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Harry Lever, MD Medical Director, Hypertrophic Cardiomyopathy Clinic, Robert and Suzanne Tomsich Department of Cardiovascular Medicine
Hypertrophic cardiomyopathy (HCM) is a complex type of heart disease marked by thickening of the heart muscle, left ventricular stiffness, mitral valve changes and cellular changes. HCM affects an estimated 600,000 to 1.5 million Americans, or one in 500 people. HCM is the most common cause of sudden cardiac death in people under age 30 and may be best known for its role in cardiac arrest and subsequent death in some young professional athletes. Dr. Lever, a Cleveland Clinic cardiologist and renowned expert on HCM provides answers to your questions about HCM.
Cleveland_Clinic_Host: Welcome to our Online Health Chat with Harry Lever, MD a staff cardiologist who will answer your questions about hypertrophic cardiomyopathy (HCM). Dr. Lever is renowned expert on HCM. Welcome Dr. Lever and thank you for being here with us today.
Speaker_-_Dr__Harry_Lever: Thank you for having me.
gdavisA: My son's heart was damaged by a virus about five weeks ago resulting in a 15% ejection fraction. Does he hypertrophic cardiomyopathy or some other form of cardiomyopathy?
Speaker_-_Dr__Harry_Lever: He has developed a dilated cardiomyopathy from viral myocarditis - that is not hypertrophic cardiomyopathy.
CLSTAR: I am late to the chat, so I don't know if this question has been asked; but what is the difference between hypertrophic and dilated cardiomyopathy?
Speaker_-_Dr__Harry_Lever: HCM is a thick walled heart with a small cavity and dilated cardiomyopathy is a thin walled heart with a large cavity.
LibrarianGirl: What is the likelihood of an adult who has been diagnosed as nonobstructed developing a significant obstruction later in life?
Speaker_-_Dr__Harry_Lever: We don't have statistics - but it is possible.
matt-st: What is the upcoming research or treatments for people with HCM?
Speaker_-_Dr__Harry_Lever: Treatments have not changed but we are carefully looking at papillary muscles, mitral valves, and scarring seen on MRI scan.
jess5: I was recently told I have SAM of the mitral leaflet with moderate obstruction – what is SAM and what does this mean?
Speaker_-_Dr__Harry_Lever: SAM stands for systolic anterior motion of the mitral valve. This means that the mitral valve moves anteriorly when the heart contracts and it can cause obstruction to blood flow resulting in increased pressure in the left ventricle.
racecartfan_2: Hi, I have been tested At a COE and echo shows no SAM. I also participated in a study at a different COE that ran an MRI with contrast, The results state HCM with SAM. Which do I believe? I also wonder if SAM would be more evident if exercising while the echo is performed.
Speaker_-_Dr__Harry_Lever: Patients with HCM can have resting obstruction or they can have provocable obstruction and if we find no resting obstruction, we use provocative maneuvers such as stress testing - using a treadmill or upright bicycle.
racecartfan: Hi Dr. Lever. I have been receiving care for HCM at a COE for HCM. The diagnosis is that I am not obstructed. I participated in an MRI (with contrast) study at another COE which concluded that I have HCM with SAM. I brought the results to my appt. at my COE and they don't agree with the SAM diagnosis (even after looking at the same MRI Disk). Who do I believe? When I look at the MRI, it looks like the leaflet is hitting the septum but I realize that I am not qualified to read an MRI. I am stumped that I have conflicting diagnosis from two COE's. Can you comment?
Speaker_-_Dr__Harry_Lever: we have a service called eclevelandclinic - I could evaluate your information and provide you with a second opinion through this secure online service - or I would be happy to see you for an appointment.
jall49: Dr. Lever: In following the national health insurance debate, it looks all the plans contemplate some type of panel of super docs (like you) who will recommend what tests should be reimbursed and which one will not. Assuming that passes, what is your best guess as to how our annual HCM check-ups might be affected at places like Cleveland in terms of what tests will stay, which might be less frequent or which might be dropped, if any?
Speaker_-_Dr__Harry_Lever: The two most important tests for yearly check up are an echocardiogram and a holter monitor.
shirleymy: My question is in a metabolic stress test your oxygen is it supposed to fall during the test, and when I was done they took my BP and it was 170/50, is this ok?
Speaker_-_Dr__Harry_Lever: It depends on your baseline blood pressure. Oxygen is not supposed to fall.
howardgef: Dr Lever, at what age is a Holter Monitor recommended? Our 3-yr old daughter was diagnosed with HCM at 7 months of age. A recent ECHO showed that her heart is within normal limits all around, but she's never worn a Holter Monitor, so I still worry that we aren't seeing the full picture. Her EKGs have always been normal, but I understand those are just a snapshot in time.
Speaker_-_Dr__Harry_Lever: Why does your daughter's doctor think she has HCM if her echo is within normal limits?
buly: Would that be the same two most important tests for kids? Anything else that they must have each year?
Speaker_-_Dr__Harry_Lever: The holter monitor and echo are the two most important tests. If a relative was gene tested and positive for a specific gene and they were to have a gene test and don't have it - you don't have to continue with the screening.
elaine: Also my own EKG has show problems lately, is this the disease showing itself?
Speaker_-_Dr__Harry_Lever: You have many questions - it would be best for you to call.
dorothy015: What type of MRI needs to be done to determine amount scarring in the heart, what is the contrast called? If myectomy has been done and holter screening are ok, could there still be a need for an ICD based upon scarring?
Speaker_-_Dr__Harry_Lever: Gadolinium is the contrast. We would need to evaluate you for need for ICD.
lmthole: My 20 y/o son and 14y/o dtr have both tested positive for the gene for HCM. Both have rigorous and strenuous athletic schedules. After having an echocardiogram and EKG that resulted as "normal", their physician stated they could resume their normal lifestyles. Is this advice accurate?
Speaker_-_Dr__Harry_Lever: Yes - but they need to be carefully monitored with an echo at least every other year. They may never develop the disease.
captom: In addition to HCM, extended family members also have thyroid problems and 4 have had pituitary tumors. Is there a form of HCM associated with these issues?
Speaker_-_Dr__Harry_Lever: Not that I know of.
rlhall: What is the status of genetic tests for hcm?
Speaker_-_Dr__Harry_Lever: It is becoming less expensive and we are using it more.
chad23: Is HCM something you are born with – I have a friend that is 18 years old and she has HCM – do you get it or is it genetic?
Speaker_-_Dr__Harry_Lever: In someone of that age - it is usually genetic.
lesliberk: If the father has HCM should kids with functional murmurs be evaluated further? Pediatrician said not necessary, but HCM is new diagnosis, so he is not aware of that part. Thank you.
Speaker_-_Dr__Harry_Lever: Yes - they should be screened. This is where gene testing could be helpful. If they find the gene in the father but not in the kids, then there is no further need for screening.
elaine: I have positive results for the HCM gene. Presently I have only a small thickening of my heart muscle 1.3. My two brothers have Hcm and are my only siblings. One brother went into full cardiac arrest and was revived after a few minutes but suffers from brain damage. He has an ICD. The other brother, I have some symptoms of the disease, like shortness of breath and trouble with steps. My second question concerns my two daughters. They haven't been genetically test yet. One daughter is extremely physically active. She works out at least three hours a day. Will that cause her harm? The only two other relatives in my family are my brothers two kids who have tested positive to the dna gene. PLEASE RESPOND!
Speaker_-_Dr__Harry_Lever: Your children should be gene tested.
You should also have an MRI to look for scar and have your rhythm monitored with holter monitor and you should have a stress test. We would be happy to see you - or you can go to www.4hcm.org to find a HCM specialist close to home.
lesliberk: Is genetic testing covered usually under insurance? If not, how expensive is it? Sorry, I know you are not a billing person.
Speaker_-_Dr__Harry_Lever: Some insurance cover it and some do not. It depends on the laboratory you are using what the cost is. Some are willing to take only what insurance pays - you may need to ask your insurance company as well as labs.
elaine: I had a heart MRI that showed no scarring. The gene found was MYCBP3, which I was told causes late onset HCM. One of my brothers was first diagnosed at 56. I have been told the probability of getting the disease is about 90% Is this right? What tests should I have done and how often should I be checked? As to my two daughters should I have them genetically tested or should I have EKG's or echos?
Speaker_-_Dr__Harry_Lever: Have you had an echo - if not, you need one - and if positive a holter monitor. If you have HCM by MRI or echo - should be seen once a year.
Your daughters should be genetically tested as well.
kterry: Are you saying that SOB, chest heaviness with related upper back pain and short periods of dizziness or lightheadedness even when resting should be treated with intervention other than just medications?
Speaker_-_Dr__Harry_Lever: You would need to be evaluated at that point for the best treatment for you.
captom: I have always been fatigued even as a child,and have thought that HCM contributes to this, is there anyway this can be managed---I am taking Verapamil but this not beta blockers have had an effect.
Speaker_-_Dr__Harry_Lever: You really need to be evaluated to provide you with an answer.
kterry: Is the upper back pain I experience common or is that due to something unrelated? It seems to come more when I'm on my feet at work and my chest gets heavy.
Speaker_-_Dr__Harry_Lever: If it occurs with exercise - then it can be related to HCM. You should see your doctor or we would be happy to see you at Cleveland Clinic.
jall49: I have run across a number of people with HCM and also thyroid issues. Could of course be all anecdotal and coincidence, but I was curious if you have ever noted this in the large population that you follow?
Speaker_-_Dr__Harry_Lever: I cannot say that I have noticed this.
mcolem: Would you do any interventions with a 51 year old on bystolic 5mg who has a ppm and has for a while shortness of breath at the start of activity, steps, lawn mowing, walking etc. Seems better once he's into it 10 min. or more. Feels that his heart needs to "catch up" I also noticed pursed lipped breathing that he says is a habit now. He has not tolerated higher doses of beta blocker in the past do to low BP. Also did arise quickly from a nap this weekend and fell to his knees, before almost passing out. Very new for him.
Speaker_-_Dr__Harry_Lever: It is time to be seen with these changes in symptoms. We would be happy to him.
JudyAB: Can PredForte eye drops used over a one month period affect an HCM heart ? If so is it enough to necessitate finding an alternative med?
Speaker_-_Dr__Harry_Lever: PredForte eye drops are fine.
kterry: I am currently on metoprolol xl 25mg and prn lasix for when I feel the pressure in my chest building up. Are there any other suggestions you have that I could present to my doctor medically that would possibly help before considering anything invasive? The heaviness in my chest also seems to cause upper back pain and I am wondering if this is a common thing with this or something unrelated?
Speaker_-_Dr__Harry_Lever: I would increase the dose assuming your heart rate is not too low and your blood pressure will tolerate it. If you continue to have symptoms you can add diltiazem or verapamil. If you still have symptoms a drug called disopyramide can be used - but it has to be started in the hospital.
buly: Are there long-term negative consequences to beta blockers? How about to early implantation of ICDS? (another pediatric concern!)
Speaker_-_Dr__Harry_Lever: No to beta blockers. Of course it depends on how young the kid - ICD leads need to be carefully placed to allow for growth of the child.
Jillmgk36: Are there any contraindications to taking Adderall XR for ADHD when one has high LV pressures?
Speaker_-_Dr__Harry_Lever: We don't like to use it. You need to see someone who understands HCM.
shirleym: This is for Dr. Lever: I have Hypertrophic Cardiomyopathy and I have had a myectomy in 2004, Was told I was restricted 6 months later both ventricles and now my echo is showing a completely normal heart , How could this happen? Could my heart be remodeling? I thought once you have HCM you have it for life. Thank you.
Speaker_-_Dr__Harry_Lever: It is possible that the Hypertrophy after successful myectomy could regress somewhat. It is not clear that the muscle could become absolutely normal but that is not a major concern as long as you are feeling well.
567LY: I had a myectomy 5 years ago. I now have moderately severe mitral regurgitation and my outflow tract obstruction has come back – significant. What do you suggest in my situation – for recurrent outflow tract and need for mitral valve surgery? What are my options?
Speaker_-_Dr__Harry_Lever: We need to see you to be thoroughly evaluated.
youngatheart: By way of reference I am almost 5 weeks post Septal Myectomy at Cleveland Clinic. I have HOCM with a gradient at rest of 120. I have several questions and you can answer all if possible. 1)Are the normal post surgical results a zero gradient or is it more normal to be left with a gradient/obstruction.? 2) Realistically how much thinning of the septal muscle and lowering of a post surgical gradient can one expect with "remodeling"? 3)Please explain what is meant by the left branch being "shot" by surgery. 4) What is your view on Genetic Testing for HCM patients? I have teenagers and they have been tested and cleared. My immediate family has also all been tested and are all clear. Thank you.
Speaker_-_Dr__Harry_Lever: Let's get you in touch with your doctor at the Cleveland Clinic to answer your questions. You can contact Dr. Lever directly. If your family members have been tested and cleared - they do not have to be further screened.
heart1996: Do I need to have a check up every year, or is every other year okay as long as I am feeling fine? My myectomy was in1996 and I received a pacemaker in 2005.
Speaker_-_Dr__Harry_Lever: The pacemaker has to be checked yearly and we like to see people every year for a follow up evaluation.
vive34: If you have HCM – will it always progress to needing surgery? Are there things you can do like diet and exercise to prevent that? Can the septum ever get smaller without surgery?
Speaker_-_Dr__Harry_Lever: If you have HCM it does not necessarily progress to surgery. We tell people to avoid weight training - but there are no specific diet or exercises to prevent it. We do know of any cases of the septum getting smaller without surgery.
kterry: I was diagnosed with HOCM a year ago. I have an appointment with my cardiologist this afternoon to discuss the results and any changes from last year in an echo and holter monitor testing I had 2 weeks ago. He is familiar with the diagnosis but doesn't see many patients with it in this rural area. I am a nurse as well and have done my own research on the disease. I have noticed more and more that my stamina is decreasing and am not happy with living this way. Is there any reason that alcohol ablation could not be the first invasive treatment to attempt prior to doing open heart procedures to correct the situation?
Speaker_-_Dr__Harry_Lever: We don't like to do alcohol ablation in young people because they leave scars in the heart muscle. If the alcohol is not successful then the results of surgery are not quite as good - and there is a high likelihood of needing a permanent pacemaker after surgery if it is preceded by alcohol ablation.
kterry: What is the success rate with ablation in shrinking the muscle enough to be normally active once again and what are the actual risks of the alcohol going down a coronary artery during the procedure? And with myectomy how soon should one see significant reduction in symptoms? Also, with either procedure, will life ever be "normal" again?
Speaker_-_Dr__Harry_Lever: An overall success rate for ablation is 75 - 80 percent. It is not as good as surgery. And the risk of alcohol is not very high if done by someone who knows how to do it.
With myectomy - one should see reduction of symptoms pretty much right away allowing for healing after surgery.
I would expect life to be normal again for most people.
eechiez_2: Is there evidence that repeated use of the chest muscles in ICD wearers increases the possibility of a fracture in the leads? If so, what is recommended for very active ICD wearers?
Speaker_-_Dr__Harry_Lever: Yes excessive use of chest muscles can lead to lead damage. You could ride a bike - you can swim, walk. No contact sports or weight lifting.
mcolem: Are you of the opinion that a 51 year old with a pacemaker inserted 5 years ago for bradycardia, should have an ICD instead?
Speaker_-_Dr__Harry_Lever: Not necessarily - it depends on the clinical situation. If you are having ventricular tachycardia - then an ICD may be necessary. Also in cases of poor ventricle.
markiev: I am 25 years old. My dad has HCM with a defibrillator put in. My doctor told me to keep an eye on symptoms and if they get worse – I should have an ICD put in too. I don't want an ICD put in if I can help it – how do they know when you need one? If you have one, does it make you more tired?
Speaker_-_Dr__Harry_Lever: It does not make you more tired. We carefully monitor for rhythm disturbances - but you really need to be seen.
jall49: Dr. Lever: For someone with a very small resting gradient, but a gradient that gets up between 100 and 200 with exertion, does the gradient cause any long term damage to the heart during exercise. Assume that the exercise is "HCM safe" (ie not basketball or the like) and is of moderate intensity for about an hour.
Speaker_-_Dr__Harry_Lever: We do not absolutely know the answer to your question but you have to be carefully monitored with yearly echo and Holter monitor and should you develop any symptoms with exercise such as shortness of breath, chest pain or dizziness- then an intervention would be required.
mcolem: Does regular, moderate aerobic exercise cause progression of HCM? This is for an active 17 year old with no outward symptoms, but a thickness of 30 and some fibrosis, and an ICD for precaution. Also, could exercise increase fibrosis?
Speaker_-_Dr__Harry_Lever: Moderate regular exercise does not cause progression of HCM that we know of - and we do not know if it increases fibrosis. However, we like to have patients on beta blocker medications.
buly: How about skiing with HCM? What are the dangers if it's not excessively cold and you're not pushing it?
Speaker_-_Dr__Harry_Lever: It depends on the altitude as well as "pushing it" - if you wanted to ski I would do lower elevations - and if you get short of breath or symptoms - stop.
buly: I didn't know there were altitude considerations for HCM hearts--what are the altitude concerns and at what altitude?
Speaker_-_Dr__Harry_Lever: At higher altitude it decreases the amount of oxygen you inhale and increases stress on the heart.
cindyL: Is HCM the same condition that causes sudden death in young athletes – they do not provide any special screening at my son's school. How would he know he has that before he begins football this fall?
Speaker_-_Dr__Harry_Lever: Yes - this is what causes young athletes to fall from sudden cardiac death. He needs to have a thorough history and physical exam, including a family history. If there is concern, he needs to have an electrocardiogram (EKG). If that is abnormal, other studies can be done.
buly_2: Hi Dr. Lever, We have a 7 year old with an impressive septum -- 4.0 cm and no symptoms, we're wondering what the latest is on kids with HCM and one risk factor like this is----do we try to wait until she's 10 to place an ICD (some folks recommend that)? Do we do it now and risk the other complications from that? She is gene positive, found out dad has the gene and grandma (she's now in her 80s). We also wonder, if this was your grandkid what pediatric HCM specialist would you take her to? The pediatric HCM world is a very scary place to be.
Speaker_-_Dr__Harry_Lever: It is best for your daughter to be evaluated. At the Cleveland Clinic - you could see Kenneth Zahka. We do eclevelandclinic - but he is not a doctor on that service - but has a long history of treating HCM pediatric patients. For other hospitals - I would suggest you contact 4hcm.org.
howardgef: Regarding my 3-year old daughter's HCM, I should have clarified that her most recent ECHO showed her heart to be within normal limits. It had not been in the past. From everything I've read and heard, though, I'd call it "resolved", although I understand that she will need to continue to be monitored annually. Just wondering if a holter monitor would reveal anything the ECHO hadn't. Thanks!
Speaker_-_Dr__Harry_Lever: I would suggest that you have a second opinion with Dr. Zahka. Holter is looking at heart rhythm. An echo looks at heart structure and function.
Jillmgk36: Is papillary muscle "displacement" in and of itself considered a form of HCM? if so, is it felt to be genetic?
Speaker_-_Dr__Harry_Lever: In some cases it may be - but we do not have enough data to be certain at this time. It may be genetic.
Jillmgk36: My son has papillary muscle displacement but no septal thickening or other signs of HCM. he shows high pressures during exertion on the stress echo there at CCF. he has been advised to stop some of his athletic activities, but will medications such as beta blockers also be needed? he feels fine and in typical teen fashion, not too eager to accept limitations since he has had no symptoms.
Speaker_-_Dr__Harry_Lever: He still needs to be on beta blockers.
stiffheart: Can someone with HCM have a successful pulmonary vein ablation to control a-fib?
Speaker_-_Dr__Harry_Lever: Yes - they can have a pulmonary vein ablation to treat afib.
LindaS: Has EECP been used to relieve ongoing angina after medications have failed?
Speaker_-_Dr__Harry_Lever: No - not for HCM
JudyAB: Dr Lever- I was seen by you in may 2007, post alcohol ablation in another state, and have had a somewhat roller coaster ride since then, but have been pretty stable for the past year after following your main suggestion to lose weight (50 lb so far) My most recent cardiologist is wonderful and has helped me find a good balance of meds(Cardizem 240 BID and bisoprolol 2.5mg daily) I do not currently experience any noticeable arrhythmias since he placed me on potassium to keep my levels in the middle of the normal range. In fact I am a nurse working part-time in home care and feeling better than I have in 10 years. Good enough to be in denial that I have very many problem at all! as long as I do not overexert myself. now the rub - this wonderful local cardiologist is retiring next month.(Columbus, Ohio) Do you have any protégés that have relocated to the Columbus area? If not any other cardiologist to suggest? Thanks for all you do for this HCM community!!!
Speaker_-_Dr__Harry_Lever: Please call me at work.
Cleveland_Clinic_Host: I'm sorry to say that our time with Dr. Lever is now over. Thank you again Dr. Lever for taking the time to answer our questions about hypertrophic cardiomyopathy today. Please visit http://www.4hcm.org/ for more information on HCM. The Hypertrophic Cardiomyopathy Association website is a great resource for HCM patients and family members is.
Speaker_-_Dr__Harry_Lever: Thank you for having me today.
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- 20 Oct 2014 - Biesterfeld AG announces minority partnership with Hannover Finanz Group to strengthen growth ambitions »...Source: Biesterfeld Press release
- 16 Oct 2014 - Surfachem Ltd, a 2M Holdings Ltd Company, strengthens its Marketing team »...Source: Surfachem Press Release
- 10 Oct 2014 - Ravago Chemicals (formerly BRCS) acquires UK specialty distributor, Innovia Solutions »...Source: Innovia Solutions Press Release
- 6 Oct 2014 - Caldic expands production capabilities and services in silicone preparations for food and personal care »...Source: Caldic Press Release
- 30 Sep 2014 - Hawkins to acquire Florida-based distributor of water-treatment chemicals, Dumont Company »...Source: Hawkins Press Release
- 30 Sep 2014 - Omya and Algol Chemicals to establish Russian JV for the distribution of calcium carbonate and specialty chemicals »...Source: Algol Chemicals Press Release
- 30 Sep 2014 - Brenntag set to acquire Chimab SPA, an Italian distributor of food ingredients »...Source: Brenntag Press Release
- 29 Sep 2014 - Recently floated IMCD Group acquires Danasia Inc., Philippines as it continues to expands its global network »...Source: IMCD Press release
- 15 Sep 2014 - Colonial Chemical Solutions, Inc. has merged with fellow US chemical distributor Acme Southern, Inc »...Source: Colonial Chemical Solutions Press Release
- 11 Sep 2014 - Banner Chemicals UK, part of the 2M Holdings, signs Worldwide licensing agreement with Pigmentan »...Source: Banner Chemicals
- 8 Sep 2014 - International ingredients distributor, Barentz establishes its first office on the African continent »...Source: Barentz Press Release
- 2 Sep 2014 - Brenntag buys Pioma Chemicals as they continue to build-up their distribution business in India »...Source: Brenntag Press Release
- 16 Aug 2014 - Australian multinational, Orica to demerge or sell its chemical distribution and manufacturing business »...Source: Orica ASX announcement
- 16 Jul 2014 - UK based 2M Holdings becomes the latest distributor to join FECC »...Source: FECC Press Release
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text:
Community Partners for Affordable Housing (CPAH) provides safe and healthy affordable housing along with support and skill building activities for individuals and families with the greatest need who live or work in the Tigard-Tualatin area, Beaverton and SW Portland, Oregon.
CPAH owns seven apartment complexes which provide housing for families at 60% or less of the Portland metropolitan area median income:
|* The Knoll at Tigard
|* Village at Washington Square
|* The Watershed at Hillsdale
|* Greenburg Oaks
|* Oleson Woods
|* Metzger Park
|* Spencer House
|Income Property Management
|Cascade Management, Inc.
The Barcelona is moving forward! The Barcelona at Beaverton, a four-story affordable housing project (47 units) to be developed by Community Partners for Affordable Housing, is one of two projects slated to be built in Old Town Beaverton – along with a five-story retail-commercial-market rate housing project developed by RKM Development Inc.
The two projects are planned for the block located between SW Lombard and Chapman avenues and First and Second streets in Beaverton, and construction on The Barcelona is slated to begin fall 2014.
CPAH's flagship fundraiser was once again a huge success! Check out photos from this year's event on our Facebook HomeWord Bound photo album.
CPAH is celebrating 20 years of Building Housing, Building Hope, and Building Lives. Download a copy of CPAH's 20th Anniversary brochure.
Watch the video for a glimpse of what we've accomplished, with help from our partners and supporters in the community!


text:
Illustrations for shirts and some others graphics works by me
Asgard Tales
Here's my submission to the Threadless Thor Challenge, with the classic style from the magnificent Jack Kirby and the iconic reference from the Star Wars Episode IV poster.
You can now vote for this design to become an actual shirt right here.
Home • Archive • RSS • hasaportfolio theme by matt mcinerney


text:
PROPERTY "FOR SALE" Info
About HAY-YO-KAY
About the Water
Area Attractions
Contact Us
to Hay-Yo-Kay Hot Springs,
located in Truth or Consequences, New Mexico, USA.
We are located approximately midway between
Albuquerque, New Mexico and El Paso, Texas
on Interstate 25.
Hay-Yo-Kay Hot Springs
, originally known as
Hot Springs Bath House, was constructed in 1920
and has been in the Kortemeier Family since the
early 1970's. We are the oldest, continuously
operating bath house in town.
We offer hot mineral "baths/soaks" in private
natural artesian spring fed pools.
Our indoor facility features six (6) private pools of hot mineral water,
each fed by its own artesian spring. Outdoors we have five (5) pools,
including "The Longhouse", approximately 20' x 10' x 4' deep, which
is the largest free flowing pool in town.
Water temperatures range from @98 degrees F to 108 degrees F
(104 degrees F = 40 degrees C). Our mineral water is some of
the most heavily mineralized water in the United States at
approximately 2541 parts per million of total dissolved solids.
We have seasonal hours but are usually open from
10 am - 7 pm - Wednesday - Friday
Saturday 1o am- 8 pm
Sunday 10 am - 5 pm.
Closed Monday & Tuesday
We are also closed on
Thanksgiving and Christmas Day.
We look forward to seeing you...
Thanks for coming to visit!
Return To Top
Copyright Hay-Yo-Kay Hot Springs 2014
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text: GA Voice Pet of the Week: Saffron The GA Voice Editors October 19, 2012 Features Name: SaffronBreed: Hound/MixAge: 3 monthsSex: FemaleAdoption fee: $225 Saffron is a loving little puppy with so much love to offer. She would love to grow old with an affectionate and loyal family. She is anxious to learn new things, and she will do great with training. Like a true baby, she loves toys and treats! PAWS Atlanta5287 Covington HighwayDecatur, GA 30035770-593-1155www.pawsatlanta.org Photo by Jennifer Gregg SHARE ON Leave a Reply Cancel Reply Your email address will not be published. Name* Email* Website six × = 54 Comment Notify me of follow-up comments by email. Notify me of new posts by email.


text:
"get out of my face daniel!" you say. diggy doesn't listen. he just goes on and on with his little rant. you were not even listening at this point you slid under his arms to get away from him. he grabs your arm and slams you back into the wall. "Ouch diggy what the hell!" you scream. you get fed up a just kind of lose it, you slap diggy right across the face. making a shocked look grow on his face.
diggy unpins you from the wall and walks over to the bed. you're still angry but you walk over to him. you could tell he was holding back from hitting you. diggy quickly gets up and screams "you know what! im going to be ungrateful too, get on your knees… NOW!" you being scared you did as he said. diggy starts to circle around you saying "i bust my ass daily for you, and never get a thank you. you always think im cheating just because i don't text you back a few times BECAUSE im working to keep your stupid ass happy!"
"im not stupid!" you scream". "SHUT UP!" diggy screams back. you were really scared, what was he doing to do? was he going to hurt you? or something worse. diggy angrily laughs and says "you're accusing me of cheating me so much that i would think YOU'RE cheating, why YN? why do you think im cheating? why do you put me through hell? huh". "i don't put you through hell" you say softly.
"well what do you call these last few months then?" diggy says. you try to get up. but diggy screams "Get back on your knees NOOWW!" you do as your told not daring to get back up. "all we do is argue YN, you don't know how much i care for you but it's slowly fading away before of you being insecure " diggy says. "im not insecure, you're a liar" you growl
"i'm a what?" diggy says roughly picking your chin up "wanna repeat that?". i tear flows down your face. when diggy sees the tear he slowly lets go of your chin, as if he regrets yelling at you or something. "and now you wanna cry and make me look like the bad guy" he says. "you always flip things on me, and im tired of it!" you scream. "shut up before someone calls the feds over here!" diggy says.


text:
Below are the first 10 and last 10 pages of uncorrected machine-read text (when available) of this chapter, followed by the top 30 algorithmically extracted key phrases from the chapter as a whole.
Intended to provide our own search engines and external engines with highly rich, chapter-representative searchable text on the opening pages of each chapter. Because it is UNCORRECTED material, please consider the following text as a useful but insufficient proxy for the authoritative book pages.
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OCR for page 38
Guidelines for Transportation Emergency Training Exercises Badges; Name tents and table tents; Invitation packages; Rules of conduct signs; Sign-in sheets; and Participant feedback forms. The G&T Secure Portal contains sample room layouts, invitation packages, sign-in sheets, and partici- pant feedback forms. HSEEP Volume IV describes these materials and is available at http://www.ojp. usdoj.gov/odp/docs/HSEEPv4.pdf. MEDIA POLICY Members of the media can support the transportation progressive exercise program. Not only can they inform the public that an exercise is taking place, but they can also make the public aware that the trans- Transportation portation agencies and public safety community are preparing for disasters and terrorism. agencies, perhaps more than their Most experienced exercise planners in the transportation community recommend close coordination partners in public with the media. Many agencies even include media representatives as participants in tabletop exer- safety and cises, since their activities and perspectives will help ensure that transportation service changes and emergency delays are broadcasted in a timely and accurate manner and that, in the event of a major incident on management the transportation system, the emergency response and investigation are broadcasted. Media partic- agencies, have a ipation builds trust and understanding and provides additional working contacts. In addition, members long history of of the media may learn more about what is involved in responding to an emergency in the transporta- including media tion environment. representatives in tabletop exercises. Of course, if the media participates, an agreement needs to be established with the participating media representatives that they are there as participants and are not to report on the specific event. The exer- cise planning team should discuss possible media involvement with all participating agencies and deter- mine if any elements of the tabletop are considered too sensitive for media involvement. If so, certain restrictions can be placed on media participation. Whether the media participates in the tabletop or not, the transportation agency should develop a writ- ten news release to be disseminated to media outlets. This release should inform the media and the public about the tabletop exercise. Additionally, the news release can be distributed to VIPs and other observers as further evidence of the transportation agency's commitment to its exercise program. The news release may include the following information: Introduction to exercise, Identification of the sponsoring transportation agency, Brief overview of the transportation agency's progressive exercise program, Exercise purpose and expected outcomes, Exercise scope and duration, General scenario information (e.g., location, goals, and objectives), and List of participating agencies. 38


text:
A Promise to Remember
- Thursday, November 01, 2007
She swiped at her painting, the bright colors blending and cutting mournful gray across the canvas in four long streaks. Those eager, smiling vehicles could not pretend to be all right anymore. The cars were frauds and liars anyway. They weren't happy. Nothing could ever be happy again. Andie used both hands, wiping and mixing until the entire scene vanished into unrecognizable, unknowable darkness. A dark reflection of how she felt.
"What do you think you're doing?" Blair's voice was followed by the music clicking off. Andie had been so engrossed in her pain, she hadn't heard him enter the house. She didn't turn.
His footsteps paced toward her but did not stop, his shoulder brushing hers as he strode to the window, squatted, and picked up the brush, careful to hold it away from his gray suit.
He turned. "Andie, if this dries, it'll ruin the sealant we just put down."
He dropped the brush into a cup of turpentine with a splash and snatched a rag. After scrubbing for some time, he stood and wiped his hands on the cloth. "I got it off the floor, but it smeared on the window. You'll need a razor to get it all."
Andie looked at her husband's handsome face. The salt and pepper of his hair only added to the lightness in his blue eyes. Eyes whose spark now dulled when he looked at her.
He hung the rag over the edge of the utility sink. "What is this all about?"
She wiped her eyes and choked on the words. "The painting for the fundraiser."
He brought her a towel for her hands and leaned over for a closer inspection. "No wonder you're in such a state. What are you thinking? No one expects you to do this now."
"Chad wanted me to do it. It was important to him."
Blair knelt before her, his eyes suddenly soft. "Andie, Chad is gone." He stopped, swallowed hard. "Torturing yourself over projects at his school—a school we no longer have a child attending—is not going to change that. This isn't healthy. You've got to stop."
"Chad was chairman of the committee. His dream was to double last year's fundraising. The least I can do is try to help."
She wouldn't say the rest, but Chad's words still bounced through her memory. "I'm going to show them all—just like Mom does with her cancer fundraiser every year."
"Oh, Sweetie." Blair wrapped his arms around her and pulled her close.
Andie sank into his arms. Sobs spilled forth, like a tube of paint bursting, splattering everything in its path.
Blair's arms trembled and she realized that he, too, was crying. Some time later, they pulled away from each other, tears spent. Blair's face was set in decision. "How much money did the scholarship fund raise last year?"
"Twenty thousand dollars."
Blair lifted her chin with his fingers so that she was forced to meet his eyes. "Okay, here's what we're going to do. Tomorrow, I'll go to the school office and tell them that our family is donating forty-five thousand dollars to the scholarship fund. We'll do it in Chad's memory. How would that be?"
She looked back at the smeared scene on the canvas. "What about the painting?"
"That goes away. Things like this will only pull you down. We need to be strong and keep going. For Chad's sake."
Andie nodded. Chad would want her to keep going. "Okay. For Chad's sake." I'm sorry I let you down again, Chad.
* * *
Melanie Johnston placed the stack of mail on the frayed bedspread, then settled herself on the lumpy mattress. She sliced through the first envelope. The cream-colored card inside was embossed with a shining cross on a hillside and glossy doves flying in the sky above. She flipped it open, not bothering to read the poem of five or six verses. Why should she care what some poet thought about grief? She knew grief, lived it, and there was nothing poetic about it. She skipped instead to the handwritten message below, scrawled in blue ink.
Jeff's absence has left a hole in all our hearts. My greatest comfort is knowing I will see him
again in heaven, someday. Please feel free to call or visit if you ever need to talk.
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text:
So Halle Berry's baby has been officially and belatedly unveiled. That's Nahla at the L.A. Zoo. So you be the judge ...
I actually admire Halle for not "selling" pictures of her baby girl. Very cute child.
Beautiful. Both of them.
Dang! I thought for a minute that this was Michael Jackson with his 50th Birthday present to himself. My bad!
She's OK.
Sooo beautiful!
Aw. Her baby is adorable.
she's gorgeous!!! just like mama!
So who is the old lady next to her..nanny? Anyway why no man at the zoo?
Gorgeous baby! Cute nose, full lips, pretty complexion. We've got another star in the making! Should have made money from the pictures though. Just give it to charity. Why give paps and mags the pics for free?
Very gorgeous baby. Good for Hallie Berry for not selling her child's photo to the magazines. She's simply a beautiful mother.
The woman with her, is Halle's Mother.
The "old lady" next to her is her mother.
That baby is gorgeous!
Beautiful child. I love her arched eyebrows and full lips. She seems to have light eyes. I wonder if they'll stay light.
Some of y'all are so disrespectful! Y'all know that baby is pretty as hell!!!!!!!!


text: STEAMPUNK Now here is just the thing to go with your top hat, brass goggles and sidewhiskers. From an excellent site giving detailed instructions how to build a variety of Electric vehicles with much useful information on suppliers both UK & US. A small Electric "Genevieve"but no Kay Kendall alas. Ex SU Electric Car steampunk


text:
30dayPUSH: Day 17
Today is Back and Shoulders
I decided to lift heavy today since I have been lifting light with more reps and slower. It felt good to be lifting heavy again! Now if I can just get my diet 100% under control! I splurge at night on the sugar x__x
Here is my heavy back/shoulder work out.
Keep up the hard work FitFam!
**DB Press 12,12,11,10 [35,40,45,50]
Side lateral raises 15,12,12,11 [15,17.5,20,22.5]
Front DB raise 12,12,11 [20,22.5,25]
Cable lateral raise 12,12,10,11 [15x2,17.5x2]
Wide grip lat pull down 12x4 [85,100,110,120]}
Machine row 12,12,12,12 [80,90,95,100]
Lower back hyper ext 12x3 [35lb plate]
Standing oblique crunch 45plate 20x3
Rope Pull Down crunch 20x3
Hanging Leg Raises 15x3
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- owthao reblogged this from evangunville30daypush
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text:
Spanish Video Tutorials
myMix System
myMix Install
myMix Control
Transport Cases
Package Solutions
What is myMix?
System Overview & Examples
Mixing with myMix
Recording & Play Along
Audio Networking
General Connectivity
Connect Your Console
House of Worship
Performing Arts
Live Sound
In Action
Testimonials and Reviews
USA myMix Dealers
International myMix Distributors
Product Support
FAQ & Troubleshooting
Contact Us
Product Support-Espanol
Connect Your Console
FAQ & Troubleshooting
Frequently Asked Questions
General FAQ
How is myMix different from other personal monitoring systems?
Is there a maximum number of myMix units in a system?
What components do we need to get started with myMix?
What's the meaning of "3D sound"?
What are profiles good for?
If we connect our instruments/mics directly to myMix, how do we get the signal to the main console?
We are four musicians with seven mics/instruments, but the keyboardist needs three channels, how do we connect his third input?
We are a band with four musicians, how many myMix do we need?
Our singer uses an in-ear system, but our guitar player wants to use his wedge, can we use both for myMix?
How does audio work on the myMix network?
myMix FAQ
What kind of headphones do you recommend?
How do I save my settings to profiles?
How can I save all settings, or transfer profiles from one myMix to another?
Do I need a special type of SD/SDHC card?
Can I mix myMix devices powered by power supply and powered by POE?
Can I plug my guitar directly into myMix, or do I need a guitar amplifier?
Can I use the headphone outputs and the line level outputs at the same time?
How about connecting MADI or Dante signals to myMix?
Switches FAQ
What Ethernet switches can be used for myMix?
Can myMix be integrated in an existing Ethernet network?
Can't find what you are looking for?
IEX16- connected a myMix directly to the IEX16 but can't see the channels on the myMix screen.
IEX16- the channel signal levels are very low in every myMix unit.
IEX16- we use the direct outputs of my mixing console, but the level in the myMix system changes somtimes
IEX16- when I connect to myMix I don't see the 16 channels
myMix- channels on the mix screen disappear randomly. Rebooting the unit usually helps short term.
myMix- no audio when I use a condenser microphone on the local inputs
myMix- playing back a recorded session, the audio skips and/or is sometimes distorted
myMix- the overall level in my headphones is very low compared to others
myMix- the unit stops on the myMix logo screen (after a firmware update)
Switch- I bought one of the Cisco switches you recommend from a third party, while I can see all of the channels, I don't hear any audio.
Switch- using an unmanaged switch with our myMix system. We have 16 channels from an IEX-16L and some local myMix inputs. We are getting random distortion on our myMix units.
Switch- we are using two of the recommended Cisco switches but only see the channels of the units connected to one switch.


text:
Tardises Are Cool Like
I, however, am not Abigail. I'm Kellyn Elaine, a friend of Abigail's.
The thing is, Abigail is fairly dumb when it comes to technology [I am not! I made this note all by myself]. Therefore, I am here to save the day and make her blog prettier! Yay!
Abigail, in addition to being my friend, is very into acting. I've seen her in two musicals, but that's because I'm a bad friend. :) Abigail has a BEAUTIFUL singing voice, and she is an amazing actress. (Abigail, don't argue. It's true.) She is, of course, a fan of other musicals. Her favorites include Rent, Chicago, Wicked, Dr. Horrible's Sing Along Blog, Sweeney Todd, Singing in the Rain, and White Christmas. (Jesus, woman! I asked for three, not seven! Oh well.)
Abigail is also a Whovian, and I will admit, that is my doing. She and I are known to make constant Doctor Who references at school while everyone else looks at us like we're weird. Though... We are weird.
Abby is also a Nerdfighter. DFTBA!
I am quite prone to writing long about me's. It isn't that I talk a lot about myself, I just... Talk a lot.
Even though I hardly accomplished anything by writing this, I believe that this DEFINITELY adds to my dear friend's blog.
Abigail, I love you like ice cream! [I love you like shippers love their OTPs]


text:
Senior Member
Emissary of the League
DJ Shyvana
How many guys are actually considering Fiora and Lux default skins fanservice? I literally had to reopen LoL and go to the character screen just to remember their default splashes. The only skin that even sticks in my mind as fan service (As far as default skins) in Sona. But, even after playing her/reading her lore I've erased that opinion. The first thing I notice on Lux is how her head doesn't seem to line up with her neck, and Fiora always perplexes me on how to get that much bend in your wrist when flipping it over like that.
I dunno, maybe it's just my lack of trying to find sexual reference in splash art about a fictional character or maybe people are just grasping at straws. But provacative pinups are really the last thing that comes to mind when I'm buying new skins for my characters.
Edit: Also, that armor on Fioras arms make her look she has some guns. I bet her bi's and tri's are flipping buff.
qa analyst
What I have trouble determining when these discussions come up is this ... are you upset because there is oversexualization of champions? Or because you want more of it ... just with better balance?
Why is fanservice a bad thing? I really like fan service, however, I do agree that we need more fan service for females, but it's hard since all of you have so much different taste.
More fan service! I can't see why good looking characters would be a bad thing, but there need to be a balance between male and female champions.
© 2014 Riot Games, Inc. All rights reserved. Riot Games, League of Legends and PvP.net are trademarks, services marks, or registered trademarks of Riot Games, Inc.


text: Horne asks judge to disband polygamous enclave's police force By: Gary Grado June 17, 2014 , 5:42 pm After twice failing to convince lawmakers to pass a law forcing a polygamous enclave to disband its police force, Attorney General Tom Horne is now taking the request to a federal judge. Subscribe Login Email Address: Password: Already a paid subscriber but not registered for online access yet? For instructions on how to get premium web access, click here.Forgot your password? Share this:EmailPrintFacebookLinkedInTwitterGoogle +1 Arizona Arizona Attorney General Colorado City disband Fundamentalist Church of Jesus Christ of Latter-Day Saints Helaman Barlow Hilldale Utah Mohave County Sheriff's Office police force polygamy Tom Horne Washington County Sheriff's Office 5:42 pm Tue, June 17, 2014 Arizona Capitol Times Gary Grado tweet


text:
lahore gang rape case covered by sare aam team on 18 January girl black malid by dear ones and ask for sex again and again finally she decide to get rid off this shit she connect to sare aam team than what happened see this watch this video
Armaan & Tanisha Caught Kissing in Bigg Boss 7
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Something hidden from Big boss 7 http://www.dailymotion.com/video/x18anyt_armaan-tanisha-caught-kissing-in-bigg-boss-7-ooybazaajaa-com_shortfilms
Living on the Edge Girls Fighting and Abusing Video
337 Views0 Comments0 Likes
A new video from a reality show Living on the Edge Girls Fighting and Abusing Video taken from Mobile. Two girls fighting and abusing each other, fight goes wild. http://www.dailymotion.com/video/x182qkp_living...
Mathira Hot And Sexy Naked Pictures
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Mathira a model from pakistan and also do many show including morning exercise segment on TV Channels. Mathira went toples following the way of veena Malik for
Mona Singh MMS scandal. Fake Or Reality
1.23K Views0 Comments0 Likes
Popular TV Actress Mona Singh has become the latest victim of obscene MMS. A MMS clip, purportedly featuring 'Jassi Jaisi Koi Nahi' fame actress, has gone viral on http://www.dailymotion.com/video/xyo2xp_mona-singh...


text:
I met a traveller from an antique land
Who said: Two vast and trunkless legs of stone
Stand in the desert. Near them, on the sand,
Half sunk, a shattered visage lies, whose frown
And wrinkled lip and sneer of cold command
Tell that its sculptor well those passions read
Which yet survive, stamped on these lifeless things,
The hand that mocked them and the heart that fed.
And on the pedestal these words appear:
'My name is Ozymandias, king of kings:
Look on my works, ye mighty, and despair!'
Nothing beside remains. Round the decay
Of that colossal wreck, boundless and bare,
The lone and level sands stretch far away.
Last year, Hank's toilet discovery of Walt Whitman's Leaves of Grass left Breaking Bad viewers hanging on the edge of their seats. In July, before the return of the final episodes of the series, a promotional trailer featuring the voice of Walter White reciting Percy Bysshe Shelley's 1818 Ozymandias was released. On September 15th, Ozymandias will be the title of the show's 14th episode of Season 5, and its sixtieth episode altogether. As we approach the finale (Felina) of Breaking Bad, prepare for the collapse of Heisenberg's "Blue Sky" crystal meth empire.
A verse from the sonnet was also referenced in a 2012, season 5 episode of Mad Men (set in 1967) by Michael Ginsberg. In celebration of a successful pitch for Sno Ball, he says, "Look on my works, ye mighty, and despair!" Stan Rizzo is quick to point out the irony, telling Ginsberg, "You should read the rest of that poem, you boob."
Note that while Ginsberg's pitch involves various types of people in a humorous predicament, Don's pitiful pitch incorporates the Devil and a supposedly subtle catchphrase alluding to death, a reoccurring theme of which he is engrossed in (e.g. post-traumatic war memories, contextual murders, drug-induced hallucinations of drowning, his personal responsibility for his brother's suicide and his mother's death during child-birth, reading Dante's Inferno, etc…) There is so much to say about Donald Draper's obsession with death and it's metaphorical significance that I am not going to delve into.
The story lines of Breaking Bad and Mad Men are replete with foreshadowing methods and ethically corrupt character motives for such plot devices. Featuring a central character wrought with grief and fear of death, yet equally determined to alter their lives in a dangerous struggle to avoid their inevitable demise, both series' offer common moral uncertainty of how far a person can push themselves to get what they desire before "the bad" overshadows "the good". As we, the viewer, watch Don Draper (aka Dick Whitman) and Walter White (aka Heisenberg) commit selfish, heinous acts while simultaneously acquiring wealth, recognition, and security, we see both men fight internal battles with their mirrored/dual personalities formed by the polarizing effects of their bitter, more humble past and their greedy, grandiose alter egos.
We have yet to find out whether either leading man has any chance at redemption from themselves. Soon, both Mad Men and Breaking Bad will come to an end. Until then, all that we are able to do is wait in suspense for judgment day; Not only of our favourite prominent prime-time powerhouses and supporting roles, but of ourselves as their reflection.


text:
The Alzheimer's Association released their annual Alzheimer's Disease Facts and Figures report yesterday. And the news unsurprisingly was not good.
Here are a few alarming facts contained in the 2013 version of this report (which encompasses only the US):
- One in three seniors dies with Alzheimer's or another form dementia. (Read this to understand the difference between dementia and Alzheimers.)
- This year, 450,000 people are expected to die of Alzheimer's.
- Someone develops Alzheimer's every 68 seconds. By 2050, this number will be every 33 seconds.
- An estimated 5.2 million Americans of all ages have Alzheimer's disease in 2013. As you would expect, 5 million are 65 and older.
- One in nine people 65+ has Alzheimer's.
- By 2025, the number of people age 65 and older with Alzheimer's disease is estimated to reach 7.1 million, a 40 percent increase from the 5 million seniors currently affected.
- By 2050, that number is expected to triple to 13-16 million, unless there is a breakthrough that slows or stops the disease.
- Alzheimer's disease is the sixth leading cause of death. While deaths from heart disease, HIV/AIDS, and stroke continue to experience significant declines, Alzheimer's deaths continue to rise — increasing 68% from 2000-2010. This means your chances of dying from or with Alzheimer's is growing at an alarming rate.
The Six Alzheimer's Risk Factors
This report states the six top risk factors for developing Alzheimer's as aging, having the disease in the family, having fewer years of formal education, or having been diagnosed with Mild Cognitive Impairment (MCI), heart disease, or a Traumatic Brain Injury (TBI).
It might surprise you to learn that according to this report, the only known cause of Alzheimer's is a genetic mutation that's responsible for a mere 1% of Alzheimer's cases. So if Alzheimer's runs in your family, the overwhelmingly more critical factors are a shared environment and lifestyle.
It's not understood the exact role education plays. Some researchers believe that having more years of education builds a "cognitive reserve" that enables individuals to better compensate for changes in the brain that result in mental decline, while others believe lower educational attainment may lead to certain at-risk lifestyle factors like smoking or poor nutrition. Another component is education as it relates to socioeconomic standing and access to medical care.
Brain injuries have been in the news a lot this year as the effects of playing professional football have become public. But for the average person, the most likely cause of TBI is from car accidents, which accounts for half of all cases.
2013 Alzheimer's Report is more bad news; they say there is no way to prevent it. See why we strongly disagree!
Recognized Treatment — "Active Medical Management"
The only medically recognized treatments are five FDA approved drugs that temporarily improve symptoms of Alzheimer's disease by increasing the amount of neurotransmitters in the brain. These can slow the rate of mental decline, not stop or reverse it.
The best medical course currently prescribed is "active medical management". This means prescribing one of these medications, "managing" behavioral symptoms that arise (which means more medications), coordinating care between medical professionals, and having the patient participate in adult day care programs or support groups. Sounds like my idea of hell.
Not a White Man's Disease
Roughly 2/3 of Alzheimer's patients are women. This is a consequence of women living longer than men.
But longevity is not why African-Americans and Hispanics are much more likely to develop Alzheimer's than Caucasians.
The reasons for this are another unknown. There may be a genetic component but, according to this report, it's more likely that these groups have less access to good medical care. It is known that there are more misdiagnosed cases amongst these groups.
No Happy Ending for Anyone
For those who succumb to this disease, there is no happy ending. The average person lives 4-8 years after being diagnosed but can live up to 20. You can expect to spend more years in the severe stages of this disease than in any other.
After age 80, there's a 75% chance that a person with Alzheimer's will live out their life in a nursing home. Compare this to the 4% chance you'll do so if you don't have Alzheimer's.
In 2012, unpaid caregivers — friends and family — provided an estimated 17.5 billion hours of unpaid care. Their contribution has been valued at over $216 billion. Shockingly, this is more than eight times the $27 billion total sales of McDonald's in 2011!
Initially, that care involves doing household chores, shopping, making meals, providing transportation, making sure medications are taken, and managing financial and legal affairs. Later on this involves more personal matters such as helping that person dress, bathe, groom, eat, and use the bathroom.
In later stages, it gets more difficult for lay persons to manage behavioral symptoms of the disease such as aggression, wandering, depression, agitation, anxiety, and nighttime disturbances.
It's not unusual for the caregivers themselves to experience increased emotional stress, depression, and a decrease in general health not to mention lost wages due to disruptions in employment and depleted finances.
No one wants this end for themselves, and no one wants to put their loved ones through this, either.
"No Prevention"? We Strongly Disagree!
You can access the report 2013 Alzheimer's Disease Facts and Figures here. You can watch the Alzheimer's Association's accompanying video, which summarizes the report's statistics.
But before you do, I want you to know that I take great exception to their conclusion that Alzheimer's can't be cured or prevented.
The Alzheimer's Association claims to be the world's leading Alzheimer's care, support and research organization. They state their mission is to "eliminate Alzheimer's disease through the advancement of research". You may even conclude, as I have, that they are trying to scare you into giving of your time and money.
This organization seems to be a lumbering giant closely aligned with the medical establishment. Peruse their site and you'll find more links that lead to requests for donations, joining walk-a-thons, or becoming a corporate sponsor than you will find ways to prevent this disease.
Peruse our site and you'll find plenty of good news — steps you can take to improve your brain health and improve your chances of not becoming an Alzheimer's statistic!
Maintain Your Brain®?
The Alzheimer's Association has trademarked the phrase "Maintain Your Brain"®, yet the information on their site about how to do that is almost non-existent. They recommend staying mentally, physically, and socially active and eating a healthy diet. But I bet you already knew that.
Their diet instructions mention eating dark fruits and vegetables (like kale, blueberries, and prunes), cold water fish for their beneficial omega-3 fatty acids, and using mono- and polyunsaturated fats such as olive oil, and that's basically it.
They don't mention that coconut oil has helped people reverse Alzheimer's symptoms. They gloss over the details that most fish you buy won't contain the brain-essential omega-3s, that most olive oil is fake, or that polyunsaturated fats' high omega-6 content causes chronic and systemic inflammation which contributes to most major diseases.
Knowing these details can make all the difference between giving your body what is needs to prevent disease and actually contributing to it.
They also don't mention that Alzheimer's may be type 3 diabetes, and that our high sugar diet is contributing to the epidemic of brain diseases or that widespread omega-3 deficiencies cause 96,000 preventable deaths per year.
If you read the report, don't get too discouraged. You've made it here, which shows you're looking for answers, and refuse to accept the status quo. Yes, the big picture of the future might look dire, but that doesn't have to be your future.
SOURCE: (including graphs, report, and video) – ALZ.org


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Bushwhacking on Elephant
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Fairly recent logging activity on Elephant shows with the young forest near 3,500 feet. Even so, some areas were thick and needed to be skirted.
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Elephant Mountain (Mountain/Rock)
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New England Rambling (Trip Report)
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Object Title: Bushwhacking on Elephant