The Blurt

As a kidney doctor, one question I get asked, usually daily (this came from an actual patient interaction), is “Do I really need to drink THAT much water EVERY DAY. Does the Starbucks quadruple shot topped off with coffee that I chase with 6 Cokes, oops, Diet Cokes and 4 cans of Red Bull and the 5 Miller Lite’s I drink during the day count in that total?” Read the editorial in the recent Journal of American Society of Nephrology and look at the evidence (evidence? really?) and decide for yourself. Maybe, Maybe not. Gotta run, have several Meerkat Manor shows on DVR and that show ROCKS!

Signed: I P Freely.

Okay, just Dave

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Just Add Water
Dan Negoianu and Stanley Goldfarb
Renal, Electrolyte, and Hypertension Division, University of Pennsylvania,
Philadelphia, Pennsylvania
J Am Soc Nephrol 19: –, 2008.
doi: 10.1681/ASN.2008030274
“Just add water” is the modern chime turning various prepared foods into family dinner; however, is it good advice forpeople at the table as well? In this issue of JASN, Berl1 describes how solute intake affects the kidney’s handling of water. What of the converse: How does intake of water affect kidney function and other physiologic variables? A brief search of the Internet will find multiple web sites warning health-conscious readers they must drink eight glasses of 8 oz/d to remove dangerous “poisons.”2,3 Is there evidence behind
these recommendations? Furthermore, if targeted amounts of water consumption are therapeutic, then what
are the improved outcomes?
It is widely known that humans cannot survive for more than a few days without ingesting water in excess of solutes.4 The dangers of severe hypertonicity and volume depletion are not up for debate. It is also obvious that individuals in hot, dry climates have increased need for water, as do people who engage in strenuous physical exertion.5 There are certainly well-recognized disease states, such as nephrolithiasis, for which increased fluid intake is therapeutic,6 but do average, healthy individuals living in a temperate climate need to drink extra fluid—even when not thirsty—to maintain health? The classic recommendation is known as “8
8”: Eight glasses of 8 oz of liquid per day—not including caffeinated and alcoholic beverages. Where did this recommendation come from? In his exceedingly thorough review of this subject, Valtin7 reached the following conclusion: Nobody really knows. There is no single study—and therefore no single
outcome—that has led to these recommendations. Different authors make different claims regarding the potential benefits of water drinking, and it is instructive to examine some of these in turn. First is the notion that increased water intake improves kidney function and clearance of toxins. The kidney manifests
several mechanisms to rid the body of toxins, including glomerular filtration, tubular secretion, and various degradative metabolic pathways. If excess water intake were to have an impact on toxin removal, then it would be through one of these mechanisms. Water ingestion can acutely affect GFR, although not necessarily in the direction one might expect. Using 12 young, healthy individuals as their own controls, Anastasio et al.8 found increased water intake actually decreases GFR. It might therefore seem that any “toxin” removed purely by glomerular filtration is cleared less efficiently in the setting of increased water intake; however, it is not certain such changes in GFR persist over time. Indeed, GFR was unchanged during
a 6-mo randomized trial of increased water intake in older men who had benign prostatic hypertrophy.9 Of course, the populations in the two studies are different, and the main goal of the randomized trial was to evaluate bladder function rather than kidney function; as an aside, the study did show some improvement in bladder function, although the clinical significance of the findings is unclear.10 Of course, most endogenous substances are not cleared purely by glomerular filtration alone. Anastasio et al.8 found
the total clearance of osmoles increased as water intake increased, probably as a result of reduced reabsorption. If there are “dangerous” substances among these osmoles, then increased water intake might indeed help in their clearance. Interestingly, one of the osmoles whose clearance was increased was sodium. Given the suspected role of long-term sodium retention in the development of hypertension,11 one could speculate that increased clearance of sodium is beneficial. Urea clearance also increases with high water intake, but urea is not a toxin. It is unclear whether any of these changes persist in the long term. In short, increased water intake does have some impact on renal clearance of various substances, but current data are insufficient to assess the clinical significance of these observations. In fact, given how little is known
about the identity of toxic substances cleared by the kidney, it is unlikely this type of data can conclusively demonstrate a benefit from excess water drinking. Another popular idea found on Internet sites is that ingested water is retained in various organs and improves their function. For this hypothesis to be plausible, one must first show that “normal” individuals who are not thirsty will nevertheless retain ingested water in their body rather than excrete it in the urine. One study of 14 individuals in “good health” suggested that water retention is quite variable and depends significantly on the speed with which water is ingested.
A water load ingested over 15 min is largely excreted, whereas a water load ingested over 2.5 h is largely retained.12 In addition, water mixed with a poorly absorbed sugar, thereby slowing absorption of water from the gut, is largely retained, whereas water mixed with an easily absorbed sugar is largely excreted. This pattern is similar in both men and women, although a separate study suggested water retention in women is greater than in men.13 Such studies examine relatively short-term changes, usually over 24 h. We are not aware of data regarding what type of steady state develops over longer periods of increased water intake. Even if such data were available, it is difficult to know how to interpret their clinical importance; therefore, it may be more fruitful to focus on outcomes that have more established clinical relevance. One frequent rationale for increasing water intake is to increase satiety as part of the self-management of obesity. There
is surprisingly little evidence regarding this issue. One study of women found water drinking before a meal increased satiety during a meal—but not after it.14 Caloric intake was not measured. Another study—this time of men—found total caloric intake decreased by increasing the volume of a calorie-containing drink given before the start of a meal.15 Another study by the same group—of women only—showed increasing the water content of foods themselves decreased caloric intake, but offering water in parallel with food did not.16 None of these studies makes clear whether drinking a large volume of fluid over the course of a day will decrease the number of ingested calories. As an interesting corollary, ingesting water could also affect caloric balance by increasing energy use. Two studies by Boschmann et al.17,18 found consumption of water increased thermogenesis—boosting the number of calories used by thebody. This effect is not seen with ingestion of salt-containing fluids. Another group found increased body temperature in athletes who rehydrated with pure water when compared with athletes given a carbohydrate/saline solution19; however, other authors have disputed Boschmann’s findings.20 It is unclear why water ingestion would increase energy consumption, although it is relatively well documented that ingestion of pure water increases sympathetic tone whereas consumption of saltcontaining solutions does not.21 In fact, ingestion of 16 fl. oz. of water to activate the gastropressor response is recommended as a treatment for orthostatic hypotension.22 Although the data regarding satiety and thermogenesis are intriguing, they are insufficient to clarify the role of water intake in mitigating the obesity epidemic. Although it may be cliche´ to suggest further research is required, the impact of water on obesity seems the most compelling choice among

multiple issues to test regarding the benefits of supplemental water intake. Not only is it highly relevant to public health, but also changes in obesity-related outcomes such as caloric intake and body weight are readily quantifiable and therefore lend themselves to study. There certainly are other public health concerns invoked in the debate over water intake. Retrospective case-control and cross-sectional studies showed associations between decreased fluid intake and the incidence of such disparate conditions as coronary disease, bladder cancer, and colon cancer.23,24 Of course, these studies suffered from weaknesses typical of epidemiologic and retrospective case-control data: Are people sick because they drink less, or are they drinking less because they are sick? Only large and expensive randomized trials could settle these questions definitively. Given that water cannot be patented, such trials seem unlikely. Not all conditions worthy of study need be life threatening. Headache is frequently attributed by the lay public to water deprivation, but there is little study of this phenomenon.25 To our knowledge, only one trial has examined headache prevention by increasing water intake.26 Fifteen patients with migraine headaches were randomly assigned to increased water intake or placebo for 12 wk. The number of hours of headache was quantified over 14-d intervals at the beginning and at the end of the trial. Although the treatment group had 21 fewer hours of headache compared with the control group, this difference did not reach statistical significance (the number of patients was obviously quite small). Given the economic impact of migraine on time lost from work, this area would seem to be ripe for further study. A frequently cited cosmetic benefit of water drinking is improved skin tone. Although frank dehydration can obviously decrease skin turgor, it is not clear what benefit drinking extra water has for skin. One study suggested ingestion of 500 ml of water increases indices of capillary blood flow in the skin.27 It is unclear whether these changes are clinically significant or how to interpret them in light of water’s potential impact on sympathetic tone. We were unable to find any other data regarding the impact of water intake on skin in otherwise healthy people.
To summarize the conclusions of other, more exhaustivereviews: There is no clear evidence of benefit from drinking increased amounts of water.7 Although we wish we could demolish all of the urban myths found on the Internet regarding the benefits of supplemental water ingestion, we concede there is also no clear evidence of lack of benefit. In fact, there is simply a lack of evidence in general. Given the central role of
water not only in our bodies but also in our profession, it seems
a deficit worthy of repletion.
DISCLOSURES
None.
REFERENCES
1. Berl T: Impact of solute intake on urine flow and water excretion. J Am
Soc Nephrol 19: 000–000, 2008
2. Jegtvig S: Drinking water to maintain good health, 2007. Available at:
http://nutrition.about.com/od/hydrationwater/a/waterarticle.htm. Accessed
March 18, 2008.
3. Drink to your health. . .with water! Mother nature’s healthy “cocktail,
2007.” Available at: http://betterwayhealth.com/drinking-water.asp.
Accessed March 18, 2008.
4. Adolph EF: Physiology of Man in the Desert. New York, Interscience
Publishing Co., 1947, pp 357
5. Institute of Medicine (U.S.). Panel on Dietary Reference Intakes for
Electrolytes and Water: DRI, Dietary Reference Intakes for Water,
Potassium, Sodium, Chloride, and Sulfate. Washington, DC, National
Academies Press, 2004, pp 617
6. Borghi L, Meschi T, Amato F, Briganti A, Novarini A, Giannini A:
EDITORIALS www.jasn.org
2 Journal of the American Society of Nephrology J Am Soc Nephrol 19: , 2008
Urinary volume, water and recurrences in idiopathic calcium nephrolithiasis:
A 5-year randomized prospective study. J Urol 155: 839–843,
1996
7. Valtin H: “Drink at least eight glasses of water a day.” Really? Is there
scientific evidence for “8 x 8”? Am J Physiol Regul Integr Comp
Physiol 283: R993–R1004, 2002
8. Anastasio P, Cirillo M, Spitali L, Frangiosa A, Pollastro RM, De Santo
NG: Level of hydration and renal function in healthy humans. Kidney
Int 60: 748–756, 2001
9. Spigt MG, Knottnerus JA, Westerterp KR, Olde Rikkert MG, Schayck
CP: The effects of 6 months of increased water intake on blood
sodium, glomerular filtration rate, blood pressure, and quality of life in
elderly (aged 55–75) men. J Am Geriatr Soc 54: 438–443, 2006
10. Spigt M, van Schayck O, Knipschild P, Westerterp K, van de Beek C,
van Kerrebroeck P, Pel J, van Mastrigt R, Knottnerus A: Is it possible to
improve elderly male bladder function by having them drink more
water? A randomized trial of effects of increased fluid intake/urine
output on male lower urinary tract function. Urology 68: 1031–1036,
2006
11. Adrogue HJ, Madias NE: Sodium and potassium in the pathogenesis
of hypertension. N Engl J Med 356: 1966–1978, 2007
12. Shafiee MA, Charest AF, Cheema-Dhadli S, Glick DN, Napolova O,
Roozbeh J, Semenova E, Sharman A, Halperin ML: Defining conditions
that lead to the retention of water: The importance of the arterial
sodium concentration. Kidney Int 67: 613–621, 2005
13. Claybaugh JR, Sato AK, Crosswhite LK, Hassell LH: Effects of time of
day, gender, and menstrual cycle phase on the human response to a
water load. Am J Physiol Regul Integr Comp Physiol 279: R966–R973,
2000
14. Lappalainen R, Mennen L, van Weert L, Mykkanen H: Drinking water
with a meal: A simple method of coping with feelings of hunger,
satiety and desire to eat. Eur J Clin Nutr 47: 815–819, 1993
15. Rolls BJ, Castellanos VH, Halford JC, Kilara A, Panyam D, Pelkman CL,
Smith GP, Thorwart ML: Volume of food consumed affects satiety in
men. Am J Clin Nutr 67: 1170–1177, 1998
16. Rolls BJ, Bell EA, Thorwart ML: Water incorporated into a food but not
served with a food decreases energy intake in lean women. Am J Clin
Nutr 70: 448–455, 1999
17. Boschmann M, Steiniger J, Hille U, Tank J, Adams F, Sharma AM,
Klaus S, Luft FC, Jordan J: Water-induced thermogenesis. J Clin
Endocrinol Metab 88: 6015–6019, 2003
18. Boschmann M, Steiniger J, Franke G, Birkenfeld AL, Luft FC, Jordan J:
Water drinking induces thermogenesis through osmosensitive mechanisms.
J Clin Endocrinol Metab 92: 3334–3337, 2007
19. Bergeron MF, Waller JL, Marinik EL: Voluntary fluid intake and core
temperature responses in adolescent tennis players: Sports beverage
versus water. Br J Sports Med 40: 406–410, 2006
20. Brown CM, Dulloo AG, Montani JP: Water-induced thermogenesis
reconsidered: The effects of osmolality and water temperature on
energy expenditure after drinking. J Clin Endocrinol Metab 91: 3598–
3602, 2006
21. Brown CM, Barberini L, Dulloo AG, Montani JP: Cardiovascular responses
to water drinking: Does osmolality play a role? Am J Physiol
Regul Integr Comp Physiol 289: R1687–R1692, 2005
22. Lu CC, Diedrich A, Tung CS, Paranjape SY, Harris PA, Byrne DW,
Jordan J, Robertson D: Water ingestion as prophylaxis against syncope.
Circulation 108: 2660–2665, 2003
23. Chan J, Knutsen SF, Blix GG, Lee JW, Fraser GE: Water, other fluids,
and fatal coronary heart disease: The Adventist health study. Am J
Epidemiol 155: 827–833, 2002
24. Altieri A, La Vecchia C, Negri E: Fluid intake and risk of bladder and
other cancers. Eur J Clin Nutr 57[Suppl 2]: S59–S68, 2003
25. Blau JN, Kell CA, Sperling JM: Water-deprivation headache: A new
headache with two variants. Headache 44: 79–83, 2004
26. Spigt MG, Kuijper EC, Schayck CP, Troost J, Knipschild PG, Linssen
VM, Knottnerus JA: Increasing the daily water intake for the prophylactic
treatment of headache: A pilot trial. Eur J Neurol 12: 715–718,
2005
27. Wipke-Tevis DD, Williams DA: Effect of oral hydration on skin microcirculation
in healthy young and midlife and older adults. Wound
Repair Regen 15: 174–185, 2007
See related article, “Impact of Solute Intake on Urine Flow and Water Excretion,”
on pages 000–000.

There are many sentinel events in a young persons life. At the Kovaleski Compound today we arrived at one that we knew was coming, and honestly had done our best ostrich imitation by deciding to stick our heads in the water saturated turf at our house. John, the first born, the prince, the apprentice to all that is Kovaleski, first in line of succession, okay, you get my point, arrived at home today with none other than his very own learners permit to drive, unsuspectingly issued by the State of South Dakota (I wonder if there is a hidden psychological aspect to the point that it is not in a very calm blue color like the one you get when you turn 21, but screaming danger red). You would have thought he was Charlie from Willy Wonka and found the golden ticket to the kingdom. At this point I was seriously questioning our (I have to lay some blame with my wife!) decision to skip drivers education, even though we would receive no discount on our insurance, surely the amount of money we would have saved in valium and psychotherapy would have been worth the cost of the course (I hear one of the perks to being a drivers ed instructor is they receive their medication and electric shock therapy free as a bonus for teaching a prebuscent hormone enraged teenager how to drive a two ton killing machine on 41st street). Like a convict who had been incarcerated and now with keys to the world, John was ready to saddle up and explore the neighborhood with the four-dollar-per-gallon horse. As he looked at my wife and I sitting at the kitchen table (which for some reason he decided to clean up tonight after dinner…), my lovely bride pointed out to me as she was racing up the stairs to complete some chore that had conveniently just popped up, that he is actually more responsible than I am (which is actually true by the way), and to have fun. Have fun? That is queen of the household speak for, “tag, your it!” I checked off the appropriate check boxes in my mind: 1) health insurance paid, check 2) life insurance paid up, check 3) long term disability paid just in case I need to be fed through a straw for the rest of my life, check. We then had a major decision to make: Sleek Honda Odyssey or Mighty Toyota Tundra. As football stud pointed out, it just wouldn’t be right to be seen cruising the hood in a minivan, but the Tundra allow him to more appropriately display his new stature in life. Actually I thought this was a huge plus because the Tundra is the only full-sized pickup to earn the IIHS’s Top Safety Pick (which was actually part of the plea used on my wife when I was begging her to let me get one two years ago!), and had excellent scores on frontal, side impact, and rear collisions and could easily roll over any unsuspecting tree-hugger type car like a Prius or several unwary Harley-Davidson riders.  We proceeded to the garage where Big Red was stabled (which actually caused me physical pain to say, those of you who know I bleed U of Michigan blue and would crawl across broken glass to avoid anything associated with the U of Nebraska. What exactly is a cornhusker anyway?).  John took the appropriate position, adjusted the seat, put the key in the ignition and brought the Tundra to life. As he quivered with excitement, I was actually saddened because not only is this a sentinel event in John’s life, it is just another milepost crossed to the time I don’t have me buddy at home with me as he moves on to college (Michigan!?!). He put the truck in gear. I calmly pointed out the reverse would probably work better than drive for backing the truck out of the garage and that Mom probably wouldn’t appreciate the truck parked in the kitchen. As we backed out, I comforted Prince John that is exactly why the engineer at Toyota designed folding mirrors, to fold in, instead of being ripped off by the wall of the garage as we backed out. My neighbor, who has one son out of high school and the other a senior in high school (going to Nebraska by the way. We still talk.) gave me the two thumbs up sign as to say, “dude, I feel your pain and can I have your riding lawn mower if you don’t happen to survive the quest.” The rest of the trip was for the most part, uneventful. I pointed out that the point of acceleration was not based on the space shuttle take-off theory, that we were not trying to go from zero to Chuck Yeager breaking the sound barrier speed within the space of one city block to try and escape the gravitational pull of the earth, that the point was smooooooth acceleration. I also found out that the inertia reel placed on the passenger side safety harness was working as designed as we approached the first intersection and the Tundra’s speed went from escaping gravitation pull acceleration to zero in the blink of an eye. The people who designed anti-lock breaks: way, way, way underpaid. Overall, the first ride went well. I gave the new driver kudos. I tried to tell him that the mirrors fold both ways, but he decided to leave the truck in the driveway. He then jumped on his bike and rode over to a friends house to jump on his friends new trampoline. I sat there for awhile (no, I didn’t wet my pants. I made sure to go before we left!), realizing that kids grow up way to fast and I won’t have my best big buddy (John: Best Big Buddy, Luke: Best Little Buddy, Abby: The Princess and Best Girl Buddy, Denta: My Best Friend in the whole world buddy) around much longer.

I was sent this video clip by my brother-in-law yesterday. It was just what I needed at this time in my life (funny, no pun intended, how God works that way). I was laughing so hard I about wet my pants (sorry, I had to get some sort of kidney reference in there). My brainiac 12 year old (see gun wielding Pookie post) who watches things like the National Spelling Bee informed me this contestant, Sameer Mishra, actually went on to win the whole, “kit and caboodle.” As a long time connoisseur of the cliche, I quickly informed brainiac that it was an improper cliche to use in this situation because the meaning certainly wasn’t appropriate. He proceeded to take me out to the newly renovated basketball court and give me the “whole nine yards” (yes fellow cliche freekazoids, I am using the war time meaning of the term, jeez) by beating me P-I-G to nadda (nice use of urban slang huh!).  And in case you were wondering, he didn’t make me use it is a sentence.  In the famous words of Homer, Simpson that is…DOH!
http://video.google.com/videoplay?docid=6214100200406816721&q=spelling+bee&e

I went downtown tonight to see not only one of my former guitar instructors but a good friend, Dan Mahar (www.danmahar.com). As usual, he didn’t disappoint. Dan not only is a super guitar player (definitely one of the best in Sioux Falls), but has a great voice. The weather was great for sitting outside on the patio at Stogeez and enjoying his music. I am looking forward to Dan’s new CD which will hopefully be out soon.  There is a good review on the Argus Leader (www.argusleader.com) web site in the entertainment/link section of Dan’s cd Long Stones Throw.

On a similar note, over the last three days I have been able to listen to three guitar oriented cd’s. The first was the latest offering from session guitar master Steve Lukather, Ever Changing Times. As one would expect from one of the greatest guitar players ever, great guitar chops. One can definitely hear the Toto like songs as well as a Steely Dan influence. I knew I would like the cd when the first song, Ever Changing Times had a Zakk Wylde sounding riff. The second was the latest from Billy Idol ax man, Steve Stevens, Memory Crash. Just when I thought that Lukather’s album was going to be the guitar album of the moment (despite the singing), I was totally blown away by Memory Crash. If you are a guitar junkie, this one is a must buy. His cover of Robin Trower’s song Day of the Eagle is phenomenal (btw, Bridge of Sighs, one of the best ablums ever in my opinion). A lot of people don’t know that Mr. Stevens is one of the all time best guitar players out there. One of his best is Flamenco a Go-Go, which I still listen to frequently, shows he is not just a rock guitar god. Last, but by far not least, is the latest by the super jazz guitar player and one of my all time favorites, Pat Metheny, called Day Tripper. I have never gotten to see my favorite guitar player John McLaughlin in concert, but I have been fortunate enough to see Mr. Metheny on more than one occasion, including the latest line up of one of the best bass players in the business, Christian McBride and wonder drummer Antonio Sanchez. Every track on this cd is incredible. Mr. Metheny probably a shoe in for his 18th grammy, definitely a must buy for any jazz junkie.

Memorial Day is often thought of as the beginning of summer (when I went to school, we always started after Labor Day and Memorial Day weekend heralded to beginning of summer vacation), but I hope we take the time to remember that this holiday, formerly known as Decoration Day, it is supposed to be a time where we honor those who died while performing military service for their country. Let us not forget the lives that have been lost to give us the freedoms we enjoy. If you have never had the opportunity to visit Washington DC and see the different memorials, it is truly inspiring. Thank you veterans who died so that we can live in the greatest country in history and so that we can enjoy the freedoms we do this day.

The boys and I saw Speed Racer this weekend.  Speed was ok but Jonny Quest is the best cartoon ever, period. When I was but a wee one a very long time ago, I remember watching Jonny Quest and dreaming one day of being Race Bannon. I wanted a little dog like Bandit. Speed Racer was cool, but doesn’t hold a candle to Jonny Quest. Space Ghost was close. Best episode?  Not even close. The Robot Spy, where Dr. Zin uses a UFO to transport a giant spider-like robot to earth to try and get info on a para-ray gun that Dr. Quest had invented.

I have certain blogs, web sites, newpapers, etc daily that I peruse. Laura Ingraham, The Weekly Standard, Rush Limbaugh, all the blogs to the left (I am in my blog infancy and haven’t figured out how to make lists yet.  Summer project…), along with several newspapers for starters. I have recently downloaded all of the video sermons from the Celebration Church with Stovall Weems, mainly because anyone with a name like Stovall Weems has to be totally radical. I was right, the sermons are great. If we happen to have more kids, probably adopted unless divine intervention is involved if you know what I mean, I am going to name a boy Stovall. I also downloaded all of the sermons from the church where Pastor Dino Rizzo (yes that is correct, it not Pastor Rizzo’s church) is the lead pastor. I was drawn like a moth to a bug zapper to a sermon titled, “You’re an Idiot.” I know, I know, blah, blah, blah. I was thinking it was him (Pastor Rizzo) I was initially listening to but it turned out to be Pastor Craig Groeschel. The sermon was outstanding. I actually listened to it twice on my way to outreach clinic in Parkston. If you have the ability to download the podcast, take a listen and let me know what you think. I think it is easy to get caught up in the flavor of the day whether it’s this praise and worship style because church such-and-such has blazing guitars and a 100 person choir, or maybe a certain doctrine that we are debating amongst (nice KJV lingo there huh!) ourselves, or maybe its our pot luck (something I learned in Richmond, VA that the Southern Baptists at Grove Avenue Baptist do without peer!), or our big shiny new building, or … you get the point. Jesus came to seek and save the lost, period. If our focus isn’t there, we should seriously think about refocusing. It is easy to get sucked into the tangential topics that would take us away from a dying world and our primary mission. I find it interesting the number of Christians, long time Christians, who have never led some to the Lord. Has it been a while? Ever? I often think the reason one hasn’t is that they have never had a revelation of what hell is and what it would be like to spend an eternity, eternity, in hell. Would I be so cavalier with my relationships to those around me if I had any idea what an eternity in hell would be like? I doubt it. I pray God would give us a revelation, of hell and that it would light a fire (no pun intended) in us for those around us and that we would realize that the preoccupation with the church should be to rescue as many as possible from an eternity separated from the One whose one mission was to leave Heaven, be born to a virgin, live a perfect life, and die a horrible death on a cross just so we could have a relationship with the Him if we would only accept the gift he presents to us.

This is a poem about Mothers that I really like. I’m not sure who penned it so can’t give credit:

The child asked God, “They tell me you are sending me to earth tomorrow, but how am I going to live there being so small and helpless?”

“Your angel will be waitng for you and will take care of you.”

Again the child asked, “And how am I going to be able to understand when people talk to me if I don’t know the language?

God said, “Your angel will tell you the most beautiful and sweet words you will ever hear, and with much patience and care, your angel will teach you how to speak.”

“And what am I going to do when I want to talk to you?”

God said, “Your angel will place your hands together and will teach you how to pray.”

“Who will protect me?”

God said, “Your angel will defend you even if it means risking her life.”

“But I will always be sad because I will not see you anymore.”

God said, “Your angel will always talk to you about me and will teach you the way to come back to me, even thought I will always be next to you.”

At that moment there was much peace in heaven, but voices from Earth could be heard and the child hurriedly asked, “God if I am to leave now, please tell me my angel’s name.”

God replied, “You will simply call her Mom.”

Thanks Mom. Happy Mothers Day!

Iron Man ROCKS!!!

15 years ago today my Dad died from lung cancer. I remember the length of time he has been gone because he died one month before our first son, John (named after my Dad) was born. Not a day goes by without me thinking of him. To this day I miss him terribly. My Dad was born in 1920. He grew up in during the Great Depression. He was a gunner on a B-17 during World War II in the south pacific. Growing up, I remember my Dad working harder than any three people I knew put together and still holds true to this day. I remember standing in a stream in Outlaw Canyon in Wyoming, learning how to fly fish at an early age. I remember going elk and deer hunting every fall. I remember going to church when I was young but not consistently growing up. After I started going to church after accepting Christ as my Saviour in 9th grade, he would encourage my sisters and I to go, but never went with us. We talked about God on many occasions but nothing ever came of our conversations. I just kept hoping that a seed was being planted. One day about a year before he died, we were living in Rapid City and I woke up one morning suddenly. For some reason I had a feeling that I had to go visit my Dad in Gillette, now. I told my wife and left for Gillette. I got there about two hours later and found him sitting at his usual spot at the kitchen table. He was surprised to see me and we talked for a couple of minutes. I then asked him about Jesus and if he wanted to ask Him into his heart. He said, “sure!” It was not long after that he found out he had cancer. He is buried at the Black Hills National Cemetery. He was a long time smoker and that took him from us early. He never met my kids. When I got the letter saying I was accepted to medical school, I drove to the cemetery and laid the letter on his grave, and sat there and cried for what seemed like an entire afternoon. I know that he is not at the spot designated by the marker on his grave, he is sitting with Jesus in heaven, whole, healthy. I know that one day we will be reunited and he’ll get to meet John, Luke, and Abby. Hopefully I have made him proud. I miss you Dad.