McCamy Taylor's Journal
Member since: Tue Nov 9, 2004, 06:05 PM
Number of posts: 14,678
Number of posts: 14,678
Here is my fiction website: http://home.earthlink.net/~mccamytaylor/ My political cartoon site: http://www.grandtheftelectionohio.com/
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Is It Possible to be TOO Clean Living? Random Thoughts on Autoimmune Disease and Infectious Diseases
Sometimes, I like to pull up Ovid and just start skimming journal articles and see where they take me. Here is where they took me today:
1. Do We Have Autoimmune Diseases Because We Evolved an Automatic Defense System Against Tuberculosis that Reacts Against Other Tissue if We Do NOt Get Tb?
About the effect of Tb on human evolution---one in four of us that did not die of something else, died prematurely from Tb before the modern era with antibiotics. That is probably true for the entire history of humanity, not just the last few hundred years. Recently, they discovered that the human HLA genes were picked up as moderns left Africa and bred with Neanderthals. The HLAs encode built in immunity and resistance to disease----as opposed to the strictly learned kind that you get when you are exposed to a new antigen and your B cells make an antibody (IgM then IgG for lasting immunity). The HLA genes gave moderns built in immunity to lots of things that they would encounter as they spread out across the world including, presumably the various types of mycobacteria which include Tb and leprosy (note that only a small portion of people can even get leprosy). HLAs also influence autoimmune disease, like rheumatoid arthritis, Crohns disease, reiter's syndrome. Some people think that we have so many autoimmune diseases in industrialized countries because the HLA portions of our genes that are supposed to be fighting Tb and other mycobacteria have nothing to do so they start attacking our own tissues instead. Which raises the question---are there less food allergies and allergies and asthma in third world countries because people there get the Tb. And, if they do not get Tb, they get the BCG vaccine (a bovine mycobacterium vaccine designed to prevent Tb infections)? We do not take it in the US for public health surveillance reasons, because Tb is so rare that it is easier just to test for Tb exposure with a Tb skin test and if you test positive you treat. The BCG gives you a positive Tb skin test whether you have Tb or not, so if you take the vaccine, you can not take a Tb skin test. However, there is a new blood test, the Tb spot that can be used instead of the Tb skin test and which is reliable even if you have had the BCG vaccine. So, should we be vaccinating with BCG both to reduce the incidence of Tb and to calm down our HLA genes so that they have something to do besides give us allergies and autoimmune diseases? And then use the Tb spot blood test to screen for Tb infection? It is worth considering.
2. Did Running Around Barefoot as Children Help Prevent MS?
Second random medical thought of the day. You know how they always used to say that no one who grew up in the South would ever get Multiple Sclerosis? This is back in the 70s and early 80s. And how it is no longer true. People from the south now get MS. They can give rats MS and if they give them a dose of BCG, their MS gets better---as if the immune system stops attacking the nervous system because it finds something better to fight. Here is my theory. What did people used to do in the South back before 1970? We used to run around barefoot all summer. We got chiggers, ticks. We got hookworms. Some of us had outhouses. We were exposed to all kinds of infections that people up north who wore their shoes and clothes when they went out to play did not get exposed to. I am wondering if all those infections that southern children were exposed to kept their immune systems so busy that they did not have time to start attacking normal body tissue. Now that kids in the south stay indoors and play video games and wear shoes if they go out and use bug spray--maybe now they are so sterile that they do not get enough infections to keep their inherited immunity busy.
Posted by McCamy Taylor | Fri Aug 22, 2014, 07:40 PM (11 replies)
If you are like me, you were brought up to believe that Hitler created fascism, antisemitism, ideas of racial purity and everything else for which he was known out of his own crazed imagination, and because he was gifted with a silver tongue, he was able to prove the truth of the old adage you can fool all of the people some of the time. Therefore, I was startled, amazed, astounded to read that as far back as 1889, Austrian business leaders, politicians and landowners were desperately trying to hold onto their own laboring class---their "human capital"--which was emigrating to the US in search of better wages and living conditions. In an attempt to keep that all important low wage labor that capital so desperately craves, Austrian leaders went to court and charged travel agents with being part of a Jewish conspiracy to lure "white" Austrians into slavery in America where they would be bred with Blacks so that their progeny would live in slavery forever.
Here is a link:
Imagine growing up in Austria, listening to the equivalent of the Koch Brothers telling you that Jewish people want to sell you into slavery. That they want to make sure that your children live in perpetual slavery. That your only hope is to stay at home in Austria and Germany and do what your masters----Austrian/German landowners and business leaders----tell you what to do.
Hitler did not create Nazi style fascism on his own. Hitler fulfilled the dreams of Austrian and German industrialists who were desperate to hold onto their "human capital"---the serfs, their slaves. And Hitler was able to seduce the Austrian and German people, because they had been brought up hearing that it was better to stay at home, even if that meant starving, than it was to go to another country where you risked being treated as less than human.
Posted by McCamy Taylor | Sun Aug 10, 2014, 04:21 PM (4 replies)
Proving that they are truly the party of conservatives*, the House GOP has decided to borrow from the Newt Gingrich 1998 election play book and file a lawsuit against President Obama, charging that he has overstepped the bounds of his office.
“Are you willing to let any president choose what laws to execute?" asked House Speaker John Boehner. "I mean sure, the Department of Justice gets to decide which laws to enforce and who gets prosecuted----" The rest of his words were muffled as the Sock which was once used to silence GOP pit bull and watermelon serial killer Rep. Dan Burton was stuffed into the Speaker's mouth by Majority Whip McCarthy.
"Don't pay any attention to the man behind the sock," said Rep. McCarthy. "We decided not to impeach, because Democrats were raising too much money using the 'I' word. Plus, we found out that impeachment hearings are held in the House, and frankly, we've got better things to do with our time this fall than be in Washington."
The Republican's strategy, says a beltway insider who asked to remain anonymous, will borrow from the Ken Starr play book. The House's team of powerhouse lawyers will issue subpoenas for everything they can think of and then attempt to trip witnesses up in accidental perjury. "We call it Tar Baby II. Once enough people find themselves behind bars because they couldn't remember the meaning of the word 'is', someone will roll over and testify against Obama. And Hillary, too."
When asked to comment, Former House Speaker Newt Gingrich shook his head and muttered something about history classes being underfunded before limping off. "It's that old foot injury," explained an aide. "The one he got in 1998 when he took aim at Clinton and shot his own big toe, instead. It always acts up around midterms."
Democrats are said to be delighted at this turn of events.
"We were getting worried that we were gonna have a real midterm election this year," said James Carville. "In an ordinary midterm election, the party out of power always gains seats in Congress, because the folks that like the president stay home. But if you put the president's name on the ballot---say by impeaching him for having sex or suing him for doing his job---then the president's supporters show up to give him a thumbs up."
*"A conservative is a man with two perfectly good legs who, however, has never learned to walk forward." FDR
McCamy Reports: Because Truth is Stranger Than Fiction
Posted by McCamy Taylor | Wed Jul 30, 2014, 10:13 PM (0 replies)
For two wholes hours, folks who had bought their own insurance on a federal-not-state health exchange were faced with a predicament. The DC Circuit Court did what everyone knew that it was going to do and declared "We want to take back your ACA insurance in time to influence this fall's Congressional election!" Yes, that is what they said. You just had to read between the lines.
Luckily, two hours later, another court said "Who are you kidding?" and gave those of us who purchased ACA insurance on federal exchanges back our health insurance.
Now it is in the hands of the US Supreme Court. And the Koch Brothers want us to remember that the Supreme Court can be supremely stupid and partisan (Bush v. Gore, Citizens United, No Medicaid for Poor Folks in Red States). So that we will panic. So that we will begin wringing our hands. So that doctors will stop scheduling surgery and hospitals will start demanding cash up front...
But think about it. Which financial interests in this country stand to benefit if the Koch Brothers have their way and millions of Americans retroactively lose their health insurance? Not the hospital chains that will have to reimburse insurance companies. Not the pharmacies that will have to reimburse insurance companies. Not the insurance companies that will have to reimburse the federal government. A whole lot of special interests in the US will be out a whole lot of money---and I do not think that the money loving SCOTUS will be willing to go against the interest of the health insurance industry, pharmaceutical industry and medical industrial complex all at the same time. Just to curry favor with the Koch Brothers. And maybe influence the outcomes of a handful of Congressional elections. Maybe.
This, dear readers, looks to me like sound and fury signifying nothing. The result of this little skirmish is more likely to be another deep division in the ranks of Republicans, many of whom have begun to realize that megalomaniacs like the Kochs and Sheldon Adelson do not want what is best for Corporate America as a whole. They want what they want! And if they end up driving five or six other businesses bankrupt, the Kochs could care less.
Divide and conquer. It is very amusing watching the Republicans do it to themselves.
Posted by McCamy Taylor | Tue Jul 22, 2014, 06:50 PM (9 replies)
Just in case you have ever wondered why insurance companies and their representatives seem so cocky when dealing with individual physicians, maybe it is because they have so much power. All that money allows them to do things that you might think were impossible---like stifle the doctors who are supposed to be advocates for their patients by usurping control of the regulatory bodies that police doctors.
This is a real story. In happened in Texas between 2003 and 2007. The next time you hear a physician whistle-blower describe insurance abuses, remind yourself that he or she does so at great personal risk. Where there is money involved, there are likely to be a lot of unscrupulous people who will stop at nothing to protect that money---especially if the money is coveted by Blue Cross Blue Shield, the mega-behemoth of insurers which has been guilty, among other things, of lying about losses so that it can raise premiums and dump sick patients and defrauding Medicare (and yes, the links are easy to provide if you really want them. The NYT covers big stories like those). BCBS, whose MikeHightower was one of Bush's Pioneers. BCBS which counted among its board members Uncle Bucky Bush. BCBS which was the only non-bankster in the list of top donors to Bush in 2004. Bush---who bragged about the Texas Patient Protection Act (which he vetoed) in a 2000 debate with Gore then had Ashcroft get it struck down in federal court for his good buddies in the insurance industry. Bush, who set back the cause of universal health care for eight years.
Dirty Dealings in Texas (On The Texas State Medical Board)
Remember Dr. Keith Miller? A Ricky Perry appointee. He served on the Texas Medical Board. The board that is supposed to keep the public safe by making sure that doctors practice good quality medicine. Turns out that Miller had a conflict of interest. He worked for BCBS, at a time when health insurers were attempting to control costs by rationing care. When an insurance company wanted to punish a doctor that it did not like, it would make an anonymous complaint. And then, no matter what the evidence, Dr. Miller would make sure that the doctor suffered.
However, critics of Dr. Miller’s tenure have further accused him of improperly using his position on the TMB to transform the Enforcement Committee into a virtual arm of the insurance industry. Board Rules allow anonymous complaints to be made to the TMB which can then serve as the basis of a disciplinary action. Aggrieved physicians have alleged that insurance providers who are dissatisfied with the level of care provided to a covered patient have used such anonymous complaints as a way to punish doctors and maintain low cost levels. Such physicians point out that it is not actually the standard of care which motivates these anonymous complaints but rather a doctor’s decision to supply care whose cost exceeds insurance company guidelines and therefore hurt profits. These maligned anonymous complaints originate from the insurance providers and not the actual patients. In fact the patients whose care is supposedly at issue are frequently surprised when notified of the pending disciplinary action and often testify in favor of their doctor.
One of the doctors that got in BCBS's way was Dr. Shirley Pigott. She decided to help other Texas doctors organize to fight insurance abuses. BCBS did not like that. So, they used their doctors inside the Texas Academy of Family Physicians and the Texas State Medical Board to stop her. And, they sent a ringer--a patient to file a frivolous complaint so that their man, Dr. Miller on the Board could railroad her.
Too bad for them, she fought back.
Dr. Shirley Pigott was indefatigable in her investigations of Miller. Dr. Pigott uncovered Miller's relationship with Hughes, his work as an expert witness for plaintiff attorneys against physicians and his conflict of interest as a member of the Blue Cross Blue Shield Medical Advisory Committee which looks for ways to cut costs by limiting physicians' evaluations and treatment of patients. Dr. Pigott deserves our deepest gratitude.
This story had a happy ending...sort of. In 2007, doctors sued the entire Texas State Medical Board. Turns out another doctor on the Board had her husband "turn in" her competitors so she could drive them out of business.
Dr. Miller tried to sue the whistleblowers. That did not get him very far.
However, while everyone was properly horrified at doctors for working for BCBS to stab other doctors in the back in order to make sure that doctors were too afraid to fight back against insurance company abuses--which included denials of necessary services and care---I can not find anyplace where BCBS suffered at all for what they did. They continued to be the official insurer for the Texas Employee Retirement System until just a couple of years ago, when they screamed bloody murder because someone else got the contract. I guess they figured their good buddy Rick Perry had them covered.
Moral, never ever underestimate the lengths an insurance company will go to make a buck. There is absolutely nothing too low, too devious, too illegal. Just because they have the word "insurance" in their name, they are no more virtuous than Big Oil or the Banking Industry. The bottom line is still money.
Posted by McCamy Taylor | Sat Jul 19, 2014, 03:25 PM (0 replies)
You gotta love the Tea Party. First they are against...
Then they were against....
Now they are against....
What will they be against next?
The Tea Party, your anti-care/marriage/children party. Thank Karl Rove and the Koch brothers they chose to ally themselves with the GOP, because with public relations guys like that, there is only one way they are going...
Posted by McCamy Taylor | Sat Jul 19, 2014, 02:32 PM (3 replies)
This video touched me...the result of this brave young man's actions shocked me.
Would police really wrestle a young American to the ground and wrap his face in a cloth, gagging him, because he dared to speak out for the people of Gaza? Yeah, I guess they would. Police are police the world over. But, would the Israeli legislator, who called upon her country to exterminate old women and children (little snakes) because terrorists hide among---would that same woman demand that her country bomb areas where American citizens were standing in solidarity with the people of Gaza? American citizens who happened to be Jewish? Or, would words of compassion coming from members of the faith which Israelis value so dearly reach their ears in a way that the same words coming from ancient "enemies"---Christians and Muslims---never can?
Israel does not represent Judaism, any more than the Conquistadors represented Catholicism. Both were/are political groups that have a religion which they use but which they do not always represent, political groups having interests which are not always best served by spiritual values.
When self proclaimed "Buddhists" in Myanmar burn mosques and attack Muslims, we know that they do not represent true Buddhism.
It does not matter if they wear robes. Buddhists, like me are not fooled. We do not make excuses for the violence. We do not express support for the awful dualism. We do not hesitate to call this what it is----genocidal violence carried out by one group against another group, hardly different from what happened in Rwanda except no one is carrying a machete.
It is summer. Maybe it is time for some young Americans to take a vacation to the Middle East. Maybe it is time for them to demonstrate their faith in action, nonviolently, the way that MLK JR and Gandhi demonstrated their faith. If someone wants to start a group, I'm willing to donate. Maybe if the U.S. stopped sending so many weapons and started sending more minds, we would be doing our closest ally in the middle east more good.
Posted by McCamy Taylor | Sat Jul 19, 2014, 02:21 PM (5 replies)
I'm gonna make this short and sweet. You can look at the article I wrote at Kos if you want the links. Up until the passage of the ACA, BCBS partnered with ALEC to defeat it. And now, everywhere you look---especially in California---people are complaining about "bait and switch" being committed upon them by BCBS reps. Every time I hear one of these stories about someone who was told "Your doctors are in the network" only the doctors are not in the network, it is always a BCBS plan.
What if it is not just plain old incompetence? BCBS is no fly by night just started up company. It is enormous. It has been around forever. What if BCBS failed to scuttle the ACA in Congress so they decided to do it by selling the wrong plans to the wrong people on purpose, convinced that no one in the administration would want to lift a finger or say a word for fear of making the ACA look bad--and the ACA ends up looking bad because so many people get nothing for their money?
Anthem is being sued in California. Maybe the feds ought to take the whole Blue Empire to court. There have to be other health insurers out there who would love to have the business that BCBS apparently doesn't want badly enough to try to keep customers satisfied---or even this side of furious.
Here what I wrote with links.
Posted by McCamy Taylor | Fri Jul 18, 2014, 11:04 PM (6 replies)
During a public health class, the lecturer spoke of a conference in which the speaker said that thanks to advances in disease prevention, most of the world's communicable diseases would be wiped out in a decade. I thought about this for a second. It sounded good---but implausible. It only took me a moment to figure out why. I was a lot older than the other 20 something students. I had been around a long time. I raised my hand.
"Only if we eliminate war," I said. "War destroys all public health infrastructure."
There is no disease so deadly as war. Even Ebola strikes by accident. Ebola does not deliberately target the women of the opposition, raping them in order to impregnate them, in order to dispirit them. Ebola does not turn children into soldiers, imprinting their young minds with images so ghastly that they will never be sane, no matter how much psychotherapy they have. You can outwit Ebola. Ebola can not steal dozens of young women and hide them away, threatening to sell them into slavery. Ebola can not sell blood diamonds in exchange for bigger, better weapons with which to kill more effectively.
Coronary artery disease strikes middle aged men and elderly women. It does not take out children, because the middle aged men happen to be standing among the children. The same for stroke. Vascular disease does not mean to terrify you into submission. It just is. If you eat a balanced diet and don't smoke and exercise, there is a good chance that you can avoid vascular disease. Some people have no chance of avoiding war. If you live in a country where a fascist dictator has decided that your race or ethnic group or religious group will make a convenient scapegoat, you will die. If you are standing in the wrong place at the wrong time, playing ball with your brothers and sisters, you won't die of a heart attack or a stroke, but you could die from a bomb. You could even die from a bomb that someone planted twenty years ago beneath the ground in a war that ended before you were born---because wars never really end.
When you have an asthma attack, your asthma will not leap from your chest and accidentally kill someone passing by--but a bullet aimed for your head can. Your tuberculosis may infect your neighbor, but it won't leap up into the sky and shoot down a plane that just happens to be passing overhead. War turns health care workers into CIA spies--and therefore children catch polio. War destroys water treatment plants, causing cholera. War destroys crops, causing famine. War is the first and last horseman of the apocalypse.
Eventually, when the wars "over there" get bad enough, someone "over there" brings it "over here". Civilians die. We rally around the flag. We send out the troops. Our troops die by the thousands. Their civilians die by the millions. Our troops come home. Some have PTSD. Some kill themselves. Some just live as if they were dead. Once you have seen death up close, it is hard to forget it.
War is an excuse for every atrocity. No civil liberty is safe in time of war. War devours the nation's resources. The most basic human necessities must come second to the needs of the war machine.
War puts everyone at risk. No one is safe. Trying to solve the world's disputes by war is like trying to harvest crops with fire----
Posted by McCamy Taylor | Thu Jul 17, 2014, 08:09 PM (1 replies)
Life Without CPAP is about a public hospital and clinic system that decided that sleep studies to detect sleep disorders such as obstructive sleep apnea and treatments for OSA such as CPAP were ineffective and too expensive. The money spent diagnosing and treating sleep disorders could be better spent elsewhere. And so, the administrators adopted a system wide policy. No county patient would get a sleep study. No one would get CPAP. Period. If anyone was in danger of dying from untreated OSA, they would be offered a tracheostomy—a surgical procedure in which a hole is cut in the throat and a tube in inserted in the airway. A permanent fix. And about as appropriate for most OSA as decapitation would be for migraine headaches.
The decision was a quiet one. There was no sign over the door of the hospital advising patients that if they had a sleep disorder, they should probably seek treatment elsewhere. The people being seen assumed that their health care providers would diagnose and treat their medical problems to the best of their ability. Since public awareness of sleep disorders is low, very few of them would have noticed if a sleep disorder was missed or not treated. They were grateful to be getting “free” health care that they otherwise could not afford.
This book is about the five years I spent working as a family physician with an interest in sleep disorders for a public health system that declared that sleep disorders did not exist—and if they did, we would not treat them. Sort of like Alice through the looking glass.
While the administrators’ intentions were good----allocate limited resources where they could be used most effectively---the results were not what they hoped. For sleep is an essential function of all higher animals, including humans. If you disrupt sleep, you disrupt the system of checks and balances that keep our bodies functioning in times of low stress. Sleep disorders tell the body, in effect, “You are living in a time of war. Mobilize all your defenses now. Live like there is no tomorrow.”
Do that long enough, and there may well be no tomorrow. Blood pressure goes up. Blood sugar goes up. The appetite goes up---have to put on pounds in preparation for that coming famine. Stress goes through the roof. So does paranoia. Can’t trust anyone. Pain levels rise, the body’s way of keeping you alert even when you don’t need to be alert. The libido falls. Don’t want to sire any children, not with all this danger looming. The elevated blood pressure and sugar take their toll on the arteries. Here comes that first heart attack at 3 am in the morning. That first stroke----
Now, add in unlimited medical resources to treat the results of that chronic sleep deprivation and what do you get? A lot of money spent chasing consequences when it might be cheaper and more effective to treat the underlying disease. But once folks in power make up their minds, it can very hard to persuade them to change their minds. If you know that sleep disorders are inconsequential and that the available treatments are ineffective, you will not see sleep disorders. You will see an epidemic of coronary artery disease and uncontrolled diabetes. You will allocate your resources towards the cardiology department. You will hire more clinical pharmacologists to get your patients’ blood sugars under control----
Never realizing that all that money is being thrown down an enormous sinkhole. For, if you fix the coronary arteries without fixing the underlying sleep apnea, the heart will quickly become diseased again. If you control the sugars without controlling the OSA, the patient will continue to put on weight. If you allow sleep deprived men and women to drive on the streets of your community, they put everyone at risk, and Everyone will be brought to your emergency room in an ambulance to be treated for their life threatening injuries.
What’s that you ask? What difference does it make to you, in your community, if people with sleep apnea in some other part of the country are not getting the treatment they need? Right now, at this very moment, around 8% of Americans over 40 all across the country have OSA and do not know it. But they sense that something is wrong. As more and more of them get insurance, they will seek out doctors, trying to figure out why their minds are no longer sharp, why their bodies seem to be falling apart, why they ache all over. They will visit doctors complaining of memory loss---and their new doctors will get expensive neurologic work ups. They will describe joint and muscle pains---and they will be checked for arthritic conditions and get MRIs of their spines, knees and shoulders. They will describe their panic attacks---and spends years in therapy, taking two, then three, then four medications, some of which will cause their weight to rocket up, making their underlying sleep disorder all that much worse. They will talk about the palpitations that wake them from sleep and get extensive cardiology evaluations. These tests will cost tens of thousands of dollars. They will see specialists and subspecialists. And, in 4 times out of 5, none of the doctors will guess what is really wrong with the patient, unless he happens to be hospitalized and unless a nurse happens to walk by in the middle of the night when he is snoring and she or he notices that the patient has frequent pauses in breathing and the nurse alerts the doctor and the doctor knows what the snoring and apneic spells mean.
Because, with the exception of pulmonologists (lung specialists), Ear Nose and Throat (ENT) specialists and a handful of Sleep Medicine Specialists, American doctors are extremely bad at diagnosing sleep disorders. So bad, that they miss 8 cases out 10. Meaning that unless something is done to bring physicians up to speed, they will waste a lot of valuable time and medical resources before their patients with OSA receive a correct diagnosis.
How much time and how much money?
Back in 1999, Kapur et al. calculated the excessive cost associated with undiagnosed OSA as $2700 versus $1,384 per year. In other words, in the year before doctors determined that someone was, in fact, suffering from sleep apnea, they did tests and treatment totaling twice what they would have done on the average person. Where did the money go? To work up chest pain. To treat uncontrolled diabetes and high blood pressure. To look for brain tumors and multiple sclerosis.
“Although the data are limited, the effect of sleep disorders, chronic sleep loss, and sleepiness on accident rates, performance deficits, and health care utilization on the American economy is significant. The high estimated costs to society of leaving the most prevalent sleep disorders untreated are far more than the costs that would be incurred by delivering adequate treatment.”
From Sleep Disorders and Sleep Deprivation: An Unmet Public Health Problem http://www.ncbi.nlm.nih.gov/books/NBK19958/
There is an epidemic of undiagnosed and untreated sleep disorders. It has a huge economic impact on our country. It affects road safety, work place safety. It leads to early disability and retirement, putting a strain on the Social Security fund and Medicare.
If we get universal healthcare without improving our primary care physicians’ ability to recognize and treat sleep disorders like sleep apnea, we risk wasting enormous sums of money the way that the health clinic I am about to describe wasted health care resources treating the effects of sleep apnea instead of addressing the underlying problem.
From the Introduction to Life Without CPAP, available free for five days at Amazon for Kindle (and other electronic readers) by McCamy Taylor. http://www.amazon.com/Life-Without-CPAP-Healthcare-Eliminated-ebook/dp/B00LS9K5GG/ref=sr_1_4?s=digital-text&ie=UTF8&qid=1405537020&sr=1-4&keywords=mccamy+taylor If you would like to read Life Without CPAP but do not have an electronic reader send me a message and I can send you a word document.
Posted by McCamy Taylor | Wed Jul 16, 2014, 02:58 PM (23 replies)