text:
HealthWatch Magazine - June/July Issue
HALO: Minnesota couple turns tragedy into safety in SIDS prevention wearable blanket * The truth about ticks: What you need to know about prevention and treatment * Minnesota legislature takes a crack at concussion prevention in young athletes * A life-changing diagnosis: Nisswa toddler diagnosed with Type 1 diabetes * The life of a 4-year-old girl with FAS Life changes for grandparents who officially turn into parents * Anesthetic may bring people to prodecure they rarely relish * Essentia Health takes another leap into digital age with smarphone app
2 4 6 8 12 HALO: Minnesota couple turns tragedy into safety in SIDS prevention wearable blanket By JENNY HOLMES, HealthWatch Correspondent The truth about ticks: What you need to know about prevention and treatment By SHEILA HELMBERGER, HealthWatch Correspondent Table of Contents 16 18 vors by 2022 The life of a 4-year-old girl with FAS Life changes for grandparents who officially turn into parents By JENNIFER STOCKINGER, Staff Writer American Cancer Society continues efforts to fight cancer: New report estimates nearly 18 million U.S. cancer survi- Minnesota legislature takes a crack at concussion prevention in young athletes By SARAH NELSON KATZENBERGER, HealthWatch Editor A life-changing diagnosis: Nisswa toddler diagnosed with Type 1 diabetes By JODIE TWEED, HealthWatch Correspondent On the cover 19 20 22 Essentia Health takes another leap into digital age with smarphone app By JESSI PIERCE, Staff Writer Anesthetic may bring people to prodecure they rarely relish By RENEE RICHARDSON, Senior Reporter HealthWatch service provider directory Who We are Publisher - Tim Bogenschutz Advertising - Sam Swanson Editor - Sarah Nelson Katzenberger Contributing writers Sheila Helmberger, Jenny Holmes, Jessi Pierce, Renee Richardson, Jennifer Stockinger, Jodie Tweed. HealthWatch is a quarterly publication of the Brainerd Dispatch. Read Healthwatch online at www.brainerddispatch.com Lucas Cline, 2, was diagnosed with Type 1 diabetes. Lucas lives in Nisswa with his parents Scott and Amanda Cline and brother Drew, 5. Photo by Kelly Humphrey Cover design by Janet Finger For advertising opportunities call Sam Swanson at (218) 855-5841. Email your comments to firstname.lastname@example.com or write to: Sarah Nelson Katzenberger Brainerd Dispatch P.O. Box 974 Brainerd, MN 56401 3 HALO:Minnesota couple turns tragedy into safety in SIDS prevention wearable blanket Minnesota-based company HALO Innovations Incorporated safe-sleep swaddling blanket is designed to protect infants and toddlers from Sudden Infant Death Sydrome. Both Essentia Health St. Joseph's Medical Center and Cuyuna Regional Medical Center in Crosby have implemented the use of the HALO sleepsack with new families. t was 11 years ago By JENNY HOLMES that Bill and Cathy HealthWatch Correspondent Schmid lost their eight-week-old baby girl to SIDS. But to the couple, some days, it seems just like yesterday. Haley was the Plymouth couple's first baby. The notion of Sudden Infant Death Syndrome (SIDS) was only just surfacing within the medical community, but never did the Schmids think it could or would happen to their perfectly healthy daughter. "As you can imagine, it's a life changing, devastating thing," Bill Schmid said. "We struggled with it for awhile, looking for answers. And there really weren't any answers at that time." Bill, an engineer by trade, and his wife a pharmacist, the Schmids were determined to dig deeper into this phenomenon called "SIDS" that robbed them of a precious, new life. It wasn't until 1992, when the "Back To Sleep" campaign was unveiled and offered as a way to educate parents, caregivers, and health care providers about ways to reduce the risk for SIDS. The campaign, sponsored in part by the American Academy of Pediatrics, was named for its recommendation to place healthy babies on their backs to sleep. Placing babies on their backs to sleep was proven to help reduce the risk for SIDS, also known as "crib death." Employed in engineering heating and cooling ventilation systems both residential and commercial, there was a sense of irony when Bill Schmid learned a component of SIDS involved the rebreathing of carbon dioxide. "It can occur when a baby lies on its stomach, face down in bedding, and exhales and rebreathes carbon dioxide," Schmid said of his findings. "We now know some babies don't respond normally to that challenge, and need more air. Normally, a baby would move their head around, but in some babies, the sensors in their brain don't respond properly and, instead, they suffocate." I 4 Drawing from personal experience and professional findings, Schmid created Haley Incorporated and rolled out the company's first invention -- a crib mattress designed to allow oxygen and carbon dioxide to pass through and decrease the risk of a fatal build up of carbon dioxide in an infant's blood. The product was shared with SIDS researchers. While it was endorsed and sold a few mattresses, the product did not prove profitable enough to sustain the company. In the meantime, the Schmids welcomed twin boys into the world. Carefully guarded and armed with research regarding the silent killer that took their infant daughter, Bill and Cathy tried to follow the guidelines set forth in the Back to Sleep Campaign. Unfortunately, they soon discovered their boys preferred stomach sleeping. "We just put our fate in God's hands," Bill said. "Fortunately, they did just fine; but it really, to me, signaled that not all babies will tolerate sleeping on their back � even some for medical reasons. We decided we needed to do what we could do to prevent SIDS from happening to other babies and to help save parents from similar heartbreak." Through his tireless research, Bill came across information from the Netherlands regarding the use of sack-like garments to keep babies warm, secure and safe. Schmid quit his job and devoted his time to create a product that would replace loose blankets in the crib that can cover a baby's face and interfere with breathing. Haley Incorporated eventually became HALO Innovations Incorporated; and, in 2001, the HALO SleepSack was born. The SleepSack is similar to a small sleeping bag with arm holes, prohibiting babies from spreading their legs far enough to roll from their back to their stomach. Since 2005, the American Academy of Pediatrics has suggested the use of wearable blankets. Today, HALO SleepSack wearable blankets are used nationwide to help babies sleep safely from the start. The SleepSack also comes in a SleepSack Swaddle version, with wings for swaddling newborns and infants. The product is carried by many major retailers nationwide, as well as sold in Canada and Australia, Schmid noted. In addition to the invention of this groundbreaking product, Schmid is also the creator of the HALO Safer Way to Sleep� Initiative, which is now implemented at more than 800 hospitals around the country and growing daily. Essentia Health St. Joseph's Medical Center in Brainerd implements the HALO Safer Way to Sleep program, which teaches new parents about safe sleep for baby before they even get home. Teaching is done through observation and imitation � the parents model the behavior and techniques they see the nurses using on their baby in the hospital. Cuyuna Regional Medical Center in Crosby participates in the program by gifting each new family with a HALO SleepSack Swaddle and information to implement at home. "Before this program was implemented, a lot of hospitals were using blankets for wrapping and propping babies up. All things parents are told not to do at home. For a new parent, when you get home with a new baby, you probably will only remember what you saw the nurses doing. This program aims at trying to change that. We want all hospitals to change their standard of care practices." Since 2001, Schmid said much progress has been made in educating new parents of the risk factors and prevention measures associated with SIDS. However, Sudden Unexplained Death in Infancy (SUDI) and accidental deaths continue to create concern for the medical field and new, or expecting, parents. "Ultimately, our hope is to not have any babies dying," Schmid said. "Realistically, in the next couple of years, we want to reach at least half the babies born in the United States, expose them to the Safer Way to Sleep program � not just product usage, but also SIDS literature, and safe sleep literature. We want to continue to educate as many as we possibly can and eventually try to eradicate these unnecessary deaths." For more information on the Safer Way to Sleep Initiative, visit www. halosleep.com/safe_sleep_for_baby. 5 The truth about ticks itkin, Cass, Crow Wing, By SHEILA HELMBERGER Morrison and HealthWatch Correspondent Mille Lacs counties are all among those with the highest population of ticks in Minnesota. It also means we are home to the highest risk of tick-borne disease. Of course not all tick bites result in disease but the numbers are becoming troubling. Enough so that local authorities recognize the importance of getting accurate information to the public and are offering an opportunity to learn more about ticks and the diseases they carry. A five person panel has been assembled to present the information. An evening presentation will be given 5:30�7 p.m. Monday, July 16 at the Arboretum and a morning session will be held 8:30-10 a.m. Tuesday, July 17 also at the Arboretum. Dr. Peter Henry, medical director of emergency services at Essentia Health St. Joseph's Medical Center, will serve on the panel. Other members include Dr. Kurt DeVine � Urgent Care, Essentia Health St. Joseph's � Baxter Clinic, Gwen Anderson, RN/PHN Manager - Crow Wing County Public Health, David Neitzel, M.S., Epidemiologist - Acute Disease Investigation and Control, Minnesota Department of Health and Eric Goslovich, OHST - Safety and Health Officer, Minnesota Department of Natural Resources. We enjoyed an earlier than usual spring this year and Dr. Henry said it has also meant earlier visits by patients concerned about tick bites. The three primary tick diseases in the state are lyme, anaplasmosis, and babesiosis, the last seen measurably less because it most often affects people who have a compromised immune system or who have had their spleen removed. The tiny deer tick, or black legged tick, is the transmitter of these diseases. In the spring the nymph is remarkably small and hard to spot or feel, unlike the larger wood ticks. Symptoms Anaplasmosis is now the most common of the tick disease seen in our area, replacing Lyme. "Anaplasmosis is not a new disease. It had previously been called ehrlichiosis.," said Dr. Henry. "Veterinarians have seen it in dogs for a very long time."Typically the symptoms of anaplasmosis of headaches, muscle and joint aches, and fever are the more severe than lyme. Often fevers climb as high as or higher than 102 degrees. The high fever is what brings most people in to the doctor once they've been infected says Dr. Henry. "Many people ignore the muscle and headache symptoms thinking they just have a virus or a bug," which is, sometimes, the case. Not every muscle ache and headache is necessarily tick-borne disease, A What you need to know to about prevention and treatment Use a repellent. Most effective brands have high levels of DEET so follow directions carefully on how to apply. Check dogs, cats and other pets for ticks often and don't allow them to sleep in your bed. The risk of transmission goes down significantly if an infected tick is removed within the first 24-48 hours. Transmission of the disease usually happens if a tick is attached beyond that time. Removing the tick The proper way to remove a wood tick is to grasp it near its head and slowly pull it out. Do not grab it by the body. Gently pull it straight out until it is free. If a small part of the mouth remains there's no need to remove it, says Dr. Henry. Digging too much may lead to the risk of infection and your body will automatically expel the remainder as the skin gets rejuvenated. It is important to remove the body because the bacteria are contained in the stomach. "If you have symptoms of tick-borne disease is when you should seek treatment," says Dr. Henry. Essentia Health provides many different options for the community including ConvenientCare, Urgent Care or a family care provider. ConvenientCare is located at Baxter Cub Foods,14133 Edgewood Drive in Baxter, and is open 8 a.m. to 8 p.m. Monday and Friday, 9 a.m. to 3 p.m. Saturday and Sunday. UrgentCare is located at Essentia Health St. Joseph's-Baxter Clinic, 13060 Isle Drive in Baxter, and is available 8 a.m. to 8 p.m. Monday-Friday, 9 a.m. to 3 p.m. Saturday, 11 a.m. to 3 p.m. Sunday, 9 a.m. to 1 p.m. holidays. Both ConvenientCare and UrgentCare are walk-in services with no appointment needed. If your symptoms are severe the Emergency Department sees patients when UrgentCare and ConvenientCare are closed. Effective treatment Dr. Henry moves cautiously when it comes to prescribing medicine for possible tick disease. The symptoms of tick-borne illness mimic that of other common diseases. We treat each patient individually and responsibly so they are receiving the correct antibiotics. Being good stewards of antibiotics is beneficial for the entire community so the treatments can continue to be effective. The overuse or inappropriate use of antibiotics creates the possibility that the bacteria will develop resistance to current anti-biotic options for treatment. Prolonged use of antibiotics has the potential for significant side effect and adverse health risks. The key to treating any disease is a relationship a patient has with their care provider. To attend one of the panel discussions and learn more on prevention for tick-borne diseases register to attend a session on-line at EssentiaHealth.org or call (218) 828-7414. says Dr. Henry. So, is testing for tick disease the first step in seeing these patients? Not always. If someone has a classic symptom of tick disease, a history of a tick bite and a rash, the Center for Disease Control says that is enough evidence to start treatment. "When testing is performed in the initial stages of the disease the test is not as accurate as we would like it to be. Because you're testing for the antibody to the bacteria itself and in the early stages you might not have mounted enough antibodies yet to result in a positive test," says Dr. Henry. "However our physicians are well aware of the symptoms and treatments due to the number of cases of tick-borne disease in our community." Most people, by the time they develop a rash, would have a positive test, but even that's not 100 percent. Bulls-eye rash "There's a lot of misconception about the bullseye," says Dr. Henry. "Many people see the little purple- red ring that's typically a centimeter or pennysize or less right where the tick has bit them. That's a local allergic reaction to the tick bite. The saliva from the tick actually causes a local irritation and allergic reaction." The red ring often fools people. The actual target lesion or "bulls-eye" is larger and will slowing expand in size. It is most often found at the site of the bite or but can be found any place else on the body. It is also not unusual to have more than one bulls-eye. Statistics vary but Dr. Henry also says anywhere from 20-40 percent of victims will never develop a rash and 20-30 percent of those with confirmed lyme disease aren't even aware they've had a tick bite. Adult deer ticks are tiny and the nymphs even smaller so these are often missed by those that are bitten. Prevention Dr. Henry is pleased for the opportunity to serve on the panel and believes it is a great time to get some important information to the public. "My personal goal would be to get better information about prevention to the public. That's really the key to stopping these illnesses in the first place because they are preventable." Wear light colored clothing when walking in tall grass or wooded areas so ticks can be spotted easily. Tuck your pants inside of your socks. Before going outdoors follow a few important steps: 6 Check thoroughly every time you're outdoors and in a tick environment. Do a head to toe check in a well lit room. If possible have someone else check the areas that you can't see yourself such as your hairlines and back. 7 Minnesota legislature takes a crack at concussion prevention in young athletes addie Hasti n g s doesn't remember much about the concussion she suffered on the soccer field two years ago. After her team scored a goal Hastings, 15 at the time, returned to the center line and as the other team restarted the ball, Hastings did what any center mid-fielder would do -- she charged. Only instead of stopping the team from advancing, Hastings ended up taking a hard ball to the face, breaking her nose. "The impact of the ball made me fly backwards and I nailed my head on the turf, " Hastings said. "That's what I was told at least." Hastings said after the impact she blacked out for a minute, but then tried to get up and continue playing. "I played for another minute until my coach took me off," she recalled. Coming off the field is one of the last things Hastings remembers from that day. "After that it's pretty much all kind of a blur," she said. Incidents like the one Hastings suffered are the reason Minnesota passed a concussion law requiring all coaches and officials receive concussion training and education every three years in an effort to eliminate continued play after a concussion has been suffered, and subsequent re-injury in players who have suffered a concussion. The law requires coaches to remove an athlete from activity if they exhibit any signs or symptoms consistent with concussion. An athlete that has been removed from play due to concussion symptoms cannot return to the playing field until they have been cleared by a doctor to resume play. Brainerd varsity girls soccer coach Ricky Lacerte said he is in favor of the new requirements for concussion training and plans to require his players to undergo the video training sessions provided by the Center for Disease Control (CDC), so that they too are educated on the signs and symptoms of concussion. "We want to try to get a baseline of understanding from all our players," Lacerte said. When Maddie Hastings suffered her concussion, Lacerte was among the coaching staff that decided it was best to pull Hastings -- against her will -- from the By SARAH NELSON KATZENBERGER HealthWatch Editor M Maddie Hastings, 17, practiced juggling the ball at her Lakes Area Youth Soccer Association summer practice. Hastings suffered a serious concussion on the soccer field requiring weeks of recovery before returning to the Kelly Humphrey � email@example.com 8 game. "I was kind of stubborn," Hastings recalled. Lacerte said coaches need to understand how to handle an injured player who doesn't want to leave the field. "For a player it's about being put in the spotlight," Lacerte said. "They don't want to be that player, but at some point it's not their decision." Lacerte, who also acts as the coaching director for the Brainerd Lakes Area Youth Soccer Association (LAYSA), said beyond high school sports, LAYSA is requiring concussion training for all coaches at every level of play. The required training is for good reason. The CDC said soccer player players suffer the highest number of head injuries in all sports, second only to boxing. Lacerte said he believes the high number of head injuries in soccer has a lot to do with improper training. "The majority of heading is done improperly," he said. "Plus, the more popular the sport becomes, the more aggressive it becomes. That means more injures." Lacerte said the biggest issue he faces as a coach of a player with a concussion comes with games away from home. "Do you spend two hours on a bus with a kid who has a concussion," he said. "Getting them the care required is a logistical nightmare." Dr. Arden Beachy, who practices family and sports medicine with Lakewood Health System in Staples said proper care for concussion injury is crucial for young athletes. Beachy said an athlete who suffers a concussion undergoes a traumatic functional injury, as opposed to a structural injury. "That can be hard for people to be understand." Concussion causes neurons to misfire affecting a person's personality, behavior and memory, but a structural change is rare. Beachy said 65 % of concussions occur in kids See, INJURY, Page 10 WHAT IS A CONCUSSION? A concussion is an injury that changes how the cells in the brain normally work. A concussion is caused by a blow to the head or body that causes the brain to move rapidly inside the skull. Even a "ding," "getting your bell rung," or what seems to be a mild bump or blow to the head can be serious. Concussions can also result from a fall or from players colliding with each other or with obstacles, such as a goalpost. The potential for concussions is greatest in athletic environments where collisions are common. A concussions can occur, however, in any organized or unorganized sport or recreational activity. As many as 3.8 million sports- and recreation-related concussions occur in the United States each year. Information provided by the Center for Dispease Control. Physical Therapist Becky Henderson (right) demonstrates a balance test used for patients undergoing therapy at a result of concussion. Garrett Matteson � Intern Photographer MSU/ Moorhead 9 Dr. Arden Beachy explains the importance of concussion awareness. Garrett Matteson � Intern Photographer MSU/ Moorhead From, INJURY, Page 9 ages 5-18 largely because a child's developing brain does not recover as quickly as an adults. Like Lacerte, Beachy blames poor technique for a lot of the concussions he sees. "Some of those kids can hit really hard," he said. Beachy, a high school basketball coach, said he sees athletes from all sports including football, hockey, soccer, baseball, BMX and motocross. He said over the years he has seen a lot of change in how concussion symptoms are treated on the playing field when it comes to making the decision to pull a player from the game. "The thing people need to know is that a mild concussion is still a brain injury," Beachy said. "That gets people's attention." "If there's any question at all -- hold them out of play." Once a coach makes a decision to pull a player, Dr. Beachy said it is important for the player to see a physician within the first 48 hours to evaluate symptoms and then to refrain from playing until the player has made a full recovery. Beachy said it often takes time to determine the severity of the injury and coaches, parents and athletes need to work together to make sure the player does not return to play before they are ready. "If you don't let something heal, the chance of re-injury is greater," he said. For Madeline Hastings, recovery was slow. Hastings said the morning after the injury occurred she woke up with two black eyes and a broken nose, but was more concerned about the game she would be missing that day due to her injury. Hastings' evaluation with her doctor showed she had suffered a concussion and would be off the playing field for weeks. Over the first few days, her recovery meant no school, no texting, no TV, and no homework. "I sat in a dark room by myself and basically stared at the wall," she said. Once she was feeling well enough to return to practice, Hastings said her reintegration into full contact play was slow. "I wasn't really allowed to play in any of the games at first," she said. "Even when I was allowed to play it wasn't full games -- just a little at a time." Hastings is still playing soccer, but said since her injury, she now thinks twice before charging the ball. "Every time I'm against the ball or one-on-one with a player I'm terrified 10 RECOGNIZING A POSSIBLE CONCUSSION To help recognize a concussion, you should watch for the following two things among your athletes: A forceful blow to the head or body that results in rapid movement of the head. Any change in the athlete's behavior, thinking, or physical functioning. SIGNS OBSERVED BY COACHING STAFF � Appears dazed or stunned � Is confused about assignment or position � Forgets sports plays � Is unsure of game, score, or opponent � Moves clumsily � Answers questions slowly � Loses consciousness (even briefly) � Shows behavior or personality changes � Can't recall events prior to hit or fall � Can't recall events after hit or fall SYMPTOMS REPORTED BY ATHLETE � Headache or "pressure" in head � Nausea or vomiting � Balance problems or dizziness � Double or blurry vision � Sensitivity to light � Sensitivity to noise � Feeling sluggish, hazy, foggy, or groggy � Concentration or memory problems � Confusion � Does not "feel right" Physical Therapist Becky Henderson (left) demonstrates a balance test in the physical therapy center at Lakewood Heathcare System. they're just going to nail me," she said. "One-on-ones are kind of stressful." Like many athletes her age, Hastings participates in multiple sports in addition to playing soccer. Hastings spent a number of years playing hockey. Dr. Beachy said it is the lack of rest and recovery kids are allowed between sports that contribute most to improper technique and slow reaction that often contribute to traumatic injury. "There's not a lot of rest," he said. "The odds of (concussion) just go up. I don't know how to change that." Beachy said his he'd like to see coaches work on developing strength training programs to develop the whole athlete -- not just the sport. "Not enough kids spend time doing the fundamentals," he said. "Kicking the ball into the net 50 times is not going to give you a concussion. "The better you get at the sport you do the less likely you'll cause or suffer an injury." Dr. Beachy and coach Ricky Lacerte both agree that the bottom line in most sports is safe play on and off the field, and that starts with coaching. "You can't account for every single play in a game," Lacerte said. "But you can teach safe smart play." For Beachy, safe play goes beyond the playing field and should to be considered part of the bigger picture -- eventually athletes stop playing sports and have to be able to function in society. "You're not going to stop concussions unless people stop playing sports," Beachy said. "The goal is for players to grow into adults who can function, hold down a job at the age of 25. To me, that's the big thing. Some of that responsibility should fall on coaches." SARAH NELSON KATZENBERGER may be reached at email@example.com or 855-5879. 11 A lifechanging diagnosis: Nisswa toddler diagnosed with Type 1 diabetes By JODIE TWEED HealthWatch Correspondent N Lucas Cline (right) and his dad, Scott Cline, hold up Lucas's insulin pump. Kelly Humphrey � firstname.lastname@example.com ISSWA � Even now, one year later, Dr. Scott and Amanda Cline still feel guilty. They feel they should have recognized the warning signs. Their son Lucas was gradually, over a period of about four months, becoming more cranky and clingy. He wasn't sleeping very well at night and then, a couple of weeks before he was diagnosed, he developed an insatiable thirst for water. Lucas was only 18 months old at the time. They thought he was teething, that he was sick, that he had an ear infection. Well-intentioned friends told them their children loved water, too, and maybe it was just a phase. Lucas's mom,Amanda Cline, holds an infusion site applicator used to administer insulin. Lucas would get up at 2 a.m. and slug down nearly three sippy cups filled with water. He also urinated a lot. A couple of days before Lucas was to undergo a fasting blood sugar test ordered by his pediatrician, the Clines decided to check his blood sugar at home with his grandmother's glucometer. His grandmother happened to be visiting from Illinois and has Type 2 diabetes. Lucas' blood sugars were exceptionally high. Dr. Scott Cline, who is an emergency medicine physician at Essentia Health-St. Joseph's Medical Center in Brainerd, started pricking his own fingers with the device, checking his blood sugar several times to see if the machine was malfunctioning. He hoped the machine was broken. It wasn't. "I just started freaking out," admitted Amanda. They immediately took their son to Essentia Health Brainerd Medical Clinic to see his pediatrician, who then sent the family directly to Children's Hospital in Minneapolis. Lucas was diagnosed with Type 1 diabetes and was suffering from diabetic ketoacidosis, a serious condition that could lead to a diabetic coma. His pancreas had stopped producing insulin and ketones were building up in his blood and urine. The family had to undergo a crash course from that day forward in living with a young child with diabetes. It's been a struggle and a learning process for them, even though it helps that Scott is a physician. The entire family, including their 5-year-old son, Drew, are enduring the daily challenges of raising and living with a child with diabetes. Initially after Lucas was diagnosed in April 2011, they would have to poke Lucas' finger about 10 times a day, giving him six to eight shots of insulin each day. Since Lucas' body doesn't make insulin, his parents have to predict how much insulin he should have before he eats carbohydrates. But Lucas is 2. What parent can predict how much food, if any, a toddler may want to eat at any given meal? They have to try, measuring out his food using a digital scale to attempt to figure out how many carbs he's eating at each meal. When Lucas gets cranky, they have 12 "It's been quite the learning process but when it's your kid, you don't have a choice, you have to be strong." -Amanda Cline to always first ask themselves, "Is it the diabetes?" Lucas started wearing an insulin pump last October, which allows his parents to administer insulin using a remote control, rather than giving him shots. The pump is worn around his waist, attaching internally with two small catheters, which have to be changed out every two days. In May he began wearing a glucose monitor on his arm, which monitors his blood sugar. The Clines continue to set alarms at midnight and 3 a.m. to wake up and give Lucas additional insulin each night. "It's been quite the learning process but when it's your kid, you don't have a choice, you have to be strong," said Amanda Cline. Lucas is too young to truly understand what is happening to him, but his mom said he is starting to ask questions. The other day he asked his brother Drew, "Where is your diabetes?," referring to the insulin pump and glucose monitor his big brother doesn't have to wear. They hope to help other families who are struggling with the same challenge. They started a blog, www.faceofdiabetes.com, to share their story and help other families who are going through the same situation. Amanda underwent training and is in the process of starting a support group for families with diabetic children in the lakes area. Contact her at firstname.lastname@example.com for more information about the support group. There are many misconceptions about children with Type 1 diabetes. Children like Lucas can have sugar; in fact, 50 percent of his diet is supposed to be See, TYPE 1, Page 14 Kelly Humphrey � firstname.lastname@example.com Lucas Cline has a constant glucose monitor on his arm and an insulin pump site at his waist. 13 "We've adjusted, but we don't like it." -Scott Kline Kelly Humphrey � firstname.lastname@example.com Above: Lucas Cline (right) and his brother play with a wheelbarrow at their house in Nisswa. Right: Lucas Cline's glucometer shows the approximate amount of glucose in Lucas's blood. Testing Lucas's glucose concentration helps keep his levels as close to normal as possible. carbohydrates, so he's not deprived of anything. The Clines just have to make sure to give him a corresponding amount of insulin so his body can process the sugar. They also have participated in fund-raising efforts to raise money for research to find better diabetes treatwments and a cure. They gathered a team, named Team Lucas, and walked in the Juvenile Diabetes Research Foundation's Walk to Cure Diabetes at the Mall of America Feb. 25, raising $5,000 for diabetes research. Scott Cline said there are treatments on the horizon that are promising. One experimental treatment now in clinical trials involves transplanting islet cells from stem cells into the pancreas of a person with Type 1 diabetes. Once transplanted, the cells begin to produce insulin. Another treatment that recently started in clinical trials is the creation of an "artificial pancreas," in which a computer device would monitor and administer insulin on its own. While Cline often sees the consequences of uncontrolled diabetes in patients who come through the ER, he realizes that it doesn't mean this is Lucas' destiny. Many children with Type 1 diabetes go on to lead normal, healthy lives. The Clines are optimistic a cure will be found in their young son's lifetime. "We've adjusted, but we don't like it," Scott Cline said of his son's diabetes. JODIE TWEED is a former Brainerd Dispatch reporter who is now a freelance writer for several area publications. She lives in Pequot Lakes with her husband and three daughters. 14 Scott (top left), Amanda, Drew (bottom left) and Lucas Cline enjoy the play set in their yard. What is Type 1 diabetes? Type 1 diabetes occurs when the body's immune system attacks and destroys cells called beta cells in the pancreas. Beta cells produce insulin, a hormone that helps the body use glucose, or sugar. When beta cells are destroyed, insulin can't be produced and the glucose stays in the blood, which can cause serious damage to all organs in the body. Type 1 diabetes is usually diagnosed in children, teenagers and young adults. Scientists don't yet know exactly what causes Type 1 diabetes. People with Type 1 diabetes must take insulin, which could mean undergoing many injections each day or having insulin delivered to their body through an insulin pump. They also must test their blood sugar by pricking their fingers six or more times a day to get blood samples. Along with insulin, people with diabetes have to balance their food intake and exercise to help regulate their blood sugar levels. Low or high blood sugar reactions can be life threatening. There is nothing that can be done to prevent or get rid of Type 1 diabetes. Type 2 diabetes typically develops after age 40, although it can appear earlier, even in children. In Type 2 diabetes, the pancreas still produces insulin, but the body either doesn't produce enough or can't use it effectively. Treatment for Type 2 diabetes includes diet control, exercise, self-monitoring of blood glucose and sometimes oral drugs or insulin. The warning signs of Type 1 diabetes The signs and symptoms of Type 1 diabetes in children can develop quickly. Extreme thirst and frequent urination. A child may drink and urinate more often than usual. Increased appetite. Unexplained weight loss. Drowsiness, or lethargy. Irritability or unusual behavior. Blurred vision. Yeast infection and diaper rashes. If your child exhibits one or more of these symptoms, call your doctor immediately. For more information on Type 1 diabetes, visit the Juvenile Diabetes Research Foundation website at www.jdrf.org <http://www.jdrf.org/> . Information provided by the Juvenile Diabetes Research Foundation. 15 The life of a 4-year-old girl with FAS Life changes for grandparents who officially turn into parents Jade York (left) and Tristan Warwas, her personal care assistant of Advantage in Brainerd, recently played with a train set at her home in Merrfield. Garrett Matteson � Intern Photographer MSU/ Moorhead ERRIFIELD -- A 4-yearold Merrifield girl has had more turmoil to deal with in her life than any child should have to endure. And this girl will have more struggles to deal with for the rest of her life. When someone first meets Jade York, who was adopted officially June 13 by her biological grandparents Sheila and Barry York, they will see a typical and sweet 4-year-old girl. But she is not typical. Jade has Fetal Alcohol Syndrome (FAS). FAS is among the disorders of Fetal Alcohol Spectrum Disorders (FASD) that can occur in a baby when the mother drinks alcohol during pregnancy which causes the baby to have physical problems and problems with behavior and learning, according to the Centers for Disease Control and Prevention (CDC). The CDC reports that each person is affected by the disorders differently and can range from mild to severe. Sheila and Barry York have taken care of Jade since she was 15-months-old. When they got her By JENNIFER STOCKINGER jennifer.stockinger@ brainerddispatch.com M she was an unhealthy 13-pound child. Sheila York said that her son and Jade's biological mother, who has since passed away, got married when she was 9-months-old, but split three months later. York said both her son and the mother were drug addicts and drank alcohol. The mother drank throughout her pregnancy. "I was in contact with my son and he was being evicted and they had no hot water or electricity and were having a hard time financially," said York. "The money they had was going to drugs. So they asked me to take Jade until they got back on their feet. "We had to drive to Illinois to get her and when we got home we brought her to the doctor and she had multiple medical conditions. She was sexually abused, neglected and was not cared for. They (the parents) denied it all, but they didn't take care of her. When she was pregnant she was drunk all the time. I told her to stop, but she was 22 and she wasn't going to listen to me. After they had her I told them not to smoke pot in front of Jade because of the secondhand smoke, but they again didn't listen and didn't believe me that it could harm her. I was getting no where." York said when they took Jade in she was ecstatic to have her and get her away from the neglect, but it also was scary for her as she had just turned 50. "When we picked her up she hadn't eaten for three days," said York. "We started her on milk and introduced her to baby food. We had to force feed her because she didn't like the texture or the taste. But eventually we got her on real food. She also didn't talk when we got her. She'd grunt." York said the doctor said that Jade has some of the typical physical signs of a person with FAS, which were having a smooth ridge known as the philtrum between the nose and upper lip and smaller eyes. Then when Jade went to the Early Childhood Family Education program, they found out how delayed she was academically. Jade was evaluated by the Paul Bunyan Cooperative and learned she was developmentally delayed. York said Jade worked with a psychologist from St. Cloud and then went to be fully evaluated for FAS at the Lakewood Health Systems in Staples. The doctors diagnosed Jade with full FAS. York said there are three types of FAS: FAS (the worst type), alcohol related neuro-developmental disorders and partial FAS. 16 Jade York recently played with a train set at her home in Merrifield. Garrett Matteson � Intern Photographer MSU/ Moorhead "I was not shocked," York said when she learned that Jade had FAS. She knew deep in her heart that Jade did have the disorder, but she didn't want to believe it. "I was more confused on what to do next." York said when she was in high school she worked with developmentally delayed children, who were violent and had a lot of mental problems. So she knows how challenging it will be to work with Jade. York is concerned about how Jade will feel once she gets older and realizes that she is different from the other students. "Right now at age 4, Jade is at the level of a 2-year-old," said York. "But it will go down because of the brain damage. "Longevity of life for people with FAS is down because they are suicidal, a lot are in the judicial center because their ability to understand consequences for their actions and they don't understand danger ... Some FAS kids live a normal life, but it is a minor proportion of the population." York said her and Barry's biggest challenge is re framing how they themselves think about Jade's condition. "She acts like a normal kid and has all the energy of a 4-year-old," said York, but she is not normal. "She has more meltdowns than a normal kid and she must be supervised 100 percent of the time, otherwise she could get something that she shouldn't or get injured. If we were not here right now, she'd eat Mr. Potato Head's ear. York said that Jade does not understand abstract thinking and everything is black and white. For instance, York said Jade doesn't understand innuendos. She also is a "2-minute kid," where she goes from one activity to the next every two minutes. Jade is seen by a personal care assistant (PCA) daily for five to eight hours a day, when she is not in school. Tristan Warwas of Advantage in Brainerd is her PCA. Jade also is seen by an occupation therapist. See JADE, Page 21A 17 American Cancer Society continues efforts to fight cancer New report estimates nearly 18 million U.S. cancer survivors by 2022 new report this month, estimates the number of Americans with a history of cancer -- now about 13.7 million -- will grow to almost 18 million by 2022. The data is from a first-ever report by the American Cancer Society (ACS) in collaboration with the National Cancer Institute. Data for the report generates new estimates of cancer survivor prevalence in the U.S. "The reports find that even though cancer incidence rates are decreasing, the number of cancer survivors is growing due to the aging and growth of the population, as well as improving cancer survival rates," the ACS reported. "The growing number of cancer survivors in the U.S. makes it increasingly important to understand the unique medical and psychosocial needs of survivors and raise awareness of resources that can assist patients, caregivers, and health care providers in navigating the various phases of cancer survivorship." The report states: The three most common cancers among males living with a history of cancer in 2012 are prostate cancer (43 percent), colorectal cancer (9 percent) and melanoma (7 percent). Among women in 2012 with a history of cancer, the three most common cancers are breast (41 percent), uterine (8 percent), and colorectal (8 percent) cancer. The ACS reported in 2022 those proportions are expected to be largely unchanged. Other selected findings from the report included: Nearly one-half (45 percent) of cancer survivors are aged 70 years or older, while 5 percent are aged younger than 40 years of age. The median age of patients at the A time of cancer diagnosis is 66. There are 58,510 survivors of childhood cancer living in the U.S. An additional 12,060 children will be diagnosed in 2012. The majority of cancer survivors (64 percent) were diagnosed five or more years ago; 15 percent were diagnosed 20 or more years ago. As of Jan. 1, 2012, there were 266,510 cancer survivors in Minnesota. As of January 2012 there were 2.7 million prostate cancer survivors and 2.9 million breast cancer survivors in the U.S. Breast cancer. The overall five-year relative survival rate for female breast cancer patients has improved from 63 percent in the early 1960s to 90 percent today. This increase is due largely to improvements in treatment (i.e., chemotherapy and hormone therapy) and to widespread use of mammography screening. Colorectal cancer. It is estimated that as of Jan. 1, 2012, there were almost 1.2 million men and women living in the U.S. with a previous colorectal cancer diagnosis. The ACS estimates an additional 143,460 will be diagnosed with colorectal cancer in 2012. The median age at diagnosis for colorectal cancer is 68 for men and 72 for women. The ACS reports 59 percent of men and women age 50 and older receive colorectal cancer screening. Consequently, less than 40 percent of cases are diagnosed at a local stage, when treatment is most successful. Leukemia. It is estimated that as of Jan. 1, 2012, there were 298,170 leukemia survivors living in the U.S. The ACS estimates an additional 47,150 people will be diagnosed with leukemia in 2012. Lung cancer. There were 412,230 men and women living in the U.S. with a history of lung cancer as of Jan. 1, 2012. The ACS estimates 226,160 people will be newly diagnosed in 2012. The median age at diagnosis for lung cancer is 70 years for men and 71 years for women. Melanoma. Estimates point to 1 million melanoma survivors living in the U.S. at the beginning of 2012. The ACS estimates an additional 76,250 people will be diagnosed this year. Melanoma incidence rates have been increasing for at least 30 years. About 84 percent of melanomas are diagnosed at a localized stage, when they are highly curable. The ACS reports the median age at diagnosis for melanoma is 63 for men and 56 for women. Though melanoma is rare before age 30, it is the third most commonly diagnosed cancer, after thyroid and testicular cancer, in those ages 20 to 29 years. Prostate cancer. It's estimated that there were nearly 2.8 million men living with prostate cancer in the U.S. as of Jan. 1, 2012, and 241,740 men will be diagnosed with prostate cancer in 2012. The median age at diagnosis is 67. Uterine corpus cancer. The ACS reports there were 606,910 women living in the U.S. with a previous diagnosis of uterine corpus cancer as of Jan. 1, 2012, and 47,130 women will be diagnosed in 2012. Uterine corpus cancer is the second most common cancer among female cancer survivors, following breast cancer. The ACS reports more than 90 percent of these cancers occur in the lining of the uterus. The median age at diagnosis for uterine corpus cancer is 61. Urinary bladder cancer. The ACS reports there were 585,390 urinary bladder cancer survivors living in the U.S. as of Jan. 1, 2012. The society estimates 73,510 people will be diagnosed with bladder cancer in 2012. The study noted half of all bladder cancer patients are diagnosed while the tumor is localized and present only in the layer of cells in which the cancer developed. Cancer of the urinary bladder is most common among older adults with a median age at diagnosis of 73 for men and 74 for women. Thyroid cancer. This cancer is the fastest-increasing cancer in both men and women, the ACS report noted. Estimates have 558,260 people living in the U.S. with thyroid cancer. An additional 56,460 will be diagnosed in 2012, the ACS reported, adding the incidence rate of thyroid cancer has been increasing sharply since the mid-1990s. Testicular cancer. It is estimated there are 230,910 testicular cancer survivors in the U.S., and an additional 8,590 men will be diagnosed in 2012. The five-year relative survival rate for men diagnosed with early stage testicular cancer is 99 percent, that drops to 96 percent if the cancer has spread regionally and 72 percent if the cancer has spread to other areas of the body. The ACS describes its mission as helping people "stay well, get well, find cures and fight back." "We fund and conduct research that helps us better understand, prevent, and cure cancer," the ACS stated. In the United States, the ACS is the largest non-government funder of cancer research. The ACS reports it spends about $130 million each year in the search for cancer cures by providing grants and scholarships and conducting its own research. "We fund beginning researchers with cutting-edge ideas early in their careers -- 46 of whom have gone on to win the Nobel Prize, the highest accolade in scientific achievement," the ACS reports. 18 Essentia Health takes another leap into digital age with smartphone app t seems like nowadays, the smartphone makes anything possible. Going above and beyond just making a phone call, users can play games, music, book their next vacation and scan their airline ticket all with the ease of a finger touch. And with nearly 2 million smartphone apps available to consumers, Essentia Health is adding to the app craze, allowing patients access to their health records at the tips of their fingers. "Any user with a MyHealth ID and account can download the free app," said Jenny Krueth, analyst in Essentia Health's Information Managament department. "With the app, you have the opportunity to go and look for your healthcare institution, see lab results and do many of the same things that you can do online with MyHealth but now it's on the go with this smartphone app." In exsitence for the past couple years but just recently made available to users in the Brainerd lakes area, the Essentia Health app -- named Epic MyChart -- allows patients to access both their own and their children's health records along with the ability to review medications, track blood pressure and weight over time, request or cancel appointments and even review test results instantly. "When you go to the doctor and have some lab tests done, as soon as those tests are done in the lab and released and verified, you have that information on your phone," said Krueth. "A lot of times you can see the results within a half an hour, instead of waiting around for a phone call." Krueth said the app also includes the same security as accessing online banking information and protects medical information in its fullest. She also added that despite Essentia Health's move forward in technology with MyHealth, old-fashioned communication hasn't gone away. "We still send out paper mail and are available over the phone for patients who are more comfortable communicating that way," Krueth said. "But for those on-the-go and who are looking for that instantanious way to access much of the information in their medical records, we have the (Epic MyChart) app. "A little something for everybody." By JESSI PIERCE jessi.pierce@ brainerddispatch.com JESSI PIERCE, staff writer, may be reached at 855-5859 or email@example.com. Follow her on Twitter at www.twitter.com/jessi_pierce (@jessi_pierce). I 19 Anesthetic may bring people to procedure they rarely relish ROSBY -- It's probably not a stretch to say most people don't enjoy the trip to the doctor's office. Add in a colonoscopy and watch that number drop out of the basement. But what if the choice of anesthesia could make a difference? That's what the hope is at Cuyuna Regional Medical Center (CRMC) in Crosby. Dr. Mark Gujer, chairman of the department of anesthesia, said previously when patients came for an endoscopy -- where a tiny camera on a long, flexible tube is used to examine the upper digestive system -- or a colonoscopy, they were sedated perhaps with drugs common for that task in the emergency room such as a sedative like Versed or with narcotics like Demerol or morphine. Those drugs last four to six hours when a colonoscopy may last 15 minutes. "So you have a minor procedure with no pain postoperatively yet you are done for the day," Gujer said. "You are just wiped out from all those medications." Patients would go to the same-day surgery recovery room and maybe spend another hour before they felt clear-headed enough to leave for home. While the patient was out for the minor procedure, they could be left with hours of waiting for the drugs to sufficiently clear their systems to feel better. Some were nauseous. Others felt dizzy. Gujer said patients could basically lose an entire day to have a colonoscopy. That time commitment may have added just one more obstacle to patients who hesitate to have a minor procedure that may just catch colon cancer early and ultimately save lives. Gujer, medical director of perioperative services at CRMC, wanted to change that. He was working on a program to train nurses to administer an anesthetic agent called propofol. That anesthetic could only be used by people trained in anesthesia and was normally administered by personnel trained in delivering anesthesia, such as certified registered nurse anesthetists or anesthesiologists. In Minnesota, nurses could be trained and certified to administer propofol sedation. The plan was to bring in a simulation lab and do the training. "I wanted to do it for a couple of really important reasons," Gujer said, seated at his desk at CRMC during a break between seeing patients and a leadership meeting. "The biggest one is patient satisfaction." Gujer said patients sedated with propofol remember talking to their doctors only minutes after the procedure is done because the drug is gone from their systems that fast. "We can do that at a depth of anesthesia that provides patient comfort and surgical relaxation with just that one drug," Gujer said. "We don't give them anything else. They don't get any narcotics so no nausea afterwards. So they feel better. They wake By RENEE RICHARDSON renee.richardson@ brainerddispatch.com C up. They are more alert. ... Some of our patients now are going out the door 15 minutes after they get out of the procedural room. "Patients repeatedly tell nurses `wow I had this done four years ago; this is nothing like that.'" For the hospital, using propofol is a way to eliminate a bottleneck. Having patients move through the recovery area more quickly instead of lingering because they feel groggy is a benefit to keep the system from bogging down, Gujer said. "So we did it from a flow standpoint, too, but there are other added benefits," he said. Those benefits are coming from patients who have a better experience. Gujer said now they believe they will have much better compliance with the colonoscopy, a screening tool for cancer. In 2005, the Institute for Safe Medication Practices, a nonprofit organization, reported using propofol for endoscopic and other diagnostic procedures was gaining momentum in hospitals, outpatient surgery centers and doctors offices. "In trained hands," the institute reported, "propofol offers many advantages Dr. Mark Gujer is the chairman of the department of anover other drugs used for sedation." So in 2009, Gujer was ready to start that training esthesia for Cuyuna Regional Medical Center. program at CRMC to use propofol. Then came the overdose death of Michael Jackson in acute propofol and sweaty. "Yuck feeling, I don't know how else to intoxication. According to a Scientific American ar- describe it," she said. If the patient's colon has some twists and sharp ticle, the autopsy report found propofol in Jackson's case was administered in a nonhospital setting and corners, it can be painful to have the scope move through it. She said it was tricky to provide enough without the proper medical indication. Gujer said the lesson from Jackson isn't that sedation so the patient was comfortable, but not too propofol is dangerous. The message, he said, is not much to cause a concern for their breathing. "With propofol it's much safer for the patient," to have a cardiologist who is not trained in its use Forstner said. "Now there is a nurse anesthetist there administer it improperly. "In the hands of someone who is trained to use monitoring the patient." Propofol has a mild amnesia effect, she said, so it, this is the safest anesthetic drug we've ever had," patients have no knowledge of the procedure. They Gujer said. Believing there will be changes in how the drug sleep through it and because they are relaxed, it is is regulated by the Federal Drug Administration and easier for the scope to make the colon's corners and the state of Minnesota, Gujer said instead of putting they are not feeling that pain, Forstner said. "If it was uncomfortable, they don't remember it in the simulation lab and going through the expense to train nurses to administer propofol another option and it is very often not uncomfortable for them at all," was suggested. Hire another nurse anesthetist and she said. With older patients the drugs previously cover the procedures using anyone from the anes- used also created a concern for falling as drugs could thesia department with its two anesthesiologists and leave people light-headed and drop blood pressure. Forstner said now patients wake and are sometimes five anesthetists. CRMC kicked off that plan a year ago and reports ready to go home in 20 minutes. Recently a patient cutting discharge times in half using propofol. It's a who had the procedure done years ago came in saylittle more expensive to provide the service, which ing she almost canceled after not sleeping at all and the hospital is absorbing, but Gujer said they are anxious about the colonoscopy. This time, Forstner gaining in patient satisfaction and the surgeons re- said the woman said she felt wonderful. And that's what health care providers wanted to port better procedures. Patients are in a deeper level of sedation for the colonoscopy so surgeons have an hear especially for a procedure that patients may be reluctant to have but that could catch cancer in an easier time to perform the procedure, Gujer said. At CRMC there area bout 5,000 surgical proce- early, more treatable stage. dures in a year with 1,500 of them colonoscopies/ endoscopies. RENEE RICHARDSON, senior reporter, may be reached Peggy Forstner, patient care coordinator for same- at 855-5852 or email@example.com. day surgery and recovery, said prior to propofol pa- Follow on Twitter at www.twitter.com/Dispatchbizbuzz. tients woke up feeling groggy, hung-over, nauseous 20 Sheila York and her daughter Jade posed for a photograph recently at their home in Merrifield. Garrett Mattsen � Intern Photographer MSU/ Moorhead JADE , From Page 17 York wants the public to be educated about FAS. York said according to the FASD organization in Minnesota that as many as 8,500 babies are born in the state with prenatal alcohol exposure. Nationally, FASD affects one out of every 100 births. York said it is never OK for women to drink while pregnant, not even one drink. York said there are many cases of children who are diagnosed with attention deficit hyperactivity disorder or autism, who could very well have a type of FASD. "If a medication or treatment is not working a parent may want to look into seeing if the child has FAS," said York. York said even her son, who lives in Illinois, does not believe that Jade has FAS. She said he talks to her two to three times a week on the telephone or through Skype. "To really be able to see her struggles, you have to be around her for a few days. She looks normal, it takes time." As for the Yorks' life being changed as they have become parents of an FAS child, York said, "We were looking forward to our retirement years, growing old together and enjoy my time as a wife. We never thought we'd go back and be taking care of a baby and have our life turned upside down. But I wouldn't change it for the world. It's a full schedule every day." Facts of Fetal Alcohol Spectrum Disorders (FASD) � FASD is caused when a woman drinks alcohol during pregnancy. � It is 100 percent preventable and there is no cure. � There is no known amount of alcohol that is safe to drink while pregnant. There is also no safe time to drink during pregnancy and no safe kind of alcohol to drink while pregnant. � Nationally, FASD affects one out of every 100 births, which is more than autism and Down Syndrome. � Approximately 57 percent of women of childbearing age in Minnesota are current drinkers (drank in the last 30 days) and of these, about 19 percent binge-drink (more than three drinks in one sitting at a single point in time). � In Minnesota, about 12 percent of pregnant women consume five or more drinks per month and 6 percent bingedrink. � Of the pregnant women who use substances, 80 percent use alcohol during pregnancy, while 8-23 percent use illicit drugs and 33 percent smoke. � According to the CDC, the lifetime cost for one individual with FAS in 2002 was estimated to be $2 million for medical, educational and residential care. � A person with an FASD might have: Abnormal facial features, such as a smooth ridge between the nose and upper lip, small head size, shorter-than-average height, low body weight, poor coordination, hyperactive behavior, difficulty paying attention, poor memory, difficulty in school (especially with math), learning disabilities, speech and language delays, intellectual disability or low IQ, poor reasoning and judgment skills, sleep and sucking problems as a baby, vision or hearing problems and problems with the heart, kidneys or bones. Source: CDC and The Minnesota Organization on Fetal Alcohol Syndrome, a statewide organization serving as the leading voice and resource on FASD in Minnesota. 21 Health Watch Service Directory � June 2012 Assisted Living Excelsior Place 14211 Firewood Drive Baxter, MN (218) 828-4770 www.wtohdevelopment.com/baxter Good Neighbor Home Health Care (218) 829-9238 (888) 221-5785 www.gnhomecare.com Good Samaritan Societies of Brainerd and Pine River (218) 829-1429 www.good-sam.com Cosmetic Surgery The Vein Center 1990 Conneticut Ave S. Sartell, MN (320) 257-VEIN (8346) www.beautifulresults.com MRI Glass/Windows Lakes Imaging Center 2019 S. 6th Street Brainerd, MN 218-822-OPEN (6736) 877-522-7222 www.lakesimagingcenter.com Gull Lake Glass 18441 State Hwy 371 Brainerd, MN (218) 829-2881 1-800-726-8445 Opticians Great Northern Opticians 2020 South 6th Street Brainerd, MN (218) 829-1335 Northern Eye Center Brainerd Little Falls Staples 218-829-2020 1-800-872-0005 www.northerneyecenter.com Health Care Audiology Accucare Audiology 14275 Golf Course Rd #220 Baxter, MN (218) 454-3277 Preferred Hearing 17274 State Hwy 371 Brainerd, MN 56401 1-800-458-0895 www.preferredhearingaidcenter.com Cuyuna Regional Medical Center (218) 546-7000 (888) 487-6437 www.cuyunamed.org Essentia Health St. Joseph's Hospital 218-829-2861 Brainerd Clinic 218-828-2880 Baxter Clinic - Coming Soon! www.essentiahealth.com Lakewood Health System Staples Motley Pillager Eagle Bend Browerville (218) 894-1515 (800) 525-1033 www.lakewoodheathsystem.com Orthopedics St. Cloud Orthopedics 1901 Conneticut Ave S. Sartell, MN (320) 259-4100 www.stcloudorthopedics.com Construction Nor-Son 7900 Hastings Rd Baxter, MN (218) 828-1722 (800) 858-1722 www.nor-son.com Psychiatrists Northern Psychiatrics 7115 Forthun Rd # 105 Baxter, MN (218) 454-0090 www.northernpsychiatric.com To have your business listed in future editions of Health Watch, please contact Dave Wentzel at 218-855-5821 Download the Brainerd Dispatch iPad App Now! Scan this QR code to download the app or visit the iTunes App Store *free for a limited time Have an iPad? View archived editions See the "real" paper on your iPad Have instant access to news, pictures, even classifieds! Share the news stories via Facebook, Twitter or email! 22 24


text:
Think you're smarter than your friends? Prove it by tackling Sport24's almost impossible yet highly addictive quiz!
Get Sport24 on your mobile
Martin played 71 Tests for New Zealand over an international career
spanning more than 12 years, claiming 233 wickets at an average of
The 38-year-old, who played his last Test in January and has fallen down
the pecking order as a new generation of fast bowlers emerge, said he
had enjoyed every moment with the Black Caps.
"It feels like the right time to step down," he said.
New Zealand Cricket chief executive David White said Martin had made an outstanding contribution to the Black Caps.
"During his career, Chris has formed a reputation as one of the most
consistent performers in world cricket, something which can be put down
to his relentless work ethic," he said.
While lauded for his bowling, Martin was also a fan favourite for his
plucky, if inept, efforts with the bat, averaging 2.36 with a high score
of 12 over his Test career.
He is second only to Courtney Walsh in the number of Test ducks
recorded, notching 36 to the West Indian's 43 - although Walsh did play
almost twice the number of matches.
Follow Sport24 on Twitter and Facebook and on Mobile and Have your Say on our Forum
Read News24's Comments Policy
24.com publishes all comments posted on articles provided that they adhere to our Comments Policy. Should you wish to report a comment for editorial review, please do so by clicking the 'Report Comment' button to the right of each comment.
Got something you'd like to get off your chest? Got a burning desire to air an opinion? If so, be sure to sign-up on Sport24's FORUM!
I believe CSA. No SMS from CEO Haroon Lorgat was sent. The team was picked on merit - and just wasn't good enough on the day
Mike Horn's comments that there WAS political interference to some degree
Right now, the tooth fairy in more believable!
View Results |
Vote Archive
I believe CSA. No SMS from CEO Haroon Lorgat was sent. The team was picked on merit - and just wasn't good enough on the day
Mike Horn's comments that there WAS political interference to some degree
Right now, the tooth fairy in more believable!
Vote Archive
Follow Sport24 on Twitter
"Like" Sport24's Facebook page
Sign up for the Morning Glory, Super 15 and Soccer newsletters
Enter and win with Sport24!
Sport24 on your mobile phone - WAP, alerts, downloads, services
Have your Say on Sport24's brand new Forum!
Stay in the loop on your BlackBerry
Latest Sport24 news on your iPhone
RSS Feeds
Sport news delivered really simply.
Yes your opinion counts. Get it out there
24.com: Legal notices
Advertise on 24.com
Contact us
24.com. All rights reserved.

subset: commoncrawl


text:
CORPUS CHRISTI ARMY DEPOT. The temporary post established by Zachary Taylor in 1845 at Corpus Christi was designated Fort Marcy, for Secretary of War William Marcy. The name was seldom used, and it fell into complete disuse when another Fort Marcy was founded in New Mexico Territory; the Texas site was usually called Corpus Christi instead. In September 1852 Gen. Persifor F. Smith announced his intention to move United States Army headquarters in Texas from San Antonio to Corpus Christi on December 1 of that year. The post at Corpus Christi had a garrison of 150 to 200 men between the end of the Mexican War and Smith's decision. The place was chosen largely because Smith had been ill from the day he arrived in San Antonio, and he found the climate and food in Corpus Christi more healthful; he was said to have particularly liked the local oysters. There were complaints about the location from some of his subordinates, especially the quartermaster, who found San Antonio more central to the forts the depot was to supply. Smith also sought to establish an army general hospital at Corpus Christi on land offered by Col. Henry L. Kinney, but his design was frustrated by a conflict between Senator Sam Houston and Secretary of War Jefferson Davis. Smith was transferred to Leavenworth, Kansas, and died in the spring of 1858. In 1856 Col. J. K. F. Mansfield, inspector general of the United States Army, pointed out the disadvantages of Corpus Christi as a supply depot for such distant forts as Fort Bliss, Fort Mason, and Fort Worth. The depot was closed in January of 1852 but regarrisoned in 1869–70 and again in 1880–81. The present Corpus Christi Army Depot was activated in 1961 on the site of the Corpus Christi Naval Air Station and is the army's main helicopter overhaul and repair facility. By the late 1980s it was the largest single employer in South Texas.
M. L. Crimmins, ed., "Colonel J. K. F. Mansfield's Report of the Inspection of the Department of Texas in 1856," Southwestern Historical Quarterly 42 (October 1938, January, April 1939). Francis Paul Prucha, A Guide to the Military Posts of the United States, 1789–1895 (Madison: State Historical Association of Wisconsin, 1964).
The following, adapted from the Chicago Manual of Style, 15th edition, is the preferred citation for this article.Frank Wagner, "CORPUS CHRISTI ARMY DEPOT," Handbook of Texas Online (http://www.tshaonline.org/handbook/online/articles/eqc23), accessed May 23, 2015. Uploaded on June 12, 2010. Published by the Texas State Historical Association.


text:
You are here:
Journeys for sale by Region
Journey Used cars by Transmission
Journey Cars by Type of Fuel
Display: Sort by:
Showing Results 1 - 9 of 9 used Dodge Journey for sale
Journeys for sale by Body Type
Journeys for sale by Year Model
Used Journeys for sale by Price Range
Auto Dealer - Quality used Dodge Journey for sale in Durban, Cape Town, Johannesburg and Pretoria. Second-hand Dodge Journey cars for sale in South Africa. Browse hundreds of demo Dodge Journey and pre-owned Dodge Journey used cars in South Africa. Apply for Dodge Journey finance or sell your Dodge Journey car privately. South African second-hand Dodge car dealers online.


text:
LOTS FOR SALE: LOT FOR SALE 417 Michigan St. $5000 Call 859-913-0485More info Email a friend
LOTS FOR SALE: SOMERSET, KY Beautiful lot, upscale sub.½ac. $15,500 606.219.1410More info Email a friend
HOMES FOR SALE: Autumn Ridge ranch with hardwoods perfect for downsizing $196,000 Devondale ranch totally updated great starter home $124,900 Mona Marshall, Principal Broker M & M Realty Inc.,of Lex. 278-7772More info Email a friend
LOTS FOR SALE: 7 ac. beautiful, secluded & priv. Build your dream home. Jessamine Co. Bill Thomas 859-221-2462 United Real EstateMore info Email a friend
CONDOS FOR SALE: The Woodlands Luxury Condominiums 3rd Floor with balcony Completely remodeled Large 2BR, 2BA Formal Living rm & dining rm Den w/ Fireplace $525,000 2nd Floor Corner Unit 2BR 2BA, Living & Dining rm combo Den w/ Fireplace $350,500 Call ...More info Email a friend
MISC. REAL ESTATE FOR SALE: Open Sun 1:30-4:30 Private Urban Riverfront Park 701 Taylor Ave Frankfort, KY 2,000 Sq. ft. Clubhouse on 10 Acres. Emerald lawns, majestic cliffs, deep crystalline pool & more. $169,000 Eddie sayre 502-320-1399More info Email a friend
HOMES FOR SALE: NICE HOME, 252 Ellerslie Park Blvd. 6BR, 4BA, Come See! 859-317-0457.More info Email a friend
HOMES FOR SALE: 307 Thompson Rd. Lex. 3BR, totally remodeled,move in ready. Extra clean 1/2 mi. from Rupp. Lg. yard. $92,500. 859-494-0751More info Email a friend
COMMERCIAL BUILDING: . SIGNAGE! Class A office condo with exterior signage. Superior location with close proximity to St.More info
SINGLE FAMILY HOME: 4 bed, 2 full bath, 1 half bath. Great home on the 1st block of South Hanover. Many recent improvements. Needs some TLC and could beMore info


text:
Israel has few options for rocket fire from Egypt
JERUSALEM Israel's prime minister on Thursday warned that Egypt's Sinai desert is becoming a "terror zone" and vowed to strike at militants there after a rocket fired from the area hit a southern Israeli resort town.
The tough talk, however, was tempered by Israel's desire not to disturb the already fraught relationship with Egypt. Israeli officials acknowledged their options are limited as the new government in Egypt - one of Israel's few allies in the Arab world - tries to secure its sovereignty over the mountainous Sinai Peninsula.
Thursdays' rocket attack, the first on Eilat in nearly two years, raised new Israeli concerns about militant activity in Sinai, particularly since the fall of Hosni Mubarak's regime last year. Israeli security officials have repeatedly warned of a power vacuum in Egypt and say that Islamic militants, including al-Qaida, have stepped up their activity in Sinai and are now active on Israel's doorstep.
"We are seeing now with Eilat that the Sinai Peninsula is turning into a terror zone," Prime Minister Benjamin Netanyahu said. "We will strike at those who attack us. There can be no immunity for terrorism; it must be fought and we are doing so."
Israeli Defense Minister Ehud Barak threatened to "strike those responsible for firing (the Grad rocket) at Eilat."
No injuries were reported in the overnight strike against Eilat, a normally tranquil Red Sea vacation spot that is set to welcome thousands of visitors this weekend for the Passover holiday.
There was no immediate claim of responsibility, and Egypt denied the attack was launched from its territory. "The chief of security of southern Sinai has already denied that the rocket was fired from the Sinai territory," Egyptian Foreign Minister Mohammed Amr told reporters in Cairo.
But Israel military officials, citing intelligence, said all signs were that the rocket had been fired from Egypt. It would be the third such time since 2010 that militants in Egypt have fired rockets toward Israel.
Israel has warned of growing lawlessness in Sinai following the uprising last year that overthrew Mubarak's regime.
Sensing the growing threat, Israel has increased its surveillance on the Egyptian border and is building an electronic barrier along the 230 kilometer (150 mile) frontier in a bid to keep out militants and illegal migrants. It is expected to be completed by the end of the year.
But the fence cannot protect southern Israel from rockets, a gap that Netanyahu pointed out on Thursday.
Palestinian militants in the Gaza Strip, separated by a border fence from Israel, have fired thousands of rockets into Israel in recent years. Israel has responded to Gaza rocket fire with military reprisals and the deployment of a rocket-interception system known as Iron Dome.
Rocket fire from Egypt is far rarer, and it is not clear if Israel plans to move the anti-rocket system, which is still in its infancy and expensive to deploy, to the border with Egypt.
Thursday's attack left Israel in a delicate position: absorbing hostile fire from a neighboring country but having few options to respond.


text:
Should government turn foreclosures into rentals?
Help us
Know someone who would be a good subject for "Five on Friday"? E-mail suggestions to Lily Leung email@example.com. Please include a couple sentences on why the person should be profiled.
Know someone who would be a good subject for "Five on Friday"? E-mail suggestions to Lily Leung email@example.com. Please include a couple sentences on why the person should be profiled.
Should unoccupied bank-owned homes held by the government convert to rentals?
That's one idea to address the nation's housing backlog, said HUD Assistant Secretary Mary J. Miller this week at the CFA (Chartered Financial Analyst) Institute this week.
From her prepared statement:
We think there is an opportunity to address the backlog of unsold homes by creating a process for moving real estate owned by the government to new private owners, with a particular interest in creating rental options, as we see more demand right now for home rentals than home sales.
Two months ago, the government asked the public for suggestions on how to get something done. Miller said the Federal Housing Finance Agency received 4,000 comments. (Read more about the idea here.)
The Union-Tribune this week asked University of San Diego real estate professor Norm Miller on his thoughts about such a strategy, in an email. This is this week's Five on Friday Q&A.
Q: What are the pros about doing something like?
A: I think that one objective (not stated) that is achieved by renting housing and not selling it off is that the GSEs (government-sponsored enterprises Freddie Mac and Fannie Mae) don't have to write down the losses any more since they can delay the actual sale. This may save face for awhile.
Q: What are the potential drawbacks?
A: Converting several previously owned units to rental does not necessarily stabilize a neighborhood. If the renters are former owners, they might take better care if there is some hope for lease-to-own, so there may be some merit in the idea. They may be more engaged neighbors. At the same time, investors could do the same thing: simply rent it out to existing and prior owners for awhile until the market gets in better shape, at which time they could sell the units.
So perhaps the government would be a more tolerant landlord by not selling the unit out from under the newly converted renters. It is simply hard to speculate about such issues. The only clear benefit for the GSE is to delay showing losses, and there is no clear benefit for tax payers.
Q: What about demolition?
A: Demolition in some cases may be better for the neighborhood, such as when an abandoned house is known to be a crack house or hang out for gangs. So this strategy may be helpful for really distressed neighborhoods.
Q: Other options?
A: I applaud the interest of the GSE in minimizing tax payer losses and helping neighborhoods, but it seems that what would really help would be speed. Get the pain of selling these over with so the market can start to heal. Prices may be depressed for awhile and investors would buy these and rent them to the highest bidders, and over time, the market would regain more owners as these units are eventually sold off back to owner occupants.


text:
The Comedy In Fifty Shades of Grey
By Amy Nicholson
Wild Tales Lays Bare Everyone's Awfulness
By Stephanie Zacharek
Approaching the Elephant Is a Bracing Education Doc
By Calum Marsh
By Stephanie Zacharek
By Inkoo Kang
The Results of Our 2014 Film Critics' Poll
By Voice Film Critics
By Alan Scherstuhl
The Blue Room (La Chambre bleue)
By Alan Scherstuhl
Big dreams come in small, slimy packages in Turbo, the story of a garden snail (Ryan Reynolds) who realizes his need for speed after a freak accident involving a hot rod's nitrous oxide tank turns him hyper-fast. Chastised for his race-car dreams by curmudgeonly brother Chet (Paul Giamatti), Turbo nabs a farfetched shot at Indianapolis 500 glory after he winds up at a local taco stand and befriends Tito (Michael Peña), a kindred dreamer whose fanciful future plans are similarly put down by a pragmatic sibling (Luis Guzmán). David Soren's story peddles rote messages about believing in yourself and seizing the day, all while adhering to convention at every hairpin turn, be it a cast of comedic-relief sidekicks (voiced by, among others, Samuel L. Jackson and Snoop Dogg) or an arrogant villain in Turbo's idol-cum-rival Guy Gagné (Bill Hader). Among this illustrious voice cast, only Giamatti stands out, bringing an exasperated protectiveness and anxiety to the otherwise sunshiny-bright proceedings, which exhibit scant interest in drumming up any sense of danger or dread. Content to be merely cheerfully clichéd, it's an assembly-line kids' film that, unlike its daring protagonist, risks little, and thus reaps only modest rewards.Follow @VoiceFilmClub
Sponsor Content
Find capsule reviews, showtimes & tickets for all films in town.
Join My Voice Nation for free stuff, film info & more!


text:
Home / Candice Swanepoel Interview in V Man / Naked Candice Swanepoel VMAN Magazine Part Two – (2)
Bloginity recently met young photographer Neringa Rekasiute, who explores art out of her studio in the cosmopolitan metropolis of London. She gives us some insight about her likes and preferences, including why she prefers film over to digital, who her favorite subjects to photograph are, as well as touching on the roots of her motivation. Neringa is a true generator of ideas. Find out more about her below.


text:
Is that football or 'Dancing with the Stars?
As if college football's beleaguered referees didn't have enough to worry about, soon they'll be pressed into service as talent judges, too.
It will no longer be enough to decide when taunting crosses the line. Beginning in 2011, the refs will have to decide exactly where the "crime" began.
Under current rules in the NCAA and NFL, if a player commits a taunting foul en route to a score, a 15-yard penalty is assessed on the extra point attempt, 2-point conversion attempt or ensuing kickoff. But the NCAA said Thursday that it wants those penalties assessed from the spot on the field where the violation occurs, even if it means wiping out a touchdown.
Wait until some overzealous ref decides some player slowed down too much, stepped too high, pranced too merrily, looked back over his shoulder too long or launched himself too early into the end zone - and then calls taunting in the final seconds of a game on a hot, boozy afternoon with first place on the line in the SEC. Better yet, he needs a replay to make the determination.
No doubt coaches, players and especially fans will take it all in stride - on their way to storming the field.
"Nothing's perfect," said Grant Teaff, executive director of the American Football Coaches Association. "I'm sure something, or some situation will come up down the road that's going to cause a lot of people some consternation. And when that happens, we'll look at the rule and decide if it needs adjusting.
"But I don't think the coaches were looking at that aspect. They've been talking about it for a while and decided it should no longer be a part of the game. And this rule is one way to make sure the kids pay attention."
If only it were that simple.
The NCAA rule book tries to be specific on the matter of taunting, and most of the examples offered hardly require interpretation.
Players can't use "threatening or obscene language or gestures," such as "imitating the slashing of a throat." They can't stand over a fallen opponent and beat their chest. They can't point any part of their anatomy or the ball itself at an opponent. Going into the stands is definitely verboten. So is pretending to fire a weapon, and even cupping a hand around the ear, as in the "I-can't-hear-you" pantomime.
But just about everything else falls into a gray area.
Players can get whistled for "obviously altering stride," a penalty previously called only on "Dancing with the Stars." And how about "bowing at the waist after a good play"?
Say some mammoth defensive lineman causes a fumble, then bends over to catch his breath even as the teammate who scooped up the loose ball is running it back for a score? Fair or foul?
"That's a good one," Teaff said. "I imagine it's one of those cases where the refs may have to go back and take another look."
If you've ever attended a game where an excessive celebration penalty came back to bite the offending team, you know how well those things go over. Especially when it happens to the home team. In case you forgot, think back to last season, when Georgia receiver A.J. Green was flagged after catching the go-ahead touchdown late against LSU.


text:
Find Ways to Normalize of Public Education and Close Gap in English Between Students
Date Added: Jul 2009
Format: WORD
Jeollanamdo region faced difficulty in providing a balanced opportunity about public education of English because it has many islands where the native English teachers tend to avoid working. As such, the Jeollanamdo Office of Education found the answer in IT technologies. In order to realize its idea of enabling English education in island regions similar level to cities, the Jeollanamdo Office of Education reviewed several e-class solutions. After examing several possibilities, Jeollanamdo Office of Education determined that Microsoft Office Live Meeting 2007 is most ideal for 1:1 method of class, the most effective method of education and not 1 to many method.


text:
Royal Palace Hotel
No availability found through our partners. Please contact the business directly or check some of our recommended alternatives.
How has this hotel rated in the past?
Photos of Royal Palace Hotel
Travelers also recommend:
TripAdvisor Reviews Royal Palace Hotel Hurghada
Travel Blogs from Hurghada
Moving Day 2
... have given us where ever we have travelled in this amazing country. We both feel very privileged to have travelled to amazing temples, pyramids and tombs and learned all about life in ancient Egypt. We suspect that Australians are thought of very highly here in Egypt and we felt like we received special treatment everywhere we stayed because of it. Egypt could certainly do with more visitors from western countries as we ...
Hurghada Day 2
Today turned out to be a lay day as Tish awoke early with an upset tummy. By late morning, she was feeling much better and we made our way down to the resort beach and had a swim with the local resort dolphin. We read about the dolphin on reviews written about the resort by previous guests so it was a privilege to actually touch and swim with him. We were able to secure two deck chairs ...
Hurghada Day 1
... Red Sea is truly up there in terms of quality diving/snorkelling locations and at 23 degree water temperature in early spring, is accessible all year round. After the second dive site we returned to shore and went on a walk around the resort and along the area of Hurghada outside the resort to get our bearings. And speaking of bearing (or Bearing Straight to be precise) more than 90% of the guests here at the resort are Russian so it could be said that be actually staying in "Little ...
Relaxing at Red Sea
Dawar El Omda Hotel
Mangroovy Bay, El Gouna
Flug �ber altbekannte mediterrane Reiseziele mit vielen Erinnerungen an fr�here Zeiten:
- Tauern, Cres-Mali Losinj, Krk, Mlijet-Korcula (Luz), Dubrovnik, Korfu, Peloponnes.
Europe is beautiful - at least from above and under sunny conditions.
We have left Europe and have transpassed the first time zone East.
145km, pain and lost EFI
... are close walk, but dunes are not as high, but hey, we all know what we are doing! Despite losing EFI and another stage (which honesty I have no chance in winning but was second yesterday) am in a good mood, and ready for tomorrow, a short 84km ride to Safaga, where we have access to showers and hopefully wifi! Another lesson learnt, don't camp so close to camp! Noisy and busy! But coming up to 7 so should die down ...


text:
Houston's Chuck Hayes battles for a rebound with the Pistons' Ben Wallace, top, and Tayshaun Prince during Detroit's loss Tuesday.
- Filed Under
WHAT HAPPENED: The Pistons fell to 7-15 on the season when they faltered down the stretch against the Rockets (8-13). Tracy McGrady, in his return to Houston, nailed a deep triple to pull the Pistons to within one point with 8:17 left. But the Pistons' struggles against the pick-and-roll continued as power forward Luis Scola and point guard Kyle Lowry had monster games. And the Rockets were aggressive in passing lanes, picking up 10 steals. Rodney Stuckey led the Pistons with 18 points, Austin Daye scored 12 and McGrady had 11.
THE OTHER SIDE: Scola, with an ...


text:
Who is having a nuchal scan?
That is the first trimester screening for Down's. It's an ultrasound they do between 11 & 13 weeks. I turned it down because it is very expensive and is sometimes not covered by insurance. I am doing the quad screen at 16 weeks which is just a blood test.
Devyn Elizabeth 2.21.12
Ethan Daniel 3.23.14
Mine is tomorrow as well. It's my 3rd pregnancy but 1st time doing this screening. I'm looking forward to seeing the baby again.
Do you guys know if we're suppposed to have a full bladder for the ultrasound? My clinic didn't give me any instructions.
Proud mom of 3 gorgeous kids!
Yes, I had instructions because i had scheduled this and then cancelled it. 32oz of water an hour before your appt is what my flyer said.
Devyn Elizabeth 2.21.12
Ethan Daniel 3.23.14
i just had mine today and everything looked great, plus it was nice to see the baby again :) gotta wait a few weeks for full results. i had a full bladder because they didn't give me instructions beforehand either, and she did the US transabdominally with my full bladder (but commented "Wow, your bladder is REALLY full!" so i'm not sure if it matters either way)
XJM born 1/30/12
my dr ( same one) did not offer this to me with my DS, but he told me to get one this time.. its on 8/4.
Anna- Double J's 10/09 & 02/12
Order your custom hat or scarf at Double J Crochet
Ruth(35) + DH(40) = DD(03/09) + DD(02/12)
My OB office said 12 oz water 1 hr before the scan. I have mine on Thurs.
Alyssa (33) and hubby married 2007 with 1 furbaby Kona
2 Angels 7/10 (11 weeks)and 2/11 (7 weeks)
Jonah arrived 1/29/12!
Mine is next Monday. I can't wait to see the munchkin again!
Married my wonderful husband (2004)
Mommy to Amelia (8/2009)
6 little angels in heaven.


text:
Catherine Ashton leads the six-nation group - the US, Britain, France, Russia, China and Germany - in talks with Iran over Tehran's nuclear programme. Iranian media said the visit signals the normalisation of Iran's relations with Europe after eight years of tension.
Iran struck an initial deal on November 24 to curb its nuclear programme. Negotiations for a final deal are ongoing.


text:
ATP World Tour VTR Open Results
Updated: February 8, 2013, 7:15 PM ETAssociated Press
At Club Naval de Campo Las Salinas
Vina del Mar, Chile
Purse: $467,800 (WT250)
Surface: Clay-Outdoor
Rafael Nadal (1), Spain, def. Daniel Gimeno-Traver (7), Spain, 6-1, 6-4.
Horacio Zeballos, Argentina, def. Albert Ramos (5), Spain, 6-1, 5-7, 7-6 (6).
Jeremy Chardy (3), France, def. Paolo Lorenzi (6), Italy, 6-2, 6-3.
Read full story
You must be signed in to post a comment
You are fully responsible for the content you post. Content that includes profanity, personal attacks or antisocial behavior (such as "spamming" or "trolling"), or other inappropriate content or material will be removed. We reserve the right to block any user who violates our terms of use, including removing all content posted by that user.