surgery.
February 20
Still flaky. Scratching
shoulders... no idea whether it's due to the spray
so I stopped it. Briefly lathered up with a watered
down solution of Douxo and rinsed/dried.
Took him
out to play. Wild man... first real play since
surgery. More exercise may help too.
That is NOT a patient face... he wanted the
Jolly Ball frisbee-thing and didn't want to wait.
LOVES that toy!
February 19
I bathed him with Douxo 3%
Chlorhexidine and left on for 8 minutes.
Allowing him to begin play indoors and alone
outdoors.
February 17
THANK GOoDness! The emu oil
spray still seems to be right for him. Sprayed
again this afternoon since he's improved so much.
Made sure I got his whole trunk, chest, armpits,
hips, rump... rubbed in good, let dry a bit, then
brushed out.
Only thing change were- added Kenic Emu Oil Spray
and back on the higher protein diet. His skin
was EXCELLENT before he required surgery.
Hoping we will soon find a balance again
without the need for antibiotics (stopped).
Ear flap looking better too.
Will wipe flaps once daily with Douxo or TrizCHLOR4.
February 16
Still flaky but appears less so.
Doesn't appear to be causing irritation. Sprayed
again lightly, the same as before but both sides.
It's a product leaves the coat light... feels like
Teflon... doesn't gunk up/pollute the coat.
February 15
Brushed him and oh boy... had to
shake out the rug due to the flaking that came off.
Trial and error time...
Moisturizing dog products tried in 2010 made his
skin red/irritated. Took out the Kayala Kenic
Emu Oil Moisturizing Spray again. Sprayed area
shown below, rubbed in, let dry. No immediate
redness, irritation, heat.
Using Douxo wipes on
inside ear flaps.
STILL ON ANTIBIOTICS.
Ingredients:
Deionized Water
Purified Emu Oil
Glycerin
Wheatgerm Glycerides
Papaya Extract
Mango Extract
**Does not contain alcohol or animal by-products
Also contains aloe vera
February 14
Very flaky... haven't bathed for a
week because of incision. He HAS to have
a bath to clear his skin and treat
the ear flaps. No choice. Avoided incision area...
covered with dry wash clothes when rinsing. I bathed him with Douxo 3%
Chlorhexidine and left on for 8 minutes.
Changed diet to original ostrich and potato +
20%
Higher protein/meat so possibly higher fat
even though ostrich is low fat to start with.
Sheesh. Lowering potato in case it's contributing to funky
skin.
Potatoes, boiled, without skin- 17.9
ounces (501 g )
Ground ostrich, pan cooked- 16 ounces (454 g)
Safflower oil- 1 tablespoon
Iodized salt- 1/4 teaspoon (1.5 g)
1 tablet TUMS Ultra Strength (400mg calcium per tablet)
4 BLACK scoops plus 5 WHITE scoops (19.8 grams) of Balance IT canine
Incision site looks good.
But ear flap have sores.
And skin is terribly flaky.
February 10
We had to leave Bumble at MSU on Wednesday the 8th for a
progress check. They repeated x-rays later that day and
surgically removed his chest port yesterday the 9th. All
went well. There are some changes in his lungs since the
last visit, still some slight effusion that could be due to
the drainage tube but the doctors say, "Overall, we
are thrilled with Bumble's progress!" Will
repeat x-rays in 2-3 months and probably forever watch for
exercise intolerance and monitor his breathing.
Spoke with Dr. Rosser. There's no question... Bumble
definitely has a food allergy and he has enough notes plus
the photo proof to support this. He felt he would have
problems no matter what kibble we were to use. Staying
with ostrich and white potatoes because it's worked best.
There is likely something else he's also allergic to but
testing has failed to determine it. He will notify us
if ever new testing becomes available.
Once he's well and healed, the only way to test a new
food is to feed it and see if there are any negative
reactions... it's trial and error.
Dr. Rosser will pop in to see Bumble during his visit on
Wednesday. Coat is still flaky but better. He
says to continue with the safflower oil and see how he does.
February 4
Doing well... coat feels good (not dry) and skin is healed.
Intense itching has subsided. Seldom scratched today.
Stopped loratadine a few days ago. Dropping back on
hydroxyzine.... down to 5 per day.
Will bathe on Monday to
prepare for expected port removal. Will try to remove
protective shirt tomorrow.
It's amazing to watch him lately... his breathing is that
of any normal dog, he's full of energy, playful. No
longer panting. Had been unwell for such a long
time...
January 31
MUCH better today. Less scratching. Less flaky.
Wearing a shirt again instead of heavier jacket.
January 30
Itchy. I bathed him with Douxo 3%
Chlorhexidine but again did not leave in contact
with the skin. Only washed trunk, hips and belly.
Rinsed, dried.
January 27
Areas being scratched-
Shoulders, armpits, chest, chin... previously ears too.
Horribly itchy at 3am so I bathed him with Douxo 3%
Chlorhexidine but did not leave in contact.
Soaped his trunk and hips only, then rinsed him off.
Dried and put a Thundershirt on him. He went back to
bed...
Itchy, flaky. Needs more oil in diet?
Pictures at 3am before bath... click to enlarge
Pictures at 3pm... click to enlarge
January 25
Dr. Nelson said, "At this point, I don't think that dietary
fat content will appreciably change anything---to my
knowledge, recurrence of chylothorax after resolution has
not been described, and dietary therapy isn't really that
effective to begin with. I think that it would be fine for
him to increase his dietary fat %."
Staying with 100%
safflower oil. Skin is not as red today. Adding
loratadine has greatly decreased the itching at night.
January 24
Saw Dr. Jossens today... she asked what we had changed in
the past 3 weeks. Discussed corn oil started per
nutritionist's recommendation on December 19th.
Possibility that this is the cause. Lower quantity of
corn, add safflower (already went to all safflower on 23rd),
write to Dr. Nelson.
Hydroxyzine 100mg 3x per day
already... add one 10mg loratadine per day.
85 @ vet
January 23
Picked up prescription. Not sure if it might instead
be more of a contact dermatitis?? Doesn't look the
same and horribly itchy. Still happy though!
Shaved
down with #6 blade, 1/2" comb on legs. Bath
with Douxo 3%
Chlorhexidine shampoo
Chicken??
We had not allowed it in the house...
January 11th- 21st Chicken wings in house, KFC chicken, bag
of Canidae Elements (chicken), C.E.T. dental rawhide,
chicken flavor toothpaste.
Change in diet- Do
not want further weight gain. CHANGE-
Took Tufts post-surgery diet. Had been feeding that
+15%. Dropped down to a 5% increase maintained the ostrich
boost by 10%. Stopped corn
oil.
87.5 @ home
January 21
Horribly itchy. Bath again with Bath
with Douxo 3%
Chlorhexidine shampoo @ 2am. Used
4% chlorhex spray. Gunks up coat. Added socks.
Found Cephalexin... giving 1,250mg 11pm.
January 20
Horribly itchy and now has sores. Coat still feels
DRY though. Bathed with Douxo Maintanence, spot treated sores
with 3% Chlorhexidine shampoo. Used Dermapet
Mal-A-Ket Plus spray.
January 16
Strongid dewormer... whole pack.
January 15
Itchy but in a good mood... playful. Coat feels dry?
Maybe needs more oil in diet? Still getting corn oil.
Bath
with Douxo 3%
Chlorhexidine shampoo.
January 13
Small sore on side at back incision site and 2 small ones at
port site. Maybe ingrown hair? Shaved area of larger one and cleaned with Douxo wipes.
Better day as far as itching. EXCELLENT energy, played
like a wild man for about 1/2+ hour. Never once laid
down. The stinker pushed out the backdoor to play
twice while I had Kaytee outside. HAPPY BOY!
CHANGE-
Took Tufts post-surgery diet. Had been feeding that
+25%. Dropped quantity from a 25% increase down to a
15% increase but boosted the ostrich by 10%. So in the
end, everything was decreased except for the ostrich which
stayed the same. He's at a good weight, just needs
more protein I think. Diet said treats were not
supposed to = more than 10% so that should do it.
We'll see how he does.
January 10
Hot, hot patch on back of neck, flushed... probably the
yogurt, maybe the other dogs kibble. BLAH. Has been
itchier.
January 9
Bath
with Douxo 3%
Chlorhexidine shampoo.
From Dr. Nelson... :) YAY!
"I just looked at the films vs. the images we acquired
in December with Dr. Hadley--doesn't look like any
increase in fluid at all. As such, I would say let's
see him back next month, re-radiograph, and pull the
thoracic drainage port.
I don't have any issue with the increase in protein
(though I will admit that nutrition is not my area of
greatest expertise). Please let me know if there are
any changes in his status in the meantime. Overall,
we're really pleased with the apparent resolution of his
chylothorax."
Boosted protein a couple of days ago.
Better energy. Gave a spoonful of yogurt... also
started feeding Canidae Elements to the rest of the pack
(has chicken).
January 6
X-rays today. There is still fluid but Dr. Peck didn't feel he
needed to be tapped. Sent to Dr. Nelson and Dr. Jossens.
Vomited tonight... not long after eating. Wondering if
maybe diet is making him breathe heavy...
January 4
Bath
with Douxo 3%
Chlorhexidine shampoo. Wondering if
we should tap Bumble’s chest, get an x-ray or continue to
wait...
He seems more tired today, was lying down outside
while playing with the others tonight, didn’t come out of
his room to do his business with the others later on. His
respiration at rest is around 20-22 the past few days. He
seems to be breathing heavy and deeply at times but he’s not
in distress. He rolled on his back tonight and did that
hack-type-gag-cough thing he did before. But... his
respiration is not over 40 at rest. Weight was 85.2
the other day, eating well. What to do...
But after his bath and being dried, he ran around the
yard with the others for a few minutes (breathing
deeply/heavy as mentioned early on), came in, ran to his
bedroom to wait for his B4 bed meal. Ate well, climbed up on
his bed and went to sleep...
6pm R=21
(sleeping)
January 3
More playful in the late afternoon... played and played
outdoors. Played some more when he came in too!
Jacket seems to fit more snug... not much gap so weight
is likely due to increase in actual weight, not chest fluid.
6:30pm R=22
December 31
Bath
with Douxo 3%
Chlorhexidine shampoo. Kind breathing
heavy but not faster. Less active.
85.2 @ vets office
December 29
Played outdoors a few times today... running and playing.
Played ball with me (fetch). Good endurance.
A sore on top of his head too.
Same treatment.
Excellent
Normal
December 27
Woke up this morning with him standing by the door ready to
come out of his room. Went into the kitchen with the
others to "help" get breakfast ready. Hasn't been
doing that. Greeted me too. Then ran to his room
to eat.
Bath
with Douxo 3%
Chlorhexidine shampoo.
Sores inside ear flap. Shaved inside flap area short
and wiping with Douxo pads.
12:15pm R=21
December 26
Better energy... play was stopped before he stopped. I
think he needs more calories or more protein. Target
weight will be 85-87 pounds so he have a little in reserve
in case more surgery is needed.
6:15pm R=20
December 25
I listened to the left side of his chest... heartbeat isn't
as strong as when heard on the right side. Timed
breathing at rest= 28.
Has not gained any weight. It seemed like he didn't feel
well today OR... could it be there's not enough calories or
enough protein?? Boosted protein by 10%... diet said
he could have 10% treats...
When we first started the revised version of the Tufts
diet, we increased the amount fed by 25% from day one... it
wasn't enough food for him.
Took him outside to play last night... played Frisbee.
Laid down a couple of times.
Have noted over the past couple of days that he's breathing
like he doesn't feel well.
2:15pm R=28
December 22
Bath
with Douxo 3%
Chlorhexidine shampoo.
December 20
During play, he's no longer lying down to rest. On his
feet and chasing after the others... like the others chase
after the others! <grin>
Itchy at times but no sores.
83 @ home
December 19
Switched to CORN OIL per Tufts nutritionist's
recommendation. I guess all I can do is try it.
December 17
Bath
with Douxo 3%
Chlorhexidine shampoo.
December 16
December 13
Bath
with Douxo 3%
Chlorhexidine shampoo.
Questions for tomorrow-
When can he resume
normal activities such as playing outside by himself and
play with the pack?
When will the port be
removed? Now!
Do I need to worry about
how he will do once we change his diet? Continue
with diet.
How likely is this
condition to recur?
Could hypertension cause
chylothorax? Always a nervous dog... whites of
eyes turned red when out in puppy class. Had to
quit classes because of noise sensitivity.
December 10
Bath
with Douxo 3%
Chlorhexidine shampoo.
It's easy to forget what he's
been through because he seems normal. I never would
have thought we would reach this point. Hoping the
chyle volume will be insignificant and surgery on the other
side won't be needed.
Will ask when the pleura port is removed if they can do
elbow/shoulder x-rays and have an ortho specialist look at
them to tell whether there should be any restrictions and
advice on supplements in a dog with allergy issues.
His skin looks good but he's still itchy. First day
without a jacket or shirt. I've stopped his scratching
a few times if it gets too intense. We'll try to go
without clothing to protect his skin.
Noted him breathing deeply at rest once today.
84
Excellent
Normal
December 8
Smeared poop on the quilt
this morning too! Glad I didn't sleep with him last
night! Sheesh! Must be the higher level of
potatoes in the diet. Will add more vegetables to see
if it makes any difference.
HAPPY boy this morning though.
Wanted to run and bounce outside but curtailed the activity.
He's feeling good and acting healthy. Breathing is nice and
easy after eating, going out to potty and lying on his bed.
It's a beautiful sight.
Skin looks good... no sores but still itchy at times.
Have discontinued the heavier dog coats today and have gone
to a lighter shirt.
Excellent
Adding vegetables each meal.
List of Choices:
Zucchini/Summer Squash
Broccoli
Cauliflower
Green Beans
Brussels Sprouts
Asparagus
Normal but taking a while to
go.
December 7
Bath
with Douxo 3%
Chlorhexidine shampoo.
Late due to caring for Maggie after her surgery on the 6th.
Skin looks good though but he was itchy.
Having poop
issues... the diet change may be leaving him with anal gland
problems or problems emptying his bowels. Poop on the
bed twice today. Smeared on the sheets so I
think he may be scooting. Attempted to express his anal
glands but nothing much in them.
Excellent
normal but taking a while to
go.
December 5
Port evacuation today.
The color of the fluid has changed. There is no longer
any pink color to it. It's more of a cream color...
Dr. Jossens thought it was thicker. Had him standing,
sitting, sternal, on side, on back. We won't remove
fluid before our trip down to MSU.
Still itchy but not as
intense. Will go back to the Blue Buffalo foods for the rest
of the pack to see if I can replicate the great skin we had
before the chylothorax.
Longevity Mature for Darby, Kaytee and Maggie. Basics
Salmon and Potato for Emma, Kobuck, Panda.
83.2 @ vet but he had his coat
on.
Excellent
normal
1cc cream color
December 2
Horribly itchy but have not noted deep, heavy breaths today.
Wiping with Douxo pads. Back on
1,250mg of cephalexin... (3 doses at 1000mg). Allowed
him off-leash in backyard today to trot around and do his
business... get his mind of the scratching. Not allowed to play with other dogs.
Seems happier with a little freedom, picked up the Jolly
ball and tennis ball as he normally would. He's a dog
that lives to be outdoors. Let out with
others to potty tonight, then right back in the house.
Hair is appearing in the bald
patches where it had been lost due to the staph infection.
Could the new Allure flooring
put down in the room he was in when he arrived home be
causing the itching or is it "just" the staph infection?
Finally took time to look up
the term on his discharge papers...
Notes for 11/11/11-
“...Skin staples are present over the right
thorax at the 5th and 13 rib.
There is a flattening
of the caudal aspect of the humeral head on
each lateral projection; this flattening is
likely on both humeral heads.
Interpretation:
1. Pleural effusion consistent with known
chylothorax.
2. Mild pneumothorax consistent with post
operative status.
3. Humeral
head osteochondrosis, likely bilateral.”
Called Dr. J and wrote to Dr.
H to get clarification on what the heck this means after
finding the same term on the OFA website-
http://offa.org/shoulder_info.html
STARTED TUFTS REVISED VERSION
OF THE OSTRICH AND POTATO DIET.
No longer tracking...
respirations are consistently below 40 per minute at rest.
Still monitoring however and will record if it changes.
83
Excellent
STARTED TUFTS REVISED VERSION
OF THE OSTRICH AND POTATO DIET. EXCEPT FOR CORN OIL...
wrote to Dr. Rosser to be sure it's ok to use.
We boosted
the total intake of calories by 25% and will drop it back after a
few days.
normal
Area over port... itchy.
December 1
VERY itchy.
Bath with Douxo 3%
Chlorhexidine shampoo.
Excellent
normal
November 30
His breathing is
still heavy despite x-rays looking good. Writing to
MSU and will share videos with Dr. Jossens at appointment
scheduled for today. Also need to discuss which diet
to use.
Heavier breathing due to antibiotics... pain...
limited lung function... that drainage tube snaked around in
his chest? Thinking it's discomfort of some kind...
Dr. J explained the breaths
are even in and even out though deep. Not respiratory
distress.
Fed a nice serving of zucchini. Doesn't appear to
be putting on weight... possibly a little if there's no
fluid in his chest cavity because he's weighed prior to
evacuation.
Delayed A.M. Cephalexin dosing
until I could talk with Dr. J at A.M. appointment.
Will give sucralfate 1 hour before antibiotic.
Vomited
about 1/2 hour after sucralfate and did not follow up with
antibiotic. Dr. Rosser happened to call shortly
after... recommends dropping to 1000mg cephalexin
for 2 days then back up to 1,250 for 21 days total treatment.
5:40am R=19
100.4
Excellent
normal
59cc
Positioning-STANDING!
THREE
videos... click on "PLAYLIST" in lower right corner.
Video
#1: At around 11pm... had been sleeping,
likely heard me come in.
Video #2: Just after video #1.
Video #3: Just after being fed
breakfast at around 4am.
November 29
Breathing heavier
today but not faster. Less energy, lying down more.
Trimmed his face today and he'll usually stand... he kept
lying down. Called Dr. Jossens office and they got us
in. Showed her the video and she agreed.
Discussed blood work and an x-ray... also whether it could
just be due to the antibiotic making him feel icky... also
pain. Ok to give 1 or 2 tramadol to see how he
responds... start with 1. Gave 1 tramadol at 4:30pm
with dinner.
The end of the drain tubing looks like it's now up near
his spine in the x-ray where it was down in the bottom of
the chest cavity on the 21st.
Not as itchy... skin continues to improve.
9:40am R= 21
1: 30pm R=26
7:25pm R=17
100.6
80.5 @ vets office
Excellent
A few frozen raspberries, blueberries.
Normal
X-rays from Nov. 21, 2011
X-rays from Nov. 29, 2011
November 28
Skin beginning to
look better but still real itchy at times. Switched
down to Douxo 3% Chlorhexidine wipes. Still very itchy at
times. Spraying sides lightly with witch hazel to help
stop the itch. Still blotchy areas but it looks like
the Chephalexin, baths and wipes are working.
Wants to play with the other dogs. Caught him doing
this today... I made him sit down. Took a good nap
today. Walked on-leash in the front yard for something
different while the pack played in the back yard.
9:25am R=25
83
Excellent
Normal
Comparison from November 26 to early November 29th.
November 27
Bath with Douxo 3%
Chlorhexidine shampoo.
100mg Hydroxyzine and 1250mg Cephalexin with meal #2 &
#4.
TrizCHLOR4 wipes twice daily.
10:20am R=20
100.4 @ 10:30am
Excellent
Normal
November 26
100mg Hydroxyzine
with second meal #2 and last meal #4
START Cephalexin
1250mg BID. Given
with #2 and #4 meals.
TrizCHLOR4 wipes twice daily.
2:55pm R=25
Breathing heavier but up and about a lot of the day.
Put in his room to rest.
8:25pm R=30 after eating
9:45pm R=15 sleeping
99.2 @ 8pm
Excellent
Normal
November 25, 2011
100mg Hydroxyzine @
9:15am
100mg Hydroxyzine @8pm
Question: Maybe go to
hydroxyzine THREE times daily?
Not itchy all the time at this dosage but there are
several times daily times when he just won't stop
scratching. Take him outside for a bit to try to
distract or try to stop him, keep skin protected with the
heavier coats I made him. Shirts are not enough to
protect his skin when he's scratching to much.
Allowed him to be with the pack much more today.
Controlling Kobuck so NO exuberant behavior. If I see
the chance for it to start, one or the other is put in his
room.
Breathing easy.
10am R= 24
8:30pm R=17
80.7 at vet.
Excellent
Normal
7cc
Positioning-STANDING!
Click on pictures to view larger images.
November 24
He's very itchy.
Bath with Douxo 3%
Chlorhexidine
shampoo again. Soaked
for 10 minutes, rinsed, dried.
100mg Hydroxyzine @ 10am
100mg Hydroxyzine @ 9pm.
Allowed him to be with pack
part of the day. Calm behavior.
Broiled an ostrich steak for
him... from Blackwing Ostrich Company. LOVED IT!!
Expensive thought. Maybe use as treats in the future...
something he'll look forward to that we can train with.
1:30am R=17
10:20am R=19 (during bath)
8pm R= 22
82 pounds on home scale.
Excellent
Stool kind of dry. Adding
a little zucchini, green beans, other non-yeast type veggies
again.
Click on pictures to view larger
images.
11/23/11
9:40am appointment to try it
all again. Dr. Jossens drew fluid from the port on the
first attempt!!! Woohoo!!!
We had Bumble stand on the table. I had my
left arm over his neck and Jim had his rear so he wouldn't
sit or back up. Dr. Jossens prepped and inserted the
1" 22 gauge huber needle (the same as he came home with).
Bumble flinched despite having the area numbed. The
needle was not seated flush with the clear disc... there was
a space between it and his skin.
She pulled back on the syringe and drew fluid on the
first attempt!!!! Jim almost cried. Dr. Jossens
drew the fluid until it stopped. Jim and I got him to sit as
she tried again, then lie down sternal and finally onto his
left side. Nothing more came out in any of the other
positions. Because of his standing position, she went
through a different area of skin. I hugged doc and
grinned like a fool as I finished up some last minute
shopping for Thanksgiving.
Still pretty itchy. Gave 1 hydroxyzine at 9:30am.
Will give 1 hydroxyzine at 8:30pm.
Spoke with Dr. Linder today from Tufts. She
formulated a new diet... will try corn oil... she's prepared
diest for chylothorax dogs before... and to lower the
fat/protein content of the diet. Need to verify that
protein level is adequate based on his still leaking chyle
and the fact that it's purged rather than reabsorbed... a
source of protein loss?
8:20am= 30
Great
Normal
410cc
Friday to Wednesday
Positioning-STANDING!
11/22/11
Called Dr. Peck's office early
to let them know we did not receive the x-rays (not attached
to Dr. Hadley's email) and provided a different email
address to me. Received them quickly and also
forwarded to Dr. Hadley as jpgs and online links to view.
Dr. Rosser called and he was able to give advice with
just the pictures!! The bald spots are a low grade staph
infection. He said the reason the cytology was negative is
because the bacteria is in the the hair shaft. You'd have to
do a biopsy in order to find it. So we're using Douxo 3%
Chlorhexidine wipes 2x per day to treat it... still had a
few on hand. Pick up more tomorrow from Dr. J.
He also had a glorious
bath tonight with the same Douxo
shampoo. After bathing him 2x per week since February, it
just seemed wrong for him to have gone for close to 3 weeks
without a bath. Dr. Hadley said it was ok, just avoid that
small incision area. He's CLEAN!!
Before and after his bath.
But itchy... probably due to the staph or yogurt.
Dr. Rosser said not to change his diet until he has no
holes, ports, etc. I had given him yogurt a couple of days
and he said it's best to avoid the dairy. He said Bumble
doesn't need chylothorax and a raging skin infection
together. I'm so glad he called... it all makes perfect
sense.
I spoke with Dr. Hadley tonight and she said the amount
of fluid shown in the x-rays isn't as much as they had when
the port stopped working at MSU so that's encouraging.
I got to see the x-rays and the drain is at the bottom of
the chest cavity so lying upright or standing may give the
best results. Doc had been able to draw like 2" of fluid
into the line before it stopped. Dr. Hadley said that it's
possible that's all she had access to at that point.
