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|June 8, 2011
Volume 13, Issue 12
|Midwifery Today E-News
"International Edition"
Print Page
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In This Week's Issue
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Quote of the Week
A "no" uttered from the deepest conviction is better and greater than a "yes" merely uttered to please, or what is worse, to avoid trouble.
— Mahatma Gandhi
Are you enjoying your copy of Midwifery Today E-News? Then show your support and get more content by subscribing to our quarterly print magazine, Midwifery Today. Subscribe here.
The Art of Midwifery
When a baby's shoulders are stuck, have the mom stand up and squat. Usually, just getting up will twist the body enough to readjust the neonate's body. Ask the mom to lift her shoulders, one side at a time, while an assistant gives suprapubic pressure (cupped hands together, knife-like and standing behind the mom). The midwife catches the baby. Gravity, twisting and suprapubic pressure usually brings the baby out right away.
— Faith Heise
ALL BIRTH PRACTITIONERS: The techniques you've perfected over months and years of practice are valuable lessons for others to learn! Share them with E-News readers by sending them to firstname.lastname@example.com.
Send submissions, inquiries, and responses to newsletter items to: email@example.com.
Subscribe to the Web Updates RSS feed to stay on top of what's new or highlighted on the Midwifery Today Web site. Be alerted when conference programs go online, new articles are posted and more.
Jan's Corner
Global Midwifery Council
I have been blessed with many international connections, as well as the ability to travel around the world for Midwifery Today conferences. As far as midwifery and birth are concerned, the situation everywhere is desperate and deteriorating. It is incredibly important for each one of us to do whatever we can to reverse this trend. Motherbaby deserves better. For the past 25 years, writers for Midwifery Today magazine have shared news and information from all over the world. Through conferences, we have met thousands of excellent but struggling midwives. The possibility of a miracle birth for every motherbaby is the goal. The health, and possibly even the survival, of people depend on what we do or don't do now. This is why the Global Midwifery Council (GMC) was birthed.
Amazing things happen when we meet in Russia, and it was during the joint Midwifery Today/Domashniy Rebenok conference in Russia last year that GMC was born. We have a great group of women working on goals, definitions and NGO status for the organization. The GMC's primary goal is to fight for the human rights of every birthing mother and baby. International training, recognition of family-centered midwifery, preserving and encouraging traditional midwifery, separating midwifery from the medical hierarchical model and giving an international voice to those who already work so hard and need recognition are among the GMC's many other goals. We plan to help the people of every country who ask for help with midwifery or birth.
One of the ideas we are working on is a "situation room." My mentor, Marion Toepke McLean, put forth that idea when we were having intense GMC meetings during the Eugene conference. In our situation room, probably a virtual one, we will keep files on the situation of midwifery and birth in every country we learn about. In looking at what we have been doing with Midwifery Today, Wanda, our fabulous Web mistress, and I realized that the GMC has a great start with Midwifery Today's Web site and magazine. We already have links to many countries' resources and an extensive list of country contacts. If someone is looking for a midwife, traveling and wanting to meet other midwives or has other needs, we may have a point of contact. (We are always looking for more contacts, so please volunteer if you are available and philosophically aligned with us.) Midwifery Today's International Alliance of Midwives page includes a definition for midwife and goals, as well as a statement on autonomy by Robbie Davis-Floyd (/iam/).
Our e-mail boxes are filled with ideas and communication as we outline the GMC's goals. If you have ideas please e-mail me at firstname.lastname@example.com and share them. We are a fledgling organization but we are strong and determined to change birth for the better!
— Jan Tritten, mother of Midwifery Today
Jan Tritten is the founder, editor-in-chief and mother of Midwifery Today magazine. She became a midwife in 1977 after the amazing homebirth of her second daughter. Her mission is to make loving midwifery care the norm for birthing women and their babies throughout the world. Meet Jan at our conferences around the world, or join her online, as she works to transform birth practices around the world.
Jan on Twitter: twitter.com/jantritten
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News and Research
Midwife Training Reduces Infant Death Rate
A study recently published in the journal Pediatrics concludes that basic training for midwives saves infants' lives, and is cost-effective.
A Zambian pilot project, costing just over $20,000, taught midwives basic skills such as warming and cleaning a newborn, facilitating breastfeeding, diagnosing common illnesses and newborn resuscitation.
Statistics comparing the infant death rate prior to and after the training found that the first-week death rate of newborns decreased significantly after the training, to nearly half the previous rate. Read the full study here: http://pediatrics.aappublications.org/content/127/5/e1176.abstract
— McNeil, D. Jr. 2010. "Infant deaths drop after midwives undergo inexpensive training." New York Times. May 9.
Featured Article
International Updates
Editor's Note: Midwifery Today maintains a list of country contacts who serve as birth and midwifery liaisons in their communities. For this international issue of E-News, we bring you updates from our contacts in Kuwait, Uganda, the Dominican Republic, France and Argentina.
It is my pleasure to inform you about the establishment of a new, volunteer-run organization: BirthKuwait. The mission of BirthKuwait is to provide evidence-based information and resources to a) help women in Kuwait have positive, healthy and safe births, b) empower women to advocate for improved maternity services and c) increase transparency in maternity services through the creation of a central, information-based Web site, an online birth survey and new training opportunities for doulas, lactation consultants and childbirth educators.
For a full report on the first meeting of BirthKuwait, visit: http://midwiferyinkuwait.blogspot.com/2011/05/meeting-birth-kuwait-may-5th-2011_09.html
— Zuzana Nadova
Birth Control and Male Involvement in Uganda
It has come to everyone's notice that birth control is one of the most sensitive and difficult issues in Uganda. The country has one of the highest population growth rates in Africa, with an average of over six children per woman. The total population of Uganda is estimated at 32 million, and at the current rate of growth could double in a matter of decades.
There is a deeply embedded attitude that having many children is a good thing. It seems pragmatic—children look after you when you are old, and since some children die, you need plenty to ensure a few outlive you. Producing many children is considered essential to one's identity.
The White Ribbon Alliance in Uganda, with support from many members, is working tooth and nail to put the message about safe birth across. If we could pull more men aboard the campaign, it would make a difference.
In Uganda, maternal mortality has fallen from 506 to 425 per 100,000 live births. Although there is an outcry for births to be attended by qualified health workers, some women still prefer traditional midwives who are within easy reach. The challenge is that traditional midwives prefer to use local herbs that are not measurable and are dangerous to the fetus. Though it is believed that local herbs ease pain during labour and make birth faster, complications to both the mother and the baby may not be noticed until it is too late.
We have a lot to achieve and the United Nation's Millennium Development Goals may be left unaccomplished unless we involve male spouses to help prevent unwanted pregnancies and promote safe birth.
— Kezaabu Edwidge
Experiences in the Dominican Republic
I am a licensed midwife from the state of South Carolina; I have been bringing student midwives and doulas from my online course (http://midwifetobe.com ), as well as others who want more experience, down to the Dominican Republic a few times a year.
Conditions are difficult and poverty is an issue, but the women sure know how to deliver babies without a lot of fuss! It is a joy to bless the women and hospital staff with sheets, baby packs, birth photos and medical supplies. We don't hear much at all about midwives in the country. Most women seem able to make it to one of the free hospitals for the general population. The ones who have connections go to smaller, nicer hospitals that can handle preterm babies and other special circumstances.
We work in the poorer hospitals that need help. Spanish is spoken, so translators are needed. We try to teach staff about neonatal resuscitation, kangaroo care for preterm babies, etc. The staff, for the most part, are open to learning new ideas.
Directors of hospitals change often, so we go to numerous hospitals to try and find the place where students can learn the most and where we can be of service. We'll sometimes help with 20 to 30 births a day. They do let us catch babies if not high risk, but we don't really manage the births. There are plenty of moms to doula, babies to exam and experiences to be had. I know we have saved lives on numerous occasions. Come join us if you want to bless the poor.
— Lisa Aman
France's Sage Femmes
It's high time for women, especially les sage femmes (Fr. midwives; literally meaning "the wise women") of France, to take over! Since 2002, midwives' wages have thinned down. Of all professionals acting in health care, we have the lowest income, and costs keep going up.
The government is cutting down expenses in every public institution, so that midwives working in hospitals are under pressure: fewer midwives, more births! Therefore, we started our first movement in 2010, a demonstration in black. We were mourning our dying profession. This year we were 3500 (we are around 23,000 in total) strong to demonstrate in the streets of Paris (http://www.youtube.com/watch?v=fINFkmtU42c&feature=related).
Our demands:
The minister of health accorded us an interview with his first secretary. We did not even receive a promise, just a vague "we will think about it." We foresee continuing to fight for true respect for our job.
— Françoise Bardes
A Review of Birth in Argentina
Doulas: Since 2007, an amazing doula movement has been taking place. Prior to 2007, the doula figure was unknown. Now, DAR (Doulas of Argentina) is educating an increasing number of doulas.
Hospitals: As the demand for homebirth and natural birth increases, many hospitals are changing their medicalized way of assistance, becoming slightly more humanized and intervening less. However, many hospital births are still very violent and harmful. An initiative has been proposed to pay doctors more for vaginal births than for c-sections as a way to decrease the epidemic rate of c-section, which is 50–90% in private hospitals and 20–30% in public hospitals. This idea was applied in Brazil with the expected outcomes but, in some cases, doctors became negligent by forcing a vaginal birth when a c-section was needed.
Midwifery: Midwives are still working to pass a law that would update their competencies. This new law aims to legitimize all the tasks and skills midwives currently practice, including suturing episiotomies and tears, assisting births by their own responsibility, using medications and taking care of the newborn in the absence of a pediatrician. The struggle between OBs and midwives is still the same, and has even gotten worse in a medical system where midwives are meant to be the doctors' assistants.
Midwifery Education: A private training course that promotes community and independent midwifery, and which bases midwifery on the continuity of care and homebirth, has been taking place in the last four years, and has resulted in young midwives establishing their own home offices to provide out-of-hospital care.
The midwifery education programme at Buenos Aires University is interested in developing a new project that would add holistic midwifery to midwifery education to broaden the knowledge base and prepare midwives to satisfy client's demands. Midwives are often perceived as lacking research-based evidence and skills that provide natural comfort to women during labor. The new training would offer more "hands-off" techniques and preparation for attending out-of-hospital births safely, with equipment and a clear transport protocol. The new training project will be launched as a course for advanced students in June of this year, and if successful, may be included in the curricula in the future.
Birth Centers: All of the initiatives regarding legal, freestanding birth centers run by midwives or medical teams have unfortunately failed. People who feel unsafe birthing at home, uncomfortable and threatened at hospital, as well as people who don't have a proper place to welcome their child or who live in more remote locations, are driving demand for freestanding birth centers. There are two hospitals that provide natural birth options (no drugs, free movement, no IVs, upright birth positions, freedom to eat and drink), delay shots and decline giving vitamin K to the newborn. One is a private hospital in Buenos Aires Province and the other one is a public hospital in Tucumán Province. It is a good start but there are many things yet to improve.
Birth Activism: In the last three to four years, celebrating World Respected Childbirth Week has been a good strategy to place birth issues on the political and media agendas, and to make the topic a public concern. The Latin American and Caribbean Network for the Humanization of Birth is very active in Argentina and stays in constant contact with Spanish organizations that advocate for childbirth rights.
— Marina Lembo
Featured Products
Web Site Update
The table of contents for the brand-new issue of Midwifery Today is now online! Go here.
Read this editorial by Jan Tritten from the brand-new issue of Midwifery Today, Summer 2011:
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Birth Wisdom from the Web
I traveled to Mexico in the winter of 2008/2009 and was blessed to work with traditional midwife Angelina Martinez Miranda and her lovely son, Esteban Garcia Martinez, serving women in the small birth center in front of the family's house. This past winter I was in Kerala, India, helping start the first birth center in Kerala, called Birth Village, in the heart of Cochin. I served the first three clients of the center, arriving on the due date of the first client!
— Kavita Darby Rosepetal, Facebook
Teaching women's health to 25–30 women, sitting on the floor in mud huts in Bungoma, Kenya, Africa—awesome! Teaching one midwife neonatal resuscitation by drawing in the sand with a stick—priceless!
— Andrea Dixon, Facebook
As a researcher it seems to me that the traditional midwives of India are an asset to my country, as in other countries, but they need proper training as far as health and hygiene are concerned. If we made an exchange of ideas using their knowledge and our modern concept of midwifery, it would be very fruitful.
— Soma Mukhopadhyay, Facebook
If you'd like to share a bit of wisdom from the Web, please send a 4–5 sentence excerpt, accompanied by a link, to email@example.com.
Conference Chatter
Katerina of Russia
We are off to Saint Petersburg, Russia, on June 6, where we will do a two-day event, and then off to Moscow, Russia, where we will hold our next joint conference, "Traditional Midwifery—The Profession, the Art, the Life."
Katerina Perkhova, the energy behind these events, is an amazing young woman. All of us who have met her know that Russia is in for some great birth changes because of the dedication and hard work of this woman and her family. She started a magazine much like Mothering (Domashniy Rebenok), and does another magazine on eco-friendly homes. Katerina has a special interest in midwifery and birth. She runs an organization named MAMA, for mothers and midwives, and travels around Russia talking with government officials to try to change birth. Did I tell you she and her husband, Phil, have two young children?
Katerina has also been translating Midwifery Today magazine into Russian, helping to share great birth information with Russian-speaking people. Our hope at Midwifery Today is to change birth around the world and this is one way to feed that goal. I asked her once how she does so much with so little and she answered, "I'm the editor, journalist, photo editor, advertising manager and Web designer. Phil is the art director, designer, photographer, publisher and heavy load lifter." They only have two other staff members! I hope one day you all get to meet this hard-working, sweet husband and wife team; meeting them is an honor.
— Jan Tritten
Think about It
We homebirthing mothers love our midwives because they are the first to touch our true love. We love our midwives because they give us life, and life again.
— Meredith Winn
Excerpted from "The Midwife Bond," Midwifery Today, Issue 89
Dear Midwifery Today,
A friend recently asked me for advice about choosing to attend midwifery school and I responded with the e-mail that follows. I have realized just how important these words are to those considering midwifery as a profession, so I thought I would share them with E-News readers.
Midwifery school has been the most challenging journey I've taken in my entire life. This path has been so incredibly beautiful, sad, amazing, powerful, ecstatic, traumatizing and breathtaking that there is no way in Hades that I could have ever stuck with it if I wasn't absolutely, 100% positive that there is literally nothing else in the entire world that I can do. For me, there is no choice. I am a midwife and I believe this path was chosen for me before I was born on this earth.
To people who are contemplating midwifery, I say to them this: If you have one ounce of doubt that this path may not be for you, don't do it. Find your true passion and follow it instead. For those whose passion is not midwifery, this way will only end in heartache. But for those who are born midwives, who accept this challenge and meet it head on, prepare to experience unimaginable joys and a pure, deep peace, the likes of which you've never felt before.
— Melissa-Marie Marks
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Midwifery Today: Each One Teach One!


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- Teachers Home
- Building Reading & Writing Skills
- Comprehension Lessons »
- Identify Problem ...
Identify Problem and Solution
Comprehension Lessons »
- Analyze Character, Setting, and Plot
- Retell a Story
- Identify an Unstated Main Idea
- Main Idea Sentences
- Identify Problem and Solution
- Find a Solution
- Summarize
- The Summary Game
- Make Comparisons
- What's the Difference?
- Listen for the Facts
- Analyze Author's Purpose
- What's Your Purpose?
- Make Inferences and Analyze
- Follow All Clues
- Cause-and-Effect Relationships
- Cause and Effect Buildup
- Order of Events
- Instructions in Chronological Order
- Draw Conclusions
- Play Detective
- Make and Analyze Predictions
- Can You Make a Prediction?
- Chronological Order of Events
- Directions Out of Order
- Identify Theme
- Theme Theater
- Identify Facts and Details
- It Looks and Sounds Good
- Make Judgments
- You Be the Judge
- Draw Conclusions
- Color Me Hidden
Explain Remind students that the plot of a story usually begins with a problem and ends with a solution. The plot development moves from conflict to resolution. Write the following paragraph on the board: Marcus needed help with his math homework because he had missed some classes when he was sick. He called a friend from class and said, "Taylor, I can help you with your science project. Do you have time to help me with the math homework?" Read the paragraph with students. Tell them that they will identify the problem and the solution, or resolution of the conflict, in this paragraph.
Guided Practice Ask a volunteer to state the problem that Marcus faced. (At the beginning of the paragraph, Marcus needed help with his math homework.) Then ask how Marcus solved the problem. (In the middle of the paragraph Marcus called a classmate and offered to help his friend with a science project. Finally, he resolved his problem by asking for help with his math homework.)
Practice Read this text aloud to students: Maria looked in all the usual places for the basement key. She needed to leave for school, and her schoolbag was locked in the basement. Having no choice, she climbed all the way up to the attic where her mother was looking through some old files. "Mom," Maria asked, "can I please borrow the basement spare key?" Have students listen carefully and raise their hands when they hear Maria's problem. (Her schoolbag was locked in the basement.) Have them raise their hands again when they hear the solution. (Maria borrows the basement spare key.)

subset: commoncrawl


text:
Studying Fentanyl in Patients With Cancer
This study has been terminated.
(poor accrual)
Sidney Kimmel Comprehensive Cancer Center
National Cancer Institute (NCI)
Information provided by (Responsible Party):
Sidney Kimmel Comprehensive Cancer Center
ClinicalTrials.gov Identifier:
First received: May 9, 2009
Last updated: April 16, 2013
Last verified: April 2013
- Full Text View
- Tabular View
- No Study Results Posted
- Disclaimer
- How to Read a Study Record
Detailed Description:
RATIONALE: Studying blood samples from cancer patients undergoing pain treatment in the laboratory may help doctors learn more about how pain drugs work in the body. It may also help doctors predict how patients will respond to treatment.
PURPOSE: This research study is looking at fentanyl in patients with cancer.
|Brain and Central Nervous System Tumors Chronic Myeloproliferative Disorders Leukemia Lymphoma Lymphoproliferative Disorder Multiple Myeloma and Plasma Cell Neoplasm Myelodysplastic Syndromes Myelodysplastic/Myeloproliferative Neoplasms Pain Precancerous Condition Unspecified Adult Solid Tumor, Protocol Specific
|Drug: fentanyl citrate Other: pharmacological study
|Study Type:
|Study Design:
|Observational Model: Cohort
Time Perspective: Prospective
|Official Title:
|Pharmacokinetics of Continuous Infusion Fentanyl in Cancer Patients
Resource links provided by NLM:
Genetics Home Reference related topics: multiple myeloma
Drug Information available for: Fentanyl Fentanyl citrate
Genetic and Rare Diseases Information Center resources: Myeloid Leukemia Acute Myeloid Leukemia Acute Non Lymphoblastic Leukemia Myelodysplastic Syndromes Myelofibrosis Chronic Myeloid Leukemia Chronic Myelomonocytic Leukemia Polycythemia Vera Chronic Myeloproliferative Disorders Essential Thrombocythemia Myelodysplastic/myeloproliferative Disease Acute Lymphoblastic Leukemia Burkitt Lymphoma Multiple Myeloma Lymphosarcoma Chronic Lymphocytic Leukemia Leukemia, B-cell, Chronic Mycosis Fungoides Marginal Zone Lymphoma B-cell Lymphoma Diffuse Large B-Cell Lymphoma Mantle Cell Lymphoma Cutaneous T-cell Lymphoma Follicular Lymphoma Waldenstrom Macroglobulinemia Lymphoma, Large-cell Angioimmunoblastic T-cell Lymphoma Angioimmunoblastic Lymphadenopathy With Dysproteinemia Leukemia, T-cell, Chronic Adult T-cell Leukemia/lymphoma Hodgkin Lymphoma AL Amyloidosis Extranodal Nasal NK/T Cell Lymphoma Large Granular Lymphocyte Leukemia Aggressive NK Cell Leukemia Monoclonal Gammopathy of Undetermined Significance Anaplastic Large Cell Lymphoma Anaplastic Plasmacytoma Lymphoblastic Lymphoma Sezary Syndrome Lymphomatoid Granulomatosis Plasmablastic Lymphoma Lymphoma, Large-cell, Immunoblastic Hairy Cell Leukemia Chronic Neutrophilic LeukemiaU.S. FDA Resources
Further study details as provided by Sidney Kimmel Comprehensive Cancer Center:
Primary Outcome Measures:
- Pharmacokinetics of fentanyl citrate [ Time Frame: two baseline samples, serial samples obtained at 0,4,8,24,48,72,96,168,240 hrs after discontinuing fentanyl ]
|Study Start Date:
|October 2007
|Study Completion Date:
|July 2009
|Primary Completion Date:
|July 2009 (Final data collection date for primary outcome measure)
|Assigned Interventions
Cohort 1
receiving fentaly citrate
|Drug: fentanyl citrate Other: pharmacological study
Detailed Description:
- To describe the pharmacokinetics of prolonged intravenous infusions of fentanyl citrate in adult patients with cancer.
OUTLINE: Patients undergo blood sample collection before and after discontinuation of fentanyl citrate therapy (10 days total). Pharmacokinetic analysis is performed on the samples.
|Ages Eligible for Study:
|18 Years and older (Adult, Senior)
|Sexes Eligible for Study:
|Accepts Healthy Volunteers:
|Sampling Method:
|Probability Sample
Study Population
cancer pts
- Diagnosis of cancer
- Inpatient at the Johns Hopkins Hospital Cancer Center undergoing pain treatment with continuous infusion fentanyl citrate for ≥ 5 days
- Willing to change to an alternative opioid
- See Disease Characteristics
- At least 72 hours since transdermal fentanyl citrate administration
- At least 12 hours since transmucosal fentanyl citrate administration
- No known requirement for continued opioid therapy with any fentanyl citrate products after discontinuation of fentanyl citrate therapy
Contacts and Locations
Choosing to participate in a study is an important personal decision. Talk with your doctor and family members or friends about deciding to join a study. To learn more about this study, you or your doctor may contact the study research staff using the Contacts provided below. For general information, see Learn About Clinical Studies.
Please refer to this study by its ClinicalTrials.gov identifier: NCT00899951
Please refer to this study by its ClinicalTrials.gov identifier: NCT00899951
|United States, Maryland
|Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins
|Baltimore, Maryland, United States, 21231-2410
Sponsors and Collaborators
Sidney Kimmel Comprehensive Cancer Center
National Cancer Institute (NCI)
|Principal Investigator:
|Stuart A. Grossman, MD
|Sidney Kimmel Comprehensive Cancer Center
More Information
Keywords provided by Sidney Kimmel Comprehensive Cancer Center:
Additional relevant MeSH terms:
ClinicalTrials.gov processed this record on September 21, 2017
|Responsible Party:
|Sidney Kimmel Comprehensive Cancer Center
|ClinicalTrials.gov Identifier:
|NCT00899951 History of Changes
|Other Study ID Numbers:
P30CA006973 ( U.S. NIH Grant/Contract )
|Study First Received:
|May 9, 2009
|Last Updated:
|April 16, 2013
Keywords provided by Sidney Kimmel Comprehensive Cancer Center:
unspecified adult solid tumor, protocol specific
accelerated phase chronic myelogenous leukemia
acute undifferentiated leukemia
adult acute lymphoblastic leukemia in remission
adult acute myeloid leukemia in remission
adult acute myeloid leukemia with 11q23 (MLL) abnormalities
adult acute myeloid leukemia with inv(16)(p13;q22)
adult acute myeloid leukemia with t(15;17)(q22;q12)
adult acute myeloid leukemia with t(16;16)(p13;q22)
adult acute myeloid leukemia with t(8;21)(q22;q22)
atypical chronic myeloid leukemia, BCR-ABL1 negative
blastic phase chronic myelogenous leukemia
chronic myelomonocytic leukemia
chronic phase chronic myelogenous leukemia
mast cell leukemia
meningeal chronic myelogenous leukemia
progressive hairy cell leukemia, initial treatment
prolymphocytic leukemia
recurrent adult acute lymphoblastic leukemia
recurrent adult acute myeloid leukemia
recurrent adult T-cell leukemia/lymphoma
refractory chronic lymphocytic leukemia
refractory hairy cell leukemia
relapsing chronic myelogenous leukemia
secondary acute myeloid leukemia
stage 0 chronic lymphocytic leukemia
stage I adult T-cell leukemia/lymphoma
stage I chronic lymphocytic leukemia
stage II adult T-cell leukemia/lymphoma
stage II chronic lymphocytic leukemia
Additional relevant MeSH terms:
Multiple Myeloma
Neoplasms, Plasma Cell
Myelodysplastic Syndromes
Nervous System Neoplasms
Central Nervous System Neoplasms
Myeloproliferative Disorders
Lymphoproliferative Disorders
Myelodysplastic-Myeloproliferative Diseases
Precancerous Conditions
Neoplasms by Histologic Type
Lymphatic Diseases
Immunoproliferative Disorders
Immune System Diseases
Pathologic Processes
Hemostatic Disorders
Vascular Diseases
Cardiovascular Diseases
Blood Protein Disorders
Hematologic Diseases
Hemorrhagic Disorders
Bone Marrow Diseases
Neoplasms by Site
ClinicalTrials.gov processed this record on September 21, 2017


text:
|Trad, 5 pitches, 650', Grade III
|YDS: 5.10d French: 6b+ Ewbanks: 21 UIAA: VII+ ZA: 21 British: E3 5b [details]
|Jorge and Joanne Urioste
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|Submitted By:
|J. Thompson on Apr 11, 2007
|RAIN AND WET ROCK The sandstone in Red Rocks is fragile and is very easily damaged when it is wet. MORE INFO >>>
|Comments on La Cierta Edad
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By J. Thompson
From: denver, co
Apr 12, 2007
It may be possible to rap the route with 1x70M rope. The problem lies between raps 3 and 4. There is an anchor (on another route) out on the right face that MIGHT solve this problem...no promise's!
Also the ASCA replaced numerous bolts on this climb. All bolted anchors are good as are the protection bolts.
By Greg Barnes
Apr 23, 2007
Just to clarify - Josh is talking about rapping down the shared Unfinished Symphony raps (not rapping the route on La Cierta Edad), and the anchor out to the right is the one on top of pitch 2 of Music to My Fears. Reaching this anchor would require a somewhat aggressive penji/tension traverse out of the main corner, and it's not clear if you'd then rap back into the corner or to the first pitch anchor of Music to My Fears.
The bolt replacement: 11 bolts on first 3 pitches replaced in March 2004 by Bryan Law, Chris VanLeuven, and Greg Barnes. The two top anchor bolts, plus 3 bolts along the shared raps down Unfinished Symphony, replaced in April 2007 by Josh Thompson & Greg Barnes. Several old bolts remain on those raps, some of which are really cool to look at (like the 3rd bolt at the second rap station - a 1/4" Star-Dryvin with a bent nail that was never driven correctly!).
By meo
May 4, 2007
rating: 5.10b/c 6b 20 VII 20 E2 5b
|I found having a # 5 Camalot for the wide cracks we're very useful. Pitch 4 the consensus was 5.10 b Maybe that's because we had a #5 cam. Just the same the best pitches we're #2, a fun chimney and #3, awesome positions while crack climbing and stemming. Great Exposure and a super safe route. I'll give it 3 stars. Thanks for replacing those bolts! The rappels went without a problem.
By J. Thompson
From: denver, co
May 14, 2007
If you wanted gear in the wide section on the crux pitch a #5 camalot would be the only way to go. However I thought that section to be about 5.8 there is very good small gear before you pull the crux however.
Interesting that you thought 5.10b, meo. I'm not one to overrate things and found the crux moves to be solid 5.10d.
By meo
May 16, 2007
rating: 5.10b/c 6b 20 VII 20 E2 5b
|Hmm I must be missing something for I thought the wide crack in pitch 4 was the crux moves. If you thought it was 5.8 then where do you believe the crux moves to be?
By JSH
May 23, 2007
Interesting comments here:
(seems they'd be glad to hear about the new rap bolts!)
These dudes call it 5.10- and say:
"The 3rd pitch was a strenuous, gently overhanging crack, varying in size from tight fingers to armbars. Felt like the true crux of the route. .... (in re: 4th pitch:) The stated technical crux was a short reachy fingercrack with one off-balance move; barely fiveten. As on Black Orpheus, this section is overrated in difficulty (the new Brock guide calls it .10d ! ), and pales in comparison with La Cierta Edad's other pitches."
By J. Thompson
From: denver, co
May 23, 2007
Hmmm. Very interesting.
The wide section only felt 5.8 to me because stacked it, instead of arm bars. I'm sure arm baring would feel harder. I think the crux moves are at the top of the short wide section. They are short, almost like a boulder problem, however they are not "barely 5.10". The only thing I wonder is if those guys were fairly tall? I had trouble reaching the good holds that end the difficulties. Which made me do several moves on small holds/thin feet. Of course there may be a different sequence or holds that I missed as well. I've spoken with others who thought the crux to be harder than 5.10d....guess folks will just have to climb it and see for themselves!
In regards to why Swain called the route "strawberry shubert"...that is an extentsion. A final pitch up bad rock, that looks quite contrived. Swain apparently mixed it all up.
By George Bell
From: Boulder, CO
May 23, 2007
|5.8 hand stacking? Is that possible? Kind of like the ratings for squeeze chimneys, never under 5.9 ...
By J. Thompson
From: denver, co
May 27, 2007
|I'll have to respectfully disagree george! When proper stacking technique is used wide crack climbing can be easier than previously thought. Of course, as with any crack's, body size plays a role. For me that section of climbing is perfect hand/fist stacks. Which is totally bomber for me...YMMV!
By JSH
Jun 7, 2007
Thing is, Josh, most folks don't get around to learning the Wide until they're well into a climbing career - like leading 5.10 or so. So it's only with the skillset of a 5.11 climber, that you can turn stacks into what feels secure and 5.8 to you. A 5.8 climber won't be able to turn that same trick - they will have to pull what feels like 5.11 to climb the same section. So by definition, even if it feels like 5.8 (to an experienced climber), it can't be rated that way. I think that's what George meant.
See, if I were climbing that section ... I'd tell my belayer to make him/herself comfortable and settle in for a long wait ;)
I wanted to get on this route in late May, but it was too dang hot, and surprisingly sunny - the sun's in a very different aspect by June.
By J. Thompson
From: denver, co
Jun 11, 2007
I certainly agree! But that would beg the qeustion....what would a 5.8 leader be doing leading a 5.10+ pitch?
By JSH
Jun 11, 2007
(yes, it's Julie, hey how are you man?)
A leader who will publicly claim she leads, say, 5.8 but has been onsighting 5.9 in Josh and led a few pitches of 5.10, -might- come across this route on fivenineclimber.com and, based on their comments (see above links) decide that 5.10- might be within her range to try, or at least hang/flail her way up. Or to climb with a stronger partner. So she's pretty concerned with whether it's 10- as they claim, or 10d, or secure 5.8, and what the nature of the difficulties are. She's pretty familiar with exactly why "secure 5.8 stacking" is an oxymoron!
So that's how a "5.8 leader" might end up on the sharp end of that pitch, and it's people like me (ahem, her) you have to take into consideration, when you say it's secure 5.8 stacking.
By J. Thompson
From: denver, co
Jun 14, 2007
Fair enough.
The only thing I'd point out is that I didn't put that in the route description(and wouldn't!). It was purely part of the conversation concerning the grade/crux and it's location.
I'm still alittle confused by anyone calling that pitch 5.10-.
We've( Julie) climbed together a bit, and I'd think you have a pretty good idea of my abilities and opinion's. Do you think I'm someone who would call a 5.10- pitch 5.10d?
I'm good by the way! How are you?
By JSH
Jun 25, 2007
Yeah, I'm confused all over by the various comments I read. Yours is pretty straightforward to interpret, so long as the reader knows what OW really means - it's secure for someone with good OW skills, grade notwithstanding (and knowing you personally, you're spot-on in terms of grades).
The comment on fivenineclimber (who I don't know) is the harder one - I suspect that he's taller, and his "5.10-" and "barely five ten" applies if you're his height. That's more subjective to read, and to interpret how to apply to my own body and climbing level.
At any rate - maybe I'll get a chance to see what I think it is someday!
Coming your way in mid-Aug .... stay tooned! Hope your wrists are doing well.
By Karsten Duncan
From: Sacramento, CA
Jul 2, 2007
rating: 5.10b/c 6b 20 VII 20 E2 5b
A great route that is also pretty much all in the shade. Definitely a must do climb. I would have to agree the 2nd and 3rd pitches are the best on the route too. Good rock, good protection, and fun moves make it classic.
The "crux" 4th pitch is like two moves of mid .10 and the rest is 5.8. I believe the earlier poster was talking about the offwidth (OW) section on this pitch being 5.8 (which I agree with). There are dished feet in the OW that allow you to squeeze up without having to use handstacks or the like. Above, the crux moves come as you pull out of the OW. As far as the crux moves, I would say that if you do the moves correctly (psssst . . . . heel hook,mantle) it felt more .10b/c to me. The pro before the crux is good and protects nicely with a #5 camalot but can also be protected with a medium sized nut at little higher up (I used both).
Overall I think you'll find the 2nd and 3rd pitches more sustained with almost as hard moves on the 3rd.
I might also add that you can continue up above the last bolted anchor up the chimney for another 50ft or so on 5.7ish climbing and rap from a cordage built station.
From this cordage anchor rap to the last bolted anchor first and then down and right to the anchor mentioned above.
By Cunning Linguist
Jul 9, 2007
rating: 5.10a 6a 18 VI+ 18 E1 5a
|This is just my two cents: the 10d pitch felt like 5.9 max; I just stepped over Meo's head and laybacked it. There was literally maybe 5 5.9 moves in a row right off the belay, well protected by a new C4 camalot (old 4.5) on slick, pretty chocolate varnish with adequate feet. Any 5.9 gym climber shouldn't have ANY trouble laybacking these moves. From there on I maybe placed two or three more pieces until reaching the belay ledge shared by Unfinished. The crux for me was the third pitch-Mikey lead it and it felt like solid 10b as I seconded. The 5.8 pitch at the top was super fun and Bob Conz told me that his x-rated face pitch at the top could have been protected by a crack to the left-he was just feeling his oats and having fun climbing the face that day. A sweet route regardless, my girl leads 5.8 on gear and I'd have no problem sending her up on any pitch but the "10a"-this is a good beginner 5.10 multipitch. More fun than Y2K by a mile!
By J. Thompson
From: denver, co
Jul 14, 2007
It gets weirder!!! Now the 5.10d is 5.9....but the 5.10a is 5.10b!
Looks to me like this route is a classic example of WHO THE FUCK KNOWS What the rating is!!!
LOL....main thing anyone should take away from this is that the route is exceptional!! Go climb it and see how hard(or easy!) YOU think it is!
By rex parker
From: las vegas n.v
Aug 26, 2007
|ok to further the confusion.to climb this route you need to have your offwidth technique down cause personally the cruxes are offwidth,and i suck at them so the cruxes were difficult. the rest of the route was awsome.
By John Wilder
From: Las Vegas, NV
Aug 27, 2007
rating: 5.10c 6b 20 VII 20 E2 5b PG13
karsten- heel hook, mantel???
i thought that the crux was solid 5.10 if you climbed it straight in. i watched my partner do it, and it looked much harder. there are definitely options- left, right, or center. take your pick. i got a no-hands kneebar and was able to finesse my way out of the corner at what felt like 5.10-ish, but, solid OW technique makes that exit easier, i think. i cannot see how that corner could possibly be 5.9, since the crack seams out.....
the pitch below was low .10s, maybe .9ish- the OW wasnt that bad, but definitely took some technique and patience to get through it without crying for mommy.
really good route- but, since no one has mentioned it, the loose rock on the 2nd pitch makes for a pretty heads up lead....keep that in mind!
By Pete Bresciani
Sep 7, 2007
Michelle and I did this route today and enjoyed it. I was not thrilled however with the poor rock quality on pitches 2 and 4. Fortunately the short crux section of pitch 4 had bomber rock and pro.
Pitches 1, 3, and 5 were my favorites. Great rock, great pro and fun climbing.
I'm 6'1" tall and can confirm that height helps a lot on this climb. Long legs make for easy stems reducing the difficulty especially on pitch 3. On pitch 4, I easily reached the good face holds coming out of the offwidth.
This is a good route. Just be sure you are familiar with climbing on fragile sandstone (pitches 2 & 4) being careful what you step and pull on.
By Karsten Duncan
From: Sacramento, CA
Dec 24, 2007
rating: 5.10b/c 6b 20 VII 20 E2 5b
I didn't find the rock to be that questionable.
I thought info seekers might like this website which has another route descritption and some great pics.
By Greg Barnes
Dec 28, 2007
Well, for those who aren't strong gym or sport climbers, I'd rate this sucker at least 5.10d. No way is that crux anywhere near 5.9! Maybe it feels easy if you sport climb 5.11, but my only question was whether the crux was 5.11- or 10+, and 5.10- didn't even vaguely enter my mind. And I tried the heel hook mantle thing (couldn't press it through), liebacking, etc - ended up doing super dicey moves that I never would have tried on lead.
It's funny how the ratings are diverging - the skill sets are just so different with different groups of climbers. 5.11 gym equals 5.10 sport equals 5.7 slab equals 5.4 offwidth equals 4th class chimney...and outdoor 5.10+ trad equals 5.9 gym if you're weak and you never climb steep sport or gym routes!
By rpc
Mar 13, 2008
My wife & I climed it this February. An amazing route - probably our favorite RR outing to date. Rap gully to the right had ice in it which kept coming off all day long -- felt almost alpine :)
Given that we were able to get the thing cleanly, I'd sort of go with a 10- rating. Maybe you'll laugh, but I found Sour Mash significantly harder (not so good at face climbing).
By PumpkinEater
From: Sacramento
Apr 9, 2009
|I won't quibble about the grade though I do think the 3rd pitch was slightly harder. As for rapping, the Handren guide suggests rapping Unfinished Symph or the route itself. We got our ropes hopelessly caught rapping the route (had to relead the "crux" with both ends of the same rope). Unfinished was much cleaner for pulling the ropes. Use the 1st anchor on Music to My Fears for your final rap.
By MJW
From: Boise, ID
Apr 27, 2009
rating: 5.10a 6a 18 VI+ 18 E1 5a
Did this one the other day....pretty good.
Pitch 2 - 5.9+ Fun/tricky chimney. Be careful pulling out of it up higher. Loads of rotten rock and your belayer is right below all of it!
Pitch 3 - 5.10a. Cool stemming and jamming. Good pro. Classic
Pitch 4 - 5.10a. Plug your big cam in the wide crack above the belay. I had a #5 WC flex friend. Pull a(one) lieback move with pro at your waist and hike your feet up to a giant foothold. The rest of the pitch is a yawner and very easy. IMO pitch 3 should have ended above this move adding a nice sting at the end! One move wonder...No way it's 10d!
Pitch 5 - 5.8 crack. OK. Rap Unfinished Symp. Then go do Breakaway!!!!
By Andy Laakmann
Site Landlord
From: Bend, OR
Oct 17, 2009
rating: 5.10b 6a+ 19 VII- 19 E2 5b PG13
Fabulous and well protected route. My favorite route of our current trip. I didn't love the raps though.....
Approach - A fairly good trail takes off to the left about 100' up the wash once the main trail hits the wash. When you hit the pillar, wander left and up to the starting ledge.
P1 (5.8) - Mostly great rock up past four bolts and some gear. Bomber anchor bolts. 130'
P2 (5.9+) - Chimney up past one bolt and some gear... and then chimney out and up over the roof. Awesome climbing! The next 80-100' of climbing up the crack is on less-than-inspiring rock. Be careful. There is plenty of gear, but your placements are limited to the spots where the crack walls are solid. Bomber anchor bolts. 130' or so. I think this pitch is PG13 because of the rock... if not for the leader for the belayer.
P3 (5.10a/b) - AWESOME pitch. Up the steep crack and into awesome stemming when it gets wide. The difficulties stay with you until the end, though you do get a rest about 15' below the anchor. This pitch will take as much gear as you throw at it. If you ask me, this pitch is the crux of the route. Bomber bolts. Hanging stance. 90'
p4 (5.10?) - The #5 camalot goes in perfectly. I don't consider myself a sandbagger, but the crux felt 10-- to me. I pretty much just faced left, with a right hip scum, and worked up the crack... left foot on the offset left wall. I suppose I was laying it back, but with the hip scum it wasn't pumpy at all. At the top of the wide crack more gear is available, and then I just squared up to the crack and grabbed a nice edge up and right. My wife got the move as well, she thought around 10b/c or so. I'm 5'9, and she is 5'5. The rest of the pitch was easy climbing on so-so rock. We built a belay by the little shrub/tree. 150'
P5 (5.8) - Short, fun, varnished 5.8 corner. Lots of edges and heucos makes the climbing much easier then it looks. 80'. Two good bolts with a bunch of tat.
And now the rap....
The first rap sucked big time. My rope fell into the crack and got stuck in the crack right above the crux move on P4. So I rapped down and freed it. I debated just going down to the anchor bolts for the climb and rapping the route (all the anchors are rigged with rings), but was concerned about getting the rope stuck per the comment above. So I ascended the rope about 50' back to the big ledge for the Unfinished Symphony raps. After my wife came down, I had her belay me out left for the pull. The ropes came..... BARELY.
The next three raps down Unfinished Symphony went OK, but each anchor consisted of just one good bolt, another OK bolt, and tat.
I don't think the last pitch is worth the risk of the last rap. Next time, I'll just finish on the sloping ledge and the Unfinished Symphony anchor.
Gear: nuts, one or two sets of TCUs, double camalots from #0.5 to #4 camalot, and one #5 camalot. I was happy to have two #4s and the #5. With this rack you can pretty much sew up the route.
By brucelacroix
From: Carson City, NV.
Jun 17, 2010
rating: 5.10- 6a 18 VI+ 18 E1 5a
I was intrigued after reading all of the comments. Hand stacks, heel hooks, 5.9 or 5.10d. Normally I wouldn't get on a route rated 10d, but as someone else posted, you won't know unless you try it. My partner and I felt it was 5.10, but not hard 5.10. I'd break it down this way.
P2-5.9, The crux felt a little like Epinephrine.
P3-5.10- Some loose rock on this pitch.
P4-5.10- Plug in a #4, layback 3 to 4 feet to a good stance.The rest of this pitch is pretty easy.
The rap to unfinished symphony went ok, the first pull was hard, the next three were good.
Bonus-We got to the base of the climb at 10am. The first pitch was in the sun, the next four pitches were in the shade.
By Fett
Oct 30, 2010
rating: 5.10b/c 6b 20 VII 20 E2 5b
|Awsome route. I thought the 3rd pitch was more of a challange because it was more sustained. The 4th pitch start was just a very short offwidth crux.
By Sherri Lewis
From: Sequim, WA
Oct 11, 2011
rating: 5.10b/c 6b 20 VII 20 E2 5b PG13
I'll add my 2 cents to ratings debate for P4. I'm 5' 1" and felt that the two bouldery moves immediately above the wide crack to be the crux; I'd say .10b, mabye 10c, though it didn't feel as stiff and desperate to me as Triassic Sands' crux. The wide part felt 5.9+--I was short enough that I could hip scum the whole thing with no laybacking and no offwidthing.
On the flip side, I offwidthed the entire length P3 because it was too wide to stem. This made it a much more sustained, physical pitch compared to P4, though perhaps not technically harder. I was glad for good pro all the way.
The quality of the rock, pro, and climbing above the crux of P4 deteriorated significantly. I cut the pitch short and belayed from the rap anchor on the right of the sloping ledge midway of P4. We rapped Unfinished Symphony from here.
P2 is definitely heads up. For short folks, it may be a challenge find solid stances in that initial chimney. The loose rock was also disconcerting.
By Jon O'Brien
From: Nevada
Nov 22, 2011
rating: 5.10a/b 6a+ 19 VI+ 19 E2 5b
cierta edad means "advanced in years"
By Tim Wolfe
From: Salt Lake City, UT
Mar 29, 2012
rating: 5.10b 6a+ 19 VII- 19 E2 5b
|Wow. Another great route by the Urioste family. After 25 years of climbing here I continue to find gems they have established. I was quite intimidated by the grade given to pitch 4 - 5.10d OW. I kept climbing and climbing and never found that part. The start of the pitch is 5.10 and takes a big piece (great gear so no fear) but a little foot work and side pulling for a few feet and that is done without ever using off width technique. Despite this route being labeled as a wide crack, there is almost no wide crack technique other than a little 5.9 chimney on pitch 2 so don't let that scare you away. You will want some big gear for protection, but face climbing, stemming etc suffices for the wide sections.
By Cunning Linguist
Apr 8, 2012
rating: 5.10a 6a 18 VI+ 18 E1 5a
Did this route again recently, my partner called it 9+. Substantial amount of hollow rock on upper crack of P2 got my attention; an extra #4 might have made that section feel more solid-still doesn't feel all that well cleaned, holds will break, heads up. "10a" 3rd pitch still felt 10a to me, mainly awkward for my body size (5.10 165). My two smaller female partners cruised it and thought tough nine was right on. The "10d" crux above is for sure 5.9 for my body+technique; I watched both the girls do it differnetly, but with all the great feet and hands outside the crack, you can go no-hands on every move up to the jug rail. There was one .9ish move for me laying back a sidepull above, but the pitch is easy if you don't go all Belly Full of Bad Berries on it. Protect in the crack, stay outside, milk huge feet on the right.
The raps down Unfinished/Music to My Fears have new webbing courtesy of Bluewater Ropes, but there's bolt replacement that needs to be done sooner rather than later. This rappel has snag potential, watch your ends as well.
As a final note about the grade, it's a good rock climb regardless of what label we affix to it. Get out there and enjoy it. For what it's worth, the Swain guide (which calls this Strawberry Shubert) calls this 10- with a 10c X finish pitch (conz variation), which seems to be closer to the truth. Brock/MacMillen calls P4 .10d, maybe Roxy got hyped on the crack stacking and never saw the good holds. In future guides, I think .10a would be an appropriate grade for the route excluding the alternate X finish for those not intending to offwidth the start of P4.
By J. Thompson
From: denver, co
May 29, 2012
Still baffles me that anyone can think that OW is the crux. I did it without the right sized gear (and no Mtnproj beta) and still didn't think it was harder then 5.8.
Whatever! Maybe I'll climb it again someday and see if it feels any different. It would be worth another lap anyway.
By Eugene Kwan
Oct 11, 2012
Did this route yesterday. I'd say it's a 5.10, but I don't know what sort. The wide chimney was a bit tricky to commit to, but the gear is pretty good if you look hard. It's easier if you stay in wide chimney mode for longer. I used arm bars and chicken wings through the OW sections, which weren't too bad. I was happy to have a #5. The #4 was occasionally useful, but I probably could have left it at home. Having double #2 and #3 was nice--one #1 would have been fine though.
I would recommend going from the hanging belay at the end of pitch #3, and going directly up to a large ledge instead of P4 belay. The right of the ledge has a bolted station on it, and you can belay from there. This lets you skip the horrible last pitch. It's full of friable rock and rope-eating chicken heads. The climbing at the top is cool, but the bottom half is kind of dull, doesn't have great gear, and has a lot of loose stuff everywhere.
We got caught in a storm on the way down. The Unfinished Symphony rap stations are right in a waterway, so we got completely soaked. I had the sense I could combine some of the raps with 2x60 m ropes, but I didn't really have the margin to experiment. I do know that from the station just below the big cave to the ground can be reached easily with a single 60. Not sure if you could do the whole route with a 70, but I don't think it's out of the question if you were creative with the rap stations.
By Brian Prince
From: morro bay, ca
Nov 29, 2012
rating: 5.10- 6a 18 VI+ 18 E1 5a
RAP BETA: I'm not sure if it's been said, but you can rap the route with a 70m if you stop midway up pitch 4 (don't know about continuing). The first rap is kind of funky since you have to rap back across the ledge but the rope pulled ok. The way all the cord is equalized also puts all your weight on this tiny little bolt (of 3) doing it this way but it worked. The rest of the belays are all new and setup for rapping.
I though pitch 2 was pretty scary after the chimney and I thought I was used to hollow RR face/crack climbing.
By Weston L
From: Summerlin, NV
Apr 28, 2013
rating: 5.10 6b 20 VII- 19 E2 5b
Wow, what a fun route! After reading the endless ratings discourse here and seeing a beautiful looking route in pictures, decided to head up it yesterday.
The rock quality on P2 on the holds you are climbing on isn't that bad, but the quality of the rock you are placing pro in is definitely entertaining. Hollow and pretty spooky, and I've finally gotten adjusted to living in sandstone lands now - still scary.
As it relates to P3, that really is more the 'money pitch' on this thing - incredible techy movement, kinda burly if yer short (5'7 here). Get some cool stems at the end, though. Sustained and solid for the grade...
Of the three of us in my party we all had a differing opinion relative to the grade on P4. It's 5.10, the OW would be 5.8 or less in the Valley...the 5.10 move is after that, protects very well, and then it's over.
RE: the rap...
We rapped from the bolts/cord combo near the top of P5, rapped the route, and had no snag problems. Hated the hanging station with three of us...
By Teresa Krolak-Owens
Aug 4, 2013
|I haven't climbed in about 5 years or so and followed a friend up this climb yesterday...It was SO much fun. Hard but fun. The crux, I thought, was definitely exiting the OW, and yes, height makes a huge difference. I'm 5'4" and believe me, that chimney was "fun", that stemming on pitch 3 was "fun" and that exit move from the crux was "fun". It is good to be climbing again (I'm a Red Rock "native") and this route has it ALL....face, stemming, chimney, OW, good rock, bad rock....a Red Rocks sampler plate, I'd say. Thanks Jorge and Joanne...you guys are wonderful!
By Jim Amidon
Nov 5, 2013
Been there done that one.....
Good fun route....
By Derek Doucet
Nov 6, 2013
Steep and enjoyable. I gave it 2 stars. P1, the first half of P2, and P3 are all very good, with P3 being the real stand-out with excellent jamming and stemming through imposingly steep terrain. It's a 4-star pitch for sure. The crux p4 is essentially 10-12' of well protected, challenging climbing before easing off to easy rambling. Not an especially interesting pitch. P5 is OK, and certainly worth climbing.
I'd have called it a 3-star route except for the rock quality on the 2nd half of P2. It's pretty bad. You're both climbing on, and protecting in, very hollow stone. The climbing in this section is easy (5.8ish?) but serious caution is warranted in places, as the gear is mostly worthless. I have a fairly high tolerance for poor rock, and this stuff is for real hollow. It's not a reason not to do the route, but definitely makes the pitch heads up to a degree completely out of character with the rest of the climb which is exceptionally well protected.
The rappels over to and continuing down Unfinished Symphony are fine. The first pull (on the ledge you walk across to get to the Unfinished Symphony raps) is potentially problematic, but by walking (on belay) to the far climbers' left edge of the ledge to pull, we found the rope to fall quite cleanly. If one were to pull from the far right where the next anchor is, I can certainly imagine problems resulting. The rest of the raps are straightforward with reasonable anchors (as of 10/13). There was at least 1 modern 1/2" bolt at each, though there were also a number of antique star drives and other junk, plus one slung pinch supplementing the good bolts. In any case, the anchors were fine in my opinion. I've seen far, far worse in Red Rocks, that's for sure.
By caughtinside
From: Oakland CA
Nov 11, 2013
|The popularity of this route is baffling. It is... ok.
By Flavaflav
From: Las Vegas, NV
Mar 27, 2015
Rapped through Tolleen and Brad, thanks for freeing our stuck rope! Message me on here to get your picture!
The above group rapped Unfinished Symphony instead, the route is really well protected. This seemed to also translate into rope eating cracks. Therefore I would rap US next time. Layback the crux, protects with a #5.
By Jessica T
From: seattle, wa
Apr 1, 2016
rating: 5.10 6b 20 VII- 19 E2 5b
|All 5 pitches are good fun and nice rock. I liked rapping US with double ropes. One single 60m from top of pitch 5 to ledge and 2 x double raps down US. Fast and easy Imo.
By John Hegyes
From: Las Vegas, NV
Aug 17, 2016
rating: 5.10a 6a 18 VI+ 18 E1 5a
We climbed all 5 pitches today and had a lot of fun! We rappelled the route using a single 70m. Here's the descent beta:
The station at the top of p4 is a gear anchor with no fixed gear. So from the top of p5, rappel down past the top of p4, to the intermediate rappel anchor, to the climber's right of the route, that is mid-way on p4. From this intermediate station rap down to the bolts at the top of p3 and then continue rapping the route. Beware there is a short, easy down climb at the bottom of the route. 5 rappels total; the pulls were not great, so watch for snags and cracks.
Two rappel stations need maintenance. The top of p5 and the intermediate rap station could use new slings or chains/quicklinks. The intermediate station also would benefit from another modern bolt. Currently that anchor consists of 1 new and 2 old bolts.
By Optimistic
From: New Paltz
Nov 19, 2016
We really enjoyed this route, with the exception of the loose/hollow stuff on p2 and the descent. Great climbing in a wide range of styles.
We found the #5 very helpful, perhaps even more on p3 than p4. As someone noted above if I had to pick one between the #4 and the #5 I'd bring the 5 and skip the 4.
We really didn't enjoy the descent too much, the rope got stuck 4 times including twice on the first rap. If I do this again I'll try John's way back down the route with the 70, although I didn't spot the p4 intermediate anchor people mentioned above. I would not skip p5, it was nice.
By Brent Barghahn
From: SLC, UT
Jan 2, 2017
The top two rappel stations now have chains. Midway p4 has one modern bolt and one homemade hanger, but it seemed solid. I pulled the AMC hanger and strardrive out with body weight at that station, so only two bolts now.
We rapped with a single 70m with no snags, just be deliberate about how the ropes sit as you head down. The Midway p4 rap anchor is probably 30ft right of the route in the alcove. Leaving this station, head back left to the route using the large bulbous flake to keep ropes in place. The final down scramble caused by a single 70 is very easy, hardly worth mentioning. You likely did this scramble on the way up to get to the large belay ledge.
By Derek Field
From: Flagstaff, AZ
Mar 22, 2017
rating: 5.10 6b 20 VII- 19 E2 5b
Reminds me of Nightcrawler: sustained stemming on steep rock. Nonstop face holds keep it a grade or two easier than Nightcrawler though. Lots of discussion; here's adding to the pitch consensus.
P1: Slab climbing with bolts at each of the cruxes. (5.9)
P2: A carbon copy of The Windows Route in Sedona! More featured though. The stemming is really wide, so very strenuous for short folks. Transitioning out of the chimney is pretty heady. (5.9)
P3: One of the best pitches in Red Rock. Eats up all sizes of gear. (5.10)
P4: Clean but short-lived offwidth crux that will feel rather simple for those with proper technique. New #5 camalot is perfect. Big runouts on the easy stuff above. (5.9+)
P5: Stellar corner climbing with oodles of face holds. Recommended beginner lead! (5.8)
Raps on Unfinished Symphony are a little funky but goes fine with a 70m.


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The Los Angeles Lakers will likely use their amnesty provision on Metta World Peace this week and take the forward off their salary cap, The Orange County Register reported Monday.
Using the amnesty provision on World Peace would save the Lakers about $30 million in salary and luxury tax, according the newspaper.
MORE: Metta cryptic | Lakers to sign Kaman | SN's Top 20 NBA free agents
Lakers star Kobe Bryant appeared to confirm the report via Twitter on Monday night.
No game 7 win without Metta! This is a tough day for laker nation #misspeace #newcbacasualty— Kobe Bryant (@kobebryant) July 9, 2013
Bryant likely was referring to World Peace's 20-point performance in the deciding game of the 2010 NBA Finals against the Boston Celtics. His 3-pointer with 1:01 remaining in the fourth quarter gave the Lakers a six-point lead. LA went on to win, 83-79.
World Peace, nee Ron Artest, announced last month that he had agreed to a one-year, $7.7 million contract to stay with the Lakers, after a 2012-13 season in which he averaged 12.4 points and 5.3 rebounds in 75 games.


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ROYAL Air Force personnel have been getting their fingers green by helping with a Winchester youth group's landscaping project.
Ten RAF officers from the Defence College of Logistics and Policing Administration at Worthy Down helped with the project at the King Alfred Youth Activity Centre (KAYAC) in Winnall.
The outdoor area of the centre, which works with young people aged eight to 17, was in much need of renovation, after becoming completely overgrown and unsafe for outdoor activities.
Officers gave up 40 hours of their time to help clear and prepare the area that will soon become a landscaped garden.
Flying Officer, Danny Benn, said: "It was a wonderful day in the sun, working up a sweat and giving something back to the community."
Once complete, the area will include an outside seating area, and allow the children to manage and maintain the garden.
Youth Options is a charity that supports children and young people through information and education, and has been active in Winchester for over 60 years.


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Tony Swaim has helped many clients, colleagues, and students reach their professional and personal goals. He has been an online instructor since 1998 and has taught at colleges and universities across the United States since 1981. His focus areas are project management, Six Sigma, and supply chain management. Tony manages a successful consulting firm, and his industry experience includes 20 years of supply chain management. He earned a Doctorate in Business Administration from Kennesaw State University and holds professional certifications in six disciplines, including the Project Management Professional (PMP)® certification from the Project Management Institute (PMI)® and Certified Six Sigma Black Belt (CSSBB)® from the American Society for Quality (ASQ)®.
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text: This news item expired on 5/31/2013, so the information below could be outdated or incorrect. Fox Found Positive for Rabies Buncombe County Department of Health officials have confirmed that a fox found near the Biltmore Square Mall has tested positive for rabies. Rabies is easily transmitted among wild animals and unvaccinated pets, and it's possible that the fox may have been in contact with other animals before being captured. Anyone in the Biltmore Square Mall area should be alert for any animal that may be behaving strangely such as acting aggressively, stumbling or foaming at the mouth. If such an animal is seen, take children and pets inside and call the Buncombe County Sheriff's office at 250-6670. See attachment to learn more. Table: News Item Documents File NameSizeTypeDate & Time Added Media Release 187 KB 05/24/2013 9:31 AM


text: Our buddy Frank Schuengel from Amadeus Photography is experimenting with shooting this year's Isle of Man TT in 3D. These shots of the 2011 MotoCzysz E1pc are anaglyph, meaning you can view them using 3D glasses, but he's also shooting for the latest generation of 3D televisions and computer monitors too. If you're so equipped, you can find those images on his website.


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I'm off to Sydney on the 24th for 4 days! - I'm sure Jack will be around
Hi Colin!!! Rosie here.........Your models at North head image both in colour and B W is great. Love it. Sitting here in rainy Hokotika with a very slow internet connection I couldnt get the inlarged images to download fully :-( Howz things? Miss the club and the like minded people..........Getting myself sorted now and should be on the forums more regularly. Plse have a look at my post at Photography Albums online....discussion...........plse help. I have some really great shots and would love to show case them. Hugs R
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text: Puma trainers - an integral part of the Puma brand that was founded by Rudolf Dassler (brother of Adolf Dassler, founder of adidas ). The company perhaps best known for its football boots and has sponsored football legends Pelé, Johan Cruijff, Enzo Francescoli, Diego Maradona, Lothar Matthäus, Robert Pires and Aleksander Hleb. In the United States, the company is probably best-known for the suede basketball trainer it introduced in 1968, which eventually bore the name of New York Knicks basketball star Walt "Clyde" Frazier. Puma is the third largest sportswear manufacturer in the world behind Nike and Adidas. In recent years the Puma brand has had a massive revival with the arrival of such trainers as the 'Car driver' and the 'Future Cat'. The Puma Suede trainer continues to be popular, while the more recent colaboration with Rihanna have led to the Puma Fenty, Puma Creepers and Puma Fierce. Office's collection of Puma trainers is distinctive and quirky, with a range of cutting edge designs and colours. Stand out from the crowd and visit www.office.co.uk to find the perfect pair for you!


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HISTORIC Towneley Hall is competing against nationally-renowned museums to bring the work of a leading contemporary artist to East Lancashire.
The Burnley landmark is up against the Surgeons Hall in Edinburgh and the Market Hall Museum in Warwick to attract the talents of Alex Hartley.
Part of the Museums at Night Project, Towneley will also be taking on the Berwick Gymnasium Museum to host a free event over the weekend of May 15 to 17.
All cultural and heritage venues are being invited to run evening events as part of the UK wide festival.
But public votes are the key to the competition and cultural leaders are urging townsfolk to sing the hall's praises for judges.
Coun John Harbour, the council's cabinet member for leisure and culture and a former borough mayor, said: "As usual Burnley is up there competing with cities and major galleries to host this event, to have got this far is proof of the cultural offer our town has.
"I'd urge everyone to vote, tell their family and friends to vote, and let's see Towneley Hall yet again recognised nationally."
If Burnley is successful London-based Alex, who was a leading light of the 2012 Cultural Olympiad, will stage workshops and installations at Towneley.
The venue has already become well-known on the small screen, as the backdrop to two series of Antique Master and a recent recording of Antique's Roadshow.
It also played host to Heritage Opera's world premiere live production of Mansfield Parkby Jonathan Dove, based on the novel by Jane Austen.
And the opportunity is the latest arts development to incorporate Burnley after the borough was one of five to receive £80,000 from the Arts Council to increase participation in the arts, from getting theatre touring companies to visit, to organising artist residencies.
Voting can be carried via the www.culture24. org.uk website, and a link for Alex Hartley.


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Topic: diagnosed with cholangiocarcinoma/bile duct cancer 3 months ago
I am done with radiation and have had three of six rounds of chemo. The first 2 rounds produced major nausea and fatigue. I had to have major spine surgery where there was a tumor separating it. I am 43 yr old guy.
I am able to eat finally and focus on treatment management. I could not really do this until now. I get an updated Scan this week, but know that the cancer has spread to many areas already.
Has anyone looked into CBD oil and extracts? Please message me if so.
I am interested in other alternatives and additions to my treatment style and am now learning quite a bit. I have been able to reduce my pain meds and manipulate my diet which has all worked together.
Thank you


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LECHLADE player-coach Luke Sellers is preparing his side for their biggest game of the so far, as the Manor Ground side get ready to host second-placed Rockhampton in a top-of-the-table clash on Saturday.
Sellers's men currently top the WEPL Glos/Wilts table and lead Rockhampton by 10 points going into the weekend fixture.
For Sellers, the outcome of this game could go a long way in ultimately determining who wins promotion to Premier Two come the end of the campaign.
"With six games still to play after this week's game, a loss for either side would not be an end to their title challenge," he said.
"However, there is no doubt that the winner of Saturday's game will certainly go into the rest of the season with the upper hand and the momentum in the title race.
"If you yook at the batting core of both side's there is not much between us.
"Brad (Dial), Joe (Breet) and Arran (Dickinson) have scored just short of a 1,000 runs between them so far this season, as have Guy Brothwood, Will and Matt Tyler for Rockhampton.
"On the bowling front, our strike and first change bowlers of Michael (Craigs), Sanks (Asanka Vithange), Willy (Nichols) and myself have taken 57 wickets between us so far, and Rockhampton's Will Cartlidge, Chris Perry, Brothwood and Dave McCabe have also taken 57 wickets this season, with the economy rates of both units very similar."
If Lechlade have any advantage over their rivals, Sellers believes it is in the depth of quality in the Lechlade side.
"Outside of their top three batsmen, Rockhampton have only one other batsman that has scored over 100 runs this season whilst we have three," he said.
"On the bowling side we have considerable options open to the captain with eight quality bowlers in the side.
"We also have Freddie Martin now available for the rest of the season and with Oli Thornley recently finding some form we bat to eleven and we are all capable of scoring quickly and big."


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An intoxicated woman seen driving her mobility scooter at Emery Gate, Chippenham, while swigging from a wine bottle was cautioned by police for being drunk in charge of a carriage.
The 53-year-old woman from Charter Road was caught on CCTV driving into the underground car park and drinking from the bottle.
Officers went to Emery Gate at 10.30am last Thursday and said she was slurring her words and smelled of alcohol. She was cautioned under Section 12 of the Licensing Act 1872.


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The statue was pulled down by Nazis in early 1939, in the wave of anti-Semitic and anti-foreign measures that followed the violent frenzy known as Kristallnacht. Destroying the statue was a crime against art, not history: Drake almost certainly did not introduce the potato to Europe. And even if he had, most of the credit for the potato surely belongs to the Andean peoples who domesticated it.
Geographically, the Andes are an unlikely birthplace for a major staple crop. The longest mountain range on the planet, it forms an icy barrier on the Pacific Coast of South America 5,500 miles long and in many places more than 22,000 feet high. Active volcanoes scattered along its length are linked by geologic faults, which push against one another and trigger earthquakes, floods and landslides. Even when the land is seismically quiet, the Andean climate is active. Temperatures in the highlands can fluctuate from 75 degrees Fahrenheit to below freezing in a few hours—the air is too thin to hold the heat.
From this unpromising terrain sprang one of the world's great cultural traditions. Even as Egyptians built the pyramids, Andeans were erecting their own monumental temples and ceremonial plazas. For millennia, contentious peoples jostled for power from Ecuador to northern Chile. Most famous today are the Inca, who seized much of the Andes in a violent flash, built great highways and cities splendid with gold, then fell to Spanish disease and Spanish soldiers. The mountain cultures differed strikingly from one another, but all were nourished by tuber and root crops, the potato most important.
Wild potatoes are laced with solanine and tomatine, toxic compounds believed to defend the plants against attacks from dangerous organisms like fungi, bacteria and human beings. Cooking often breaks down such chemical defenses, but solanine and tomatine are unaffected by heat. In the mountains, guanaco and vicuña (wild relatives of the llama) lick clay before eating poisonous plants. The toxins stick—more technically, "adsorb"—to the fine clay particles in the animals' stomachs, passing through the digestive system without affecting it. Mimicking this process, mountain peoples apparently learned to dunk wild potatoes in a "gravy" made of clay and water. Eventually they bred less-toxic potatoes, though some of the old, poisonous varieties remain, favored for their resistance to frost. Clay dust is still sold in Peruvian and Bolivian markets to accompany them.
Edible clay by no means exhausted the region's culinary creativity. To be sure, Andean Indians ate potatoes boiled, baked and mashed, as Europeans do now. But potatoes were also boiled, peeled, chopped and dried to make papas secas; fermented in stagnant water to create sticky, odoriferous toqosh; and ground to pulp, soaked in a jug and filtered to produce almidón de papa (potato starch). Most ubiquitous was chuño, which is made by spreading potatoes outside to freeze on cold nights, then thawing them in the morning sun. Repeated freeze-thaw cycles transform the spuds into soft, juicy blobs. Farmers squeeze out the water to produce chuño: stiff, styrofoam-like nodules much smaller and lighter than the original tubers. Cooked into a spicy Andean stew, they resemble gnocchi, the potato-flour dumplings in central Italy. Chuño can be kept for years without refrigeration—insurance against bad harvests. It was the food that sustained Inca armies.
Even today, some Andean villagers celebrate the potato harvest much as their ancestors did in centuries past. Immediately after pulling potatoes from the ground, families in the fields pile soil into earthen, igloo-shaped ovens 18 inches tall. Into the ovens go the stalks, as well as straw, brush, scraps of wood and cow dung. When the ovens turn white with heat, cooks place fresh potatoes on the ashes for baking. Steam curls up from hot food into the clear, cold air. People dip their potatoes in coarse salt and edible clay. Night winds carry the smell of roasting potatoes for what seems like miles.
The potato Andeans roasted before contact with Europeans was not the modern spud; they cultivated different varieties at different altitudes. Most people in a village planted a few basic types, but most everyone also planted others to have a variety of tastes. (Andean farmers today produce modern, Idaho-style breeds for the market, but describe them as bland—for yahoos in cities.) The result was chaotic diversity. Potatoes in one village at one altitude could look wildly unlike those a few miles away in another village at another altitude.
In 1995, a Peruvian-American research team found that families in one mountain valley in central Peru grew an average of 10.6 traditional varieties—landraces, as they are called, each with its own name. In adjacent villages Karl Zimmerer, an environmental scientist now at Pennsylvania State University, visited fields with up to 20 landraces. The International Potato Center in Peru has preserved almost 5,000 varieties. The range of potatoes in a single Andean field, Zimmerer observed, "exceeds the diversity of nine-tenths of the potato crop of the entire United States." As a result, the Andean potato is less a single identifiable species than a bubbling stew of related genetic entities. Sorting it out has given taxonomists headaches for decades.


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Hi there,
I know most melanoma patients don't receive chemo, which is the most common scenario for a chest port. But it's virtually impossible for the nurses to find my veins, and now that I've started an every-3-week infusion of PD1, we've decided that spending 30 minutes and many, many pokes is not worth it, and that a chest port shall be installed on August 7.
My question is, can the port be used for PET/CT and MRI contrast injections? Also, it seems surprising to me when people have mentioned using a "numbing cream" - does it hurt to have the port accessed?
Any other wise words would be greatly appreciated!
Thank you in advance,
laura - stage IV with lots of brain and body mets.
Re: Has anyone had a chest port installed?(7/18/2014 - 7:30pm)
Hey Laura,
I'm also getting anti-PD1. Mine is every 2 weeks. About 6 months ago a begrudgingly decided to have a port installed. Like you I was a very tough stick and it was starting to get old. I'm really glad I made the choice and I think almost everyone that has the procedure says the same thing. You can use the port for the contrast for scans. Only problem that arises sometimes is when you are at a facility that does not have a qualified nurse to access the port. That's happened to me a couple times but most facilities should be able to accomodate. I was very unpleasantly surprised that the first couple times the port was accessed it did sting quite a bit. The sting didn't last long but it caught me by surprise. After about the 3rd or 4th time it was accessed it really didn't hurt much. I've never used the numbing cream. Just like with some IV's, some times there's a little pinch but not bad. My facility has outstanding sterile procedures for accessing the port which is very important. Best of luck to you.
Re: Has anyone had a chest port installed?(7/18/2014 - 8:21pm)
I had a chest port (mine was a Hickman catheter, which is common, I think) placed for my TIL therapy and it was in for about six weeks total but they used it for everything — apheresis (a process to separate white blood cells from the blood), chemotherapy, blood draws, contrast, all the other various IV, IL-2, etc. It was placed by an interventional radiologist, they used a local anesthetic, and they use image guidance to get it right. A little sore the first day, if I remember correctly, but that was over three years ago.
I always just felt a little robotic with the thing hanging out of me, but that's a common feeling, I'm sure. It is certainly more convenient in many ways. Even daily blood draws at 5:30 a.m. at NIH I could just sleep through. For me the biggest downside was maintenance, especially at home. Inpatient, the nurses care for it, but at home, it still needed daily care. It needs to be sterilely flushed and cleaned daily, covered up in the shower, just kept pristine — makes sense, but it is work. We even had an hour-long "class" before going home on how to care for it. They sent us home with a 60-day supply of plastic saline flush syringes, alcohol wipes, plastic covers for the shower, etc.
I did manage to inadvertently loosen it playing tennis the weekend before I was heading back for a follow-up appointment that was going to include having the port removed, so when my doctor went to start removing it, it came right out, no problem. I was told that removing it is painless anyway, but... it was good to have in, and I was glad when it was out, if that makes sense.
Re: Has anyone had a chest port installed?(7/18/2014 - 9:39pm)
I had a port placed in early June before I started a PD-1 EAP. My veins had been getting worse and worse over the last couple of years between the surgeries, various therapies, and frequent scans. It got so bad last summer (when I was gettin Ipi) that it took them over 4 hours before someone finally got a catheter in. I decided after that experience that if I was going to do another IV therapy I would request a port. After failing Ipi last fall I was trying to get into a PD-1 trial and actually made an appointment to get a port. I ended up being disqualified from the trial, so I cancelled that appointment and went on the BRAF/MEK combo. When the combo began to fail in May and we headed off to join Merk's PD-1 EAP I set up another appointment.
There are a couple types of ports- some of them can have contrast injected into them, some can't. Mine is a "Power Port" which can have IV contrast injected into it for CT. I also have my blood draws done through it when I go for infusions. The first time it was accessed it was only 2 days after it was put in and I was quite sore so it was more painful than I anticipated. By the time I had another infusion it was healed and was much less painful. Still a bit more "pinchy" than the vein in the crook of your elbow, more like when they try for the smaller veins on the inside of my forearm, but the nice thing is that when you go for infusions and have to have scans, bloodwork, etc you only get one quick poke and it's done. I've never used lidocaine cream to numb it. I'm really glad that I have it, but it's not that "pretty"- it's a lump on my chest and no one can mistake it for anything else because the little nubbins that you use to figure out where the access point is are visible under the skin, and there's a small scar from the placement. They had a hard time getting it placed in me due to some changes to the pathways the vessels in my chest take (they've rearranged due to the many tumors that I've had in my breasts and lymph nodes). Due to that they had to place the tubing section higher in my neck than normal (typically they like to keep it below the collar bone, but mine is above). This means that the tubing is visible under the skin at the lower part of my neck and across my collar bone. For a while wearing a seat belt without a little padding was uncomfortable, but it heals really quickly and in my opinion it's 100% worth it, especially if your veins are overdue for a break.
With mine I can definitely have CT contrast (which was really important to me) but because MRI contrast is so much less volume (and I would assume possibly the same for PET scans) my local office won't use the port for MRI. They've never had trouble finding a small vein for a direct injection (no catheter), so I'm ok with that. Right now all my scans are happening at the center where I'm geting PD-1, so they access the port for everything and it's really nice not to have to worry about the pressure from the CT contrast bursting a vein or having to have multiple pokes on both arms trying to get access.
Re: Has anyone had a chest port installed?(7/18/2014 - 9:52pm)
Mine's a powerport like ecc26's. It's about 3 inches below my right collar bone. It's about the size of nickle and protrudes out about 1/4-1/2 inch. I'm a little lean so mine might protrude out more than the average. Unlike Joe's, mine and ecc26's port are placed under the skin so there aren't restrictions on swimming and things of that nature. Unless you are big into wrestling or martial arts fighting I can't think of many activities a power port would prevent you from doing. I believe my powerport needs to be flushed at least once every 30 days but since I get an infusion once every two weeks it's never been an issue because the nurses do it before and after each infusion.
Re: Has anyone had a chest port installed?(7/19/2014 - 6:00pm)
Last August I started a trial combining ipi and nivo sequentially. Started with an infusion of nivo every two weeks for 12 weeks, then an infusion of ipi every 3 weeks for 12 weeks, and now I'm in the "maintenance stage" which is a nivo infusion every two weeks. It's been a little bit of up and down for me during the trial but right now things are looking good. After the first Nivo phase I had good response and just about 50% reduction in tumors. After the ipi phase I had a slight increase in my two tumors and a breakout of mets in my right lung. After returning back to nivo the mets in my lungs have disappeared and my two original tumors shrank again and are now basically stable. Needless to say I can't say enough good things about the Anti-PD1 drugs. I've virtually had no side effects and pretty impressive results. I wish you the best as you start your treatment. I think you have a lot to be hopeful about.
Re: Has anyone had a chest port installed?(7/18/2014 - 10:23pm)
My husband has the power port. He has great veins, but makes his nurses and himself so nervous his blood often stops flowing during an IV insertion. He got the port for treatment of another disease about 9 months before he was diagnosed with Stage 4 melanoma. He is very happy with his port. He does use Emla on the skin that overrides the port, but I think it is more out of ritual than anything else.
Re: Has anyone had a chest port installed?(7/19/2014 - 8:08am)
Hi Laura,
I'm new to this illness but am a registered nurse who used to work for many years in HIV/AIDS before the fantastic combination therapies came on the scene. Central lines (ports and Hickmans) were frequently used for our patients who needed regular preventive IV antibiotics. They have been around a long time and are not new technology.
I used to teach my patients to use and maintain the port or Hickman line themselves and take ownership of it.
I realise that it is a slightly different care trajectory, but it worked very well generally - apart from one time a patient's dog decided to chew the end off a Hickman line whilst the patient slept on his sofa.....
Central IV access lines are great in my view. Sterile access is important so try to learn what you can about them in case you get a nurse who doesn't have much experience in managing them. The last thing you want is infection via a central line.
Re: Has anyone had a chest port installed?(7/19/2014 - 8:38am)
I also am a hard stick, i had a picc line put in for my interferon treatment (hated it) when it was finished they removed it..Did my scan and found out the interferon didn't work so went to Yervoy..Doc wasn't going to put anything in because Yervoy is only 4 treatments but the nurses advised him on how hard it is to find a vein for them to do infusions so he order a port placement...I like it so much better than a picc line..With the port i can go swimming and take a shower without having to worry about covering it up so it don't get wet..It doesn't hurt much when they draw blood..Good luck!
Re: Has anyone had a chest port installed?(7/19/2014 - 11:30pm)
A port is installed inside the chest. Nothing hanging out of chest.( It is not a PIC line.) I have had a double Bard Port in for 7 years now. Came in very handy when a horse killed me in 2010. Different ports can have different uses. I believe a "Power Port" is one of the most versitle (Verify what your's is and what it is available for.) Mine is an older one and cannot be used for the Scans, but can for most things. As far as the numbing cream - It is nice to have. Only had it once, but it should be administered about 10 minutes before the 'stick', this cuts down the patient thru-put, so it is seldom done. It is similiar to a shot. Pain goes away fast. Excession area was tender for about two days. Been no problem for many years now. I get it flushed every 3 to six months. Yeah, I was told it should be done every 30 days when it was iinstalled. Hasn't been done more than quarterly in 5 years. Sometimes is 6 months apart (depends on what I'm doing. Mine has not been blocked, even at the 6 month times.
I'm me, not a statistic. Praying to not be one for years yet.


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I would like to sugest that the pali subforum get out of the Classical Mahavihara category. Ben said that when posting there:
" (...) all answers should present references from either Pali language texts or expositions from scholars representative of the Mahavihara tradition. Any post that fails to comply with these guidelines may disappear without warning."
The pali language subforum shouldn't be restricted to the opinion of Mahavihara scholars. Modern scholars also have valid opinions.