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Cholesterol Management
Nutritional Approaches to Managing Blood Lipids and Lipoproteins
Nutritional approaches to blood lipid and lipoprotein management mirror many of the strategies of conventional therapies. Dietary modifications aim to reduce the intake and uptake of fats and cholesterol from the diet. The inclusion of specific dietary compounds with cholesterol-lowering (hypocholesterolemic) or cardioprotective properties may also reduce cardiovascular disease risk by several different mechanisms.
Diet is an important determinant of cardiovascular disease risk; both conventional and alternative approaches advocate dietary and lifestyle changes as the first step in meeting lipid management goals. The National Cholesterol Education Program (NCEP) developed the Therapeutic Lifestyle Changes (TLC) diet42 for medical professionals to help patients pursue nutritional options for lowering cholesterol. The TLC diet recommends no more than 25 to 35 percent of daily calories from total fat, with up to 20 percent as monounsaturated, 10 percent as polyunsaturated, and less than 7 percent as saturated fats. This relatively high allotment of fat calories allows for increased unsaturated fat intake like omega-3 fatty acids in place of carbohydrates for patients with metabolic syndrome.
Carbohydrates and proteins should provide 50-60 percent and 15 percent, of total calories, respectively. Optional dietary guidelines include the addition of 10-25 grams of soluble fiber, and 2 grams of plant sterols per day. Total calories are adjusted to maintain body weight and prevent weight gain, and enough moderate exercise to burn at least 250 calories per day is recommended.
Although not designed as a hypocholesterolemic diet, the DASH (Dietary Approaches to Stop Hypertension) eating plan encourages many of the same heart-healthy eating habits.43 The first DASH eating plan (originally called the "combination diet") focused on fruits, vegetables, and whole grains, and was especially high in fiber (31 grams/day) and potassium (4.7 grams / day), and low in animal products. Ironically, the original DASH was not a low sodium diet (allowing up to 3 grams/day), but was nonetheless hypotensive44. The low-sodium DASH diet has demonstrated even greater hypotensive effects when limiting sodium to 1.5 grams/day.45 Recall that hypertension is a major coronary heart disease factor. Hypertension magnifies the danger posed by excess LDL by damaging the endothelial barrier, allowing increased permeability.
Caloric restriction (CR) is the dramatic reduction of dietary calories (by up to 40%), to a level short of malnutrition.46 Restriction in energy intake slows down the body's growth processes, causing it to instead focus on protective repair mechanisms; the overall effect is an improvement in several measures of wellbeing. Observational studies have tracked the effects of CR on lean, healthy individuals, and have demonstrated that moderate CR (22-30% decreases in caloric intake from normal levels) improves heart function, reduces markers of inflammation (C-reactive protein, tumor necrosis factor (TNF)), reduces risk factors for cardiovascular disease (LDL-C, triglycerides, blood pressure) and reduces diabetes risk factors (fasting blood glucose and insulin levels).47,48,49,50 Preliminary results of the Comprehensive Assessment of Long-Term Effects of Reducing Intake of Energy (CALERIE) study, a long-term multicenter trial on the effects of calorie-restricted diets in healthy, overweight volunteers51 has shown that moderate CR can reduce several cardiovascular risk factors (LDL-C, triglycerides, and blood pressure, C-reactive protein).52
Replacing Lost Hormones to Achieve Optimal Cholesterol Levels
Due to the role of cholesterol as a precursor to steroid hormones, some researchers have speculated that the elevation in cholesterol seen with advancing age is a compensatory effort by the body to restore levels of hormones to more youthful levels.
In a small clinical trial, Dr. Sergey Dzugan, and Dr. Arnold Smith, found that restoring youthful hormone levels with the use of bioidentical hormone replacement therapy (BHRT) resulted in a significant reduction in cholesterol levels in 20 individuals with high cholesterol.53
Hormone replacement therapy has been shown to reduce cardiovascular risk in aging women,54 and aging men with lower testosterone levels are at significantly greater risk for heart disease.55 Thus, aging individuals should consider optimizing their hormone levels in order to reduce cardiovascular risk. More information on this topic can be found in Life Extension's Hormone Replacement Therapy protocols for Men and Women.
Nutrients for Lipid Management
There are several nutrients that have been identified as potential agents for promoting a favorable lipid profile; many of them work by the same principles as conventional therapies (such as reducing cholesterol synthesis, or interfering with cholesterol absorption in the gut). Several also have additional activities (antihypertensive, inhibition of LDL-oxidation, antiinflammatory) that complement their cholesterol-lowering activity and lend to their overall reductions in fatal and non-fatal cardiovascular events.
Inhibiting Cholesterol Synthesis
Pantethine and its metabolites appear to act on the body's fat and cholesterol metabolism pathways. Pantethine is a derivative of pantothenic acid (vitamin B5), and can serve as a source of the vitamin. One notable function of vitamin B5 is its conversion into coenzyme A, a necessary factor in the metabolism of fatty acids into cellular energy. The pantethine derivative cysteamine may also function to reduce the activity of liver enzymes that produce cholesterol and triglycerides.56 Studies of pantethine consumption have demonstrated significant reductions in total- and LDL cholesterol (up to 13.5%), triglycerides, and elevation of HDL-C in hypercholesterolemic subjects (individuals with high cholesterol)57,58 and diabetic subjects59 when taken at 900-1,200mg/day, although significant effects on triglycerides have been observed at dosages as low as 600 mg / day.60
Red yeast rice is a traditional preparation of rice fermented by the yeast Monascus purpureus. The yeast produces metabolites (monacolins) that are naturally-occuring HMG-CoA Reductase inhibitors (one of these, monacolin K, is chemically identical to lovastatin61). A comprehensive review of 93 randomized trials including nearly 10,000 patients has demonstrated that commercial preparations of red yeast rice produced reduction in total cholesterol, LDL-C, triglycerides, and an increase in HDL-cholesterol.62 A long-term (4.5 year) multicenter study of nearly 5,000 patients with a previous heart attack and high total cholesterol levels demonstrated that a commercial red yeast rice preparation reduced the incidence of major coronary events, including nonfatal heart attack and cardiovascular mortality, when compared to placebo63. Red yeast rice extracts have also been shown to be well tolerated and effective in lowering LDL in patients with statin intolerance.64,65
Due to regulations regarding their labeling in the US, standardization of commercial red yeast rice preparations for monacolins is problematic, thus levels of monacolins can vary dramatically between red yeast rice products.66 There are some standardized red yeast rice products that are standardized for monacolin K content.
Garlic has been substantiated by several human trials, particularly its ability to support favorable blood lipid profiles. Three separate analyses of 32 blinded, controlled human trials of garlic consumption in healthy or patients with high cholesterol and trigylcerides confirm significant reductions in total cholesterol by an average of 7.3 mg/dL, and triglycerides by an average of 4.2 mg/dL. 67,68,69 While the average cholesterol reductions across all human studies are modest, greater reductions in total cholesterol were realized in patients who were initially hyperlipidemic or hypertriglycemic (>11 mg/dL reduction), took the extract for over 12 weeks (11 mg/dL reduction), or took a garlic powder (as opposed to an oil or aged extract; 12 mg/dL reduction).70
Garlic also reduces systolic- and diastolic- blood pressure (SBP and DBP) in hypertensive individuals, and systolic blood pressure in persons with normal blood pressure. A recent review and analysis of 11 controlled human trials of garlic showed a mean decrease of 4.6 ± 2.8 mm Hg for SBP in the garlic group compared to placebo, while the mean decrease in the hypertensive subgroup was 8.4 mm Hg for SBP and 7.3 mm Hg for DBP.71
Indian Gooseberry (Amla; Emblica officinalis) has been used traditionally as a nutrient-dense food in Indian regions, and in Ayurvedic medicine for treating a variety of conditions. Modern scientific inquiry has revealed considerable evidence in support of the medicinal use of this nutritional powerhouse. Analytical studies on extracts of Indian Gooseberry highlight its potent antioxidant properties;72 animal studies carry these findings forward by showing that orally administered amla extract significantly reduce levels of oxidized LDL.73,74 In human studies, extracts of amla have been shown to attenuate elevations in LDL, total cholesterol, and triglycerides, and boost levels of protective HDL.75 In a study examining the antioxidant activity of amla extract in subjects with metabolic abnormalities, four months of supplementation was shown to dramatically bolster plasma antioxidant power and suppress oxidative stress.76
Studies suggest that amla extract may also protect against LDL glycation by modulating blood glucose levels. In diabetic patients amla not only significantly reduced post-prandial glucose levels, but also lowered lipid and triglyceride levels over a 21 day period77. In an animal model of metabolic syndrome induced by a high fructose diet, concomitant administration of amla extract reined in rising cholesterol and triglyceride levels, and also significantly repressed the expression of inflammation-related genes, which are typically elevated in metabolic syndrome models.78 Extracts of the antioxidant-rich fruit also reduce levels of advanced glycation end products (AGEs), which are formed by the same process as glycated LDL.79 By limiting the amount of LDL particles that become glycated, amla may help maintain proper cellular uptake of cholesterol and reduce the amount of LDL-C available to infiltrate the arterial wall.
Gynostemma pentaphyllum. Gynostemma pentaphyllum (G. pentaphyllum) is used in Asian medicine to treat several chronic conditions, including diabetes and inflammatory disorders. Its effects are due in part to its ability to activate a critical enzyme called adenosine monophosphate-activated protein kinase (AMPK).158,159 This enzyme, which affects glucose metabolism and fat storage, has been called a "metabolic master switch" because it controls numerous metabolic pathways.160,161
Activation of AMPK stimulates glucose uptake in muscles and beta oxidation, in which fatty acids are broken down, while reducing the production of fat and cholesterol in the liver.158 It can also prevent damage to blood vessel lining (endothelial) cells caused by oxidized LDL ("bad") cholesterol.162 AMPK activation reduces cholesterol and triglyceride levels.163,164
G. pentaphyllum stimulates AMPK activation and affects cholesterol levels in the blood and liver. A study in obese mice showed eight weeks of supplementation with G. pentaphyllum led to weight loss and improvements in glucose metabolism and cholesterol levels. Mice treated with 150 mg/kg (about 900 mg for an adult human) or 300 mg/kg (about 1800 mg for an adult human) of the extract had total cholesterol reductions of 14.2% and 7.1%, respectively, compared with the control group.158
Trans-tiliroside is one of the principal bioactive compounds found in rosehip, and is the principal active constituent of the Traditional Chinese Medicine remedy, Potentilla chinesis.165,166
Trans-tiliroside increases levels of adiponectin167; higher levels of adiponectin have been associated with lower body fat and body mass index (BMI).168 Trans-tiliroside also activates AMPK signaling.167 Increased AMPK signaling stimulates fat metabolism in skeletal muscle.169 AMPK activation inhibits the biosynthesis of fatty acids and cholesterol.170 Chronic AMPK activation in rats fed a high-fat diet blocked the accumulation of triglycerides in the liver.171
In diabetic mice, daily administration of 0.4, 0.8, and 1.6 mg/kg of trans-tiliroside significantly reduced total cholesterol, LDL cholesterol, and triglyceride levels in blood.165 This dosage is equivalent to 2.4–9.7 mg per day in a 75 kg human. Clinical study participants given 40 g of rose hip powder for six weeks saw total and LDL cholesterol levels drop 4.9% and 6%, respectively. The ratio of LDL-C to HDL-C improved by 6.5%.172
In addition to lowering total and LDL-C, trans-tiliroside has demonstrated an ability to protect LDL-C against oxidation.173 LDL oxidation is believed to be an early step in the development of atherosclerosis.174
Inhibiting Absorption of Dietary Cholesterol
Soluble Fibers include non-digestable and fermentable carbohydrates, and their sufficient intake has been associated with lower prevalence of cardiovascular disease.81 When included as part of a low-saturated fat/low cholesterol diet, they can lower LDL-C by 5-10% in hypercholesterolemic and diabetic patients, and may reduce LDL-C in healthy individuals as well.82 The cholesterol-lowering properties of soluble oat fiber, psyllium, pectin, guar gum, ß-glucans from barley, and chitosan are substantiated by dozens of controlled human clinical trials. 83,84,85 Soluble fibers lower cholesterol by several potential mechanisms.86 They may directly bind bile acids or dietary cholesterol, preventing/disrupting their absorption. Their high viscosities (measure of a liquids thickness) and effects on intestinal motility may slow or limit macronutrient uptake. They can also increase satiety, which can limit overall energy intake.
Prebiotics, a subset of soluble fiber, have gained attention in recent years in their ability to be selectively fermented by gut flora for a diversity of potential health-promoting benefits. The fermentation of prebiotic fibers into short-chain fatty acids such as acetate, butyrate, or propionate may inhibit cholesterol synthesis in the liver.87 In human trials, the prebiotic fibers inulin and dextrin have induced reductions in serum levels of total cholesterol (-9% and -2% for inulin and dextrin, respectively), LDL-C (-1 % for dextrin), and triglycerides (-21% for inulin).88,89
Plant sterols (phytosterols) are steroid compounds found in plants that function similarly to cholesterol in animals (as components of plant cell membranes, and precursors to plant hormones). Like cholesterol, they can exist as free molecules or as sterol- esters. Esters of sterols have a higher activity and better fat solubility, which allows for lower effective dosages (2-3 g/day as opposed to 5-10 g/day for unesterified sterols).90 Sterols themselves are poorly absorbed from the diet, but because of their chemical similarity to cholesterol, they are thought to compete with cholesterol for absorption in the intestines, which has the net effect of reducing LDL levels.91 Sterols may also reduce cholesterol production in the liver, reduce the synthesis of VLDLs, increase LDL particle size, and increase LDL uptake from the blood92,93 HDL and/or very low-density lipoproteins are generally not affected by sterol intake.94
There have been numerous studies of the effects of sterol esters on reducing mean total cholesterol and LDL-C cholesterol in healthy, hypercholesterolemic, and diabetic individuals. An analysis of 57 trials involving over 3600 individuals has reported an average LDL-C reduction of 9.9% at a mean intake of 2.4 g sterol esters/day.95 Sufficient evidence of the cholesterol-lowering effects of sterols has prompted the US Food and Drug Administration to permit the health claim that sterol esters may be associated with a reduced risk of coronary heart disease, when taken at sufficient levels in the context of a healthy diet, one of only 12 permissible health claims granted by this organization96 The NCEP97 and American Heart Association98 both support the use of sterols in their dietary recommendations.
Guggul/Gum guggul, the resin of the Commiphora mukul tree, has a history of traditional usage in Ayurvedic medicine and is widely used in Asia as a cholesterol-lowering agent. Guggulipid is a lipid extract of the gum that contains plant sterols (guggulsterones E and Z), the proposed bioactive compounds.99 In an analysis of 20 human studies on guggulipid, most of the evidence support a significant reduction in serum total cholesterol, LDL, and triglycerides, as well as an elevation in HDL.100 However, most of these studies were small, and had significant design flaws (such as lack of controls or statistical analysis). More recent studies, with better designs, have produced conflicting results. The first, a 36 week study of the effects of 25 mg of guggulsterones on 61 hypercholesterolemic patients demonstrated significant reductions of total cholesterol by 11.7%, LDL by 12.5%, and triglycerides by 15%.101 A second study revealed an opposite effect; this larger (103 patient) study looked at low- (25 mg) and high- (50 mg) dose guggulsterones on blood lipid parameters for eight weeks, and observed increases in LDL-C (4% and 5% for the low and high dose groups, respectively).102 In the most recent study, 12 week administration of 540 mg raw guggul demonstrated modest reductions in both total cholesterol and HDL (3-6%), although the clinical significance of this outcome is not clear.103
Soy protein has value as an anti-hypercholesterolemic agent not only because of the potential lipid-lowering effects of its included isoflavones (which may increase the amount of LDL receptors and help to clear LDL particles from the blood), but also for its potential as an alternative to other high fat/high cholesterol protein sources. A 1995 meta-analysis of 38 controlled human clinical trials (30 conducted on hypercholesterolemic patients) revealed that compared to animal protein, an average intake of 47g/day of soy protein resulted in significant improvements in blood lipid/lipoprotein parameters. Across the studies there were observable average reductions in total cholesterol (9%), LDL-C (12.9%), triglycerides (10.5%), and VLDL-C (2.6%), as well as a non-significant increase in HDL-C (2.4%)104 These data were the foundation for the FDA approval of the food-labeling health claim for soy protein in the prevention of CHD.105
More recently, a second meta-analysis of 41 soy protein studies (including 32 new studies performed after 1995) confirmed the anti-hypercholesterolemic properties of soy protein. The average reductions in blood lipids were smaller (5.3% for total cholesterol, 4.3% for LDL-C, 6.3% for triglycerides, and a 0.8% increase in HDL-C), but this analysis was limited to studies that used soy protein isolates (which contain no cholesterol-lowering fiber).106 Some of this difference may also be explained by baseline lipid levels; persons with moderate to severe hypercholesterolemia showed the largest decreases in serum cholesterol when soy is added to the diet.107
Isoflavone-enriched soy proteins may have additiona lipid-lowering benefits. In the 11 human trials that compare isoflavone-enriched soy to isoflavone-free soy, the enriched soy products (which delivered an average of 102 mg isoflavones/day) lowered total and LDL cholesterol more than isoflavone-free soy, by 1.7% and 3.5%, respectively.108
Inhibiting Oxidation and Glycation of LDL
Coenzyme Q10 (CoQ10). The generation of chemical energy in the form of ATP by the mitochondrial electron transport chain is essential for the existence of life as we know it. Delicate endothelial cells that line the arterial walls depend on healthy mitochondrial function to control blood pressure and vascular tone. Oxidized or glycated LDL can sabotage endothelial mitochondrial function and damage the endothelial barrier, setting the stage for the atherosclerotic cascade to initiate.109,110 CoQ10 is an integral component of mitochondrial metabolism, serving as an intermediary transporter between two major check points along the road to ATP production. Interestingly, CoQ10 is also the only known endogenously synthesized lipid soluble antioxidant,111 and is thus incorporated into LDL particles, where it serves to protect against oxidation. Because of these dual roles insufficient levels of CoQ10 expedite atherogenesis from two angles – by limiting mitochondrial efficiency in endothelial cells and leaving LDL particles vulnerable to oxidative damage.
As noted above, statin drugs, which are typically used to treat high cholesterol, ironically also suppress levels of CoQ10 in the blood.112 Individuals taking a statin drug should always supplement with CoQ10.
Carotenoids are common constituents of the LDL particle. ß-carotene is the second most abundant antioxidant in LDL; other common dietary carotenoids (lycopene, lutein) may be transported by LDL particles as well.113 Together, these three carotenoids have an indispensable role in the protection of LDL particles from oxidative damage; their serum levels have been demonstrated to be the most predictive of the degree of LDL oxidation in humans.114 Carotenoids may also possess additional lipid-lowering activities independent of their antioxidant potential. The best-studied in this respect is lycopene; an analysis of 12 human trials of lycopene reveals an average reduction in LDL-C of approximately 12%.115 Potential mechanisms for this action are suppression of cholesterol synthesis by the inhibition of the HMG-CoA reductase enzyme, or an increase in the rate of LDL degradation.116 Astaxanthin, a carotenoid found in some fish and marine oils, can increase HDL.117
Vitamin E. Natural tocopherols and tocotrienols together form vitamin E. These fat-soluble antioxidants have been studied for decades and are known to protect against some cardiovascular events. Vitamin E strongly inhibits the oxidation of LDL particles.118,119
Alpha tocopherol is the best known form of vitamin E and is found in the largest quantities in blood and tissue. It is critical, however, for anyone supplementing with vitamin E to make sure they are also getting adequate gamma tocopherol each day. The key benefit is gamma tocopherol's ability to dramatically reduce inflammatory threats, a major cause of virtually all degenerative diseases. One of the most important benefits of gamma tocopherol is its ability to improve endothelial function by increasing nitric oxide synthase, the enzyme responsible for producing vessel-relaxing nitric oxide.120 One major way it produces this effect is by sponging up destructive reactive nitrogen species, such as peroxynitrite.121 In fact, gamma tocopherol is able to "trap" a variety of reactive nitrogen species and halt their negative effects on a host of cellular processes.122
Supplementation in humans with 100 mg per day of gamma tocopherol showed resulted in a reduction in several risk factors for vascular disease such as platelet aggregation and LDL cholesterol levels.123
Pomegranate is now widely viewed as a superfruit with a myriad of health benefits, and rightfully so; dozens of placebo controlled clinical trials have been carried out on pomegranate juice, or pomegranate extract. With respect to lipid management, the efficacy of pomegranate is rivaled by very few natural compounds. The high concentration of polyphenols (particularly punicalagins) in pomegranate make it an ideal ingredient for suppressing LDL oxidation.124,125
Consumption of pomegranate polyphenols significantly lowered total and LDL cholesterol concentrations while maintaining HDL levels in subjects with elevated cholesterol profiles.126 Pomegranate also suppresses immunoreactivity against oxidized LDL, a mechanisms which would be expected to limit plaque formation in the intimia.127 In fact, this is exactly what was shown in a long-term study of pomegranate consumption. Subjects received either pomegranate juice or placebo for three years; in the group receiving the placebo, carotid intima media thickness (cIMT; a measure of atherosclerosis) increased by 9% one year after study initiation, while in the group receiving pomegranate, cIMT was reduced by an astonishing 30%. Moreover, pomegranate significantly reduced oxidized LDL concentrations, and increased serum antioxidant activity, compared to placebo, while simultaneously lowering blood pressure. This study also showed that pomegranate nearly doubled the activity of paraoxonase-1 (PON-1), an antiatherogenic enzyme that optimizes the function of HDL and protects lipids from oxidative damage.128 Both groups in this study continued on standard therapy that may have included statins, anti-hypertensives, etc.
Polyphenols are a diverse set of phytonutrients that are ubiquitous in the diet. Polyphenol intake has been associate with lower risk of cardiovascular mortality, and may partially explain the health benefits of several common foods (tea, fruits, vegetables, wine, chocolate).129 Flavonoids, the largest and best studied class of polyphenols, include catechins from green tea and chocolate, theaflavins from black tea, soy isoflavones, flavan-3-ol polymers from red wine, and anthocyanidins from grapes and berries. A systematic analysis of over 130 human studies of flavonoids revealed significant improvements in endothelial function (cocoa and black tea polyphenols) and blood pressure (anthocyanidins, isoflavones, cocoa); however, only green tea catechins exhibited significant cholesterol (LDL-C) lowering in this analysis (averaging about 9 mg/dL over 4 studies).130 Subsequently, a study of black tea extract in 47 mildly hypercholesterolemic Japanese men and women demonstrated an 8% reduction in total cholesterol and 13% drop in LDL-C after 3 months.131
Other polyphenolic compounds with significant lipid modification potential based on human studies include methylated citrus flavonoids (polymethoxyflavones), which were shown to lower total-cholesterol, LDL-C, and triglycerides by 27%, 25%, and 31%, respectively when combined with tocotrienols in a small pilot trial.132 Additionally, the red wine polyphenol resveratrol was shown to incorporate into the LDL particles of human volunteers following ingestion of a high-resveratrol wine, potentially acting as a resident antioxidant.133 This is consistent with resveratrol's role in the prevention of LDL oxidation observed in humans.134
Curcumin has a variety of protective roles in CVD, potentially reducing oxidative stress, inflammation, and the proliferations of smooth muscle cells and monocytes. 95 Small human trials studies have revealed the effects of curcumin on reducing in lipid peroxidation135,136 and plasma fibrinogen,137 both factors in the progression of atherosclerosis.138 Curcumin may also reduce serum cholesterol by increasing the production of the LDL receptor,139,140 but despite successes in animal models, human data on the antihypercholesterolemic effects of curcumin is conflicting. A small study of 10 healthy volunteers revealed significant decreases in lipid oxidation products (-33%) and total cholesterol (-12%), with a concomitant increase in HDL-C (29%) when using 500 mg curcumin daily for 7 days.141 In two subsequent studies, low-dose curcumin showed a non-significant trend toward lowering total- and LDL-C in acute coronary patients,142 while high dose-curcumin (1-4 g/day) exhibited non-significant increases in total-, LDL-, and HDL cholesterol.143
Enhancing Cholesterol Elimination
Artichoke has traditional usage as a liver protectant and choleretic (compound that stimulates bile flow). In stimulating bile flow, artichoke may aid the body in the disposal of excess cholesterol. In vitro studies suggest its anti-atherosclerotic effects may also be linked to an antioxidant capacity that reduces LDL oxidation, or the ability of one of its constituents, luteolin, to indirectly inhibit HMG-CoA reductase.144
In addition to several uncontrolled human studies and case reports145, two randomized, controlled trials support the ability of artichoke extracts to lower total- and/or LDL-cholesterol. In the first trial, artichoke extract (1800 mg/day) for 6 weeks reduced total cholesterol (-9.9%) and LDL-C (-16.6%) in 71 hypercholesterolemic patients, with no differences in HDL-C or triglycerides.146 In the second, also in hypercholesterolemic patients, 1280 mg artichoke extract/day for 12 weeks reduced total cholesterol by 6.1%, when compared to a control group. Changes in LDL-C, HDL-C, and triglycerides were insignificant.147 Artichoke extract also improved parameters of endothelial function in a small human trial.148
Optimizing the Lipid Profile
Niacin/Nicotinic acid (vitamin B3) is an essential nutrient with roles throughout human metabolism. At dosages substantially above the recommended daily intake (RDI), prescription niacin treatments can significantly raise HDL-C (by 30-35% in some cases, at dosages averaging 2.25 grams/day).149,150 Niacin can also change the distribution of LDL by increasing the amount of large buoyant LDL and reducing the amount of small dense LDL.151 Niacin can also reduce the susceptibility of LDL to oxidation.152
In 2010, the results of seven published studies on the effects of niacin therapy were combined to examine the overall effect. This meta-analysis is considered more powerful than an individual study because it increases the sample size. The results showed that patients taking niacin (compared with a placebo) had significant reductions in nonfatal myocardial infarction and and transient ischemic attack.153
On May 26, 2011, the National Institutes of Health stopped a clinical trial of a prescription-strength level of niacin one year prior to its projected completion. The participants were 3400 patients with stable heart disease, well-controlled LDL, and elevated triglycerides. They added high dose, extended release niacin to their statin therapy. The level of niacin used in the study was much higher than that contained in dietary supplements. As shown in previous studies, the niacin drug successfully elevated HDL and lowered triglycerides, but failed to reduce the risk for heart attack or stroke. The findings of this trial highlight the multifactorial pathology of cardiovascular disease; Life Extension believes that had these patients been receiving antioxidants like CoQ10 to reduce LDL oxidation, pomegranate to improve endothelial function, and fish oil to regulate triglyceride levels there would have been a strong reduction in risk. Mainstream media outlets have used this study as a basis for headlines suggesting that niacin is ineffective for promoting cardiovascular health. However, the lesson that should be taken from these findings is that optimal cardiovascular protection requires a multi-modal approach, and should not be limited to one or two interventions.
Fish Oil, is a source of omega-3 fatty acids (eicosapentaenoic acid -- EPA, and docosahexaenoic acid -- DHA), which cannot be synthesized by humans but are nonetheless essential for several metabolic processes. Aside from reductions in the risk of cardiovascular mortality and non-fatal cardiovascular events (supported by studies of tens of thousands of moderate and high risk patients)154, fish oil fatty acids significantly reduce serum triglycerides. Forty-seven studies, comprising over 15,000 patients, have confirmed an average triglyceride reduction of 30 mg/dL, at an average intake of 3.35g EPA+DHA over 24 weeks.155 Triglycerides were reduced in a dose-dependent manner, and were dependent on baseline levels (reductions of greater than 40% were observed in patients with the highest starting triglyceride levels). Slight increases in LDL-C and HDL-C were also observed in these studies, although other large analyses failed to detect any significant effects of fish oil on cholesterol.156 The mechanism by which EPA + DHA lowers triglycerides thought to be by slowing the release of VLDL particles into the plasma, or increasing lipid degradation and clearance of triglyceride-rich lipoproteins from the blood.157 Lowering triglyceride levels is a known strategy for increasing the amount of large buoyant LDL and reducing the amount of small dense LDL.
Prescription fish oil uses a highly concentrated EPA+DHA fish oil ester that provides a dosage of 3.36 g of omega-3 in 4 capsules; its degree of triglyceride reduction (up to 45%) is similar to non-prescription fish oil at a similar dose (usually requiring several more capsules.)157 Non-prescription fish oil supplements sell at a fraction of the price of prescription fish oil and usually require one or more additional capsules to be taken daily to obtain the same amount of EPA/DHA.
Alpha-cyclodextrin is a soluble fiber from corn that has received much attention for its ability to bind to dietary fats and prevent their absorption.175-177 In early animal research, rats fed a high-fat diet had reductions in triglyceride and total cholesterol levels when alpha-cyclodextrin was added to their food. The addition of alpha-cyclodextrin resulted in less weight gain, reductions in plasma cholesterol and triglycerides, restored insulin sensitivity, and normalized leptin levels.176 Results from an animal study found alpha-cyclodextrin lowered total cholesterol, with an apparent ability to selectively lower pro-atherogenic apoB lipoprotein, while leaving protective HDL cholesterol unchanged. Studies in rodent models have also revealed alpha-cyclodextrin may have a special affinity to bind atherogenic saturated and trans-fatty acids rather than unsaturated fatty acids.177,178
Beneficial effects of alpha-cyclodextrin have been borne out in human studies. For instance, in a double-blind placebo-controlled clinical trial, 66 obese diabetic patients took either 2 g alpha-cyclodextrin or placebo with each fatty meal for three months. At the end of the study, subjects with hypertriglyceridemia in the alpha-cyclodextrin group had reductions in total cholesterol levels, while cholesterol levels rose in the placebo group. Adiponectin levels rose in the alpha-cyclodextrin group but fell in the placebo group; and subjects in the alpha-cyclodextrin group maintained their weight, while those in the placebo group gained weight.179 In a controlled clinical trial in 28 healthy adults, taking alpha-cyclodextrin with fat-containing meals for 30 days resulted in significant reductions in levels of total cholesterol, LDL cholesterol, and weight. Weight loss was over 90% greater in the alpha-cyclodextrin group compared with the control group. Insulin and apolipoprotein B levels also fell in the alpha-cyclodextrin group. Importantly, no adverse effects were reported. Alpha-cyclodextrin forms a complex with fats, and while it does increase excretion of fat in the stool, it does not appear to cause the fecal incontinence commonly seen with use of medications that block dietary fat digestion.175,177,180
Probiotics are increasingly recognized for their critical role in regulating immune activity, reducing inflammation throughout the body, and have attracted interest for their ability to reduce LDL cholesterol and cardiovascular risk. A review of research found that, of the probiotic strains studied, Lactobacillus reuteri (L. reuteri) NCIMB 30242 has excellent evidence for reducing cardiac risk by safely lowering levels of total and LDL cholesterol as well as markers of inflammation.181
In a randomized controlled trial, 114 participants with high cholesterol levels who were otherwise healthy consumed either a probiotic yogurt providing 2.8 billion colony forming units of microencapsulated L. reuteri NCIMB 30242 or a control yogurt daily for six weeks. The L. reuteri group had reductions in total cholesterol (9%) and LDL-cholesterol (5%), levels relative to the placebo yogurt group. ApoB100, which at high levels is associated with vascular disease, was significantly reduced in the L. reuteri group.182,183 In another controlled clinical trial on 127 healthy adults with high cholesterol levels, subjects received either capsules of L. reuteri NCIMB 30242 or placebo for nine weeks. Those taking the L. reuteri probiotic had a greater than 9% drop in total cholesterol and a drop in LDL cholesterol levels of over 11.5% compared with placebo. The ratio of apoB-100 to apoA-1 fell by 9% in the L. reuteri-supplemented group compared with placebo. The apoB-100:apoA-1 ratio is a strong predictor of cardiovascular risk, particularly in overweight and obese individuals.184,185 High-sensitivity C-reactive protein and fibrinogen, additional markers of cardiovascular risk, were also significantly reduced relative to placebo.186 Interestingly, later analyses of the results from this study identified two other attributes of L. reuteri: subjects taking the probiotic experienced general improvement in functional gastrointestinal symptoms187 and a significant increase in levels of vitamin D compared with placebo.188
Although the exact mechanism by which L. reuteri NCIMB 30242 improves lipid levels has not yet been fully characterized, it is known that intestinal microbes have a role in regulating cholesterol transport and metabolism, and this effect may in part depend on an ability to break down bile acids in the digestive tract.181,186 Bile acids have a close relationship with intestinal microbiota and help regulate cholesterol synthesis and lipid and glucose metabolism.189,190 By increasing bile acid breakdown and excretion, L. reuteri is thought to stimulate cholesterol-dependent bile acid production in the liver, removing cholesterol from circulation.190


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"AWARD WINNING REALTOR" Your Future is my Business. Working for the past 10 years as a Realtor / Broker within Newfoundland and Labrador, Holly Rideout started "Rideout Realty" which just celebrated 5 successful years in business recently expanding to include sales associates Lisa Carroll in St. Johns and Deanna Philpot Boyd in Lewisporte/ Twillingate . Holly specializes in the St. Johns marketplace offering her clients a wealth of knowledge , if you are an investor or a first time home buyer, you can be sure Holly will assist you with all aspects of the transaction! Our business is based solely on R and R, Repeat and Referral! As a co- worker and good friend quotes; a lot of your work comes from referrals and that is the "highest "compliment that can be paid to a Realtor. The reason Holly gets referrals is because she does not mind going that extra mile for the client. You do the research, you give the client choices and you direct them to the "best" purchase for them. That means the best buy for the client, not the best sale for the realtor! Holly states the most important factor in real estate to be successful, you cannot do it by yourself, and you need a team of key players around you. Holly has taken the time to build this network / team that includes mortgage brokers to address financial needs and prequalify clients, home inspectors who have the latest in technology, contractors to call upon when needed, Lawyers to handle the legalities of any transaction, so whatever the clients needs are it is only a matter of calling one of these contacts and the clients needs are met. That's what it is about putting the clients needs first, being a full service, full time agent. For me getting into real estate was a leap of faith, says Holly, after many years working within the travel industry, she was faced with the choice do what you always did or change and try something different. Holly states that there is no mystery to being successful in real estate, it takes a lot of hard work, days and nights in front of the computer, working 24/ 7. This business is face to face , one on one , and people have to trust and like you to invite you into there homes. Its personal and a lot of times your customers become your friends. I have learned that if I am honest with the client – if I take the time to understand their needs and what they realistically can get then it's going to be a win win for the client and for me. That's the kind of forthright approach to business that is earning holly a reputation in the real estate marketplace here. The company's slogan is "Your future is our business". Considering that the average Canadian will buy one or two homes in a lifetime, choosing the right Realtor can make a big difference in your life!
25 Kenmount Rd, St John's, NL, A1B 1W1
EXIT Realty in NL opened in November 2004 and it had been full steam ahead. Owner/Franchisee, Anne Squires, has been a very active REALTOR® with a prominent office in St. John's for over 25 years. Having earned many awards for sales excellence over the year, Anne just wanted something slightly different – EXIT was it! The main office on 25 Kenmnount Road has grown leaps and bounds, with 130+ REALTORS® now under the EXIT Banner. We now have been given the honor of holding the franchise rights for all Newfoundland and Labrador for Exit. With representatives now in Conception Bay South, Glovertown, Carbonear, Bay Roberts, Clarenville Corner Brook, and Happy Valley-Goosebay. We are on the road to expansion!
288 Lemarchant Rd, St John's, NL, A1E 1R2
rental, realty, property management, real estate
25 Kenmount Road, St John's, NL, A1B 1W1
Jimmy comes from a solid entrepreneurial background having spent a great majority of his youth working diligently in the family business. This invaluable upbringing not only encouraged his hard work and attention to detail, but also fostered the gift of appreciating the importance of quality customer service in today's marketplace. Coupled with his affable good nature and his unwavering desire to help others achieve their Real Estate dreams;Jimmy truly holds his clients needs as paramount through the entire Real Estate process. Please do not hesitate to contact Jimmy today to get started on the realization of YOUR personal aspirations!
175 Hamlyn ROAD, St John's, NL, A1E 5Z6
25 Kenmount Road, St John's, NL, A1B 1W1
Hello and Welcome to Exit Realty! With seven award winning years in the real estate industry combined with over 40 years of customer service and building relationships experience I am waiting to help you address your real estate needs. If you want to work with an experienced friendly realtor who brings maturity, energy, experience , expertise, honesty , personality, integrity, dedication and diligence and who has you as his priority then no need to look any further. I can assist you to address all you real estate needs .............whether buying or selling residential homes , condos , land, lots or acreages , commercial real estate and leasing .................I can get it done for you .......trouble free . Call me Joe Connors at 709 691 7449 for instant assistance...You will be happy you called!
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48 Kenmount Road, St John's, NL, A1B 2C7
EXIT Realty is revolutionizing the real estate industry for consumers and professionals alike. Thank you for allowing us to assist with all your real estate needs. Give us a call or visit our website for more information....
25 Kenmount Road, St John's, NL, A1B 1W1
Karen brings to her new career an extensive background in the private and public sector. Her experience as an Emergency and Operating Room nurse honed her skills to quickly evaluate and help resolve both medical and patient care concerns. Building on her ability to listen with discernment, Karen subsequently partnered with her husband in franchising two very successful insurance agencies for 18 years. Her role as Director of the companies included oversight of the business management including personnel, finance, advertising, and leasing. Karen offers a unique combination of skills to Exit Realty, grounded in sensitivity to the needs of a broad cross-section of individuals. Her clients will find her career background an excellent resource to pair their practical needs with their personal values and goals. No doubt they will also enjoy her relaxed but dedicated approach to get results, honed during the raising of her own four children plus five grandchildren! Please contact Karen directly at either her cell phone: (709) 325-3948 or her email: email@example.com
38 Duffy Place, St John's, NL, A1B 4M5
As a CENTURY 21® Real Estate professional, I am dedicated to providing you with the highest quality service possible. My personal knowledge of the local Real Estate market is combined with the power of the CENTURY 21 brand - the most recognized name in Real Estate today. Let me assist you in finding your dream home, in a neighbourhood that is right for you, and in the price range you want. Or if you are interested in selling a property, I also have the expertise to help you get the fastest sale possible and at the best price. I look forward to the opportunity of working for you!
Suite 102-12 Gleneyre, St John's, NL, A1A 2M7
Let me provide you with great customer service. I attribute many of my past successes to keeping the customer's concerns and interests first and foremost. I firmly believe that a satisfied client is a repeat client; it's about finding the right home that has the right fit. Growing up in St. John's, I have an extensive knowledge of the different areas of the metro region and the nuances that make each area unique. It is this keen awareness of the metro area that I find key to finding suitable homes for people on the go. The ability to locate properties that have easy access to work, schools, shopping and recreation play an important part in everyone's buying decision. Therefore, whether buying or selling please feel free to contact me today to ensure the utmost in quality client care. Put my sales experience and knowledge to work for you.
175 Hamlyn Rd, St John's, NL, A1E 5Z6
451 kenmount rd, St John's, NL, A1B 3P9
What is SETTING THE STAGE® ? It's two Realtors working together to give you the best possible real estate experience. My name is Dave O'Reilly and my real estate partner is Elizabeth Berghuis. We have known each other for over 20 years and we have business / marketing backgrounds and are passionate about what we do. Being a realtor is so rewarding as you meet new people everyday and strive to make our clients real estate experience the best!
25 Kenmount Road, St John's, NL, A1B 1W1
Who is Erica Coultas Kennedy? Why would you want to do business with her? It is simple really; she has a proven track record of success that has followed her throughout her business career. There are no fancy gimmicks or massive billboards and the chances of seeing her driving around town in the hottest cars is not likely. Erica is a regular person facing the same everyday challenges of the people she works for! From raising kids to building her real estate business her goals to give her all and be on top of her game has been her guiding light. Erica's goals are not to take over the real estate world but to ultimately provide to her family and those customers she has the fortune of representing. It is an easy formula; work hard get results! Is the person representing your business working for you or are they working for their own personal triumphs? Erica has worked with over 10, 000 families in her young business career and all of those customers came through word of mouth. She has a track record of putting her clients first and it clearly shows through her clients recommending her over and over again. Contact Erica today to discuss your needs!
81 Kenmount Rd, St John's, NL, A1B 4J8
Buy or sell with confidence When you're buying or selling a home, finding the right agent is half the battle.To ensure a good experience, you need to work with a professional who knows the area well and can help you negotiate the best possible price. First-class service and a worry-free move Thinking of selling? I will effectively market your home, and work around the clock to help you sell it quickly and profitably. Looking to buy? I'll help you find your dream home - and keep your budget and preferences in mind. I can help you: Learn about buying or selling before you begin Get organized Find a home in your price range Properly price your home Get in touch with a financing specialist Sell your home quickly and profitably Help you with all your closing details Get in touch with home-related suppliers And more!
95 Bonaventure Avenue, St John's, NL, A1B 2X5
We Know You Don't Sell Or Buy Real Estate, You Sell And Buy Homes. Never buy a home without your own representation. You may be better on your own, than have bad real estate representation. Some Real Estate Agents, work for themselves and the pay cheque. We're honest, straightforward and will know what we are talking about. Call us and find out. If you're here to invest and interested in making money in Newfoundland real estate, you have more options available to you than you think. When you buy a home or a condo for sale, you want information now and not tomorrow. That's why we can supply, you a trove of homes and condos available straight to your desktop and smartphone. Keeping you ahead of other buyer's, just like you.
12 Gleneyre St, St John's, NL, A1A 2M7
Please browse my website for listings, reports and important local real estate information. Your home is the biggest purchase of your lifetime and its more than just buying or selling a house, it's preparing your finances, learning the ins and outs of home buying and selling, educating yourself on new home construction, contractors, building supplies, home inspectors, lawyers. title searches, fees, taxes....I could go on. You need to be prepared for the next step in your life and I will make sure you are ready to go and I will support you every step of the way.Whether you are buying or selling a home, hire someone like me, who wants to earn your business. I invite you to contact me as I'd be happy to assist you with this important transaction.In addition, if you have any general questions about buying or selling real estate in Newfoundland and Labrador, please contact me as I'm more than willing to help.
161 Kenmount Road, St John's, NL
33 Pippy Place 2nd Floor, St John's, NL, A1B 3X2
Carolyn, a professional Realtor, brings her clients a wealth of experience. Identifying with buyers and sellers she is committed to top quality service, putting the needs of her clients first. I chose the field of real-estate because I love to help people achieve success. I am committed to bringing my life experience, love of people, empathy and expertise to help serve all my clients needs. If you are looking for enthusiastic, personal, dedicated and profesional service with all diligence and integrity, when representing and negotiating your best interests in today's marketplace, you've found your agent! IF YOU ARE THINKING ABOUT SELLING YOUR HOME, CALL CAROLYN FOR A FREE MARKET EVALUATION TODAY. GET LISTED GET SOLD.
146 Campbell Ave, St John's, NL, A1E 2Z8
Commercial and Residential Real Estate Sales, Leasing and Property Management, specializing in the management of condominiums, rental properties, commercial buildings and vacant properties ( we will protect your home or business while you vacation). From the first time home buyer to the seasoned investor, Burke Realty will protect you, and the value of your real estate investment. Buying or selling real estate? Looking to rent your property or have your rental property professionally managed? Considering a condominium? Start with a phone call to Burke Realty at 709-682-1118.
25 Kenmount road, St John's, NL, A1L 0A2
If you own real estate that you're thinking of selling, I would be happy to provide you with a FREE Home Evaluation. If you are buying please ask me about how you can get a mortgage with a 0% downpayment, if you are having trouble getting approved at your bank ask me about the benefits of using a qualified mortgage broker instead. In today's competitive real estate market, timing is everything. Many good homes are sold before they are ever advertised. Beat other homebuyers to the hottest new homes for sale in the metro region with my New Listings Notification.
As a CENTURY 21® Real Estate professional, I am dedicated to providing you with the highest quality service possible. My personal knowledge of the local Real Estate market is combined with the power of the CENTURY 21 brand - the most recognized name in Real Estate today. Let me assist you in finding your dream home, in a neighbourhood that is right for you, and in the price range you want. Or if you are interested in selling a property, I also have the expertise to help you get the fastest sale possible and at the best price. I look forward to the opportunity of working for you!
161 Casey St, St John's, NL, A1C 4X9
Installation And Servicing On All Types Of Res. Ventilation, H.R.A.I. Certified Installers; heat, building, caulking, interior, exterior, air sealing, insulation, ventilation; Energy Use Assessment
31 Peet St, St John's, NL, A1B 3W8
properties, property management, leasing, sales, home, service
Allow me to introduce myself. Allow me to be your realtor! I am in my 10th. year in the Real Estate business and equally as eager today as I was on day one! I am keen to offer utmost quality service combined with an extensive knowledge in residential...with extra emphasis in the field of new construction. Past clients have been extremely impressed with my real estate perfection, my attention to detail and my honest, down to earth approach. I am young, very adaptive to the newer technology, but have not missed an opportunity to learn from the best and really focus on what it takes to be a true professional in this industry. Competition is strong in this field...but show me a successful, demanding field where the best evade competition. If you are looking for someone to show you the ropes, represent you in a professional and ethical manner, then please...give me a call! I am energetic, on the ball, love what I do, and intend on making Real Estate my long term career please let me make you my long term client. Contact me today at 709-728-8912 or e-mail me at email@example.com In addition, if you have any general questions about buying or selling real estate in NL, Please contact me as I'm more than willing to help.
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Tuesday, October 7, 2008
New Red Mountain Music Christmas CD
Red Mountain Music, who I have written about previously, will be releasing a Christmas CD, entitled "Silent Night", this fall. You can view the track listing and sample all of the songs here. It sounds fantastic, and it appears that all of my favorite Christmas hymns have finally made it all on one CD. I'm pretty excited about it.
It will be released Oct. 20, but can be pre-ordered now.
Labels: Birmingham, Christmas, church, Music
1 comment:
- Grits said...
Those songs sound awesome. It's nice to hear that someone else likes traditional Christmas hymns, too!
- October 8, 2008 at 9:20 AM
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text: RT Book, Whole DB /z-wcorg/ DS http://worldcat.org ID 778074324 LA English T1 How the world was made : a Cherokee creation myth A1 Yasuda, Anita., Pennington, Mark,, PB Magic Wagon PP Minneapolis, MN YR 2013 SN 9781616418816 1616418818 AB "Cherokee myths and legends were an important way for customs, beliefs, and histories to be passed down orally through the generations. These myths often explain natural events. In this creation myth, the creation of Earth by the animals and insects is told. The Cherokee nature myth is retold in this brilliantly illustrated Native American myth."--Publisher description.


text:
Colligan: PleasantriesMature
Robin, Sekani and I spent weeks carefully assessing our options. Robin figured since Natch and the others seemed to trust him the most, he could claim he'd seen some zombies outside, which would solve our weapons issue. We'd lose the element of surprise with that plan, though, even if it was only a little. After all, if they were all tensed up and expecting a zombie attack, our own attack wouldn't be that much of a surprise. It was the best shot we had, though, and the numbers worked in our favour. All we had to do was inform the others.
We'd let everyone know what Sekani had told me, and what our plan of attack was, in pairs. Any more than four of us in a room together at one time might get the others suspicious. Sekani was still wary of getting Maria involved, but I was adamant we could trust her. She proved her point when we called her up by informing us that Grovesnor wasn't anything significant to her.
"He's good looking, but he's not my type" she'd said with a shrug. "If I can't have a little fun now, when can I? It's just sex, that's all"
We'd been about to track down Scott and Kat, when word reached us that Kat had shacked up with Rainer. Forgive me for making assumptions, but I instantly didn't trust her. Kat, more or less since the beginning, had looked out for herself an only herself. Once Pet turned up, she had the kid in her best interests. I didn't trust her not to rat us out to Natch and the others in the hopes they'd treat her and Pet nicely, or the diversion would at the very least give her and Pet time to escape. So we left Kat out. She knew nothing of our plan, nothing of what Natch and the others had done to the other survivors. I felt a little bad putting Pet at risk, but I just wasn't willing to risk Kat fucking everything up.
Eventually, the day we were launching our attack came. We waited til night, so the darkness outside would be on our side with Robin's zombie cover story. I'd been sat in the guard room with him, and I held my breath as Natch watched the screen, looking for signs of movement. Something did move, though whether it was a zombie or a stray cat, I couldn't tell, but it was enough to convince Natch.
"You and LT can handle one of them, right?" he'd asked, and we'd both nodded, getting to our feet an heading to the makeshift armoury once he'd handed us the key.
Once we were in, the others appeared, taking the guns they were most comfortable using. I did a quick headcount, and we were missing a couple people. There was no sign or Maria or Joe, but I didn't think too much of it at the time. Maybe I should have. Maybe things would've gone differently. The armoury was on the third floor, and from what we hoped, Natch and the others were still on the ground floor, which meant we'd have higher ground on our side if we were forced to retreat. Once everyone had their weapons, we made our way down, warning the few survivors that weren't on our side to stay in their apartments regardless of what they heard and that we'd sound the all clear when it was safe to come out again. We tested Kat's apartment, which was locked, as per usual, but didn't think much of it.
I'd ordered Rae to stay behind with Riley, who had set up a makeshift clinic in case anyone got injured. I guess you could call it favouritism, but I didn't want her getting hurt. I didn't want to put her at risk. So, with Sekani at my side, and Robin and Scott behind us, we made our way down to the lobby. Panic flared through me when we only came across Natch.
"Well, well, it took you boys long enough" Natch chuckled.
He had something in his hand, though I couldn't see what.
"Don't think I didn't know Spitfire'd go running to you first chance he got. But y'see, I like it here, and I'm not willing to give it up so easily"
"You're outnumbered and outgunned, Natch. We can do this the easy way or the hard way" I said, aiming my rifle at him, while the others followed suit.
"I guess it's gonna have to be the hard way, LT. If I can't have this place, no one can" Natch said, and I finally saw what he had in his hand.
"Grenade!" I yelled, and the four of us ran to the stairwell.
We barely made it before the explosion, but instead of the walls buckling like we'd expected, all we heard instead was a wet squelch. We made our way cautiously back into the lobby, and I heard Scott throwing up behind us. Natch was… Natch was splattered across the walls, blood and pieces of mangled flesh sliding down towards the floor. Through the blood, the walls seemed in good enough shape, but the explosion had shattered the windows, and left a dark burn mark on the floor where Natch had been standing.
"Where the fuck are the other two?" Sekani asked, storming into the communal kitchen.
"More importantly, how the fuck did he know?" Robin demanded.
"I knew we couldn't trust that bitch" Sekani spat.
"What makes you think it was Maria?" I asked defensively.
"Do you see her here?"
"No, but-"
"Exactly! You were so adamant we could trust her, and look how it fucking turned out"
"We don't know it was her, now calm the fuck down before I punch your lights out" Robin threatened.
The two of them squared up to each other, and I pushed in between them. "We can fight about this later, right now we need to find the other two. I hate to say it, but our best leads are Kat and Maria"
The four of us raced up to the third floor, finding Kat and Rainer outside Rae's shop, with a scared looking Pet.
"What the hell is going on?" Kat yelled.
"Did something get in, or did Robin try to cook?" Rainer chuckled.
I ignored Kat, my fist colliding with Rainer's jaw.
"What the hell?" I heard Kat yell.
"Did you rat us out?" I asked.
"What?" Kat questioned, frowning. "Rat what out?"
"I told you it was her" Sekani said, meaning Maria.
"And I told you to shut it" Robin said threateningly.
"Have I missed something?" Rainer asked and I punched him again.
"Your little games over, you sick fuck" I spat.
"Games?" I heard Kat question, confusion thick in her voice.
Rainer chuckled. "How long did it take him to tell you?" he asked, glancing at Sekani.
"Too long. Now, you have two options; go quietly, or go filled with lead"
"How about neither?" he said smugly and I glared at him.
"Will someone tell me what the hell is going?" Kat yelled.
"Your boyfriend here killed everyone I knew" Sekani said bitterly, not looking away from Rainer, who simply rolled his eyes.
"What…?" Kat said.
"Back in Washington. They rolled in, three trucks loaded up with supplies, just like they did this time, took charge and killed everyone when they got bored"
"Everyone…" she said, holding Pet tighter.
"They killed the men first, had their fill of the women, and killed the children for sport. I watched them shoot my daughter at point blank range in the back of the head for losing a game of Chinese whispers"
I glanced at Sekani. He hadn't said he had a daughter. In fact he'd been completely the opposite; he'd said he barely remembered any of the kids' names.
"You shot… children?" Kat asked, looking at Rainer, her hand resting on her stomach for some reason.
"That was Natch's area of expertise, but yeah. And I enjoyed it, too" Rainer said smugly.
"Were you going to do that to Pet? I'm gonna cut you into pieces, you monster!"
"Cut me to pieces and there won't be anyone to call off my guard dog" Rainer smirked.
Kat pushed her way past me, leaning back to kick Rainer's face, but he caught her ankle in a tight grip. Kat tugged out her gun, aiming it at him, but her hand was shaking.
"Kat, stand down" I ordered.
"You told me all those things... Were they lies?" Kat asked Rainer, ignoring me.
"No" Rainer said, and Kat lowered her gun.
"Then... Why...?"
"Why what?"
"You can't say you enjoy killing kids, and then say your words weren't lies"
"They were brats. Annoying, little brats," Rainer said, turning to Sekani, "Especially your kid. It was her own fault Natch shot her, she wouldn't stop crying"
"I'm going to tear you limb from limb" Sekani roared, and Robin held him back.
"They're children! How could you hold this from me knowing I'm-" Kat said, stopping short. She was what?
"With ease" Rainer said simply.
Pet tugged on my sleeve, and I looked away from Rainer briefly, not wanting to give him an opportunity to get away without telling us where Grovesnor was. I vaguely heard Kat hurl an insult at Rainer, and Pet tugged me down to her level.
"She's pregnant and it's not Rainer's" Pet whispered in my ear and I froze.
"Do whatever you want with him" Kat said, taking Pet's hand and walking off.
I wanted to stop her, and ask her about what Pet had said, but now wasn't the time. I turned back to Rainer, getting to my feet as he smirked at me.
"Where's Grovesnor?" I asked.
"He's hidden away somewhere with his lady"
I repeated my question after punching him again, splitting his lip, a dark purple mark starting to show on his jaw. It took another half hour before we finally got the information out of him. Kat had given Rainer a spare key for the apartment, though where she'd found it I had no idea, and he'd slipped it to Grovesnor when Natch had gotten wind of our plan. Rainer had been left in charge of distracting Kat long enough for Grovesnor to lock himself in her apartment with Maria, but Rainer wouldn't say why.
"Robin, don't let him out of your sight. If he tries anything, shoot him" I said and Robin nodded.
Sekani and Scotto followed me as we tried to find Kat, eventually finding her sat with Rae in Riley's clinic. The both of them looked up as we walked in, but we'd wasted enough time as it was. Pleasantries would have to wait til later.


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France Wedding at Le Moulin Brégeon from Poppies & MeFrance is magic. Pure magic. So getting married there just seems like the most romantic way to say I do. It also makes me a tad bit envious of gorgeous couples like this one lucky enough to host their wedding
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Hi! I'm Eileen.
I am a New York City-based independent writer and journalist, outdoor adventurer, and recovering entrepreneur.
My work explores how our connection to place and culture shapes our beliefs, identity, and behavior in the modern world. I write about these topics, and their intersections with technology, business, and policy for The New York Times, Nikkei Asian Review, and the World Economic Forum, among others.
And, as often as I can, I also write about food, climbing, and travel.


text:
In his book What's So Great About Christianity?, Dinesh D'Souza discusses the explosive growth of what he calls "Traditional Christianity" (which he acknowledges is the same concept as C.S. Lewis called "mere Christianity" in his book by the same name) in much of the world. He compares it to the withdrawal that he sees in the mainstream churches in America which are rapidly shrinking. In the course of this discussion, he sets forth a quote that I found both interesting and accurate which I would like to share.
Here in the West, there are lots of liberal Christians. Some of them have assumed a kind of reverse mission: instead of being the church's missionaries to the world, they have become the world's missionaries to the church. They devote their moral energies to trying to make the church more democratic, to assure equal rights for women, to legitimize homosexual marriage, and so on. A small but influential segment of liberal Christianity rejects all the central doctrines of Christianity. H. Richard Hiebuhr famously summed up their credo: "A God without wrath brought men without sin into a kingdom without judgement through the ministrations of a Christ without a cross."
I have met liberal Christians who are good and sincere people. But their version of Christianity is retreating, in two senses. Liberal Christians are distinguished by how much intellectual and moral ground they concede to the adversaries of Christianity: "Granted, no rational person today can believe in miracles, but..." "True, the Old Testament God seems a mighty vengeful fellow, but..." "Admittedly religion is responsible for most of the conflict and oppression in history, but..."
This yes-but Christianity in full intellectual withdrawal, and it is also becoming less relevant. * * *
Unfortunately, the central themes of some of the liberal churches have become indistinguishable from those of the American Civil Liberties Union, the national Organization for Women, and the homosexual rights movement. Why listen to Episcopal bishop John Shelby Spong drone on when you can get the same message and much more interesting visuals at San Francisco's gay pride parade?
Having left a mainstream church where my views, which are clearly more in line with what D'Souza refers to as "traditional Christianity", had been marginalized, I can definitely see what he is saying. Christ's church is supposed to stand for the truths of God that are set forth in the Word of God. Yet, too many Christians attempt to bring the world's ideas of morality into the church under the guise of merely "trying to understand the original intention" better.
These mainline churches, whose pews are now largely empty, are paying the price for trying to maintain a semblance of Christianity while really preaching the anti-Gospel of the world.


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The GreenhoodMature
Narrator: Carmelina Blaze
The Second DeFlèche Tome rests in the bottom of my backpack, heavier than any school textbook, and infinitely more valuable. Lugging my pack, I stroll into the cafeteria and place it on the table with a sigh.
My cousin, Adrian, is following me. He's filling me in on the incident that occurred at the beginning of first period. I stopped listening when he got carried away describing the sensations he felt, but now I'm trying to focus once more.
"There's one thing left hanging - something that shouldn't be," he tells me.
I scowl. "Jake's 'nads?"
He rolls his eyes. "Yes, those too." He pauses to look at me with firm eye contact. Adrian, or Arrow as most call him, is now more serious than ever. "Blaze, there is a sixth empowered one present at the school today."
I frowned, "There's a fifth?"
"Luna," he says the word with such admiration.
"Oh, right." I blush at my slow uptake.
The four of us and a teaching assistant. We'd detected her presence a month ago, and kept our distance for a few weeks. Then, we found out she was no threat to us. Just an exhiled citizen of the Arcane Duchy.
But I'm still confused about this sixth.
"Is this one from Duchy?" I ask.
"How would I know? It's when I got pushed over coming into class. Definitely supernatural, and definitely the short, hooded student I saw," Arrow says, his voice now edgy.
"Hmmm," I ponder aloud.
"Is Jake in line getting you food?" Arrow asks.
I nod, "He better be. And at the back of the line, too, 'cause I don't want to look at him just yet."
He tilts his head so that his rich, coppery bangs hang straight down over his eyes. The rest of his hair, however, is considerably shorter. The piercing in his left eyebrow is obscured in shadow, marked only by tiny, dull arrowheads. He glances down at the clenched fist I'm holding against the table.
"Duchy," I remind him.
"Right. Well, Duchians can't step on American soil, legally, without a permit," Arrow says.
"Wrong," I tell him. I remain thankful that nobody is sitting close enough to hear the specifics of our conversation. The background noise of the other students is heavy enough to obscure our odd conversation. "Most American soil, and yes some Canadian soil, is the same land occupied by the Arcane Duchy's border. Duchians walk it all the time, whenever they please. After all, it's theirs. As long as they don't phase into the central realm, where magic is scarce, they aren't violating any laws."
The central realm makes up the world as most know it, as the easily perceivable seven billion people living on the planet do. However, there's an estimated nine hundred million that live in obscurity, in the supernatural crevices and alternate fragments of the world that are hidden within reach.
"Right. But you knew what I meant!"
"Pffft," I pfft. "My mum wouldn't accept an answer like that from you!"
Arrow sighs, collapsing onto the cafeteria table. Then he perks up, "Where's Luna?"
I shrug. "Dunno. Do you remember anything more about your attacker?"
"Seemed young. Tanned skin. Dark features. Green windbreaker. Hooded."
"The hood was green?!" I ask.
"Yeah, why?" he sits up.
I pull my backpack off the floor and onto the table, and quickly open the zipper and begin to remove the Second DeFlèche Tome. "The Greenhoods. They're descended partly from a tribe of arcane Aboriginals, and some Duchian traitors. Not unlike the half-French half-Aboriginal Métis of the central realm. The First Tome has more on them, let's see." I begin to flip through the massive text.
Arrow gets nervous, because we're not supposed to have the Tomes out in front of people so casually. We usually go outside to look at it during school.
"Look here," I pass him the book. There's half a page on their suspected range, and then it ends abruptly at the bottom of the page.
He skims it. Pretty fast, considering the English used isn't entirely modern. Most of it is useless information. And then he points at the page numbers. 1104 and 1127. "Uggh... it looks as if -"
We exchange foreboding glances.
I do the math.
"Twenty-three missing pages," I say with a whistle.
He shakes his head. "Something tells me this Greenhood business goes back to Aunt Eleanor's day!"
I nod.
Then, Arrow stirs from his reverie and slams the massive book shut as if he has sensed something suddenly. Then he turns in his chair with a smile.
"There you are!" says Luna, as she approaches with Skyla in tow.


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Most of the characters and situations in this story belong to Alliance Atlantis, CBS, Anthony Zuicker and other entities, and I do not have permission to borrow them; most of the others are mine, and if you want to borrow them, you have to ask me first. No infringement is intended in any way, and this story is not for profit. Any errors are mine, all mine, no you can't have any.
Spoilers: through "No Humans Involved".
Note: Clichés four, five, twelve, and forty-seven, but I've always wanted to write one of these. Rating may change later. Thanks yet again to Cincoflex, who never fails to be wonderfully encouraging, and who thought of the title.
It was a bit ironic, doing the research in the middle of everybody, digging up secrets she'd kept for a long time. But no one was paying the least bit of attention. The boys were talking in the breakroom, Catherine was busy, and Grissom--
She looked over, and saw Grissom talking to Sofia. Letting Sofia perch on the edge of his desk and invade his personal space. Smiling at her.
It made Sara angry, and it made her tired. She started her search query and looked back again, and this time Grissom looked up and saw her watching him.
Even at that distance she saw a faint flush tinge his face. He said something to Sofia and stood, and Sofia slid off the edge of the desk; they exchanged a few more words before she turned and left. Sara went back to her research.
He appeared on the edge of her vision a few minutes later, waiting for her to acknowledge him and finally sighing when she didn't. "Sara, it's not what it looks like."
"You don't have to explain anything to me." She didn't lift her eyes from the screen.
"I don't..." He trailed off, and she didn't move, didn't even blink. "It wasn't my idea."
A bitter, impish impulse hit her. "I didn't say anything, Grissom, but I suppose I'd have to go with the evidence."
Her peripheral vision was good. He was blinking, obviously struggling to articulate something. "It's...circumstantial at best."
"Better than hearsay." She didn't bother to look at him, instead clicking on another link on the computer screen. "Sure feels like shit, doesn't it, boss?"
She could almost feel the shock. He stared at her for another long moment, then apparently lost whatever battle he'd been waging, because he just sighed and walked away.
She didn't watch him go.
Out of all of it, the most annoying thing was the constant trickle of water coming in the broken window. Blip, blip, never quite regular enough for him to expect it, but each chilly splash was its own little irritation on his scorched cheek. Almost enough to make him mad.
Except, it was also a distraction from worse things, and he was already mad. Also upset, in pain, freezing cold, and scared. Very scared.
Get a grip, Stokes. Panicking won't help anything and it will make things worse. He shuddered, and tried yet again to free himself from his restraint, but he didn't have enough leverage.
Plus, his shoulder hurt like crazy, and pushing only made stars go off in the corners of his eyes.
What a laugh. I'm soaking wet in the middle of the desert and what should have been a lifesaver may kill me yet. Though that wasn't quite fair--if he hadn't been wearing his seatbelt, he would be very messily dead.
Nick relaxed as much as he could, which wasn't much, and tried again. "Sara?"
This time, he was rewarded. A groan filtered up from the space below him. "Sara, talk to me, sugar."
"Nick?" Her voice was slurred, but she was awake. He thanked God silently.
"It's me, all right. How do you feel?"
He couldn't see her down there; he couldn't see much of anything, in fact. The SUV's headlights were out, and there wasn't anything around to give off light. But he heard her stir, and suck in a breath that ended in a cough. "Like hell."
"Join the club." He pushed once more against the belt, but his right foot was held in the collapsed space that had held the SUV's pedals, and he'd scrabbled and struggled and he just couldn't get free. Fortunately for him, his foot didn't seem to be too badly injured--just caught. But that was plenty.
"Do you remember what happened?"
Another groan. "Sort of."
"Can you move? I'm kind of--stuck."
"I don't know, give me a minute." Her voice was strained, and Nick knew she had to be hurt too. There was a rustle of cloth, a rattle, and a grunt. "Uh...no."
Nick frowned into the dark, trying to figure out how she might be pinned. "Is there something on top of you?"
"Besides you?" There was just a hint of humor in her tone. "I'm...not stuck, Nick."
He was cold, and stressed, and that took a few seconds to process. When it did, he swallowed hard. "How bad is it?"
"I don't know." And somehow he knew that was half a lie. "But let's just say I'm gonna be stuck in the lab for a while if we get out of this."
"When we get out of this," he corrected immediately, denying Murphy and all his kin. "Grissom's going to miss us pretty soon, if he hasn't already."
A faint "Ya think?" was all he got. Nick shuddered at the cold and her sarcasm, and suddenly, absurdly, found himself thinking of the lights in the lab and wondering why they never seemed to get fixed.
Focus, man. Remember what happened.
He patterned it out in his head. Catherine had lent him to the night shift because both Greg and Sophia were out with the flu; it had felt nice but weird to be back, there'd been too much change lately, little of it good.
A mountain crime scene, and he and Sara summoned to it; driving into heavy rain; Sara calling Grissom for more specific directions; rounding the curve in the darkness, a slope up one side and a slope down on the other...
...And the rush and rumble of the hillside above them giving way, overburdened with rain.
Nick remembered the vibrations as the SUV's tires skidded sideways across the tarmac, and the dreadful slow tip over the edge, but the tumble was scarcely more than a racket of sound in his head--the crush of metal and glass, the slam of the vehicle as it rolled over and over, his own voice shouting some furious swearword. When the falling stopped, there had been a breath's worth of silence, and then--with timing a Vegas performer would envy--the airbag had activated in his face.
That, out of all the jolts, had made him lose consciousness, though he didn't think he'd been out for more than thirty seconds or so. He'd woken to rain, darkness, and a left shoulder that was a mass of pain; he must have hit it against the door at least once. His right hand was caught underneath his seatbelt and going numb.
His cheek stung and his mouth tasted of blood, thanks to the airbag, and he was half-dangling over the passenger seat. He didn't know how long it had taken for Sara to wake up, but he did know it was much longer than he liked. He could smell raw mud and the sharp green of damaged vegetation, mixed with the reek from the mangled engine, and counted his blessings that the vehicle hadn't caught on fire. Yet, anyway. And then cursed himself for the thought.
"Sara, sweetheart, can you reach your phone or your flashlight or anything?" The fact that she hadn't done so already alarmed him; normally she would be the first to try to better their situation.
Another rustle. "My light's...I can't reach it. I don't know where my phone is."
That's right, he remembered now that she'd been talking to Grissom when they'd slid off the road. It was probably lost somewhere in the mudslide.
This isn't good.
At least Sara was wearing her jacket, he distinctly remembered her zipping it up as they left the lab. His own was twisted around him, but he was grateful for its warmth. Though it won't be enough, eventually. It wasn't freezing, and wasn't likely to drop that far, but it was plenty cold enough to kill them both eventually if they didn't get help.
Of course, his injuries weren't that severe, as far as he could tell. He'd probably survive longer than Sara, he'd get to listen to her breathing slow down and stop--
Nick shook his head violently, ignoring the pain it brought. "Well, there's no way I can reach mine." It was lodged behind his right hip. "Don't suppose you could reach up here?"
Sara sighed in the darkness. "I don't think so, Nick."
He bit his lip. He remembered plenty of emergency first aid, but it was all useless at the moment. All he could do was try to keep them both from slipping into shock. "Tell me where it hurts."
A sniff, as though she would have snorted if she'd had the strength. "What, you're a doctor now, Stokes?"
"Closest thing we've got," he joked. "Unless you attended the last safety seminar. Which I know you didn't."
"I was working," she retorted. "Hot case."
"They're all hot to you. Answer the question, Sar."
"Ugh. I hurt all over. How about you?"
"Quit being evasive."
"Answer me and I'll answer you."
"Fine." He sighed. "I think I've got a busted shoulder, and I can't feel my right hand, but other than that I'm just banged up. Your turn."
Fear drove his words, made them harsh. "Tell me, Sara. Hiding it won't help anything."
She grunted. "Broken ribs," she said after a moment. "There's something sharp poking into my right arm. My head's bleeding. That enough for you?"
"Is that all?" he countered sternly.
A little silence, and then-- "I'm losing body heat kind of fast, Nick. I'm lying in a puddle here."
His mind raced helplessly over the implications. Rapid loss of body heat could indicate external bleeding from something besides a head wound. Not to mention, internal bleeding was a distinct possibility with broken ribs.
He said the only thing he could think of. "They'll find us soon."
She breathed out, a ghost of a chuckle. "Depends. Grissom has to notice first."
"You think he won't?"
"You know how he gets at a crime scene."
"He's not that bad." If nothing else, Nick knew, Grissom would notice when he wanted someone for a specific task. "Keep talking to me. We have to stay alert."
"Speak for yourself."
He chuckled at her tone, though it hurt his shoulder. "Aw, c'mon, don't go to sleep and leave me here all by my lonesome."
He couldn't see her at all, but he got the feeling she was smiling. "CSI Level Three Nicky Stokes, afraid of the dark?"
He clicked his tongue. "You guessed my secret."
"Don't worry. I'm good at keeping 'em." Her voice was a little fainter, and alarm ran down his spine.
"Grissom'll notice," he said firmly, and remembered. "Heck, you were on the phone with him when we crashed. He'd notice that."
Sara groaned a little. "I lost the phone when we started to slide, Nick. It probably shut off. He'll just think we lost the signal."
"But you didn't call back," he pointed out, wishing again that the rain would stop dripping on him.
"He's probably relieved," she muttered sourly.
"Hey now. Don't go getting all maudlin on me."
"Oh, please." There was anger in her voice now, and inwardly Nick cheered it; anger would keep her alert longer. If it took poking at her sore spot to keep her angry, he would do it. "This is logic."
"Logic? You'll have to explain that one to me, sugar, I'm feeling a little slow tonight."
Another sigh. "Nick, you may have gone to swing, but don't tell me you didn't notice before."
"Hey," he interrupted, not having to feign a flash of temper. "We didn't go to swing, we got moved there. Nobody asked us."
She was silent for a moment, and the fact that she didn't snap right back at him cooled his anger with a wash of fear. "Yeah. Sorry."
Shame trickled through him. "Me too."
"What's it like?" she asked, and he grimaced unseen.
"Weird. Not bad weird, just weird weird. Cath's still jumpy, but I think she'll be a good supervisor when she settles down. But we miss you guys."
"I miss you too," Sara answered, and Nick winced a little at the pronoun. He heard her move slightly, and it was a splashy sound.
"How's the head?"
"Still bleeding."
He worked his ankle in tiny circles, trying yet again to figure out an angle to pull it free. "You sure it's not just the rain?"
"Rain's cold, Nick. Blood's warm."
"Oh." He bit his lip, and winced. Okay, genius, not when you've got a burned face. "So what are you going to do with the vacation we'll get after this?" He tried to sound cheerful.
"Stay warm," she returned, and he remembered anew how much she hated the cold. "Maybe look for another job."
Dismay had his lips parting. "You're thinking of leaving?"
She gave that faint chuckle. "I should have left long ago."
"C'mon, Sar, the shift thing'll settle down soon--"
"Give me a break, Nick." Her voice was hard. "This has nothing to do with that." She made another sound, one that was muffled but that still made his stomach twist, and when she spoke again her voice was noticeably weaker. "I should never have come. Or I should have gone right home again after I was done."
"I thought you liked it here." He had no trouble understanding her, and he couldn't keep the pain from his voice, though he tried.
"I did," she answered, as though trying to reassure him. "Once. Not anymore."
He was starting to get angry again. "It's Grissom's fault, isn't it?"
Another splash. "Not really, Nick. Or only partly. I did most of this to myself." She laughed without humor, and coughed.
"Sara, hold still!"
"I'm wet," she complained hoarsely.
"Live with it. What did you do to yourself?"
"Oh, let's see," she muttered. "Chased a guy for three years. Had him turn me down flat. Had one of my best friends use me. Found out my boyfriend was cheating on me. Nearly got blown up. Found out the guy I've been chasing cares about me, but not enough. Got turned down for a promotion. Got pulled over on a DUI." She coughed again. "Then the team I work with gets broken up, so there's nobody left to notice when I'm having a hard time. The guy I've been chasing turns out to be interested in the new girl. Everything's going to hell in a handbasket, and then I fall over a cliff and I'm lying in a puddle freezing while you ask me stupid questions "
Nick's head spun at her words, and he could feel his throat getting tight. I knew she was having a bad time...but... He wanted to apologize for all of them--he wanted to be able to give her the hug she deserved, to offer her comfort in the best way he knew. But there were more immediate concerns. Keep her mad, remember?
He made his voice harsh. "How're we supposed to notice, Sara? You never let anyone in anymore."
A longer silence, and it started to scare him; just as he was about to say her name, she broke it.
"You know what, Nick? It doesn't matter." She didn't sound angry; she just sounded weary. "None of it matters anymore. I give up. I can't advance professionally and I can't win personally."
Her voice was quieter. "No more brick walls, Nick. Grissom called me here, and all I've done since is make myself miserable. Gonna quit."
"Sara! Stop it." Panic was biting at him again.
One more ghost-chuckle. "Maybe I'll go work for the FBI. Or maybe I'll just go to sleep here."
"Sara, sugar, don't do this. Stay awake. You have to stay awake."
"Says who?" Softer still. "Damn Grissom anyway, for making me love him."
Nick seized on that with a desperate grip. "What'll it do to him if you die here, Sara, tell me that? You know he--cares about you."
"Does not. Prefers blondes." Her words were slurring a little.
"It'll destroy him to lose you."
"No it won't." She mumbled something he couldn't quite catch. "I'm cold, Nick."
"So'm I, Sara, stay with me!"
Another mumble. "Say that again, sugar, I didn't hear you."
"I'm here, Sara. Talk to me."
Her voice was almost inaudible now. "Take care of them, okay? Take care of him."
"Sara, don't!"
There was no answer.
His tears were scorching his cheeks. He didn't know how many times he called her name, begging her to answer, commanding her, without response. It seemed like forever before lights shone down from above, before voices shouted and bodies came sliding down the hill. He winced at the flashlight beams that pierced the broken windshield and caught on his face; one voice he didn't recognize, but the other was familiar. "Nick? Sara?"
"We're here," he shouted, seeing little besides the jumping lights until two forms rounded the crumpled SUV. A state trooper, and Grissom, both streaked with mud. "She needs help, you have to get her out!"
Somebody moaned, and someone else swore, and he didn't know which of any of them it was. Then they shone the lights down below him, and he looked, and he knew it was him swearing this time.
Sara lay on her side, still belted in, the shattered glass of the side window covered by a muddy puddle that had an ominous scarlet tint. Her hair was matted with blood and her lips were blue-tinged and red-smeared.
And she didn't move.
His thoughts started to come unraveled as more people appeared and the thunder of a helicopter approached.
"Get her out first!" he protested, as hands took hold of him and lifted. "Let me go, I can wait--"
"Nick, relax and let them help you." Grissom's voice was strained. "They can't move her until they move you."
He grunted in pain. "My foot's stuck."
There were long minutes of delay, discussion, and he wanted to scream at them. One of the troopers began carefully knocking out the remaining glass of the windshield, and as soon as he was done an EMT knelt in the mud outside, leaning in over Sara's still form. He blocked Nick's view, but it didn't matter as long as she was getting care--
He was starting to lose it. His awareness kept fading in and out, even though Grissom kept talking to him in that soft urgent voice. He couldn't concentrate. Then they brought in something that looked like a small chainsaw, and he was vaguely impressed at how low the EMT could crouch, and how the guy managed to ignore the racket just above his head as someone else cut through the tangle holding Nick's foot captive.
They lifted him free, telling him not to move, to let them do all the work. He recognized the stretcher they were strapping him on, and struggled a little, afraid that the chopper would leave too soon. "Sara," he pleaded, looking for understanding in the all-business faces above him. "We can't go without her--"
Grissom was there again, his face drawn, glancing back over his shoulder. "They won't leave without her, Nick. Just relax. Let them take care of you."
"I tried to keep her awake," Nick managed, trying to tell someone. "I tried."
"I know." Grissom's hand was warm on his head, the only part of him not covered. "I know you did."
He vanished, and there was no one left but strangers, talking over Nick like he wasn't even there. At least he was starting to get warm.
Then the helicopter roared, and he flew.
See Chapter 2