text:
Photo Credit: Dimitrios Kambouris/Getty Images for Michael Kors
Many people were surprised by Halle Berry's pregnancy -- including the actress herself!
News broke on April 5 that the 46-year-old is expecting her first child with fiance Olivier Martinez. (The new baby will join Berry's 5-year-old daughter Nahla, whose father is ex-boyfriend Gabriel Aubry.) The next day, Berry confirmed the reports and opened up about her emotional journey.
"I feel fantastic. This has been the biggest surprise of my life, to tell you the truth," the Oscar winner confessed to CNN. "Thought I was kind of past the point where this could be a reality for me. So it's been a big surprise and the most wonderful."
Berry also said that she plans to use her pregnancy to help educate women. She and designer Michael Kors launched their Watch Hunger Stop campaign in N.Y.C on April 6. Together, they designed two versions of Kors' Runway watch -- and for every watch sold, the World Food Programme will give away 100 meals to hungry children. Berry and Kors will be traveling with the charity to the areas where food will be sent.
"I hope we go while I'm pregnant, so I can talk about prenatal care," Berry told the Associated Press. "And I will have time off -- I'm not working right now. It's so important to me, being a mom, that I can help educate women on how important it is that when you have a healthy child, it helps set them up for life."
WATCH: Whoa, Did Tom Just Open Up About Katie?


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Marketplace Activity
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1997 Screaming Eagle - Cabernet Sauvignon Cabernet Sauvignon - USA - California - Napa - Napa Valley - Red
USA - California - Napa - Napa Valley
Cabernet Sauvignon
Producer Notes
Screaming Eagle is a success story almost without equal and is the definitive "cult" classic of Napa. Founded in 1989 by Jean Philips, it "captures the essence of one great Cabernet site in Oakville." Growing mostly Cabernet, Merlot and Cabernet Franc on its little plot of land, Screaming Eagle produces an averages of 500 cases per year. The majority of that is sold only to members on the... More »
Drink DatesVF: 2004-2020
Community Tasting Notes average score of 100 points based upon 2 reviews
0 of 1 people found this useful
Classification of Napa
Recently the Finnish publication FINE Wine Magazine has attempted to classify Napa Valley wines akin to the 1855 Classification of Bordeaux. View the article here: "Napa Valley Classification." Since then, there has been much...
Created Nov 4, 2009
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subset: commoncrawl


text:
Happy Valentine's Day!!!
I have a super sale going on at my GingerScraps & GDS Store!!
I have a special FWP going on over at my GingerScraps Store!
Spend $5 or more and receive this
p.s. - I Love You Weekend Special
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If you haven't seen the p.s. - I Love You Collection take a look!
This is an AMAZING Bundle at 60% OFF!
You'll receive 2 Full Kits, a Krafties Paper Pack, Journal Cards, a Smatters Pack,
Confetti Mix and the coordinating Alpha!
(all packs are also sold separately in both stores!)
Brand New today and
40% OFF at GingerScraps & GDS!
6 fun, 12 x 12, grungy, edgy edges for your traditional, mixed media and art journaling creations!
Mishmashed Edges 1
You'll find so many uses for these!
Layer them on top of your background paper and play with different blending modes and opacities for different effects!
Clip other papers to them for an really great look!
Use them as photo borders or mats!
Here are a few examples:
Try before you buy!
(just click the image below to download!)
(just click the image below to download!)
Don't forget....my Clearance Sale is still going on at GDS!
Take advantage of 50 products to be retired at the end of the month!
Bundles, Kits and Extras all at 60% OFF!
One last little goodie!!
Newsletter subscribers will receive an Extra 10% OFF Coupon
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Not a subscriber yet?
Make sure to sign up HERE
before February 17th!
Wishing you love and happiness this Valentine's weekend!


text:
Memos -
January 2012
USS Ponce to Become a Floating Base
The Navy has put out an RFP, with a very quick
turnaround, for conversion of the 40-year-old USS Ponce, (LPD 15), which
was due to be decommissioned on March 30, to what they are calling an Afloat
Forward Staging Base, or AFSB. Find it
here. Sounds like a more expensive version of an MLP to me and, sure enough, the Navy is apparently planning to modify the MLP
design to allow either the third MLP or a currently unplanned fourth MLP to
become an AFSB. Read the story in Defense News
January 29, 2012.
RFP Out for Dismantling Three Carriers
Now here's an interesting project. The Navy
wants a single contractor to dismantle the Forrestal (CV 59), the
Independence (CV 62) and the Constellation (CV 64). Read the
FBO announcement
here. Not
many yards have the physical resources to do a job like this, apart from the
unique management skills. How much will this cost? $80 million each?
Are they worth that much in scrap? Why not give them to our impoverished allies?
I guess nobody wants ships that big. Reef
them as targets, take them out into really deep water and pull the
plug? Can't do any of those any more - the greenies wouldn't like it. January 27, 2012.
P.S.: I'm told that my figure of $80 million
is off by a factor well over three. So I know diddly about the recycling
biz. Anyway, if the lightweight of one of these ships
is about 60,000 tons,
a price of $24 million per ship
would represent about $400 per lightweight ton. It will be interesting to see what
the bids are. January 30, 2012.
Changes in the Navy's Shipbuilding Program
As far as one can tell from Secretary Panetta's
statement, the new defense strategy will mean that the Navy's shipbuilding
programs will experience the following changes:
CVN: no change
SSBN: delayed two years
SSN: one boat dropped from the FYDP but not
deleted; Block 5 boats to carry cruise missiles
DDG: no change
LHA: second ship delayed one year
LPD: no change
LSC: two ships dropped from the FYDP but not
JHSV: eight ships dropped from the FYDP but
not necessarily deleted
MPS: no change
Bad news for Austal, but, all in all, it could
have been a lot worse. January 27, 2012.
Ship Takes Out Bridge
The Delta Mariner hit the Eggner's Ferry
(Highway 68) bridge over the Tennessee River last night, taking out two spans of
it, fortunately without any casualties. Read the story on WKDZ
The Delta Mariner is a unique shallow-draft/low-air-draft ship, built by
Halter in 1998, which is operated by Foss for Boeing: she generally carries
rockets and other stuff from Boeing's plant in Decatur AL down the Tenn-Tom to
Mobile and thence to either Cape Canaveral in Florida or Vandenburg AFB in
California. See the pictures on Foss' web site
In this case, she was way upstream of Decatur, not far south of the Tennessee's
junction with the Ohio River. January 27, 2012.
McCreary Moves Up
Only three months after joining BAE Systems,
Richard McCreary has moved up to become Vice President and General Manager of
BAE Systems Southeast Shipyards. Ever the glutton for punishment, he will
continue to be VP Commercial Business Development for BAE Systems Ship Repair.
Richard replaces Dan Welch, who is retiring. Good move. January
26, 2012.
The Atlantic published a series of
pictures yesterday of the TK Bremen, a small cargo ship which grounded on
a beach in France last month and which has already been almost completely
recycled. No particular message here, just look at these terrific
pictures. See them
here. In a
world in which so many people use a cell phone to take really crappy pictures,
it's nice to know that there are still a few real photographers around.
January 25, 2012.
Can the Costa Concordia Be Saved?
There is a really excellent graphic in the
National Post today that addresses the difficulties of salvaging the
Costa Concordia. See it
January 23, 2012.
The Costa Concordia's Wild Ride
The Dutch company, QPS, which makes Qastor
navigation software, has recreated the doomed ship's track from the AIS data. See it
here or go to
Landing Craft Grounded in Maui
In a welcome contrast to more news of the
Costa Concordia, we can report that LCM 8540, built by Rohr
in the early 70s, ran up on the beach in Maui earlier this week. Read the
story on KITV and see a video
No word on what her captain was doing at the time. January 20, 2012.
Another Refinery Closing
The 500,000-bpd Hess/PDVSA refinery on St. Croix,
for which the six Jacksonville-class ITBs were built, will close next
month. Read the announcement
here. January
18, 2012.
President of RINA Resigns
The fallout has started already. Enrico
Scerni, the President of RINA, quit yesterday after saying that everybody knew
that captains routinely "take a bow" as they pass Giglio. Read the story
in Genova 24
January 18, 2012.
Leevac Changes Its Name
LEEVAC Industries, the shipyard in
Jennings LA, and LEEVAC Shipbuilding and Repair, the shipyard in Calcasieu LA,
have consolidated and both are now LEEVAC Shipyards, LLC. Makes sense to
me. Read the announcement
January 17, 2012.
Costa's Gone
I reckon Costa's gone, don't you? They will
lose so much business as a result of this fiasco that it would take them years
to recover. Carnival won't sit still for that. They will close it
down and transfer the ships and routes to one or more of the other subsidiary
companies. Without those silly stovepipe stacks, of course.
January 17, 2012.
Seacor Takes Over Trailer Bridge
Seacor and two investment companies are bailing
out Trailer Bridge in return for control. Read the report in the JoC
here. This
is excellent news. Now, how about taking over Horizon too?
January 17, 2012.
Blame the Master But ......
So they are going to put the blame for the Costa
Concordia disaster on her Captain. Fair enough. But there may be just a few technical
questions that need answering, don't you think? Yeeeeees. It will be
interesting to watch Carnival and Fincantieri and RINA dancing around questions
that are nothing to do with the Captain's alleged negligence, such as the power
failure and the widespread flooding and the crew's training and the lack of
emergency drills and probably a bunch more that haven't surfaced yet. January
16, 2012.
Stackley Goes After HII
Reuters reports that ASN Sean Stackley is leaning
on HII to get the costs of the CVN and LPD programs under better control.
Read the story
here. I
particularly like this quote from HII's Mike Petters:
"Until those ships (the LPDs) are gone, and until we get
Avondale wound down and closed, we sleep with one eye open on all those
programs." Read the ASN's full statement on DefPro Daily
January 15, 2012.
Five-Year-Old Cruise Ship Wrecked
How exactly could a post-Panamax cruise
ship - the Costa Concordia, built by Fincantieri in 2006 at a cost of over
$500 million - be so totally and catastrophically wrecked, with such terrible
loss of life? What was a ship with a 26-foot draft doing there? What happened to two-compartment subdivision?
What happened to all the back-up systems? Why did she roll to starboard
when the gash appears to be in the port side? What
have Costa Line (owned by Carnival), Fincantieri and RINA (the Italian class
society) got to say for themselves?
Could such a
disaster happen here? In the islands? In the Florida Keys? In
Alaska? How can we say that it couldn't? Of course it could and in
fact nearly did, only two weeks ago, when the MSC Poesia, also with a
26-foot draft, ran onto a reef in the Bahamas that was in 15 feet of water.
Read about that
here. January 14/15, 2012.
Downsizing Government
It seems from today's
news that the Democrats now
agree with the Republicans that the federal government's too big and needs to be
streamlined. So this would be a good time, would it not, to act on my oft-repeated
suggestion that we should merge all the various departments and agencies that
are involved with the commercial marine industry and its infrastructure?
I'm talking about the civil activities of the U.S. Coast Guard and
the U.S. Army Corps of Engineers,
plus the Maritime Administration, the Federal Maritime Commission, the Bureau of
Ocean Energy Management and NOAA. Let's put them all in the Department of
the Interior, with an Assistant Secretary in charge. January 13, 2012.
Navy Acce
Military Sealift Command reports that the range
instrumentation ship Howard O. Lorenzen, (T-AGM 25), has finally been
accepted. Read the announcement
Built by VT Halter Marine to replace the 60-year-old Observation Island,
she was rejected back in June, but has apparently now been fixed.
January 13, 2012.
Reliable sources say that Joel Szabat, who is
currently Deputy Assistant Secretary for Transportation Policy, has been
appointed Executive Director of MARAD. This is odd, because there is no
such position in MARAD and there are several senior vacancies in the existing
organization structure, but no doubt all will be made clear soon. Mr.
Szabat appears to be highly qualified - read his bio
- just not qualified for a job in MARAD. Never a dull moment.
January 11, 2012.
Coast Guard Academy Needs More Space
According to the local press, the Coast Guard
Academy needs to expand its facilities but the city of New London doesn't want
to accommodate it. Read the story on WTNH
here. I
suppose that it's only a matter of time before someone suggests that the Coast
Guard Academy might merge with the Merchant Marine Academy. Not me, of
course. January 9, 2012.
Historic 75-Year-Old Yacht Sinks
The 93-foot Gypsy Queen, built on City Island in
1936 by Henry B. Nevins, has sunk in Steamboat Slough, near Everett WA.
Read the report from Washington State's Department of Ecology
here. January
6, 2012.
More Strange Names
The Secretary of the Navy continues to stir up
the old guard with his non-standard approach to the naming of ships.
First it was the T-AKEs, the LCSs and the JHSVs: now
it's the Mobile Landing Platforms. They will be named Montford Point,
John Glenn and Lewis B. Puller. Read the announcement
here. Read
one blog's reaction to it
January 6, 2012.
A Strategic Plan for Kings Point
DoT and MARAD have initiated the development of a
strategic plan for the U.S. Merchant Marine Academy. Read MARAD's
Good. Now, how about a new and meaningful strategic plan for an effective
Maritime Administration? (Read the current plan, published in 2008,
January 5, 2012.
Nome Tanker Gets Waiver
The Russian tanker Renda got its Jones Act
waiver and is on its way from Dutch Harbor to Nome. Read the story on KTUU
January 5, 2012.
Ship to Build a Longliner
Alaska Longline Company has ordered a new factory
longliner - similar to the one on the right - for service in the Bering Sea. The 136-foot Jensen-designed
vessel will be built by Alaska Ship & Drydock and delivered in 2013. It
appears to be the first to be ordered as a result of the recent changes to the
American Fisheries Act, which are expected to stimulate renewal of the Alaskan
fleet: read a summary of the changes
January 3, 2012.
Keppel O&M Gets Into the Wind Too
AMFELS' parent, Keppel O&M, has bought half of
the Norwegian company OWEC Tower AS, which designs offshore wind towers.
Read the press release
here. Will
we see them built in Brownsville? January 3, 2012.
Cable Ship in the Hudson
It's interesting to see Pirelli's cable ship
Giulio Verne working in the Hudson River. It's not long since we had
cable layers in the U.S. fleet but, except for the Navy's Zeus, (T-ARC 7)
- built by NASSCO in 1985 and primarily a cable repair ship
they've all now been flagged out or sold.
By my count, there are 68 large cable ships in the world fleet, including seven that belong to a U.S. company - TE Connectivity (formerly
January 3, 2012.
A Wish List for 2012
Some developments to push for in the New Year:
with financial strength will buy Horizon Lines and order some new ships
At least one Great Lakes operator will order
some dry bulk ATBs
Our multitude of industry associations will
get together and start working as a team
MARAD will drop the "National Marine Highway"
and focus on revitalizing the existing trades
DoT, the Corps and the Congress will start
rebuilding our maritime infrastructure
The industry will enthusiastically embrace
everything "green" that makes economic sense
SecDoT will fire Matsuda and hire somebody
with relevant capability and experience
The Navy will finally work out that it is
going to have to settle for fewer and simpler ships
There's a bunch more things we should be doing,
but these will do for starters. Don't hold your breath.
January 1, 2012.
HERE to read earlier editions of
"Maritime Memos",
going back to 2001


text:
There are many ways to get involved – take the lead on something or just pitch in for an hour or two. There are lots of opportunities for anyone who has time or talent to share!
Current PTSA Opportunities
Contact your PTSA Leadership Team for more information: firstname.lastname@example.com
Greater Giving coordinator: Learns the Greater Giving software that we use for the auction, PTSA membership, and other fundraising efforts. Trains others and assures the software is used to it's best potential.
E-scrip coordinator: Keeps our account up-to-date and reminds community members to sign up or renew their Safeway cards!
Co-Secretary: The secretary job is simply providing a short written summary of the topics discussed at the PTSA Leadership Meetings and the General Meetings. The time involvement is attendance at monthly leadership meetings (approx. 1.5 hours each) and 3-4 general meetings per school year (also approx.. 1.5 hrs each). The position is perfect for sharing with another person.
Legislative rep: Attend school board meetings for district level involvement and perhaps state level connections with our legislators and trips to Olympia are part of the job description. Additional info here: http://www.seattleschools.org/modules/cms/pages.phtml?pageid=189059 and here: http://34dems.org/elected-legislative.htm
Reflections coordinator: Coordinate with Chief Sealth staff for student involvement in this National PTA arts program. For additional information, Please reply to Fionnuala O'Sullivan, PTSA Volunteer Coordinator
College Preparation/Readiness: coordinate with Counseling Staff and work to organize/coordinate college-related guidance for students and parents (includes arranging for Princeton Review Assessment, Paying for College workshops, etc.). There is a wealth of info and resources already available, someone needs to shepherd it along next year!
Volunteers needed for upcoming events:
(contact Fionnuala O'Sullivan, Volunteer Coordinator,at 206-779-4643 or firstname.lastname@example.com):
- Graduation is Wednesday, June 12, 2013 @ 7:30pm. Volunteers needed for Grad Night set-up and chaperoning throughout the evening until the wee hours!
Chief Sealth Staff Volunteer/Donation Wish List
We are so grateful for the support of our Chief Sealth International community. Here is a list of wishes & needs from Chief Sealth teachers and staff. See a good fit here? Some way you can help? Contact the teacher directly for details—they will be so happy to hear from you! Thank you for your unwavering support of our students and staff at CSIHS! Go Seahawks!


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Ever wondered if there's an elaborate plot for kittehs to take over the Internets? Well, here's the expose we've all been waiting for.
(If you can't see the clip, click here.)
"If you don't want to do your job and put Maru in a box, I'll find someone who can!"
Perhaps more alarming than the conspiracy is the fact that I recognized nearly all the kittyvids mentioned in the clip.
Oh, I believe! And so should you! The kitteh conspiracy is real. Just be skeptical when they say that kittens don't dream. We all know they do.


text:
The 'Seamless Fabric'
Series About:
It all came down to a floral-print bedspread in Room 21 at the local motel. It was missing—and so was Emily Sander, 18, of El Dorado, Kan. Find the bedspread, police figured, and they'd probably find Emily, who disappeared Nov. 23, 2007, a Friday.
Room 21 at the El Dorado Motel was a mess. An employee said it looked like there'd been some sort of "altercation" there. Police found a large quantity of blood on the bed and carpet.
Meanwhile, Israel Mireles failed to show up for work on Saturday at a nearby Italian restaurant where he was a waiter. Mireles, a 24-year-old resident alien from Mexico, had been staying in Room 21 at the El Dorado Motel.
"Foul play" became the operative theory. "All we're saying is we're looking for that bedspread, and it's something we'd like to find," police Capt. Justin Phillips told reporters.
Emily had been last seen wearing low-rider jeans and a "Don't Mess With Texas" T-shirt—leaving a bar around midnight that Friday with a man matching Mireles' description. Her car was still parked at The Retreat bar. Yellow police tape went up around Room 21, now officially a crime scene.
Over the next few days, a massive nationwide search began, with local rescuers employing dogs, planes, divers and underwater equipment to search for Emily's body. Police released a photo of the floral bedspread to help in the search. On Tuesday, Mireles' rental car was discovered in Vernon, Texas, about 350 miles south of El Dorado.
It looked like Mireles might be making a run for the border—along with his 16-year-old pregnant girlfriend. That was not to be the last shocker.
It was also reported that Emily Sander, community college student by day, was something else again by night—an aspiring Internet porn star under the name "Zoey Zane." News accounts said she'd just told her family a few days before about her secret life and a contract she signed with an Internet porn enterprise.
The Emily Sander case, an unsolved murder mystery with sensational elements of sex and violence, catapulted into a national news story. Finally, on Thursday, Nov. 29, the suspense came to an end.
The bedspread had been found.
Ugly Truths
To some, the commercial sex industry is just like that bedspread — not a quilt fabricated of separate pieces, but a whole cloth, seamlessly interwoven.
In the view of some longtime anti-porn activists, prostitution, pornography, stripping and all other forms of commercial sexual exploitation are just the warp and woof of this same fabric. And that's why, they say, it's dangerous not to take pornography seriously, to dismiss it as merely an unpleasant free-speech issue.
In the business of commercial sex, pornography serves as the marketing vehicle. Or, as Alliance Defense Fund lawyer Patrick Trueman, a former porn prosecutor with the U.S. Department of Justice, testified before a congressional subcommittee several years ago, "Pornography is a powerful factor in creating the demand for illicit sex."
Some ugly truths: Experts say pornography consumers develop sexual addictions and predilections for kinky types of sex depicted in explicit material. Men then demand this from their wives—or find other, more willing sexual partners. Some young prostituted women learn how to "perform" by mimicking what they are shown in pornography. Many sexual predators use pornography to show children what they want them to do. Virtually all collectors of child pornography, some experts say, are also molesters of children.
Something else the porn industry doesn't advertise is the tremendous overlap among porn stars, strippers and prostitutes. It's not unusual for the same women to engage in all three. Dr. Barrett Duke, vice president of the Southern Baptist Ethics and Religious Liberty Commission, views it as a continuum.
"If you look at the progression of women who begin in the pornography industry, maybe they'll start out in the strip clubs or something like that, and they stay there for a while," Duke told Focus on the Family. "But as they move further along in this sexual exploitation timeline, as they become older and of less interest, they end up moving into some of the other more degrading forms of sexual exploitation."
Drug and alcohol addiction eventually becomes a vicious circle for most, he said. It takes drugs and alcohol to numb their conscience, and then it takes more sexual exploitation to support those addictions.
This is not just the view of the religious right. Increasingly, feminists are coming around to this perspective, too.
Dr. Donna M. Hughes, professor of women's studies at the University of Rhode Island, estimates from her research that at least a third of women in prostitution have been involved in the making of pornography and that patrons of prostitution are twice as likely to be porn users.
"That can be everything from sort of amateur stuff, where a john brings his camera and wants to take pictures, to some of the women who may be stars for a few months in the pornography industry," Hughes told Focus on the Family. "And where do they go after they've had their few months of stardom with a couple of movies? They usually go into stripping, which usually then just turns into prostitution."
It was Hughes who suggested the "seamless fabric" language.
"The categories we have for things like pornography, stripping, prostitution—we tend to think of them as really separate categories," she said. "But if you're actually in the sex industry, they're quite seamless. There are so many variations that I think our old categories are rather obsolete."
Feminist researcher Dr. Melissa Farley agrees. "The more distinctions we make about what johns and pimps do, the more we're letting them win," she told Focus on the Family. "Just because there's a camera in the room doesn't mean it's not prostitution."
In her 2007 book Prostitution & Trafficking in Nevada: Making the Connections, Farley quoted Roger Young, a retired Nevada FBI agent who participated in major pornography investigations: "What happened to common sense? The fact that there is a camera filming the prostitution doesn't change the fact of the prostitution. Pornography is essentially a crime scene surveillance tape. You can't say to someone, hey, let's go rob a bank, but if we film it, then it won't be robbery."
"Pornography is men's rehearsal for prostitution," Farley told Focus on the Family.
Pat Trueman, who has dealt with numerous sexual predators and addicts, confirms this view from his own experience. "They'll all tell you, they got into pornography, and that led them to the strip club," he said. "And that led them to the prostitute. … They get into pornography, they get into sex, they get into using trafficked women."
The other ugly truth: While estimates vary, experts told Focus on the Family that the average age of entry into prostitution has fallen to 12 to 14 years. The seamless fabric of the commercial sex industry represents a huge and growing threat to America's youth.
A 'Cruel World'
El Dorado, Kan., is a town of 12,000 people about 30 miles east-northeast of Wichita. El Dorado (locals pronounce it "el doh-raydoh") has been home to notables including cartoonist Mort Walker, presidential biographer William Allen White and serial killer Dennis Rader, aka the BTK strangler.
And Emily Sander—"nude model and nationally reported murder victim."
Searchers spotted the floral-print bedspread in a ditch off U.S. 54, about 50 miles east of El Dorado. Lying nearby, over a steep embankment, was the body of a young woman matching Emily's description.
Emily Sander's identity was confirmed by a forensic orthodontist. An autopsy was performed and the results sealed, along with the police report and all other facts of the investigation. A warrant was issued for Israel Mireles on charges of capital murder, rape and aggravated criminal sodomy.
El Dorado Police Chief Tom Boren disavowed any connection between Emily's death and her alter ego, would-be porn star Zoey Zane. In fact, he said, false leads connected to that Web site were seriously hampering the investigation.
Nevertheless, FBI agents and Internet crime experts were called in to assist in the investigation. A local reporter who worked the story told Focus on the Family it was inconceivable that Emily's general lifestyle didn't have something to do with her murder.
Shocked classmates organized a candlelight vigil in Emily's memory at the community college while the family made funeral arrangements. Friends eulogized Emily Sander as fun to be around, ambitious—a girl who wanted to be in movies. One said she did porn because she needed the money for school.
Clement Sander, her paternal grandfather, described brown-haired, blue-eyed Emily to Focus on the Family as a "cute little girl" who played volleyball in high school in Texas and did so well in school that she graduated a semester early. She had recently acquired some tattoos and piercings.
At the candlelight vigil, Sander offered some advice: "All I can say to you young folks out there is to be careful.It is a cruel world."
Intense news coverage of the Emily Sander case set off a debate about sensationalism and tabloid journalism. Some objected to calling an 18-year-old girl who'd been in the business just a few months a "porn star." Others accused the news media of lurid exploitation, saying they had no business exposing Emily's dirty laundry.
One report suggested big bucks were involved, claiming that Emily's Web site had enlisted 30,000 subscribers paying $39.95 a month to view sexually explicit Zoey Zane material. Even a small share of that haul—nearly $1.2 million a month—would still be tens of thousands of dollars, huge money for a teenager.
Others contended that those dollars actually were shared by a number of girls who were part of the same porn enterprise, all capitalizing on the same thing—a growing interest in younger women, and the younger the better.
Growth Market
Experts told Focus on the Family that higher-end dollar figures were not outside the realm of possibility for a girl like Emily, citing the hundreds of thousands of dollars involved in the notorious Justin Berry case.
Justin was a California teen who made headlines in 2005 and 2006 with revelations in The New York Times about subscription-based porn Web sites in which he performed from the age of 13. He was molested by more than one of his subscribers and was called to testify before a congressional subcommittee about the problems of teens in porn.
Cases like Emily's and Justin's highlight a new avenue for teen exhibitionism and exploitation—the Internet. John Shehan, director of Exploited Children Services at the National Center for Missing & Exploited Children, said it's a big problem and growing.
"As more and more teens realize how they can exploit technology, we are going to see more cases like this [Emily Sander] and cases like Justin Berry," Shehan said. "I think we'll see more and more of a transition from the real world—underage teens using fake IDs or whatever for exotic dancing/stripping—to the online arena. I think in a teen's mindset, it's much more attractive to go online. They can make far more money online and reach more customers via the Internet pay-per-view site than working at a local dive, dancing at an exotic bar/strip club."
Earlier this year the anti-trafficking organization Shared Hope International issued a report saying: "American children are victims of the sex trade, and they are being trafficked within the United States."
The numbers are disturbing. Estimates range from 100,000 to 300,000 minors sexually trafficked in the United States each year. Many are runaways or "throwaways"—kids neglected or abandoned by their families—who trade sex for survival.
The problem is particularly acute in "hub" cities for sexual trafficking, such as Atlanta and Las Vegas. Since 1994, Shared Hope has documented nearly 1,500 sexually trafficked minors in Las Vegas coming from 40 states—as many as 400 on the streets at one time.
Former Congresswoman Linda Smith founded Shared Hope International 10 years ago to expose the growing problem of domestic minor sex trafficking. Smith told Focus on the Family pornography is a prime gateway for children to become exploited.
"When they start, they think they're in control," she said. "But once they get into the porn industry, that girl is going to be in trouble. She will become a forced prostitute in most cases if she continues. Now, it could be one act that somebody convinces her to do, and she wishes she hadn't. But once that's out there, she's victimized over and over again by people seeing her moment of vulnerability—or maybe stupidity."
The U.S. State Department estimates that of the 600,000 to 800,000 persons sexually trafficked across international borders each year, 70 percent are forced into "sexual servitude"—and half of them are minors.
Curb the Demand
Daniel Weiss, media and sexuality analyst for Focus on the Family Action, laid major blame on the tolerance of porn, which in turn fuels demand for illicit sex.
"There is no difference between porn, prostitution and sex trafficking," Weiss said. "Together they form a seamless fabric of exploitation and abuse. If we ignore the threat of pornography, as is happening today with law enforcement agencies throughout the nation, we allow the sexual exploitation of women and children in the criminal sex industry to flourish."
Lisa Thompson of the Salvation Army agrees: "I think we need to completely retool how we're conceptualizing pornography," she told Focus on the Family. "Pornography is prostitution for mass consumption."
When the Salvation Army was founded by William and Catherine Booth in the 19th century, a major part of its original ministry to the downtrodden of London was rescuing "fallen women" from prostitution. That's still part of its mission.
Thompson, the Salvation Army's liaison for Abolition of Sexual Trafficking, challenges people not to discount the plight of adult women. Considering the falling age of entry into prostitution, she said, that 22-year-old street prostitute may have been victimized nearly half her life. "She's grown up in prostitution," Thompson said.
The Salvation Army works with communities and law enforcement agencies to provide support services for "survivors" of prostitution. But Thompson said "the church has really got to step up" and start dealing with this issue in a big way—prevention programs for children, more sex-addiction treatment programs for adults.
She noted that one of the biggest sex-trafficking cases in recent years involved girls and women being trafficked out of Toledo, Ohio, along truck routes across America. Two of the girls—cousins, 14 and 15—were abducted right off the street in Toledo and forced to become truck-stop prostitutes.
"If Toledo, Ohio, is a hotbed for recruitment of prostitution, it's time for the heartland of America to wake up," Thompson said. "I mean, we're not talking about Vegas or New York City or Atlantic City— places that we associate with vice. We're talking about good old apple-pie middle America."
Thompson and others are convinced that just arresting women doesn't work, and results in victimizing them all over again. They want to see more resources aimed at helping the girls, and more pressure on the demand side of the sex trade—the buyers and users.
"It is a severe injustice when American girls are held in physical and mental slavery and then punished for the crime that is committed against them," said Shared Hope's Linda Smith.
Going to War
Barrett Duke longs for a righteous revival that halts the moral free-fall in America and sends pimps and pornographers "back into the shadows."
"We've got to find a way," he said. "The good people in this country are going to have to say 'we've had enough.' The good people of this country have got to start fighting back."
That fight, Duke said, should begin with pornography. "In a lot of ways, pornography is the gateway to most of the sexual deviancy that we're seeing in this country."
And the church should lead the fight. "It's time for pastors to start calling sin 'sin,' start calling pornography 'sin' and start developing programs in churches that can help men— and women— caught up more and more in pornography," Duke said, "and begin to provide help groups, counseling and other kinds of services to help make people aware of sexual addiction and help them come out of sexual addiction."
But it may get darker before the dawn.
Dr. Gail Dines, a professor of sociology and women's studies at Wheelock College in Boston, has written and spoken on what she calls "pseudo" child pornography, the "barely legal" type of porn that appeals to fantasies about sex with children. She points to studies confirming the sinister nature of this growing market for teen porn as a gateway to child porn and pedophilia. "For some of these men [in one study], the teen sites were just a stepping stone to the real thing, as they moved seamlessly from adult women to children," Dines said.
"We've got a whole generation of men now who are aroused by [images] that look like children," Dines said. "We've never before brought up an entire generation of boys on pornography. The average age of downloading their first pornography is about 11-years old."
Ernie Allen, president of the National Center for Missing & Exploited Children, cited a study showing 42 percent of 10- to 17-yearolds are exposed to unwanted online pornography in the course of a year. "I mean, that's millions of kids," said Allen.
To Linda Smith, the battle has become very personal. Besides her relationships with a number of girls Shared Hope has helped to rescue, she's also concerned for young boys she says are being lured by the sex industry. She said Shared Hope has confirmed reports by the National Center for Missing & Exploited Children that some Internet pornographers are using misleading domain names, spam, pop-ups, tracking and other high-tech tricks directed at boys 8- to 12-years old.
"We found over 5,000 sites with key words and phrases that are associated with selling to kids, and in those it's very clear they're marketing the images to boys," she said. "I just cried, 'That's the age of my grandsons. They're after my grandsons.' They all play sports, and they all go online, and they all play these games, and they're typing them and sending them porn."
Smith likens the fight against sexual exploitation to the long battle over smoking in public. It took time to change public perception, but ultimately the tide of opinion changed.
"We're intending to go to war against the victimization of our children," Smith said.
Take Action
For additional information and to get involved, contact:
Pure Intimacy
Focus on the Family's online resource for
anyone struggling with pornography, intimacy,
addictions or homosexuality.
Shared Hope International
P.O. Box 65337, Vancouver, WA 98665
Initiative Against Sexual Trafficking
Lisa Thompson, IAST Coordinator
c/o The Salvation Army National Headquarters
P.O. Box 269, Alexandria, VA 22313
(703) 519-5896
This article was written by Stephen Adams and originally appeared in A Grassroots Guide to Protecting Your Community from Pornography, published in August 2008.


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The Greater Phoenix area, with its booming economy and vibrant community spirit, sports 180 golf courses. Phoenix's downtown, revitalized with new sports facilities, also has new shops, restaurants, brew pubs, and sports bars. Adjacent to the America West Arena, where the NBA and the NHL play, the domed Bank One Ballpark, known as BOB, is now home to the Arizona Diamondbacks. In addition to a new art museum and science center, the Heard Museum has just opened a new wing, enlivening the art ...
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Composed of products such as low saturation(LDO) regulators and DC/DC converters and others;
covers a wide range of voltages and currents.
|Home > Products > Semiconductor > Power Management
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- The various markets, such as car accessories and industrial equipments, demand the ICs with wide input voltage range. To supply the benefit for the market, New Japan Radio provides the Wide Input Range Products line-up with input voltage from few volts* to 35V.
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- High Voltage Ultra Low Current Consumption Io=100mA LDO
The NJW4182 is a 100mA output Low dropout regulator with high maximum input voltage, ultra-low current consumption and small package.
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The NJW4822 is the single low-side switch that can supply 0.2A.The active clamp, overcurrent, error flag output and thermalshutdown are built in with Nch MOS FET.It can be controlled by a logic signal (3V/5V) directly.
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The NJW4832 is the single high-side switch that can supply 0.2A. The active clamp circuit, overcurrent and thermal shutdownare built-in to Pch MOS FET.A logic signal (3V/5V) can be input directly.
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The NJW4186 is a high voltage and low current consumption low dropout regulator.NJW4186 is an adjustable output voltage type, so it can provide the optimum selection for various applications.
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MON. - THURS. 11/10c
Miriam Tolan has been told that Hillary Clinton is relieved the Senate race is over and she will never have to set foot in Buffalo, Peekskill or Syracuse again. (1:41)
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When you play a grueling three games in three days, fundamentals are key. Having a wheeling-and-dealing threat like Brea Olinda (Calif.) point guard Anna Kim certainly came in handy.
Behind Kim's 27 points and 12-for-12 performance from the free-throw line, the Wildcats defeated Hamilton, 48-43, in the Division C championship game of the Nike Tournament of Champions girls basketball tournament on Saturday.
"It's mental toughness. She really wants to take those shots, and she has the mental toughness to make them," Olinda coach Kim Cram said of Kim.
Kim's biggest contribution might have been at the 1:23 mark of the third quarter, when she blistered a pass from the post in to a driving Shaylissa Jarrett, who tied the game with a routine layup.
Kim followed that with a steal that left the floor open from two more points. Then, she took advantage of the same opening with Jenkins and fired another pass in to take the lead at 34-31.
"We tried to make to her go left. We tried to double-team her, but she's mentally tough, and she did a great job today," said Hamilton coach Jeff Kain. "We tried different things to see how she would adjust, and she just did a good job."
The loss snapped an eight-game winning streak for Hamilton, and because the Huskies (11-2) shot 6-for-25 from the floor in the first half, the Wildcats (4-4) were able to build a lead of 11 points by the 2:57 mark of the second quarter.
"I would say almost every shot we took was a good shot for us," Kain said. "We had our shooters in the right spots … Everyone took good shots; they just did not fall for us today."
The bright spot for the Wildcats was Kyndall Adams who gave the Huskies 15 points and eight offensive rebounds.
"When a shot goes up, we try to crash the boards really hard so that we can get the ball back up or get the fast break," Adams said.
Aliyah Dickson aided Adams, posting nine of her 13 points in the second half. But the Huskies saw their final lead (39-38) fizzle with Kim's 8-for-8 performance at the free throw line in the final quarter.
"That's really what Anna does, is that she's a really great floor general," said Cram. "She understands the game really well, and she's a pretty fierce competitor."
After the tournament, the Huskies (11-2) said they will take a few days off for rest, before facing St. Mary's on Jan. 7, a rematch of last year's Division I state championship game.


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[The following is a concise, well-written, semi-lucid explanation of the current "iffy" state of affairs in South Asia, but the writer is completely delusional, as are ALL analysts associated with any of the major Pak news outfits. He does not hesitate to detail the dire situation in Afghanistan, but neither does he miss a beat in broadcasting the Army's message of reassurances: "It is unlikely that Washington will let the Taliban grow again." Like all Pak writers, this one assumes that the US is seeking to stabilize the region, despite ALL the evidence to the contrary, proving that the CIA and Pentagon are engaged in a perpetual effort to DESTABILIZE the world, so that they might have a free hand to murder and maim, at will. Washington could care less (except for all of the political game-players within the Democratic-Republican war party) what happens to the people of either country, once they get clear from the mess that they have created there. Afghanistan is doomed to the same fate as Iraq, to suffer another civil war…Pakistan is just doomed.]
The only way
There are many speculations and assumptions running through the region about the US retreat and its repercussions on Afghanistan and its neighbouring countries.
It seems obvious, without a shadow of a doubt, that Afghanistan will be dragged again into a state of chaos, turbulence and anarchy. History has so far been unkind to that troubled country and every now and then it is dragged back to square one.
One wonders whether or not the US will be quitting Afghanistan for good. If so, then what's next in the kitty of US strategies? Many scholars, intellectuals and think tanks anticipate a purely Afghan civil war. On top of that, the time spent there by the US with all its underlying motives will have been in vain. What that simply means is that it was a waste of time, energy, lives and resources on the part of the US.
Half of the game plan is already on the move — I refer of course, to the election's outcome, which is just around the corner. So far Karzai has acted wilfully to his whiplashing master and will continue to do so. Nonetheless, recent resentment against US demands could prove to be expensive for Kabul. More likely still, the next government will be another dummy setup (Dari speaking), installed on the dictation of the US. Even if Karzai, otherwise, uses his own political influence in the presidential elections, the fate of the Afghan people will remain the same.
It is unlikely that Washington will let the Taliban grow again. A 60 percent turnout in the elections already assures the downfall of the Taliban. Still, the Taliban could get hold of the Pakhtun belt. Restricting the Taliban would be more conducive for US strategists, while preventing any backing or fuelling towards Taliban simultaneously.
The US departure could also have drastic implications for Pakistan. Unfortunately, Islamabad as usual seems to be in a whirlpool of ifs and buts, and no firm stance is appearing at the surface. Savvy foreign policymakers, political scientists and the military establishment must come up with visionary goals to cope with such an alarming situation.
India's elections could also play an important role and one has to wait and see how Indian influence in Afghanistan is going to shape up. India is the fifth biggest donor in the reconstruction and rehabilitation process in Afghanistan. This can bring a double advantage to India — economic stability and alliance against Pakistan. For national security measures, Islamabad must remain vigilant to secure its north-west border to sustain peace and avoid cross-border terrorism.
China's foreign policy in case of a civil war in Afghanistan is still unclear. Meanwhile, Beijing is busy promoting economic cooperation and continues to build infrastructure and roads. Even a continuation of bilateral trade depends on the volatility there; unrest in Afghanistan can put an end to China's successful economic ascension.
Iran, as a neighbouring state, is highly concerned about the post-withdrawal scenario in Afghanistan. It has vowed nearly $1 billion in aid at international aid conferences held to help Afghanistan. Its aid in the first decade after the Taliban's ouster was estimated at about 12 percent of the total assistance for reconstruction and development.
Tehran and Kabul have multiple disputes over water, Afghan refugees and drug trafficking. Tehran equally blames Kabul and Washington for not shutting down the production of opium. One should remember that Iran is a major corridor for narcotics smuggling to Middle Eastern and other European countries. Since the 1979 revolution, Iran claims to have lost more than 3,700 members of security forces fighting drug traffickers, many of whom were heavily armed. Tehran estimates that it spends around $1 billion annually on its war on drugs.
Washington has to play an anchor role before walking out; it must leave behind peace, tranquillity and stability in Afghanistan. This chiefly depends on whether the economic aid would be sufficient for Afghanistan to run its military affairs and secure the state from insurgency and internal turmoil.
As for the neighbouring states, Afghanistan would require them to pursue their foreign policies with utmost care. India, China, Pakistan and Iran will need to bury their animosities and grudges and stand together to avoid another conflict in the region. Peace is the only way forward for a prosperous and stable South Asia.
The writer is a research officer at the Institute of Regional Studies, and part of the visiting faculty at Quaid-e-Azam University.
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Buddy Does Jersey: The Complete Buddy Bradley Stories from "Hate" Comics Vol. 2 (1994-'98) [New Printing Pre-Order]
Peter Bagge The second half of the riotous Buddy Bradley saga details his tumultuous relationships with his family, his sometime girlfriend Lisa, and his junkie business partner Jay. Collects Hate #16-30 in pristine black and white. Product Details...
Buddy Does Seattle: The Complete Buddy Bradley Stories from "Hate" Comics Vol. 1 (1990-'94)
Peter Bagge These legendary stories from Hate #1-15 are a defining icon of Seattle's early 1990s culture, as well as Generation X in general. Bagge's riotous tales of the early 1990s subculture are more hilarious now than ever. Product Details...
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Jim Woodring A chain of events propels Frank out of the Unifactor and into a world where he is on his own at last; and like so many who leave home, Frank finds himself contending with realities of which he had no previous inkling. Product Details...
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Drew Friedman The third and final visual tribute to the old, Jewish and comedic is a heaping pastrami sandwich of gloriously liver-spotted, wrinkled personalities that will appeal to anyone who likes old people, Jews, or comedians. Product Details...
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Daniel Clowes Inspiration for the feature film and one of the most acclaimed graphic novels ever, following the adventures of two teenage girls, Enid and Becky, best friends facing the prospect of growing up, and more importantly, apart. Product Details...
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I Shall Destroy All the Civilized Planets
Welcome to the bizarre world of Fletcher Hanks, the mysterious cartoonist who created a hailstorm of tales of brutal retribution from 1939-1941... and then mysteriously vanished. His obscure and hard to find stories are finally collected here. Product Details...
Robert Crumb & David Zane Mairowitz This brief but inclusive biography of Franz Kafka and summary of many of his works, all illustrated by Crumb, helps us understand the essence of Kafka and provide insight beyond the cliche "Kafkaesque." Product Details...
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Jacques Tardi & Jean-Patrick Manchette Tardi, in top form, adapts Manchette's novel for another neo-noir classic a spectacularly dark, violent and fast-paced crime thriller. Product Details...
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Tony Millionaire Collecting 2 years of strips 2007-2009. More booze-soaked buffoonery, lyrical passages, violence, sentimentality, and poop jokes with Drinky Crow & Uncle Gabby. Lowbrow yuks and elegant cartooning from comics' true drunken master. Product Details...
Love and Rockets Library (Locas Book 1): Maggie the Mechanic [New Printing]
Jaime Hernandez The first of three volumes collecting the Love and Rockets stories of spunky Maggie, her brash best friend and sometimes lover Hopey, and their friends. These are the earliest, punkiest, most heavily sci-fi stories. Product Details...
Love and Rockets Library (Palomar & Luba Book 1): Heartbreak Soup [New Printing Pre-Order]
Gilbert Hernandez This beautiful, affordable volume collects the first half of Gilbert's modern-day classic, featuring the acclaimed magical-realist tales of Palomar, the Central American hamlet, and its memorable inhabitants. Product Details...
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Gilbert Hernandez The third "Fritz B-Movie" graphic novel is a trippy thriller that stars the Love and Rockets bombshell in no fewer than three roles: a beautiful waitress, her brother, and their estranged father. Money, death, sex... Product Details...
Prison Pit: Book 3 [New Printing Pre-Order]
Johnny Ryan A mysterious new a**hole has descended into the Prison Pit, looking for revenge on Cannibal F***face. But first hes got to battle his way through some pretty vicious motherf***ers. S***s about to get real. Product Details...
Prison Pit: Book 4
Johnny Ryan CF attempts to escape the Caligulon by brainf***ing the Slorge to create a giant, brainless oafchild that only knows how to annihilate. When the Slugstaxx turn this monster against CF with their nightj*** it's Total F***ing Mayhem. Product Details...
Safe Area Gorazde [Softcover Ed.]
Joe Sacco Sacco spent five months in Bosnia in 1996, immersing himself in the human side of life during wartime, researching stories that are rarely found in conventional news coverage, emerging with this astonishing first-person account. Product Details...
Set to Sea [Softcover Ed.]
Drew Weing The cartoonist's nautical debut graphic novel gets a makeover for its paperback edition. A big lug and aspiring poet gets shanghaied aboard a clipper bound for Hong Kong and learns to live and love life on the sea. Product Details...
Set to Sea [Sold Out]
Drew Weing A nautical debut graphic novel from a major talent. A big lug and aspiring poet gets shanghaied aboard a clipper bound for Hong Kong and learns to live and love life on the sea. Part rollicking adventure, part maritime ballad. Product Details...
Sheriff of Bullet Valley, Starring Walt Disney's Donald Duck [Pre-Order]
Carl Barks Donald Duck uses his knowledge gained from watching Hollywood Westerns to become the "Sheriff of Bullet Valley" in order to solve a perplexing mystery out in the wild, wild west. Product Details...
The Book of Mr. Natural [Hardcover Ed.]
Robert Crumb Over 120 pages of vintage Crumb comics starring the white-bearded, diminutive sage-cum-charlatan, from the charming, free-wheeling '70s stories to the disturbing, controversial '90s stories (as seen in the Crumb movie). Product Details...
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that would sound about right.....the boss is a 14...and I got a "free t-shirt" with some asic trainers last month ordered from them, and the large shirt i got was pretty big....it would swamp her, so guess the medium would be about right on you.
personally i have found the asics sizes pretty odd....a large in there sizes is more like a medium,,,
its just like all other clothes i guess.....misses says that clothes from mother care are smaller than items from tesco and sainburys for the kids....
good luck.....and as the boss says...ifs it to big you can always hot wash it and tumble dry the shirt and that should knock it down a size....
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Avmed is disingenuous
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FLORIDA -- We have AvMed Health through my husbands employer, so I don't have any choice.
My husband's Ophthalmologist recommended cataract removal surgery for him. AvMed gave the Authorization on June 15th with date of service to be in July.
Imagine our surprise when we received notice from Avmed that the claim for the place of service was denied for lack of authorization. They paid the ophthalmologist and anesthesiologist but not the outpatient center. When we first called AvMed to see what was up, the first excuse was they never received claim. After they received proof of claim they then changed the story to the surgical center never had authorization. I have in my possession the letter of Authorization that lists the place of service, date of service and authorization number they still deny the claim. At the same time period that they did this they also denied a claim from my primary care physician for a follow up which after complaining they then approved. AvMed appears to deny legitimate claims on a regular basis using lack of authorization as their excuse, until you provide proof. It seems this may be a ploy hoping not to pay any claims. Beware and if you have any choice do not use AvMed Health Insurance. If you have to use them, make sure you do all the work for them and gather your own copies of authorizations....you will need them!
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traceylynn on 11/08/2011:
Contact the Insurance Commission in your state. I had similar problems with BCBS, one call to them cleared it up. Good luck Op and I am wishing a speedy recovery to your husband!!
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Won't cover prescriptions
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FLORIDA -- Due to a job change we have AVMED, I went to the pharmacy to renew a prescription for Aciphex and AVMED refused to cover it. They say I need a form filled out by the doctor. I have run out of the medicine and in pain. I called AVMED and asked for help and what I should do. They said I go to the ER.
It is insane to not authorize a needed prescription, to contain costs, then recommend the ER which will be thousands of dollars. Likewise my condition is worsening which may in fact cost more.
This company does not care about the health of clients, I recommend to stay away if you can.
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Ben There on 08/22/2009:
Aciphex is one of the more expensive acid reducers... I think they are something like $5 a pill in the USA. They are probably hoping that your doctor gives you Ranitidine which is a lot cheaper for the insurance company. They are about $1 a pill in Canada so check into getting it from there.
Eloise on 08/22/2009:
I love Protonix. It works really fast, two or three days and no pain!
wolfester on 08/23/2009:
Thanks for your comments. I have taken nearly all of the acid reducers rantidine, prilosec, nexium, etc. The aciphex is the only one that has helped and I have been taking it for over a year. Now this new insurance won't pay until they get a paper filled out by the doctor, but he is closed until Monday. Meanwhile the pain in my chest has gone from my chest into my back and getting worse even though I am taking omeprazole since Friday.
It is just ridiculous that in order to contain costs and save $150, they are suggesting the ER as a covered option which will cost over 1k. We basically have government thinking in the private health care system now.
I'll have to go to the ER if this pain keeps getting worse.
tnchuck100 on 08/23/2009:
This sounds like one of the philosophy's I came up with when I worked for a government entity: "They will save money...NO MATTER WHAT IT COSTS!"
Ben There on 08/23/2009:
I would say it is more corporate thinking. "We insure just the pills, we don't want to pay for this one, we don't cover ER visits, so let him go if he wants and we will deny the claim for this expensive drug and convince his doc to switch to ranitidine on Monday"...
tnchuck100 on 08/23/2009:
Ben, the OP stated his insurance will pay for the ER visit.
Ben There on 08/23/2009:
Pharmacy plans are paid from different pots than ER visits even under the same insurance umbrella. That is why most insurance companies will give you 2 cards. Even if it is the same insurance card, the pill people have a different P&L than the med people and the management of each want to protect their own spending as that is their job.
wolfester on 08/23/2009:
I bought enough to hold me over and the pharmacy agreed to reprocess it if it gets approved. Meanwhile, I found a place online that sells gen Aciphex for the same price as my copay. So I am set.
I like that "they will save money..no matter what it costs" Maybe this mentality got the economy in the condition it is in now.
And....another call to AVMED, they said it may take a few days for the paper work so they gave me the names of urgent care centers and ER's - 50 copay. 10 bucks more than the pharmacy copay.
Barry on 01/10/2014:
More and more evidence that
AvMed is becoming bottom line
driven. Few doctors now accept
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text: TREATMENT The treatment of male breast cancer depends on the size and location of the tumor, whether the cancer has spread, and the man's overall health. In many cases, a team of doctors will work with the patient to determine the best treatment plan. Male breast cancer may be treated with surgery, radiation therapy, chemotherapy, and hormone therapy. Each option is described below. This section outlines treatments that are the standard of care (the best treatments available) for this specific type of cancer. Patients are also encouraged to consider clinical trials when making treatment plan decisions. A clinical trial is a research study to test a new treatment to prove it is safe, effective, and possibly better than standard treatment. Your doctor can help you review all treatment options. Overview of breast cancer treatment The biology and behavior of a breast cancer affects the treatment. Some tumors are small but grow fast, while others are large and grow slower. When planning the treatment for breast cancer, the doctor will consider many factors, including: The stage and grade of the tumor The tumor's hormone receptor status (ER, PR) and HER2 status The patient's age and general health The presence of known mutations in inherited breast cancer genes (BRCA1 or BRCA2) Even though the doctor will specifically tailor the treatment for each patient and the breast cancer, there are some general steps for treating breast cancer. For both DCIS and early-stage invasive breast cancer, doctors generally recommend surgery to remove the tumor. To ensure that the entire tumor is removed, the surgeon will also remove a small area of tissue around the tumor. Although surgery aims to remove all of the visible cancer, it is known that many times microscopic cells can be left behind, either in the breast or elsewhere. The next step in the management of early-stage breast cancer is to lower the risk of recurrence (return of the cancer) and to get rid of any hidden remaining cancer cells. This is called adjuvant therapy. Adjuvant therapies include radiation therapy, chemotherapy, hormone therapy, and/or targeted therapy (see below for more information on these types of treatment). The need for adjuvant therapy is determined based on an estimate of the chance of residual cancer in the breast or the body. Although adjuvant therapy lowers the risk of recurrence, it does not necessarily eliminate it. Other sophisticated tools can help determine prognosis and help you and your doctor make decisions about adjuvant therapy. The website Adjuvant! Online (www.adjuvantonline.com) is one such tool that your doctor can access to interpret a variety of prognostic factors. This website should only be used with the interpretation of your doctor. In addition, other tests that can predict the risk of recurrence (such as Oncotype Dx, and Mammaprint; may be used to find out whether your doctor recommends adjuvant chemotherapy. When surgery to remove the cancer is not possible, chemotherapy, radiation therapy, hormone therapy, and/or targeted therapy may be used as the primary treatment. The treatment of recurrent cancer and metastatic cancer depends on how the cancer was first treated and the characteristics of the cancer mentioned above (such as ER, PR, and HER2 status). Additional descriptions of the most common treatment options for breast cancer are listed below. Surgery Surgery is performed to remove the tumor in the breast and to evaluate the surrounding axillary (underarm) lymph nodes. A surgical oncologist is a doctor who specializes in treating cancer using surgery. The types of surgery include the following: A lumpectomy is the removal of the tumor and a small, clear (cancer-free) margin of tissue around the tumor. Most of the breast remains. For both DCIS and invasive cancer, follow-up radiation therapy to the remaining breast tissue is generally recommended. A lumpectomy may also be called breast-conserving surgery, a partial mastectomy, or a segmental mastectomy. A mastectomy is the surgical removal of the entire breast. Because men do not have much breast tissue, a lumpectomy, which remove only the tumor, is generally not an option. Lymph node removal and analysis Lymph nodes can trap cancer cells traveling away from the original tumor site. It is important to find out whether any of the lymph nodes near the breast contain evidence of cancer. In an axillary lymph node dissection, the surgeon removes many of the lymph nodes from under the arm, which are then examined by a pathologist for cancer cells. The actual number of nodes removed varies. Sentinel lymph node biopsy The sentinel lymph node biopsy procedure allows for the removal of one to a few lymph nodes, reserving a bigger axillary lymph node dissection procedure for patients whose sentinel lymph nodes show evidence of cancer. The smaller lymph node procedure helps patients lower the risk of lymphedema (swelling of the arm) and decreases arm mobility and range-of-motion problems. In this procedure, the surgeon finds and removes the sentinel (first) lymph node (as a practical matter, one to three nodes) that receives drainage from the breast. The pathologist then examines it for cancer cells. To identify the sentinel lymph node, the surgeon injects a dye and/or a radioactive tracer into the area of the cancer and/or around the nipple. The dye or tracer travels to the lymph nodes, arriving at the sentinel node first. The surgeon can find the node when it turns color (if the dye is used) or emits radiation (if the tracer is used). If the sentinel node is cancer-free, research has shown that there is a good possibility that the subsequent nodes will also be free of cancer and no further surgery of the lymph nodes is performed. If the sentinel lymph node shows cancer is present, then the surgeon will perform an axillary lymph node dissection, removing additional lymph nodes to look for the presence of more cancer. Most patients with invasive cancer will undergo either sentinel lymph node biopsy or an axillary lymph node dissection. For those with sentinel nodes that indicate cancer, an axillary lymph node dissection is still considered the standard procedure. If there is obvious evidence of cancer in the lymph nodes before any surgery, then the preferred approach is a full axillary lymph node dissection without a sentinel lymph node biopsy. Summary To summarize, surgical treatment options include the following: Removal of cancer in the breast: Lumpectomy (partial mastectomy) almost always followed by radiation therapy, or mastectomy (sometimes, but not always, followed by radiation) Lymph node evaluation: Sentinel lymph node biopsy and/or axillary lymph node dissection The most significant side effect of surgery is lymphedema (arm swelling), which can occur when lymph nodes are removed or damaged during surgery. Because the lymph nodes are part of the channels that drain the lymphatic fluid from the arm, damage to the area may hold back the flow of lymphatic fluid and cause it to back up in the arm. The use of sentinel node biopsy has been shown to reduce the incidence of lymphedema. Radiation therapy Radiation therapy is the use of high-energy x-rays or other particles to kill cancer cells. A doctor who specializes in giving radiation therapy to treat cancer is called a radiation oncologist. The most common type of radiation treatment is called external-beam radiation therapy, which is radiation given from a machine outside the body. When radiation treatment is given using implants, it is called internal radiation therapy or brachytherapy. A radiation therapy regimen (schedule) usually consists of a specific number of treatments given over a specific time. The lowest risks of cancer recurrence in the breast after lumpectomy are associated with the use of radiation therapy. Early randomized clinical trials showed, in general, recurrence rates of 30% or more without radiation therapy, compared with 10% recurrence rates with radiation therapy. After surgery, adjuvant radiation therapy is given regularly for a number of weeks after a lumpectomy to eliminate any remaining cancer cells near the tumor site or elsewhere within the breast. Adjuvant radiation therapy is also recommended for some patients after a mastectomy depending upon the size of their tumor, number of cancerous lymph nodes under the arm, and width of the tissue margin around the tumor removed by the surgeon. Adjuvant radiation therapy is effective in reducing the chance of breast cancer returning in both the breast and the chest wall. Neoadjuvant radiation therapy is radiation therapy given before surgery to shrink a large tumor, which makes it easier to remove, although this approach is rare. Radiation therapy can cause side effects, including fatigue, swelling of the breast, and skin changes. A small amount of the lung can be affected by the radiation, although the risk of pneumonitis, or a radiation-related inflammation of the lung tissue is rare. In the past, with older equipment and techniques of radiation therapy, patients treated for left- sided breast cancers had a small increase in the long-term risk of heart disease. Modern techniques are now able to spare most of the heart from radiation damage. Although exposure to radiation is thought to be a risk factor for cancer after many years, less than one in 500 survivors will develop a different kind of cancer other than a breast cancer (usually a type of cancer called sarcoma) within the area that was treated. Clinical trials comparing lumpectomy and adjuvant radiation therapy with mastectomy have not shown a difference in the number of patients developing or dying of other cancers within a 20-year time span. The most common type of radiation treatment is called external beam radiation therapy, which is radiation therapy given from a machine outside the body. Many types of radiation therapy may be available to you; talk with your doctor about the options, advantages, and disadvantages of these options. Radiation therapy schedule Standard radiation therapy after a lumpectomy is external-beam radiation therapy given daily for five days per week (Monday through Friday) for six to seven weeks. This usually includes radiation therapy to the whole breast first for four-and-a-half to five weeks, followed by a more focused treatment to the site of the tumor bed in the breast for the remaining treatments. This focused part of the treatment, called a boost, is standard for patients with invasive breast cancer to reduce the risk of a recurrence in the breast. If there is evidence of cancer in the underarm lymph nodes, radiation therapy may also be given to the lymph node areas in the neck or underarm near the breast or chest wall. Usually, patients who undergo mastectomy do not require radiation therapy. However, for patients with large cancers, many involved lymph nodes, or extension of cancer into the skin or chest wall, radiation may still be recommended after a mastectomy. Standard radiation therapy after a mastectomy is given to the chest wall for five days a week (Monday through Friday) for five to six weeks. Newer approaches to breast radiation therapy Several newer radiation treatment approaches are being studied in women, but have not been studied in very many men with breast cancer. Talk with your doctor for more information. Hypofractionated radiation is giving a higher daily dose of radiation over a shorter time (usually 3 to 4 weeks instead of 6 to 7 weeks). Partial breast irradiation is radiation therapy given directly to the tumor area, usually after a lumpectomy, instead of to the entire breast. This approach also results in a shorter overall time patients need to undergo radiation therapy. Intensity-modulated radiation therapy (IMRT) is a more advanced way to deliver external-beam radiation therapy to the breast. The intensity of the radiation directed at the breast is varied to target the tumor more precisely, give a uniform distribution of radiation throughout the breast tissue, and avoid damaging healthy tissue more than is possible with traditional radiation treatment. IMRT may reduce the dose to nearby important organs, such as the heart and lung, and reduce the risks of some immediate side effects, such as peeling of the skin during treatment. IMRT also may help to reduce long-term effects on the breast tissue that were common with older radiation techniques such as hardness, swelling, or discoloration. Chemotherapy Chemotherapy is the use of drugs to kill cancer cells. Systemic chemotherapy is delivered through the bloodstream, targeting cancer cells throughout the body. Chemotherapy is given by a medical oncologist, a doctor who specializes in treating cancer with medication. Most people with breast cancer receive chemotherapy in their doctor's office or outpatient clinic. An adjuvant chemotherapy regimen consists of a specific treatment schedule of drugs given at repeating intervals for a specific number of times. Chemotherapy may be given intravenously (injected into a vein) or occasionally orally (by mouth), and is usually given in cycles. Chemotherapy may be given before surgery to both shrink a large tumor and reduce the risk of recurrence or adjuvant therapy given after surgery to reduce the risk of recurrence. Chemotherapy is also commonly given at the time of a metastatic breast cancer recurrence. Patients in clinical trials may be offered new drugs or new combinations of existing drugs. The side effects of chemotherapy depend on the individual and the drug and the dose used, but can include fatigue, hair loss, risk of infection, nausea and vomiting, loss of appetite, and diarrhea. These side effects usually go away once treatment is finished. Rarely, long-term side effects may occur, such as heart damage, nerve damage, or secondary cancers, but studies have shown that these side effects do not shorten a patient's survival time. Different drugs are useful for different cancers, and research has shown that combinations of certain drugs are more effective than individual ones. The most common combinations for male breast cancer include: CMF: cyclophosphamide (Cytoxan) methotrexate (multiple brand names), and fluorouracil (5-FU, Adrucil) CAF: cyclophosphamide, doxorubicin (Adriamycin), and 5-FU AC: doxorubicin (Adriamycin) and cyclophosphamide Cyclophosphamide and doxorubicin in combination with paclitaxel (Taxol) or docetaxel (Taxotere) Other chemotherapy that may be prescribed includes paclitaxel, docetaxel, vinorelbine (Navelbine), gemcitabine (Gemzar) and capecitabine (Xeloda). Trastuzumab (see Targeted therapy below) is used to treat HER2-positive breast cancer. Trastuzumab and lapatinib (Tykerb) are HER2-targeted therapies that may be given with chemotherapy in HER2-positive metastatic breast cancer. Bevacizumab (Avastin), a blood vessel blocking drug (called anti-angiogenic), is another targeted therapy approved in combination with chemotherapy in the treatment of metastatic breast cancer. (See the Targeted Therapy section below.) The medications used to treat cancer are continually being evaluated. Talking with your doctor is often the best way to learn about the medications prescribed for you, their purpose, and their potential side effects or interactions with other medications. Learn more about your prescriptions by using searchable drug databases. Hormone therapy Hormone therapy helps manage a tumor that tests positive for either estrogen receptors (ER) or progesterone receptors (PR) for both early-stage and metastatic cancer. Because more than 75% of breast cancers in men have estrogen receptors, hormone therapy is often part of the treatment plan. This type of tumor uses hormones to fuel its growth. Blocking the hormones usually limits the growth of the tumor. If it is determined that the tumor is hormone receptor-positive (uses estrogen or progesterone to grow, then adjuvant hormone treatment may be used alone or after chemotherapy. Hormone therapies for men include: Tamoxifen is the primary hormone therapy used in male breast cancer. It blocks the estrogen receptors activity inside the cancer cell. It is a pill taken daily, usually for many years. Aromatase inhibitors block the production of estrogen. These agents are effective in treating breast cancer in women, but there is not much information on their use in male breast cancer. Caution is urged in using these agents in men with intact testes, as androgen levels may increase. Megesterol (Megace) is a progesterone-like drug used to treat a hormone receptor-positive tumor. It is rarely used in male breast cancer. Side effects of hormone therapy can include hot flashes, decreased sexual desire or ability, and mood swings. Targeted therapy Targeted therapy is a treatment that targets specific genes, proteins, or the tissue environment that contributes to cancer growth and survival. Currently the two main classes of biologically targeted therapy approved in breast cancer treatment are targeted to the HER2 molecule (HER2 targeted therapy) and the blood vessels in the area of the tumor (anti-angiogenic therapy). HER2 targeted therapy Trastuzumab is approved for both the treatment of advanced breast cancer and as an adjuvant therapy for early-stage breast cancer for HER2-positive tumors. At this time, one year of Trastuzumab is recommended for early-stage breast cancer. In the metastatic setting, the length of treatment is not limited (it is given as long as it is still working). Patients receiving Trastuzumab have a small (2% to 5%) risk of heart problems, and this risk is increased if a patient has other risk factors for heart disease. These heart problems do not always go away, but they are usually treatable with medication. Lapatinib is commonly used in patients with HER2-positive breast cancer that no longer responds to Trastuzumab. The combination of lapatinib and capecitabine is approved for the treatment of patients with advanced or metastatic HER2-positive breast cancer who have previously been treated with chemotherapy and Trastuzumab. Anti-angiogenic targeted therapy (blood vessel blocking therapy) Bevacizumab is used to treat metastatic or recurrent breast cancer (see below). This drug blocks angiogenesis (the formation of new blood vessels), which is needed for tumor growth and metastasis. When combined with paclitaxel, bevacizumab appears to shrink the tumor and keep it smaller for a longer time in patients whose breast cancer has spread compared with paclitaxel alone. Recent studies have shown benefit of adding bevacizumab to other chemotherapy as well. Anti-osteoclast targeted therapy (drugs that block bone destruction) Bisphosphonates are a class of drugs that block the cells that cause bone destruction (osteoclasts). Bisphosphonates are commonly used in relatively low doses to prevent and treat osteoporosis. In patients with breast cancer that has spread to bone, higher doses of bisphosphonates have been shown to reduce the complications of cancer in the bone, including bone fractures and pain. Pamidronate (Aredia) and zoledronic acid (Zometa) are two intravenous bisphosphonates used to treat breast cancer bone metastasis. Recent studies have suggested that these drugs may also be able to reduce breast cancer recurrences when given in the adjuvant setting, although more data are needed. Denosumab (Prolia) is in another new class of osteoclast-targeted therapies called RANK ligand inhibitors. Although not yet approved for patients with breast cancer, recent studies have shown great promise of these drugs in treating breast cancer bone metastases and osteoporosis. Recurrent and metastatic breast cancer Breast cancer is called recurrent if the cancer has come back after it was first diagnosed and treated. It may come back in the breast (a local recurrence); in the chest wall (a regional recurrence); or in another part of the body, including distant organs such as the lungs, liver, and bones. A local recurrence is frequently considered curable with further treatment. A metastatic (distant) recurrence is generally considered incurable, but is frequently treatable. Some patients live years after a metastatic recurrence of breast cancer. The goal of treatment for advanced disease is to prolong survival and/or improve quality of life. Generally, a recurrence is detected when a person has symptoms. These symptoms depend on the site of the recurrence and may include: A lump under the arm or along the chest wall Bone pain or fractures, which may signal bone metastases Headaches or seizures, which may signal brain metastases Chronic coughing or trouble breathing, which may signal lung metastases Abdominal pain or jaundice (yellow skin and eyes), which may be associated with liver metastases Other symptoms may be related to the location of metastasis and may include changes in vision, changes in energy levels, feeling ill, or extreme fatigue. A biopsy of the recurrent site is often recommended to be certain of the diagnosis and to check for ER, PR, and HER2 status, because this may have changed from the time of the original diagnosis. The treatment of metastatic or recurrent breast cancer depends on the previous treatment(s), the time since the original diagnosis, and the characteristics of the tumor (such as ER, PR, and HER2 status). For men with a local recurrence within the breast after initial treatment with lumpectomy and adjuvant radiation therapy, the treatment is mastectomy. This usually results in cure. For men with a local or regional recurrence of the chest wall after an initial mastectomy, resection (surgical removal of the recurrence) followed by radiation therapy to the chest wall and lymph nodes is the treatment, unless radiation therapy has already been given (radiation therapy cannot usually be given at full dose to the same area more than once). Total-body therapies such as chemotherapy, hormone therapy and targeted therapies are generally the primary treatment in recurrent metastatic cancer. Radiation therapy and surgery may be used in certain situations for men with a distant metastatic recurrence. Often radiation is used to treat painful bone metastases.