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We provide medical and surgical care certified to the highest national standards, locally-delivered here in Indiana.
Recognized by his peers, Dr. Agrawal is honored to be included among the "10 Shoulder Specialists to Know in America. "
We specialize in providing innovative treatments for regular and complex problems; including helping patients that have not had satisfactory results from other types of surgeries.
We have performed thousands of arthroscopic repairs and are also experts in surgical reconstruction. Along with other innovations and cutting edge procedures, we introduced all arthroscopic grafting for complex rotator cuff repairs, arthroscopic global labrum reconstruction for complex instability, arthroscopic suprascapular nerve decompression, and the Reverse Total procedure to Indiana.
The resources on this web site and our blog will inform you about some of the standard and innovative treatments we offer.. Each patient is unique, and the content of this web site is general in nature, so please do not consider the information herein as medical advice for your personal condition.
If you have questions or would like an appointment contact us.
- 1 Services
- 1.1 The Makeup Of the Shoulder
- 1.2 Shoulder Fractures
- 1.3 Symptoms of a Broken Shoulder and Treatment Options
- 1.4 Symptoms of a Fractured Clavicle and Treatment Options
- 1.5 Signs Of An Upper Arm Break
- 1.6 Shoulder Blade Fracture Symptoms
- 1.7 Recovery From A Shoulder Fracture
- 1.8 Understanding the Causes, Symptoms, and Treatments
- 1.9 Who is at Risk?
- 1.10 What Types of Symptoms Develop?
- 1.11 How Can Frozen Shoulder Be Treated?
- 1.12 What about Surgery?
- 1.13 How are the two surgeries different?
- 1.14 Are there risks associated with a reverse total shoulder replacement?
- 1.15 Is a reverse total shoulder replacement worth considering?
- 1.16 Causes Symptoms and Treatment
- 1.17 What Can Cause the Separation?
- 1.18 Symptoms of a Shoulder Separation
- 1.19 What Can Be Done?
- 1.20 Before, During and After
- 1.21 Preoperative Examination
- 1.22 Suprascapular Nerve Procedure
- 1.23 After Care
- 1.24 Conclusion
- 1.25 Defining a Failed Shoulder Surgery
- 1.26 Patient Satisfaction despite Technical Failure
- 1.27 Causes of Failed Shoulder Surgeries
- 1.28 Factors Linked to Success or Failure of Repair of the Rotator Cuff
- 1.29 Improving the Outcome Following Shoulder Surgery
- 1.30 Why Conventional Techniques Fail
- 1.31 Revision Arthroscopic Rotator Cuff Repair
- 1.32 Superior Capsular Reconstruction
- 1.33 Reverse Total Shoulder Replacement
- 1.34 Final Thoughts
Located in Carmel IN, we are dedicated exclusively to providing the most advanced care available in 2015. Our practice concentrates on providing innovative treatments for routine and complicated problems including failed surgeries and second medical opinions. Combining targeted examination techniques with the latest diagnostic modalities, our first priority is to help provide you with honest and accurate information regarding your problem. We provide surgical and non-surgical care for all shoulder troubles.
Failed shoulder surgery unfortunately occurs commonly. It's important to take a deep breath and find a specialist with significant experience in evaluating and treating patients with the most complex problems to give yourself the best chance at an excellent outcome. We hear too often of patients having multiple failed operations resulting in permanent limitations in both work and play. Whether it is a failed rotator cuff repair, failed labrum repair , failed unstable shoulder repair, failed separation repair, failed shoulder replacement, or methods to deal with arthritis, take the time to give the depth of consideration required and seek out a surgeon with extensive experience in evaluating and treating these complex issues. Most failed surgeries although very frustrating don't represent a true emergency, so you have the option to take the time needed to weigh your options and determine where and when to have any additional procedures if indicated for the best outcome for you personally. Many cutting edge minimally invasive techniques like reinforcement grafting and superior capsule reconstruction for failed and complex rotator cuff tears are only available at a few highly specialized shoulder centers around the world. The same is true for the best treatment options available for unstable shoulders including, global labrum reconstruction, Remplissage, and arthroscopic bone grafting. Failed shoulder replacement can often be the result of choosing the wrong type of replacement procedure and many patients aren't aware that there are many different types of replacement options. Many shoulder problems have hundreds of different surgical procedures described and performed sometimes varying only because of surgeon experience and training or geographic availability. Patients are increasingly traveling across the country – and around the world – to seek out the best solutions for their surgery. The solution to your failed shoulder surgery is no longer limited by your location. Contact us for a second opinion.
The shoulder remains an oft injured part of the body, and injuries range from mild to severe. Separated shoulders often occur as a result of a fall, and car accidents at high speeds may lead to the collarbone or shoulder blade being fractured. In fact, this part of the body continues to be one of the most frequently injured, with most individuals injuring one or more parts of the shoulder during their lifetime.
The Makeup Of the Shoulder
The shoulder consists of three separate bones: the scapula or shoulder blade, the clavicle or collarbone and the humerus or arm bone. Most people only associate the shoulder blade with the shoulder, yet all three parts work together to ensure proper functioning, and the shoulder also contains tissues to ensure the joint works as intended. This includes muscles, tendons, ligaments and the joint capsule.
Shoulder Fractures
A fracture occurs when a bone in the shoulder is broken. Some fractures involve the collarbone, and others occur in the shoulder blade. When the top of the humerus or upper arm bone is fractured, this is also considered a broken shoulder.
Symptoms of a Broken Shoulder and Treatment Options
Pain is often the first sign something is wrong with the shoulder, and the individual may find he or she can no longer move the joint normally. If the shoulder can be moved, it may be accompanied by a grinding sensation, and some report they notice something is wrong when the shoulder doesn't appear as it should. Bruising and swelling are other signs the shoulder needs to be examined by a medical professional.
Symptoms of a Fractured Clavicle and Treatment Options
When a clavicle or collarbone is fractured, a person may notice the middle of the bone appears to be swelling. The shoulder's range of motion may be diminished with this type of fracture and the collarbone may appear to have a bump. This is an indication the two ends of the broken bone are protruding.
In most cases, surgery isn't needed to repair a fractured clavicle. In the event of a compound fracture which broke through the skin, however, or when the bone has moved considerably out of place, surgery may be called for. When it is, rods are placed inside the bone or plates and screws are used to hold the pieces of the bone together.
Signs Of An Upper Arm Break
When the upper portion of the humerus is fractured, the shoulder tends to swell significantly. The person is typically unable to move the shoulder very much, and he or she will be in severe pain. Prompt medical attention is called for to have the bone set, so the healing process may begin.
When determining a treatment plan for a break in the upper arm or proximal humerus, medical professionals look at the placement of the bone fragments. When they have not shifted, no surgery will be needed. If they have, however, pins or plates and screws will be used to move them back to the proper position and, in severe cases, a shoulder replacement may be required.
Shoulder Blade Fracture Symptoms
When the shoulder blade sustains a fracture, pain and swelling are commonly reported. Another sign of a fracture in this area is severe bruising. Individuals cannot assume the bruising means the shoulder is simply injured. It must be checked to determine if there is an actual break.
For the majority of shoulder blade or scapula fractures, the shoulder heals with nothing more than immobilization using a shoulder immobilizer or sling, the application of ice and the dispensing of pain medications. Nevertheless, 10 to 20 percent of patients do require surgery, and this typically happens when the shoulder joint is affected or the shoulder blade and collarbone are both broken. The fracture fragments are then fixed using screws and plates.
Recovery From A Shoulder Fracture
Individuals need to allow the shoulder time to heal, as this isn't an overnight process. In fact, recovery can take weeks or months, depending on the treatment plan needed, and most plans involve both immobilization and rehabilitation. For less severe injuries, full function of the shoulder typically returns in four to six weeks. Exercises need to be completed, however, as they help to build muscle strength lost during the recovery process, improve the range of motion of the shoulder and decrease any stiffness. Patients need to follow their doctor's orders exactly to restore the shoulder to normal levels of function in the shortest time possible and to prevent any complications that may arise from not following these instructions.
Understanding the Causes, Symptoms, and Treatments
Frozen shoulder is a term that refers to stiffness in the shoulder that makes it impossible to move without experiencing a great deal of pain. In the worst case scenario, moving the shoulder at all is not possible. Fortunately, there are medical treatments that can help to alleviate the pain and restore a greater range of motion.
Who is at Risk?
Unlike some ailments, people of any age or gender can experience a frozen shoulder. The trigger for developing a frozen shoulder can vary widely, an injury or trauma to the shoulder girdle, nerve pain such as a herniated disc or pinched nerve, a stroke, heart or lung disease, and hyperlipidemia are just a few of the many causes.
Other people develop this condition after surgery, especially when the procedure was performed in the general vicinity of the shoulder. If an individual undergoes a mastectomy or lymph node dissection, the connective tissue surrounding the tendons, muscles, and bones of the shoulder may become inflamed triggering the process for development of a frozen shoulder.
Individuals with chronic conditions like diabetes and thyroid disorders are also at a greater risk of developing frozen shoulder. The exact sequence of events for the development of a frozen shoulder is as yet unknown, but the development of vascular inflammation and stiffness are the final common pathway for many different and varied initiating causes. For many patients no clear contributing factor is apparent and these cases are called idiopathic frozen shoulder (meaning no clear cause).
What Types of Symptoms Develop?
A frozen shoulder has so many initiating causes that there is not one clear pathway and timeline to the development of symptoms. Many patients experience a very slow incremental and insidious onset of pain with a seemingly sudden development of severe stiffness and pain. Often, the initial pain is felt in the lateral arm rather than the shoulder itself and only with sudden movements or at the end ranges of movements.
An advanced case will involve an inability to move the shoulder at all. At this juncture, the tissue surrounding the main components of the joint are so inflamed that the muscles surrounding the shoulder become very guarded and movement will not take place, even if the individual tries to ignore the pain. It is at this stage people begin to realize how often shoulder movement is involved in completing the simplest of tasks.
How Can Frozen Shoulder Be Treated?
One of the first lines of defense is to do something that helps to reduce the inflammation. After a doctor confirms that what the patient is experiencing is frozen shoulder, starting medication designed to ease pain and swelling may provide symptomatic relief.
Depending on the severity of the situation, the doctor may recommend the patient use an over the counter anti-inflammatory medication. For patients with more severe or persistent symptoms oral or injectable steroids may be recommended.
Many types of supportive therapy such as massage, chiropractic, and physical therapy are designed to help support joint mobility while minimizing further inflammation and trauma. This is why any aggressive manipulation or therapy should be avoided for frozen shoulder. Depending on the root cause for frozen shoulder, reaching the thawing phase of the disease process and resolution may take two years or longer.
What about Surgery?
Surgical procedures are only considered when non-invasive methods do not restore the frozen shoulder to an acceptable range of motion. If tests reveal the presence of scar tissue or adhesions in and around the shoulder, surgery may be recommended to remove some of that tissue damage. Once the removal is done, a combination of medication and physical therapy is used during the recuperative period. There are many different types of surgical procedures reported including open surgery, manipulation under anesthesia, and arthroscopic capsulotomy. The decision for surgery and the best surgical option for an individual patient involve complex decision making combined with the skill and experience of the surgeon.
Remember there can be many different causes for a frozen shoulder, and a qualified medical specialist can help you establish a comprehensive diagnosis, including other contributing factors and get you back on the road to recovery in the shortest time possible.
Joint replacement has become so commonplace that some patients simply assume surgery options available will correct virtually any type of joint pain or injury. Patients, however, are all different, and the joint replacement surgery that corrects one issue for one person may not offer the same benefits for another patient. In addition, there are now more options available for some joints that create confusion. The difference between total shoulder replacement surgery and reverse total shoulder replacement surgery is an excellent example. When discussing shoulder surgery options with an orthopedic surgeon, it's important to understand the basic differences.
How are the two surgeries different?
First, it's important to understand the shoulder includes a ball and socket joint. The socket, called the glenoid, forms the upper portion of the joint while the ball portion, the humerus, is the lower portion of the joint. The rotator cuff assists the functioning of the joint, allowing the patient to raise and lower the arm while stabilizing the joint.
If the rotator cuff is injured, some patients are no longer able to comfortably move the arm, and raising the arm above shoulder height can become quite difficult. Rotator cuff tears are quite common and often standard surgical procedures may not succeed. Some patients with rotator cuff tears do not recover full function with or without surgery.
In other cases, the shoulder joint can be injured. Accidents can cause irreparable injuries to the joint. In those types of cases, the surgeon may recommend a complete shoulder replacement, but there is one important stipulation—a total shoulder replacement will only work if the shoulder joint is stable. Patients with severe bone loss, rotator cuff tears or other severe joint damage may be much better served with a reverse total shoulder replacement.
Older individuals are prone to developing joint damage due to arthritis. When arthritis invades the joint, range of motion generally deteriorates, and that loss of motion may be accompanied by significant pain. In addition to the joint deterioration, many older patients also experience loss of rotator cuff function. That means, for the majority of sufferers, replacing the shoulder joint using the traditional total shoulder replacement may not be the best option.
A total shoulder replacement involves replacing both the glenoid and the humerus. With the original total shoulder replacement, the two elements are both replaced with mechanical substitutes, leaving the actual shoulder design much the same as it was originally.
In a reverse total shoulder replacement, the joint's design is actually reversed, hence the surgery's name. Where the ball, or humerus, was originally the lower portion of the joint, after a reverse total shoulder replacement, the ball becomes the upper portion of the joint. The socket portion, or glenoid, would then form the lower portion of the joint. The reversal of the components changes the dynamics of the joint, allowing it to function more efficiently when the rotator cuff is compromised.
Again, a reverse total shoulder replacement is generally indicated when there is damage to the rotator cuff and when arthritis has significantly impacted the joint's ability to function properly. The procedure may also be recommended when a prior rotator cuff or shoulder replacement surgery has failed to achieve the desire results. As a rule, a reverse total shoulder replacement dramatically reduces pain levels and enhances function for patients.
Are there risks associated with a reverse total shoulder replacement?
As with any surgical procedure, there are always risks involved. Obviously, infection is always a risk, as is the risk of damage to nerves in the area. Every surgical procedure involves some level of risk associated with the use of anesthetics. It is always a good idea to review any general risks or risks associated with any condition specific to the patient with the surgeon prior to any procedure. However, the benefits of a reverse total shoulder replacement can be life changing for many patients.
Of course, every patient undergoing a reverse total shoulder replacement will be required to follow a specific rehabilitation protocol after the surgery to allow appropriate healing and to enhance the results of the procedure. As the healing progresses, both passive and active motion exercises will be assigned, followed by exercises to help restore function.
Is a reverse total shoulder replacement worth considering?
Reverse total shoulder replacement is a relatively new procedure (available in Europe since approximately 1990 and in the United States since 2004), but is recognized as an option that, as a rule, dramatically improves the quality of life for patients. Range of motion is noticeably improved, and patients routinely report significant reductions in pain after undergoing the procedure. While surgery is not a panacea, it is certainly an option worth discussing with a shoulder surgeon when pain or loss of motion in the shoulders becomes debilitating.
Causes Symptoms and Treatment
Anyone who has ever experienced a separated shoulder knows that the condition is less than pleasant. Once the injury takes place, prompt attention is the best way to keep the pain to a minimum and promote the process of healing. By learning more about shoulder separation, it is easier to understand how such a condition could develop, what sort of symptoms will appear, and the options for dealing with the problem.
What Can Cause the Separation?
It takes a great deal of force to cause this type of damage. With a shoulder separation, the shoulder girdle absorbs a lot of force in a very short time. When this happens, the connecting tissue is strained and will often become inflamed. If the amount of force transmitted to the shoulder girdle is relatively minor, only a minor grade of separation results.
Because so much force is needed to cause the separation, there are only a few situations that will result in this type of issue. One of the more common causes is participation in contact sports. Participating in sports like football, soccer, or hockey are prime examples. Even other sports where contact is less frequently, such as baseball can lead to situations where the shoulder is separated, sometimes also called an AC (acromioclavicular joint) separation or dislocation. For example, if two players collide while attempting to catch the baseball, the impact may be sufficient to cause injury to one or both of them.
Auto accidents may also result in this type of injury. Anything that causes the driver or a passenger to be thrown forward has the force needed. Seat belts, while designed to minimize the potential of a fatal injury, could add to the force of the impact and cause the collarbone and the shoulder bone to separate.
Falling is another cause of this type of shoulder injury and the level of force and trauma absorbed determines the degree of shoulder separation. While stepping off a curb and losing the footing may most often result in a lower grade of separation, a construction worker who falls off scaffolding that is one or two floors from the ground is at a greater risk for a more severe grade of shoulder separation. Even if the individual lands on a grassy area, the impact could still be sufficient.
Symptoms of a Shoulder Separation
The signs that a separation has taken place will develop immediately. Pain that is somewhat like the sensation of knives being stuck into the flesh is often the first indication. Expect the area around the shoulder and up to the neck to begin swelling. It is not unusual for a bump under the skin to develop along the point where the shoulder normally meets the collarbone.
Moving the arm, if it is possible at all, will trigger more waves of pain. In some instances, the arm will seem so weak that movement is out of the question. The injured party can also expect bruises to develop around the site of the separation.
What Can Be Done?
Prompt medical attention is the most efficient and prudent way to get on the road to healing. One of the first things the medical professional will want to do is examine the shoulder and determine how severe the separation happens to be. Along with the physical examination, the physician will order X-rays as a way of identifying what sort of swelling is present and what it will take to move the shoulder back into a proper alignment.
With less severe cases, the application of cold will help to reduce the swelling. If the pain is minor, the physician may recommend specific dosages of over the counter medications. If necessary, a prescription pain killer will be provided. Expect the physician to place the arm in a sling once the shoulder is moved back into position. While many other types of braces and bandages have been used historically, most studies find a simple arm sling does the best job at supporting the weight of the shoulder girdle. It will take a few weeks for the healing process to allow the pain to resolve and then a few more months to more likely than not be able to return to normal.
When the separation is severe, surgery is a possibility. This is especially likely if the shoulder girdle muscles aren't able to restore and maintain control and stability and the patient continues to have persistent debility. The decision for surgery is a complex one and it is always best to seek several opinions and find a highly qualified shoulder surgeon.
Surgery is designed to reconstruct the torn ligaments supporting the shoulder girdle and an allograft (donated tissue tendon) is most often used for this purpose. As it takes approximately 18-24 months for the new ligaments to fully mature, it is often recommended that the amount of load applied to the shoulder girdle be gradually increased to better promote the healing process. The duration of the healing period varies with each patient and the type of activity involved.
The thing to remember is that a shoulder separation should not be taken lightly. Seek medical help as soon as possible. Doing so increases the odds of avoiding complications and being back to normal sooner rather than later.
Before, During and After
The human body is comprised of a number of distinct systems, all of which are designed to work together in perfect harmony. Among these is the nervous system, which acts as the body's mediator. Nerves send signals from other systems to the brain and relay messages from the brain back to other areas of the body. When a nerve is damaged or obstructed, the part of the body it controls may not function as it should.
One example of this type of scenario is suprascapular nerve compression. This occurs when the nerve running from between the fifth and sixth vertebrae branches off the brachial plexus very early and travels through two anatomic tunnels and then travels down along the back side of the shoulder is over-extended or pinched. Since this nerve corresponds to voluntary movements of the shoulder joint, or rotator cuff symptoms of this type of injury include pain and weakness in the affected area. Though suprascapular neuropathy can often be treated with therapy, prescription pain medications, anti-inflammatory agents and steroids, surgery is sometimes the most effective course of action.
Preoperative Examination
Because the symptoms of suprascapular nerve compression are similar to those of a number of other conditions, testing is needed to confirm this particular issue is responsible for the pain and weakness being experienced. Among the most helpful of these tests is electromyographic analysis. Electrodes are inserted into the skin, and small electrical shocks are administered to measure muscle and nerve response. Different types and grades of nerve pathology provide different responses.
A combination of MRI, x-ray imaging and ultrasound or a remote consultation may also be used to determine the root cause and extent of the injury. Should the pathology be severe and not respond to conservative measures, an arthroscopy may be chosen. During this procedure, a small incision is made, and an endoscope is inserted for more thorough examination of the shoulder joint. This technique can also be used for freeing the nerve once suprascapular nerve compression is confirmed.
Suprascapular Nerve Procedure
Patients need to be fully unconscious during this procedure, so a general anesthesia will be administered. Two small incisions will be made on the front of the shoulder from near the middle point of the acromion, the ridge along the top of the shoulder. The arthroscope will be inserted into one incision, and actual surgical repairs will be made via the other.
After cutting through the skin and fatty tissue underneath, the trapezius muscle will be exposed. From that point, the fibers of this muscle will be separated to reveal the next layer of muscle, the Supraspinatus. This muscle will be moved aside, as will the suprascapular artery and the superior transverse scapular ligament connecting to two different areas of the suprascapular notch. This is where the Suprascapular nerve typically becomes compressed.
The surgeon will now be able to free the nerve from its restriction. If necessary, the bone tissue of the Suprascapular notch may be trimmed away to allow more room for the nerve. Should a cyst or tumor be the cause of compression, it will be removed. In the event the superior transverse scapular ligament is responsible for nerve entrapment, it can also be safely removed without negatively impacting the patient's range of motion.
After decompressing the nerve, the incisions will be closed in reverse order from the inside out with no need for drainage tubes to be inserted. Use of arthroscopy in the procedure creates minimal visible scarring and usually generates a speedier recovery than other techniques. Since this is an outpatient surgery, the patient should be able to return home shortly after the procedure is completed.
After Care
Applying ice packs to the surgery site in various intervals throughout the days to follow will help relieve pain and pressure associated with swelling. Patients are advised to wear an abductor pillow for the purpose of comfort and to help support the weight of the shoulder to prevent muscle tension and pain. Pillows should be placed under the affected arm while sleeping for additional support. Pain medications will also be prescribed.
Rehabilitation efforts will come into play following surgery. Some patients may be given a regimen of light stretching exercises to be done at home, and some patients benefit by working with a physical therapist. Specific therapy programs are different for each patient and may include stretching and strengthening as well as mobility-increasing measures.
Shoulder girdle pain can result from many different sources. Pain because of suprascapular nerve pathology can be difficult to diagnose and result in significant pain and weakness. While surgery is typically a last resort, it is often necessary to prevent more extensive nerve damage and muscle loss.
Neither the patient nor the surgeon wants to discover that the shoulder surgery has failed, but it happens more often than anyone would like. Studies revealed that rotator cuff tears will happen to approximately 13% of those over 50 and to half of those over 80 years old. Obviously, this means that there is the potential for a substantial number of failed shoulder surgeries.
Defining a Failed Shoulder Surgery
The only practical definition of a failed shoulder surgery is when the expectations of both the surgeon and the patient are not met. If a strictly technical definition of failure is desired, studies have shown that three out of four rotator cuff repairs could be said to have failed surgically since the cuff is not intact following the surgery. A more practical failure rate was reported in the Journal of Orthopaedic & Sports Physical Therapy. They reviewed ten research reports and found that the failure rate ranged between 18% and 40%.
Patient Satisfaction despite Technical Failure
Further studies find that there is still a very high level of patient satisfaction following surgery. The conclusion was that rehabilitation is critically important. Even if the surgery did not achieve 100% of the goal, if patients experienced substantial pain relief and were better able to use their arm and shoulder, they were generally pleased with the surgery.
Causes of Failed Shoulder Surgeries
There is a risk of failure with any surgery. Every case is unique, with multiple variables. Some of the causes of surgical failure are associated with:
• Injuries to the nerves;
• Complications from infection;
• Weakness or instability;
• Chronic pain;
• Failure of the patient to follow post-op instructions;
• Failure to heal.
Factors Linked to Success or Failure of Repair of the Rotator Cuff
The Journal of Orthopaedic & Sports Physical Therapy review identified various factors affecting the outcome of surgery to repair the rotator cuff. They divided these factors into four categories: demographic, clinical, rotator cuff integrity and the surgical procedure.
Demographic Factors
As would be expected, the older the patient, the higher the likelihood that the tendon would not heal as it should. For those people younger than 55, there was an 88-95% probability that the tendon would heal. On the other hand, the likelihood that the tendon would heal was reduced to 43-65% for people over 60.
Early treatment improves outcomes. Unfortunately, many people delay seeking help, sometimes for years, while the damage gradually worsens. By the time they go for treatment, the damage is significant and the surgery more complex.
Clinical Factors
There were a number of clinical factors associated with poor healing following the surgery.
• Diabetes;
• Low bone mineral density;
• Obesity – associated with a 12% reduction in a successful outcome;
• Low activity level prior to surgery; the best outcomes were for those who regularly swam, golfed or ran;
• Final post-op strength was linked to strength prior to the surgery;
• Stiffness before surgery delayed recovery.
Integrity of the Rotator Cuff
Poor outcomes were related to four factors:
• The size of the tear;
• How many rotator cuff muscles were involved;
• How much tendon retraction there was;
• The degree of fatty infiltration.
As would be expected, the more the tissue had degenerated, the less likely that there would be a good outcome.
Delaying treatment after an initial tear can cause the tear in the cuff to become bigger, retract from the bone and weaken. There is almost a 97% chance that a small tear repair will heal, while a repair to a large tear has only a 58% chance of healing properly.
Surgical Factors
One study found that poorer outcomes were linked to additional surgical procedures performed on the acromioclavicular joint or biceps.
Improving the Outcome Following Shoulder Surgery
• Seek early treatment, as delay reduces the chance of a successful outcome;
• Become active prior to surgery; a sedentary lifestyle is linked to poorer outcomes;
• Lose weight prior to surgery;
• Before surgery, begin regular physical therapy; if the shoulder is stronger before surgery, it will be stronger after surgery;
• Ensure that diabetes or other medical conditions are being controlled.
The evidence indicates that shoulder surgical failures can be reduced if the patient becomes a full partner in the procedure and takes the proper actions both before and after the surgery. Some factors linked to failure are controllable, while others are not. Patient expectations need to be realistic. An active and fit 40 year old is much more likely to have an excellent recovery than a sedentary 70 year old diabetic, even if both have a similar problem and surgery. Regardless of the technological advances and skill of the surgeon, some of the factors affecting the ultimate success or failure of the surgery are entirely controlled by the patient.
Shoulders have a greater range of motion than any other joint in the human body with an entire group of nerves, muscles and tendons working in conjunction to keep them functioning properly. Unfortunately, this fluidity comes with its fair share of potential problems. Among the most common of these are rotator cuff injuries (video 1, video 2, video 3, video4.)
Though plenty of options, ranging from combinations of medications and physical therapy to various types of surgery, are available to help remedy this type of damage, a number of patients experience little or no relief through conventional means. Some even go through the full range of traditional repair techniques to no avail. While this could, understandably, leave a patient discouraged and resigned to a life of pain and limited mobility, all hope is not lost.
Why Conventional Techniques Fail
Lack of skill and experience on the part of surgeons performing these procedures can be a factor behind failed rotator cuff repairs; as such, finding one with considerable experience and expertise is crucial to success. Age of the patient and his or her level of health going into the surgery are also directly related to the outcome. Extent of damage is likewise to blame.
Patients actually bear a great burden of responsibility in some failed attempts at repairing rotator cuff tears as repairs require an extended time to heal. Smoking inevitably slows the healing process following injuries as well as surgical procedures regardless of how non-invasive they may be. Many simply fail to properly follow after-care instructions as they should. Either way, several alternatives could provide a solution to previously unsuccessful strategies.
Revision Arthroscopic Rotator Cuff Repair
In the event that despite a failed rotator cuff repair, there is still ample rotator cuff muscle and tendon available, a revision arthroscopic rotator cuff procedure with a reinforcement graft may be the answer. A small incision will be made for the arthroscope, which is a camera used to determine damage extent. Once the physician decides how to proceed, additional incisions/portals will be made for insertion of surgical instruments and to allow necessary access to tendons and muscles.
Multiple sutures are routinely used to return the tendons and muscles to their proper positions and also to apply a load sharing graft. This is the least invasive failed rotator cuff repair and may be implemented regardless of the type of surgery previously performed. Though this is beneficial in causing as little further damage to tendons, muscles and nerves as possible, this option may not be appropriate in all cases.
Superior Capsular Reconstruction
Also performed arthroscopically, this procedure uses a dermal patch to replace irreparably damaged rotator cuff tissues. The artificial patch will act just as the natural muscles and tendons of a healthy rotator cuff to hold the humerus in place within the shoulder joint. As is the case with traditional rotator cuff repair surgery, sutures will be inserted in the bones of the shoulder. Sutures will be drawn through the tendons and patch and tied in place to support the patch and, by extension, the joint itself.
While this type of repair may not fully restore strength and mobility to pre-surgery status, it often aids in reducing pain and weakness. It will keep the humerus in place and help prevent it from impinging nerves or tendons in the future. This procedure has been found most effective in patients with issues stemming from tendons in the back side of the shoulder, but it can be helpful in many scenarios where other techniques have failed.
Reverse Total Shoulder Replacement
For patients who have developed arthritis in the affected shoulder because of, or in addition to, a rotator cuff tear, reverse total shoulder replacement may be the best solution. With this strategy, a plastic cradle is attached to the top of the humerus, and a metal ball is affixed in the shoulder socket. Because this technique is essentially the reverse setup of a normal shoulder joint, it allows alternate muscles to take over for no longer functioning ones.
Final Thoughts
Rotator cuff repairs commonly fail due to a number of reasons. Finding a capable surgeon is key to regaining strength and mobility following a rotator cuff injury or unsuccessful previous techniques. Though not everyone is a suitable candidate for every alternative, many are able to experience pain relief and greater functionality through these options.


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WE HAVE A CONTRACT ON OUR HOUSE!!!! It all went down last week - right in the middle of planning Emma Ramey's birthday and family coming in town. When it rains, it pours, right? But this was the good kind of rain.
If all goes as planned, we should close at the end of April. I cannot say enough for our realtor. She is so sweet, easy to work with, and most importantly, effective! We ended up switching after our 6-month contract was up with the previous one, and Tricia had a contract on our house within 2 weeks. Amazing! I wish we had gone with her to begin with.
This is such a huge weight off our shoulders! Paying a mortgage when your house isn't being used at all is never fun. Now we can start thinking about where we want a more permanent house to be in Mississippi!
We have been absolutely loving this weather! It has been not too hot, not to cold, and sunny every day. We've spent a lot of time outside this week!
Some of our time was spent at an amazing local park. We've also been house-sitting for my in-laws, and it's been really nice to have a whole backyard for Emma Ramey to play. Definitely one of the downsides to apartment living. We picked a good week to stay here!
Have I mentioned this girl has no fear??
This week, I saw something pop up on my Twitter feed about a DietBet. I'd never heard of it. So I got to reading, and it is a really fun idea! Every person participating puts $25 in the pot, and everybody that loses 4% of their body weight in 4 weeks gets to split the pot.
And before you think someone can cheat their way into the winner circle, think again. They are super duper professional about making sure you don't lie about your weight. You have to take pictures on the scale, with code words and everything. It's kind of intimidating!
Shannon is hosting one, so I thought I'd join in! I'm excited to see how it goes. There's still time to join in on this one if you'd like!
This might somewhat limit the success of the idea above...I'm 99% sure I broke my toe yesterday. Klutzy me stumped (or stubbed? Is it stubbed? I've never known.) my toe on a chair in the living room. I'll spare you from having to see a picture - but it's huge and bruised and ugly. Not to mention it hurts like the devil. And thus ends my 29 year "no broken bone" streak.
On a somewhat related note, we have a formal event to go to this weekend...so that should be interesting. I think I'll be the only girl there in Rainbows.
Some girls get excited over new clothes - I get excited over new nail polishes. I was browsing some of the Spring 2014 colors last night...aren't they pretty? These were my favorites.
I've been meaning to buy a bottle of Orly Bonder too...I've heard really good things about it. Any experiences? Good, bad?

subset: commoncrawl


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We always like to hear from people. Say hello, don't be shy!
Simply choose who you want to contact from the wee drop down boxes below, and send messages directly into the right lap - apply for a job, send bugs to QA, harass the community team or just send hugs to us all. Oh one thing though, puurrllleeasseee don't send us ideas or suggestions for games, the world's lawyers say we aren't allowed to look at them, even though we'd really like to.
Oh, and we're super sorry, but we are currently unable to offer any placements for internships or work experience at the moment.
You can also get hold of us via Twitter.


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WATKINS GLEN, N.Y. (August 18, 2000) – Neither Rob Dyson nor Kevin Doran will need any directions on finding Victory Circle at Watkins Glen International. Both men have experienced the thrill of victory many times at the famed circuit, and will...
WATKINS GLEN, N.Y. (August 18, 2000) – Neither Rob Dyson nor Kevin Doran will need any directions on finding Victory Circle at Watkins Glen International. Both men have experienced the thrill of victory many times at the famed circuit, and will field the teams to beat in the August 25-27 Bosch Sports Car Summerfest, the season finale for the Grand American Road Racing Association.
Both Dyson and Doran are former winners of the Glen's Six Hours, which will highlight the weekend, and both have teams battling for the championship. James Weaver, Dyson's lead driver, leads the SportsRacer driver's point standings, while Doran Racing holds a slim margin over Dyson in the Team Owner Program.
Doran was chief mechanic for the Lowenbrau Special Porsche 962 of Al Holbert and Derek Bell, which won four IMSA Camel GTP races at the Glen from 1984-86. He returned as team manager for Gianpierro Moretti's Momo Ferrari 333SP, which won the 1994 Glen Continental three hours (with Eliseo Salazar and Moretti). Doran's team and Moretti also won the Six Hours twice, in 1996 (with Max Papis) and 1998 (with Didier Theys and Mauro Baldi).
Dyson's team won the 1997 Six Hours, with Elliott Forbes-Robinson and Butch Leitzinger at the wheel. The Poughkeepsie, N.Y.-based team also won the 1995 Glen Continental, with Weaver and Leitzinger driving. Dyson ended Doran's three-year Camel Continental winning streak in 1987, with Price Cobb and Vern Schuppan co-driving Dyson's Porsche 962.
"If we can win again, I'd be very pleased and proud," said Doran. "We'd really like to win the Team Owner's Program championship, and while Weaver leads the driver's championship, it's still possible for Didier (Theys) to win. This is the first time there has been a Team Owner championship in sports car racing since I've been involved with the sport, and it's extremely important to win it.
"The Six Hours is a great event. The Glen's a classic road racing circuit, and the Six Hours has plenty of history behind it. A true endurance race on a classic circuit is a great combination."
Weaver and Leitzinger will join Andy Wallace in Dyson's No. 16 Ford-powered Riley & Scott. Weaver has four victories in 2000, including a pair with Leitzinger at Lime Rock and Trois Rivieres, and with Wallace in the Paul Revere 250 at Daytona. Dyson will co-drive the No. 20 R&S Ford with Forbes-Robinson and John Paul Jr. "Watkins Glen has been very good to Dyson Racing over the years," said Dyson. "We've won there many times in a variety of cars. The first race I ever drove was at the Glen in 1974, and I won it, in B Sedan at the SCCA Regionals. "The track is absolutely terrific. It's one of the finest road courses in the country. It's a delight to drive on the long course there, and it's a fantastic place to race. This year's competition is stronger than it's been in a long time. The racing has been tight at all of the Grand-Am races. We had the top seven cars within seven-tenths of a second in our most recent race at Trois-Rivieres (Quebec), and that tells you something."
Doran will also field two cars for the weekend. Theys will join Fredy Lienhard and Ross Bentley in the Doran Special, a Ferrari 333SP chassis powered by a Judd V-10 engine. The car has two victories to date, at Homestead-Miami Speedway and Road America. Dyson will also debut a Pontiac Grand Prix in the American GT class, driven by his brother, David Doran, and Tony Ave.
"David won the 1995 SCCA Sports 2000 national championship, and is coming off a full season driving ASA stock cars," explained Doran. "The Six Hours will be a shakedown run for my new car, and I feel that class has a lot of potential for upcoming seasons."
Practice for the Bosch Sports Car Summerfest begins at 9:30 a.m. on Friday. The Grand-Am GT qualifying race is set for 7:15 p.m., followed by the SportsRacer qualifying race at 8 p.m. The weekend also includes a three-hour Motorola Cup race on Saturday, the American City Racing League, and a pair of U.S. F2000 National Championship races. For tickets, call (607) 535-2481. For additional information, visit the official web site, www.grand-am.com.


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The Last of England
The Last of England is a British film directed by Derek Jarman. It is a poetic, rather than realistic, depiction of what Jarman felt was the loss of traditional English culture in the 1980s. It is named after a painting by the Pre-Raphaelite artist Ford Madox Brown. Jarman wrote a book to accompany the film, which deals more explicitly with the relationship he had with his father, who was a Lancaster bomber pilot in the Second World War. Jarman used the impact of hi...... more on Wikipedia
The Last of England is ranked on...
List of the best Tilda Swinton movies, ranked best to worst with movie trailers when available. Tilda Swinton's highest grossing movies have received a lot of accolades over the years, earning millions upon millions around the world. The order of these top Tilda Swinton movies is decided by how many votes they receive, so only highly rated Tilda Swinton movi...
The Last of England videos
The last of england
The Last of England (1987) Clip
Derek Jarman "The last of England"
The Last of England


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What SpiceRex merchandise would you buy?: SpiceRex Flash Drive
This is a discussion on the "SpiceRex Flash Drive" entry in the What SpiceRex merchandise would you buy? SpiceList
Just a picture of him on it would be nice
4 Replies
Jul 13, 2011 at 9:48 UTC
I'd like a Spice Rex flash drive. Of course It would need to look like SpiceRex, have a terabyte or so of storage, and fold completely flat so as not to take too much space i my pocket. LOL
Seriously, I think it would be cool and functional.
Jul 13, 2011 at 9:51 UTC
KIT is an IT service provider.
I'd love to give these away in my classes as prizes.
Jul 14, 2011 at 11:00 UTC
I don't even want to know who came up with some of these items?! A thong? guys or gals? inflatable doll??
someone has toooo much time on their hands, me thinks.
Love the ideas and some of the outrageous ones especially. A user modifier? count me in! send 20 immediately please.
Nov 20, 2013 at 4:36 UTC
1st Post
How about some similar to this?


text: Mock Draft No. 3 (cont.) 11PGD.J. AugustinTexasSoph.5-11171Is he too small? The Pacers' dire need for a point guard persuades them to gamble on Augustin.12PFAnthony RandolphLSUFr.6-10197Sacramento invests in Randolph's upside as a potential second coming of Chris Bosh.13SFDonte' GreeneSyracuseFr.6-9225Do they dare take Serge Ibaka this high? Instead, they grab this athletic frontcourt shooter who was coveted by the Warriors. 14CKosta KoufosOhio StateFr.7-0265The Warriors settle for this scoring big man with perimeter range, a nice fit in Don Nelson's system.15G/FBrandon RushKansasJr.6-6210The Suns go with a winner in Rush, who should blend into their aging rotation.16CDeAndre JordanTexas A&MFr.6-11250When in doubt, go big. Jordan has lots of upside, though he played limited minutes in his one college season.17CRobin LopezStanfordSoph.7-0245His twin is the better scorer, but this Lopez will be a solid defender while helping to reduce Chris Bosh's minutes at center.18PFJ.J. HicksonNorth Carolina StateFr.6-9242A hungry inside player who could provide the Wizards with rebounding and toughness for the long term.19SFNicolas BatumLe Mans (France)--6-8210 A flashy swingman who defends and can provide scoring to help balance the floor around LeBron James.20CJaVale McGeeNevadaSoph.7-0241A long athlete who has a lot to learn, but he has the potential to excel in an up-tempo system.\t\t\tPicks 1-10\tPicks 21-30\t


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Broadridge uses cookies to give you the best experience of Broadridge's website. By continuing to browse, you agree to Broadridge's use of cookies. Find out more about cookies and how we use them.
LAKE SUCCESS, New York — February 7, 2012 — Broadridge Financial Solutions, Inc. (NYSE: BR) today announced that Bloomberg Tradebook has selected Broadridge's consolidated business process outsourcing (BPO) solution to support their equity and option clearance and settlement business. The agreement is designed to help Bloomberg Tradebook minimize its fixed-cost investment in technology and operational infrastructure while also creating new revenue-generating opportunities as it transitions from its current fully-disclosed clearing model to self-clearing.
Broadridge's technology processing platform and integrated product solutions will help to support Bloomberg Tradebook in its transition to a self-clearing operating model. Broadridge's customizable and scalable BPO solution will provide all back-office operations and support -- on a global scale.
"Broadridge's BPO model is ideal for Bloomberg Tradebook," said Joseph Barra, President, International Securities Processing and Global Outsourcing Solutions, Broadridge. "We've worked closely with Bloomberg Tradebook during the past several months to ensure our unique BPO capabilities will allow for a seamless transition to self-clearing. Our solution can enable Bloomberg to benefit from a highly scalable and customizable offering to support all aspects of its back-office operation."
This is the first agreement between Broadridge and Bloomberg Tradebook.
About Broadridge
Broadridge Financial Solutions, Inc. (NYSE:BR) is the leading provider of investor communications and technology-driven solutions for broker-dealers, banks, mutual funds and other corporations. Broadridge's investor and customer communications, securities processing and managed services solutions help clients reduce their capital investments in operations infrastructure, allowing them to increase their focus on core business activities. With over 50 years of experience, Broadridge's infrastructure underpins proxy voting services for over 90% of public companies and mutual funds in North America and processes on average $5 trillion in equity and fixed income trades per day. Broadridge employs approximately 10,000 associates in 16 countries.
For more information about Broadridge, please visit www.broadridge.com.
Media Contacts:
Linda Namias
Corporate Communications


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'Unless something cataclysmic happens to the stock market, we shouldn't have to reduce returns again.' So said Equitable Life earlier this year when it cut its returns to investors.
Last week, the crisis-ridden insurer again raised the penalty it imposes on policyholders who take their money away, from 7.5 per cent to 10 per cent. Equitable has not cut returns for all policyholders, but the higher exit penalties show the seriousness with which financial institutions view conditions in the stock market after the tragic events in the United States. Equitable's sensitivity to share prices is unusually high, of course, but other insurers also imposed, or raised, exit penalties as they took fright at the new outlook.
A week ago, the future for world share prices was already gloomy after falls the previous week. One veteran analyst said investors should prepare for 'three to five years' of shrinking savings.
Less than 48 hours later things had worsened dramatically. The FTSE 100 share index fell nearly 280 points in the hours after the first strike on the World Trade Centre in New York. There were fears that the US would go into recession, dragging other economies with it. Anyone with money in shares - if only through pensions and endowments - may take a little comfort from knowing that some of this was anticipated.
An expectation of lower returns prompted the Financial Services Authority (FSA) two years ago to reduce the rates companies must use when predicting returns for investors. This had an immediate devastating effect on mortgage endowments in particular, because it exposed potential shortfalls in millions of home loans.
A further FSA review is now possible, though it says it is too early to reach conclusions about the long-term effects of last week's atrocities.
The key to security over the next year or so will be to stay in work if at all possible, and take all the steps you can to get your finances fit to ride out a serious downturn. Here we offer a guide to how events affect you, and advice on what to do.


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Battling malaria with treated bednets
Among the best news of this century is that malaria deaths fell by 25% between 2000 and 2010, to 655,000 a year. The roots of this achievement can be traced back to the 1990s when IDRC and the World Health Organization began supporting research on how insecticide-treated bednets could help reduce malaria's relentless toll.
Those nets have proven crucial to the global anti-malaria campaign, which has been especially effective in Africa. A study published in the March 2012 Malaria journal, for example, concludes that treated bednets accounted for 99% of child malaria deaths estimated to have been prevented in sub-Saharan Africa in recent years.
This remarkable outcome defies earlier expectations. In the early 1990s, bednets were of only marginal interest to most international health organizations, recalls former IDRC health specialist Don de Savigny. But groundbreaking research soon helped move treated nets onto the global agenda.
Large-scale studies
Since the 1980s, it had been known that insecticides on nets could kill malaria-carrying mosquitoes. It was also known that treated bednets could diminish an individual's susceptibility to contracting malaria, recounts de Savigny, now a Basel-based professor of epidemiology and long-term advisor to WHO and Roll Back Malaria. But what remained unknown was whether using the nets could actually reduce the overall death rate.
With that question in mind, in the early 1990s IDRC and the WHO co-funded large-scale trials of the nets in Africa, and in 1994 convened a conference of experts to map a way forward. The 1996 publication of the research findings and recommendations in the IDRC book Net Gain alerted the world to the treated nets' life-saving potential.
It would be logical for the role of research to end there, but IDRC-supported researchers had a different idea. They moved on to a new research agenda focusing on the "how" of fighting malaria with the bednets. Major practical questions remained: how to encourage people to obtain and use the nets, how to distribute them to millions of people, how to encourage their manufacture, and how to finance the whole endeavour.
Spurred an industry
- Net Gain: A new method for preventing malaria deaths (IDRC, 1996)
- Case study: New weapons in the war on malaria
- Fixing Health Systems: Net Solution (5-min video)


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Disables all sound notifications in Windows 10
It is more common than we would like: we are listening to music on our PC quietly but the system riddled us sound notifications at the wrong time. Fortunately, you can easily disable them so that nothing interrupts your experience.
In Windows 10 it has built-in notification system very practical, that appears directly on the desktop and is inspired by what is usual when using smartphones and tablets. So, if for example someone interacts with us in a social network, we will see an instant pop-up window that warns us of any updates without having to do anything. The downside is that they are accompanied by sound, if we receive many ads at any given time may turn out to be very annoying.
To disable sound notifications in Windows 10 , all you have to do is enter the Control Panel : Just search for "control panel" in the Windows search box and you will access it directly (or failing that, make right-click the Windows logo and comes from there to the control panel).
Change system sounds in the control panel
Then enter the section Hardware and Sound submenu and find the Change system sounds (within the menu Sound ).
Then, a window in the open field appears sound combination . Here you must select the " soundless " instead of the one that was in default of Windows.
Click on Apply and then on OK and ready. No sound will bother you unless you re-enable them, for which you must repeat this process to leave everything as it was.
On the other hand, if you prefer, you can also turn off only some of these sounds , not to take such a drastic step. Browse through the available options and disable only those that do not want to hear more (eg, notifications of instant messages or e-mail on the desktop).
And now, enjoy your favorite music without interruption!


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Site Supervisor Training?
OSHA's Hazardous Waste Operations and Emergency Response (HAZWOPER) standard requires that site safety and health supervisors of hazardous waste sites receive over 40 hours of specialized training ...
Read More »
Script Supervisor Training?
It is possible to become a script supervisor without having had any formal training. In the film and television industry, experience is more valuable than qualifications. However, this doesn't mean...
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Supervisor Lead Training?
Supervisor leads hire, train and schedule a staff. They work in every industry and are largely responsible for ensuring workers stay motivated and organized, and function as a team. Supervisor lead...
Read More »
Dispatch Supervisor Training?
Training sessions help dispatch supervisors make sense of the techniques that used to dispatch workers, equipment and service vehicles outside the place of business. Through these sessions, trainee...
Read More »
Field Supervisor Training?
Field supervisors typically oversee the work of trainees, for example student teachers or social workers, in their first on-the-job experiences. These supervisors provide (to the people they are he...
Read More »


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GLASGOW practice Bishop and Robertson Chalmers has opened an office in the Lithuanian city of Vilnius.
The firm, one of the largest in Scotland, is opening in the former communist state after 18 months of research in the region showed there was a market for providing advice to Western businesses and investors.
The office, officially opening this week, will be staffed by two Western-trained Lithuanian lawyers Ramune Duleviciene and Dangute Ambrasiene, and will be supported by Bishops' solicitors in Scotland.
Bishops partner Iain Taylor, who has made a number of visits to the former Soviet Republic, says the reasons behind opening in Lithuania are two-fold.
"First, with the opening up of the old Eastern bloc, there are now a number of excellent opportunities in Lithuania for Western businesses and investors, but experienced commercial lawyers who can give advice in English are a scarce commodity," says Taylor.
"Second, it is anticipated that Lithuania will eventually become a member of the European Union and many of the firms in the area are already looking to do business with the West."
He adds: "Through our Lithuanian office, we will be able to advise these businesses of the commercial realities of what is, to them, still a new culture."


text:
100% verified reviews
Real guests. Real stays. Real opinions.
The rooms have an oven with a stove top and a small kitchenette area. We had a room with a view of the lake, which was beautiful. The beds were not the most comfortable, as they were very soft and not super supportive. Also, the walls between rooms were a little thin, as we could occasionally hear our room neighbors.


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Repeat until after the popular series beauty leg jeans appeared in long-awaited slimline 13-483 C!
Silhouette difference here in the same design.
Lean and simple design.
Grow slender silhouette is the yearning beauty leg style ★
Definitely a style up!
It is the best fit and stretch.
Comfortable it felt cramped and tight-fitting stretch edgy tactfully while also!
Slim line is also suitable for layering tunic and one-piece, so widely could use!
Clean adult heel shoes to fit it, it becomes dressed!
Hip pockets with good balance, so rip up effect.
Stylish triple stitched pockets, yellow stitch accents.
The most popular D.M.G signs color 27-9-color blast.
Is the process of a feel for the quality of their presence.
Insisting on a real color is partly ( thigh-knee, hip ) in effect legs giving cleaner USED natural beige blast the sharp sense of and.
Look sharp and stretch jeans.
From the time the first time through the legs is my favorite!
■ material: cotton 95% polyurethane 5% ■ country of origin: Japan
■ coordination
Le minor Multi border pattern boat neck 3 / 4 スリーブカットソー
|Hem width
|Approximately 70 cm
|19 cm
|76 cm
|24 cm
|14.5 cm
|Approx. 84 cm
|Approx. 74 cm
|19.5 cm
|76.5 cm
|24.5 cm
|15 cm
|87 Cm
|Approx. 77 cm
|20 cm
|77 cm
|25 cm
|15.5 cm
|About 89 cm
|Approx. 80 cm
|20.5 cm
|77 cm
|26 cm
|15.5 cm
|About 90 cm
|* single wash, because the holes are tapped, 1 book 1 should be finished this subtle difference. In the size more than long inseam shrinkage and somewhat shorter ordered size representation of the last on average there has been delivered.
|JP Post EMS
|Your order will be shipped to you via Japan Post EMS. Japan Post is a speedy delivery service that delivers to more than 120 countries. With an effective tracking system and insurance program, EMS is able to offer a secure delivery worldwide. You can track your package with the tracking code provided and it will be delivered within a week. See estimated shipping fee
|Credit Card
|We accept credit and debit cards.
The following credit and debit cards can be used:
•American Express
|We accept PayPal. After receiving the order confirmation e-mail, please proceed with the PayPal payment.
*Please note that if payment through PayPal is not confirmed by the date indicated in the e-mail, your order will be automatically cancelled.
Start Date:01/05/2017 00:00 JST
End Date:31/07/2017 23:59 JST
This product cannot be shipped to United States from the store.
Please contact the store for further information.


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ED Magedson – Founder
Ripoff Report
speedy health supplements1079 W. Orange Blossom Trail Apopka, Florida USA
speedy health supplements charged $231.80 to credit card and did not even have the product to send. Two months and still nothing. Will not even respond. Apopka Florida
Does your business have a bad reputation?
Fix it the right way.
Corporate Advocacy Program™
Warning! This company will charge your credit card and then not ship the ordered product. Ever! In fact I found out it never even had the product when it charged my credit card. Then it sent bogus shipping e-mail notices to make you think your order had been shipped when it had not. Then it sent e-mails to say it had not been shipped. It could not ship a product it did not have. It will not respond now and will not reimburse my credit card. This company has a history of this exact conduct. Do not order anything from it or it is at your risk.
This report was posted on Ripoff Report on 01/21/2014 04:01 PM and is a permanent record located here: http://www.ripoffreport.com/reports/speedy-health-supplements/apopka-florida-32712/speedy-health-supplements-charged-23180-to-credit-card-and-did-not-even-have-the-produc-1117366. The posting time indicated is Arizona local time. Arizona does not observe daylight savings so the post time may be Mountain or Pacific depending on the time of year.
Ripoff Report has an exclusive license to this report. It may not be copied without the written permission of Ripoff Report. READ: Foreign websites steal our content
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Anonymous on Oct 18, 2011
This doll is a masterpiece, absolutely exquisite, you have every right to be very proud of your creative ability, thank you so very much, sincerely, Marilyn
Art Doll
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text:
11225 W. 6th Ave.
Lakewood, CO 80215
Used 1999 Fleetwood RV Prowler 275
Call Us Today At 303-274-9009
1999 275 Features and Options
Call for details.
What Our Customers Are Saying
Manny was great, very personable and helpful. Everyone at the dealership was great throughout the process of purchasing our new Airstream. - mike
Location: Lakewood
Stock# 15T7218A
Location: Lakewood
Stock# 15T7218A
Stock# 15T7218A
For more information, call us at 303-274-9009 or Contact Us
Similar RVs and Floorplans
Fleetwood RV, Inc. is a leading manufacturer of Class A and Class C recreational vehicles. The Company has one of the best and longest standing distribution networks in the industry and boasts some of the industry's most recognized and iconic brand names such as Discovery and Bounder. Fleetwood RV is headquartered in Decatur, Ind., which is also home to its manufacturing facilities.
Windish RV is not responsible for any misprints, typos, or errors found in our website pages. Any price listed excludes sales tax, registration tags, and delivery fees. Manufacturer pictures, specifications, and features may be used in place of actual units on our lot. Please contact us @303-274-9009 for availability as our inventory changes rapidly. All calculated payments are an estimate only and do not constitute a commitment that financing or a specific interest rate or term is available.


text:
Replay XD's Appearances
Monoposto at Brands Hatch GP - August 2011, Qualifying 201:45
This was my best lap of first qualifying, on the Saturday, around the magnificent Brands Hatch Grand Prix circuit at the MSVR meeting. There was no testing, so we all had to learn the circuit as…+ More details
Browse VideosVideos
Here are all of the videos that Replay XD has uploaded to Vimeo. Appearances are videos that Replay XD has been credited in by others.


text:
JET Magazine highlights the Leaders of Tomorrow National Business Competition hosted at Bentley.
You are here
Newsroom: Media Coverage
Steve Weisman, senior lecturer and author of 50 Ways to Protect Your Identity in a Digital Age
Marketing Lecturer and retail expert Mike Tesler joins Bloomberg Radio's Vonnie Quinn to discuss the future of ailing retailer J.C. Penney.
Bentley graduate Marisa Falone is highlighted for utilizing her business skills to help advance her career at a high-end Boston hair salon.
Dean of Arts and Sciences Dan Everett discusses many aspects of Bentley's integrated approach to curriculum including new six credit undergraduate courses created and co-taught b
Bentley's Service-Learning Center is working with partner organizations to provide a new playground for the children at the Prospect Hill Terrace Housing Development in Waltham.
Natural and Applied Sciences Professor Fred Ledley shares his insight on the new method for calculating GDP and how it will affect entrepreneurial innovation.
Forbes highlights Economics Professor Dhaval Dave for a recent survey he conducted which examined how having, or not having, health insurance can impact someone's behavior.
Language: The Cultural Tool, written by Dean Daniel Everett, is highlighted and reviewed by o
Twin brothers attending Bentley, Alex and Erik Villandry '14, are highlighted for rescuing a man at the Kinney Shores Beach in Saco, Maine.


text:
The Russian connection: See all our coverage | Read about our investigation
Andy KrollApr. 2, 2010 10:21 AM
Yes, you read that right. Bill O'Reilly, the bloviating face of Fox News, actually came to the (somewhat) defense of Sen. Al Franken (D-MN) the other night on his wildly popular show. O'Reilly was speaking with Jason Mattera, editor of Human Rights, about the latter's recent ambush of Franken (a classic O'Reilly tactic, of course) in an airport and interrogating him on the recently passed health care bill, without ever letting a dismayed Franken actually respond. Shockingly, O'Reilly scolded Mattera, who, as evidence of his intellectual rigor, previously claimed the left's notion of freedom consists of "smoking cocaine," for the Franken stunt: "The mistake you made," O'Reilly intoned, "was you were disrespectful for him—to him, when you called him 'Sen. Smalley,' and you gave him a reason to blow you off."
Here's the video of the exchange, courtesy of Talking Points Memo:
OK, so O'Reilly was just giving Mattera some helpful hints, in father-like way, on how best to be a pesky right-wing journalist. Still, maybe Bill's warming to that loveable senator from Minnesota after all.
Mac McClellandApr. 2, 2010 7:20 AM
This week, Burma's National League for Democracy, the party of detained Nobel laureate Aung San Suu Kyi, announced that it wouldn't participate in the country's first elections in two decades, which are to be held sometime later this year. Than Shwe, the general who heads the Burmese junta, insists that the contest will be "free and fair," and despite mountains of evidence to the contrary, some outside observers appear to be buying the hype: ASEAN Secretary-General Surin Pitsuwan said that the elections are "a new beginning," and the New York Times ran a bizarrely rosy story about the country's future. But the NLD boycott reflects what everybody in Burma already knows—that the elections are a farce.
Let's take a look at the aforementioned mountains of evidence:
1. The government is already cheating. The military's proxy political party, the Union Solidarity and Development Association, has spent millions currying favor with the populace by paving roads, opening free health clinics, and giving away high school tuition. This started before the junta announced the rules for participating in the election (or even a date; October is the rumor), effectively crippling other parties' ability to start campaigning. When the government finally did reveal the campaign rules, they were so stacked against the opposition—for example, barring Aung San Suu Kyi from participating—that the NLD sued to have them revised. The case was rejected.
2. Even if the generals don't win, they could still "win." In 2008, 92 percent of Burmese voters allegedly said yea to a constitution drafted by the junta. Never mind that the new constitution basically legalized forced labor or that the vote was held in the chaos following a cyclone that killed 140,000 people. Also, the last time the government held multiparty elections, in 1990, and lost to the NLD by a landslide, it simply declared the results void and kept Aung San Suu Kyi incarcerated.
3. Even if the generals admit that they don't win, they still can't actually lose. According to the constitution, 25 percent of the seats in parliament are reserved for the military, and the current government picks the candidates for president. And in the event that parliamentarians do start exercising too much power, the military machine could always just reassert control of the state, as it did in the coups of 1962 and 1988. Than Shwe reminded the populace of this possibility last weekend when he made the wholly unveiled threat that the army can step into politics "whenever the need arises."
4. Bad guys will continue to hold the purse strings. The Times has cited the government's decision to sell "a raft of state-run factories and assets to cronies in the private sector" as a sign of progress. But the reason the military is hastily selling off hundreds of state-owned properties—buildings, land, oil and hydro projects, ports, an airline—to its leaders and crooked friends is to guarantee that the country's economy will remain in their grasp no matter what the election outcome.
5. There's the matter of rampant discrimination and war crimes. Don't discount, as most Western media does, the millions of ethnic minorities inside Burma's borders, many of whom will not participate in the elections (the rules of which were published only in Burmese and English) and some of which have armed insurgent groups threatening to come out of retirement in the face of election-related turmoil. Also rarely discussed is the full-on, horribly bloody war in the east of the country. These minorities' continuing disenfranchisement and targeting for annihilation is hardly a move toward peace and democracy. A UN official and more than 50 US congresspeople have called for an investigation into the regime's crimes against humanity, but a clause in the wildly popular constitution stipulates that the perpetrators cannot be brought to justice.
ASEAN's Pitsuwan may have cause for saying that the Burmese government's decision to hold elections is a "step forward"—after all, that's not saying much about a government known for its total disregard for political and human rights. But such falsely hopeful messages diminish the gaping distance between Burma's current state and true democracy. Did the National League for Democracy have any choice but to sacrifice their chance to play along with the charade?
Evan JamesApr. 2, 2010 7:10 AM
"Much Ado About Cutting," Nikhil Swaminathan's piece from our March/April issue, is about the ongoing circumcision debate in the US. A lighthearted romp through a controversial subject, it features a couple trying to decide whether or not to have their new baby circumcised, adult men trying to restore their foreskins with the assistance of weights, and the professional opinions of both medical researchers and a porn star named the Italian Stallion.
While fact-checking this article, I was struck by the passionate opinions people held on both sides of the debate, from the larger issues at stake (whether or not US health organizations should recommend circumcision as an HIV prevention measure, after trials in Africa found it to be beneficial in this regard) to the personal details (whether or not snipping male newborns dooms them to a life of diminished sexual pleasure). Everybody seems to have a strong opinion about this, so we'll be expecting quite a few wily comments concerning the fate of the foreskin.
Read Nikhil's piece here.
Suzy KhimmApr. 2, 2010 5:30 AM
Idaho veterinarian, elk rancher, and political hopeful Rex Rammell first attracted national attention last year when he joked about buying "Obama tags" to hunt the president. Now the conservative activist is running to be the GOP's candidate for governor of Idaho. His platform? Revving up right-wing militias so they are "prepared" to deal with the growing threats to freedom posed by a federal government bent on "socializing" the country.
On ABC's "Nightline" on Tuesday, Rammell explained why it's reasonable for those unhappy with the Obama administration to threaten violence:
"I don't think anyone would argue that America is getting more and more enemies all of the time—both foreign and domestic," said Rammell. "I think the way politics is going in the United States and the Tea Party movement—the whole atmosphere promotes people wanting to get prepared. And I think that is what this is about...
"It's because of the current administration's politics—the more they force upon the states, the more noise there is," Rammell said. "The more concern people have, the less freedom there is. Lots of Idahoans believe the health care bill is very intrusive on our individual rights. ... We are not going to allow them to come into the state and make what we believe are unconstitutional mandates. Even if they can get them passed in D.C., we are not going to all that to happen. These guys want to show a little force behind the scene... I don't have a problem with that."
Show a little force? Was Rammell calling for right-wing militias to try to intimidate the federal government days after the feds cracked down on the Hutaree Christian militia for plotting to kill police officers? Idaho has certainly spawned it own share of militia groups and sympathesizers. Groups like Northern Idaho's Lightfoot Militia claim to have more than a 100 members, though they insist they aren't looking for a "showdown" with the government and consult with local officials to make sure they're above board. But the increasingly hysterical tone of anti-government rhetoric and growing concern about extremism have drawn increasing scrutiny to such heavily armed extracurricular activities.
Rammell himself is a fundamentalist Mormon who has long stood on the fringe of Idaho's right-wing political scene. He began his political crusade as a property rights activis when the state refuse to license his elk ranch due to inadequate fencing. And he first got a taste of the spotlight in 2006, when over a hundred elk escaped from his ranch, prompting the governor to order a large-scale hunt.
Since then, he has espoused a series of extreme views. "All of the evil empires that have ever existed have dictated what their youth would learn and by whom," Rammell thunders on his campaign website, slamming the federal government's role in the education system. A climate change denialist, he argues that those who advocate addressing human-generated global warming are godless fearmongers: "The catastrophic consequences predicted by the doomsayers are evidence of their lack of faith in a Supreme Being who holds the creation and the future of the world in His hands." He has also called upon the Almighty to help save the Constitution during the Obama years: "We are in America's second Revolutionary War to save our freedom, which we paid for with blood. We need God's help and I'm not ashamed to ask for it," he proclaimed in January, around the same time that he held a series of male-only Mormon campaign events.
Rammell's extreme views haven't always endeared him to his fellow Republicans. He ran for Senate as an independent in 2008 and only managed to get 5.4 percent of the vote. Since he launched his primary campaign for the governor's seat, the state GOP hasn't rushed to embrace him. And after he refused to apologize for his joke about hunting Obama last year, he came under heavy criticism from state and national Republican leaders, as well as the Mormon church.
The incumbent governor, Republican Butch Otter, is projected to win another term. But Rammell's entry into the race could still have an impact. Otter has been challenged repeatedly by the right wing of the state party—in addition to Rammell, he has three other challengers in the GOP primary. In response, he has moved to burnish his own conservative credentials—for instance, by making Idaho the first state to sue the federal government over the health care bill. In a crowded primary contest, Rammell's militia hawkery could gain traction with the Tea Party crowd—and push the Idaho Republican Party even farther to the right. "At one time, that wing represented a minority of the state's dominant party," a columnist from the local Lewiston Morning Tribune wrote last year. Now, he noted, "Idaho Republicanism is becoming little different from Rammellism."
Apr. 2, 2010 5:00 AM
Afghan Army soldiers patrol near the village of Kusheh, Afghanistan, on March 24, 2010. The Afghan soldiers have been partnering with US Army Soldiers to help bring stability to part of Khost province. Photo via the US Army photo by Spc. Spencer Case.
Mac McClellandApr. 2, 2010 2:46 AM
Speaking of spousal abuse, I just arrived in New Orleans for World Affairs Council and University of New Orleans events. Guess what was on the front page of the Times-Picayune.
Apr. 2, 2010 12:43 AM
David Corn appeared on MSNBC's Countdown with Keith Olbermann to discuss the importance and quirks of the national census.
Visit msnbc.com for breaking news, world news, and news about the economy
David Corn is Mother Jones' Washington bureau chief. For more of his stories, click here. He's also on Twitter.
Adam WeinsteinApr. 1, 2010 7:47 PM
Bill O'Reilly is a mensch. A politically obtuse, verbally abusive, filthy rich one, but a mensch nonetheless.
That's no April Fool's Day joke. O'Reilly really is, today, a standup guy.
The conservative pundit put a little more daylight between himself and the Glenn Beck-loving, conspiracy-theorizing right wing Thursday with a touching personal gesture: He offered to help the father of a Marine killed in Iraq after he lost a lawsuit to the neoluddite child-hating Westboro Baptist Church of Fred "God Hates Fags" Phelps.
It wasn't supposed to be this way. After Albert Snyder lost his son, Lance Cpl. Matthew Snyder, in a vehicle accident in Anbar province, he was shocked to find Matt's military funeral mobbed by Phelps' crew of sign-carrying flat-earthers, whose shtick involves loudly thanking God for smiting gay-loving, libertine America and its sworn defenders. Snyder did what most grieving parents would have done: he sued the church. "They wanted their message heard, and they didn't care who they stepped over," Mr. Snyder testified. "My son should have been buried with dignity, not with a bunch of clowns outside." The court awarded him $11 million dollars.
[Read more]
Titania KumehApr. 1, 2010 7:02 PM
That well-documented religious extremist group from Kansas known as the Westboro Baptist Church recently announced it would picket Bay Area schools and Jewish institutions to show its disapproval of the locals' acceptance of gay people. Palo Alto's Gunn High School—which apparently is still reeling from its recent student suicides—was one of Westboro's stops on its ever-considerate hate-speech trail. Not a bastion of tact, the church attributed Gunn's suicides to a "lack of religious faith."
So in a deft act of Biblical aikido, students, parents, and neighbors countered the so-called Christian organization's "God Hates You" placards with "Love Thy Neighbor As Thyself" signs. Watch the inspirational video below to see the community's myriad slogans and to listen to the songs. You can't miss the songs. Apparently, Stanford University adopted Gunn's counter-protest tactics, using copious amounts of levity to ward off Westboro's Debbie Downer message. One sign read "Gay for Fred Phelps"...my personal favorite.
Follow Titania Kumeh on Twitter.
Kevin DrumApr. 1, 2010 6:32 PM
Roger McShane summarizes the results of an Economist poll about the effect of No Child Left Behind. Here it is:
That's pretty remarkable. Not only is NCLB massively unpopular a decade after it was passed, but it's about equally unpopular with both Democrats and Republicans. Everyone hates it. If Barack Obama really wants to bring the nation together, it sounds like deep sixing NCLB completely might be a pretty good way to do it.
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Chris Otule's performance doubly important for MU
Lexington, Ky. - Chris Otule picked the right time for his first Marquette double-double.
When absolutely nothing else was going right Thursday for the Golden Eagles in their second-round NCAA Tournament game against Davidson, the fifth-year senior center was keeping them in the game with his determined play.
Otule finished the 59-58 victory with 11 points and 11 rebounds, numbers that were necessary to position the Golden Eagles to win on clutch shots from Vander Blue and Jamil Wilson.
"He's so big and No. 15 ( Jake Cohen) is so skilled," Marquette coach Buzz Williams said. "I told him, as I did Davante ( Gardner), throughout the week that if it's a skill game, they win that matchup.
"I thought that Chris' physicality, length and strength were really important. He made really big baskets to begin the second half and I thought his offensive rebounds were absolutely critical. So happy for him, considering all that he has had to overcome."
Otule has missed large parts of two seasons because of injury. He has another season of eligibility remaining should he choose to exercise it.
Meanwhile, senior guard Trent Lockett, playing in his first NCAA Tournament after transferring last summer from Arizona State, also came through with 11 rebounds.
"Isn't that something? So proud of him, so thankful he's here," Williams said. "I have such admiration for his diligence and consistency."
Don't bet the house
Williams was asked about the odds of Marquette making 3 three-pointers inside the final minute when it had made just one before the comeback.
"I don't know how you bet in Vegas, but typically they keep building casinos because they bet on the house," he said. "One thing I would say is, all those needed to be threes, right? So it was like we didn't have a choice."
The Butler did it
You can bet the 72-71 loss to Butler on Nov. 19 at the Maui Invitational is still fresh in Marquette's mind.
Butler's Rotnei Clarke made a crazy shot at the buzzer for the victory, and now Marquette gets another shot at its future conference mate in the third round Saturday.
"I would say it's fresh in their minds because they've seen the commercial countless times on ESPN," Williams said. "The other thing I would say is Butler hasn't been to two Final Fours because they're the same team they were in November."


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London, September 27 : A new book on the history of cider entitled 'Ciderland' suggests that Champagne was invented in Somerset, England, not France.
Author James Crowden, 54, contradicts the French belief that the method of secondary fermentation called methode champenoise was invented by a Benedictine monk named Dom Perignon.
The author insists that the credit should actually go to Christopher Merret, the West Country scientist.
Crowden writes that Merret had outlined his method of making sparkling wine in a paper to the Royal Society in 1632, six years before Perignon was born.
The writer, who himself hails from Somerset, believes that the popularity of sparkling wines began when British cider-makers added sugar to acidic French white wine, and then learnt how to control the resulting secondary fermentation.
He says that the sugar caused secondary fermentation in the bottle, which created sparkling wines.
Crowden also reveals that Merrett invented the thick green bottle strong enough to contain the pressure of secondary fermentation.
He says that the problem of unintended fermentation was giving French wine-makers a tough time, as it could cause whole cellars of their fragile bottles to explode.
By learning to control it, according to the writer, they were able to create sparkling wine by design rather than accident.
Crowden will spell out the English connection in a paper to the Royal Society, claiming that the methode champenoise was only refined by the French friar.
"What is extraordinary is that these cider-makers did not realise the potential of their discovery," Times Online quoted him as saying.


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Eight civilians killed in Russian air raids on Aleppo and Idlib, SIA reports citing the foreign media. .
According to sources, the Russian airstrikes targeted the same area again while Civil Defense teams were attempting to rescue victims stuck under the collapsed buildings.
Meanwhile, one civilian was killed and seven others injured in a Russian airstrike on Sultan village in Idlib province.
Russia began carrying out airstrikes in war-torn Syria on Sept. 30. According to the Kremlin, the strikes are aimed at supporting the Assad regime -- an ally of Russia's -- against Daesh.


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Chaps & Handcuffs
- 1-2 Hours
- Intermediate
Additional Information
- Foamies® craft foam:
1 roll white
2 large sheets, black
1 small sheet, brown
1 sheet sticky-back glitter
- Silver buckle
- 2 pkgs red suede cording
- Fiskars® hammer punch, scissors, pinking shears, scallop-edge shears
- Craft knife
- Tacky glue
1. Measure length of child's pants. Cut 2 strips to length x 8½" wide. Cut 3" notch on each piece at the crotch.
2. Cut a curved yoke with scissors and pinking shears. Glue to the top of each chap leg.
3. Cut black cow spots and glue to the chap legs. Measure child's waist, add 6"; scallop-cut a 1¼"-wide white craft foam belt. Glue on small black cow spots; attach buckle, belt loop & belt holes. Slit the yoke to accommodate the belt. Slip the belt through the loops.
4. Cut 6 black craft foam circles with pinking shears for the tassels. Punch 2 holes in each. Cut lengths of red suede & tie through holes with the knot in the front.
5. Cut 6 larger self-adhesive glitter circles with pinking shears. Punch holes through circles; adhere to outer edge 6", 12" and 18" from the top of the chaps.
6. Cut twelve 14" lengths of red suede. Thread 1 length through holes from underside of chaps, glitter circle, tassel circle & back through. Tie off, leaving 12" suede tail at the side. Repeat for 6 outer-edge tassels.
7. Create other end of the ties on inside edges of chaps. Punch 2 holes on the inside edges of the chaps, opposite the tassels. Some will be 2 layers because of cow spots; other will be 1 layer. Reinforce single layer with circle of craft foam on inner edge. Anchor the layers together with brads & reinforce the craft foam. Tie other strips of lacing through the holes & tie off.
8. Trim or fringe bottom edge of chaps.
- 2 small Foamies® craft foam sheets
- Fiskars® hammer punch, scissors, pinking shears, scallop-edge shears
- Large eyelet, eyelet setter
- Tacky glue
1. Cut two 1"x10" strips of craft foam, large enough for a child's hand to slip in & out of easily.
2. Using scallop-edge or pinking shears, cut small cow spots and glue to strips. Allow glue to dry completely. Curl each strip into a ring that overlaps itself 1". Punch 2 holes through the layers; secure with eyelets.
3. Cut seven 4½"x1/2" strips of craft foam with pinking or scallop-edge shears. Curl one into a ring that overlaps itself 1/2". Punch hole through layers; secure with eyelet. Loop another strip through 1st loop & secure with an eyelet. Continue with remaining 2 strips to connect handcuffs to the chain.


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Eric's online journal of myths, legends, memories and an occasional short story.
Sunday, February 10, 2013
Enchiladas in New Orleans
There were so many houses foreclosed in Oklahoma City that the FDIC had to open an office here. Soon, they had a thousand employees working in the city. We were not the only Oklahoma oil company in trouble. Everyone was in trouble!
Our banking leads exhausted, we began looking for a "white knight" investor, someone that would inject some much-needed capitol into the company. Anne and I did not know such a person but we knew someone that did.
Harold (at least this is the name I am giving him for this story) is from Alligator, Mississippi (I am not making this up!) and knows more people than the census bureau. He is also a brilliant, self-taught geophysicist, and just a little shady.
A fiction writer with the world's greatest imagination could never create a fictional character as interesting as Harold is. If I were inclined to write a biography, I would write Harold's biography because he is perhaps the single-most interesting person I've ever met. He knew a possible "white knight" in New Orleans so we headed south to make our pitch.
Harold booked us at the Monteleone Hotel, a wonderful place on Royal, just a block from Bourbon Street. He had invited his new girlfriend as his latest marriage was already in the dumpster. Harold was not good with relationships. The next day after checking in, we took a taxi down Bourbon Street.
Mr. X (a very real person) lived in a million dollar shotgun house on the end of Bourbon Street. A shotgun house, built in the 1700s so named because if you unloaded a shotgun at the front door, the load would exit the back door without striking a wall. There is not much to a shotgun house but because of their location, they are worth millions of dollars - yes, even after Katrina.
Harold introduced us to Mr. X, a friendly man with dark Cajun hair and eyes, and a long black moustache. He had a manservant that I will call Hay-sus. Hay-sus could not speak English but he knew how to mix drinks. Mr. X started talking and we listened, and drank, all day long. A one-time banker friend (surprise, surprise!) had apparently ruined Mr. X. They were now bitter enemies.
Mr. X told us hours of interesting stories, but we never got a chance to state our case but he did take us back to the Monteleone for dinner. He was allergic to seafood and did not like steak so we had enchiladas at the restaurant's Mexican restaurant. There was a troupe of Mexican singers and Mr. X paid them probably a thousand dollars, at a hundred dollars a pop, to sing various Mexican songs.
Harold's girlfriend left sometime during the night (he was hell on relationships!) so we met at the Monteleone's Carousel Bar the next day for drinks before flying back to OKC. I got so drunk and disoriented that I could hardly walk out of the place.
Anne and I never found a "white knight" and our company's bankruptcy stood, our hopes and dreams struck down like so many tin soldiers. Thanks to Harold, though, we had an experience almost impossible to believe. It is now but a memory and I am passing it on, albeit in an abbreviated version.
Someday I might write Harold's story, but it should really go straight to the big screen because I'm positive it would break all attendance records.
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