World's Most Dangerous Leaders

An 4nlikely .

Fa mlly Reunion

Driven Crazy

,By MyGPS

July 20'07 $2.9'9

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~·l'ieslh.lDavbr'e;ilkil ,area ~~'a'!lt ;and USA fOday ill te both II",eie~" So. is: ,the hiig,h-speed ] nternet~ And the 'eQ!.tr~ rewa rds YOll earn wit h

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~i1ifll;ial rut~ at 'lMWt.lcl_pJf!)f~cl_~Cl1!!@tloJ!. tb IIU rmh:aM or online enttY meooualj'. P~ftha'Stwin 001: rm~ ~lM' ~ham((i of winning. SWt!!!IlS'l3~~S is qpl!!li ~tlllli-Ji!~'1 r.asr.l:ib, age 21 (If' iIIld!e~, of tme illS" its; U!:litori~ ,am ~ POS:sess!~!'!~. sWBI!P\'llta'~e!: Ilrm~m: SlUm7. '110 liD WHERfE lPiROHlenEliI1. All h~s !Ion lTI~tel$ a re ind~p(!imden~1y (lw,r:ed: ,~llId ~per,ated. @~07 [lolYS IlIn~ Wl:i~ldwide. 1~1l:~

IMab ,the, 01,051 oI,o:Ulli' IP8r:lil:yi~i;t illlfI;1liI1 h'iIIye 'un. Di'¥iil:ille ,oulFl:amH, into team:!l~ set ,il!! "'line Uimit ,and se.>e, who u!llllilild~he m_t ittem5 on Ihiil.l~st.

0 R.ock lh:e s~apaDf ,our D Hat nn a park ranger D PurFl!e wild f~'owet!ii
home dale 0 Trail marker 0 Spierweb
0 Stream ef nmning woller 10 PiFie eone (with a spider~)
0 A leahhe sizec' your hand 0 Bird ir. f1ight D 5utteri~y AMERICA iN YOU R POCKET

eaders Digest

JULY 2007

FEATURES

8,2, 7 Back Pail1 Blreakthroughs*

MliCHAE.L J, WEISS

Are YOU, aching?Here~s he'],p.

90 SIPi'nout WI.LUAM M_ HENDRVX The real trouble began after

the carpluoged to the bottom.

ofa ravine.

97 You Be the Jiudg1e

ROBI N G ERI3 E.R

A straybottle rocketb! ltlds, a chi]C:tW~10j8 tnblamer'

107 Say What?

MITCHELl. SYMONS

The real skinny on eve:ryday expre s~io'f:I s,

110 Spikedl ~.~.

The Danqer ;. '

i t1 1<1 ds r Dri nks

KAT HAIR INE M I E5zKOWSK Kids an:'

consurrung more

caffc inc [han ever. How dangerous

is ] t?

I ~

138 World~s Most D'ang,er,ous, Leaders ,'It

VA L E VAt~ ATIA

These four pose the greatest threat to America.

GARYS: U::OrGE Engulfedby flame s,

Sucked underwater, Buriedalive, A IDa zing photogr aph s

of narrow escapes.

120 Sanctuary

CAR:OL KAUfMANN Th(H153nds of

exotic pets are abused.

and abandoned eV'E,U'Y year, A]ucky few make it to

this refuge in Keenes burg, C olorado,

126 Road Tr'ilJI '*

ANDY SIMMONS

A GPS takes a technological ig])or.amus for a ride ..

130 FiindMolre liin1e '"

CAMILLE NOE FAGAN Twenty-three great ideas for getting it all done-and getting the most out of life,

145 Healrt 2 He,art

G,A~L CAMERON WESCOTT

When her husband faced a Iife-threateningcondit i on. she' didn't know she'd be' next.

152 Fac:e to :Face with J()lh,in Travolta '*

MEG, GRANT

He's p~ay,ed a disco, stud and a cold-blooded killer, So what So he doing

in a, dress!

BONUS READ 160 Missingl

KE:NNETH MILLER

When people disappear, Monica Caison gets

the call,

100 Side By Side '"III

PETER PANEPENTO nl,ey'd been working together {OE months, not knowingthey shared a deeper con nection,

DON'TM.ISS lAUGH UNES

IRAGE12

,________.-. eaders Digest

J U l Y .2007

C:OLUMNS & DEPARTMENIT'S

37 That's Outvagleous~ M~CHA[L CROWLEY

41 HeaUh IQ DRS. Mi~CHAH ROI.ZEN :& MEfiMET oz 4·7 food ~Oll' U~e DEAN OfilfIUSH .. MD

51 My Pil,anet MAR'd R'OACH

71 Mom!! .. ' Ma.keys MAFHA 8AFlT[ROMO 77 Asl!, La:skas JEANN~ MAFU[ LASKAS 192 R:D CI1.alij(3IIlc]'e W"L.L SHO~TZ

19 You Said mt

23 (] I1hl ~n Arnelric.a 33 EVletry1(]Jay HeIFO€S 59 :.4.111 ill a. ~Jay's W(wl< 61 Word Powelr

65 Humor [il1l UI1IifOl"l1l1

81 Quotallll:,e Quotes.

158 tauCllhtelr the BestM'edidne 1:90 lj~e iil1 These UI11itecli States

Summer travel secrets

for flying smarter, banliing poison ivy, getting a doc to your hetel, choosing exotic fruits, beating the traffic, packingfor pets-eplus the surprising benefit of lemonade.

176 H,eaJtlh 178 food. 181 '~Ol~ 182 Tlrave;1

184 Home 186 Can; 188 piets

W'ho would've thought something you put in your shoes coulld reduce the pain in your lower back?

Ilnlr,oduciAlgl Dr. Scho,II's· Bialek Pain Helielfr' Drthotic:h Its Shock Guard''''r,echna,lo.9Y is dlnkclly proven to. work by (lbsorbing iar:rin9~mpacls beFo{'~ they N3CJch your bClck.

Works with eve ry slep y,o,u ,takie.

Plan a Terrific Trip

O r~· ki d .] ,. d 1 . dri .

1"-.' .,'. '1',,_, .'-'.=.- __ -',-;~ .. '-I-~''''-, ,:'1'" - '~I'-:- ,.,'.~ '"",-- ,- '··.--'~II'.-,-:-·-'._-j~~·' ~"'.~ __ '.i' """,.-,~_",-

ur on,e or-a .. U'I .. trave gU] .. E! .maps out r re most seerue urrvesm

America .. We divided the cOU1'JJlry into four regIons-Wester]) states. Rocky Mountain, Central and. Eastec.r]),-then CbCHIC 40 spectacular routes fi]1edwHh must-see sites and hidden geJ1[Ds. Visjt[d.eom/trav,et

u," and share your best photos Abreathtakiag beach. A hidden lake. A spec tacular mountaintop. Ifyou'vebeen inspired by a special spot in the great outdoors this summer, we'dIove to see it. Go tOr'd.combnttl'!l.re.

-------------------------------------

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I J~lIJly '5 h[~h~ igjhts,;a fa Ilk ,witllii Ad.rialtil Grenie:r of fntou,;age.t mO;riIey tips, the best barbecue recipes, Listernat n:I~DlIIJtI1c'udl.oQtiI1l.

•••

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Get every tlliling you need at Fd.,oom/help ..

.' C~]jflnge you.r addlJ.'iess

.' Mm:ke a p,ayme::I1it .R.ellfW your subscription

'.' Give a gift, and .. morel

R\eiSllei'loS Lf::giS S!i'V'Jdrn:f'!Ile !Rl:S~ ~s a reoo9nrre~1 m;edical >OOll!allti.Qn.

,One lhal's sha!<!'d by Iloorl:,' ~ in ]0 USaduUs. Moot !Jeq:l;'e ~rlB:l'lC1ll i!s.~p:looJg In 1Il~ e't'eniF){l(

RecUliip helped me make pe,ace 'Wilh mil II'eg5io

'" The CO~mf'lg IIJge to rno()ve:

'" 1[)ii!ilJiJmj~9 OOii'l>$a'lkins Ii'! tl1~ legs .IMOvlIllQj aRl'elfS temlpOoraiIY ~e1[ef

~ Tro:u'bre ~estlng, 011" Jamilgasreejp

~v.tJo stiffEr ~OOlIALSQfloo d9scfi!:!e !hfiirtegl oo!lsab1Jf!s, as D'"OO~. crawly, b;nifn.tl', ()' lifiltefli'tg. {Mlill;l! up and fliO'IIiilJI ~h9:I8QS ctiern SOTJe re-'"...irl, blllIAeS'l'~OFl1!S al!!iays{'Ooo twl Cny EJidocL'Or csn c1e1.8Tnne ~ yell h1WB ~!Iess Legs ~rome.

R)BquJ~ lis t~et!n;t flD,A'<ilPJ:i'rQ,ll\i;Id 'lre.atllliil!!ililtloiillfll.$,. Taken wil!!', IlQfl.JlatK't·fDmlil'llJl pr~ior! RequJp heips ~~,~ thE! sympttJll5 oi 1IiI0cieTate.!to·s.iiiwTe P'.rl:rJilialY ResUess I~ ByndroJ'I'W ~;5011" IIIWTe eljliSOCK moJ1llllj:.1. Asl! your Wi:ttll' tr Plequ(p js; lig'h t for ~w.

Inrl;POrlal'i!t SaJ-eity IliI'1!f~m

~p~ioo R~p Is rlOI !Qf e"!i€li)'CW\~- FI~q!llr;p iabl~1.s ni'liSy Crll,JiSi)! lI*~ t.o faD ~$lIoop or r~el'velY ste'ep.y durilllg 1ilCN'IDa'lac'liiVliUesSiLlCh asdffilillg; Cf re flill~ or f€eI dizzy, r.aLlS!!lated, (if oooo!y \i,~en rou S'I~ up_ Tell yr.u da::tor H you ~ti900e ~hese pt''Otjems or II Yf'1,I &if'l'lC. alootl::ll or

am 1a.~1lIJ o'iIlerrm:lc!lles Itl8'l m~ ~ 001;'8)1'. Plso tell ywr OO;;tUf i~ you Of !!OUr ~m:l' no:ioes ~hal ~ ~e'bp 8il1f ul'kJsLid Inj)~ or b~~rs. S>,JOh es pa:IhoIQa:C;l'l1 gam!tAlJ er ~~Iy-

Sde: i1'IlfeclS trtdl¥J@ naU$eiiil, drt)~~, \fO(I'(III'Ig, ,anddiLMB~. MoSl patreril$ ~~r~ nol bDtller~ 'OOJ:I.1.J9h to ~'ll:lp taklrlJ ~1,Ip. Requip should be Wlkf'l'l '('.I'Im da.'y t-3 hOtlf$ Wore bfdma.

·See lmilQr'liMllpaliem ln~ormalion Orrllhe Iilext page. visIt www.requfp,GOm or' C>il111"'Ff/l·ITIEQUIP'4

Requip~

(ropin i role He!:)

NJr _dera!Ii-Jfl>":5."rI'~ prim-M' R,~I~g .Legs S_)',r;rd~e

PAi:11E NT '1r:4 FOfiMAiIl0r:41 REJ!JUIPft' ~roprnirole' hydroc~'I'orid9) irallrets

lFoJ RfS~I~.5:5 Legs Syndrome (FILS) Als,(j Khow,1il as I~olil'l Syrni rome

RUci 'Ihis inrCilf'lmll!Uon ~on1l:l~le~1y be'lbre you slart 'lakin:.gREOOIP:R€ad Il1e fnlorma'bbn ~aoo IfR~U get more medicine. Tms may bel1ew inrOrlMu)Jll, This !eaflel ~des ell summary about REQU I F! Itdoos 1101 indlude MI'l/Ih]ng 1.here i!$ to' kmow ~bolUl ~lJr mediGfrle, This infOf1FlJli3,Vion sl'iotJtd 11101 'iarre 1ihe I:)race 01 dl5(l~SSLons wJ~'h ¥(l!1.I dodo, aboot your l'rlOOicaJ ,oor1di~o:n or FlE.OOIR~

Whll!~ i~s nI!:QUI:P'l

A EQUIP iiS a! preoorfIptiar. medi6nelo' tretll !!iiode!rate-~-$evere p.rimary FI~lte~, Legs SyIldrortte, It iS$omelilTiesl,lSeo to trea't Par~llS!)n's disease. Haviilg CIne of ~hese mrldihlons does IIlOI me.a.n)fClU haw or will~ deo'&leplMMoor.

Wmt~ li'slhe mst ili'lilpo~n'l, iflirorflnailion, I~ should !~oow a!~l)y~ REOUIP1

,. P'afierr\!s ~~h RL8 s:~.!rd ta:~ REOOIP' dTrerell11y' !han p.a:II&!Jls wllh Par1lilinrorl'5 disease {see How ~l:1oYI:d I 'Iak:e AEQl1liP 'ror RlS.~lor UU±! rOOlIfl Il'lEmded dosilflg !oJ RLS;~. A iIrlwer 00:98·01 REQU IP is ge.oora11¥ needed for pattien~ wJIh ALS. an:! icsla'kBn QIlC13'dai~ OOfore b~me:,

i. There1lJe ~ side effects: of REQUIP. If yoU la'l~ astOOp or fee~ very sreepy mire doing oormal at1illJi1fes ~tdi as d(l\I'lng,lainl, ~e~di\lZ~ na!JJs.ealoo, or swealy m~nyou staoo up bom s~lin9 or ~~ng OOMl,ytI!lJ should lalk lfIIi,til !fOur dQC1~r (see Whal :iI~ Ih'e :p(lssiilJr.e i~iWje etrects or A~iQU.llP?).

~ I3e'1fire starting REQUI P,' be sure to te~ yQU! OOc!Or iif you are' IalIln:g afl'i medii;:lile:S 1BlallrMKe you drowsy,.

Who, s~;Ql,lrJi:i' l~ot!lIke I'IEQ,\JIP'?

Yoi!J snolJl:d Mt take REQUIP il you. are allergft ta,U"ie ac~ve' in:groolGnt .ropJniroleor to, ill'fy orlfle [i\aG!&li<E! ilflgrerJienls. Your dootor and pharlf'lla.clsl. n1i.will.liiSt aline inacHve ~l1gredien~.

WM! ~l1\iol!rd I 'Iell my dOC'I.or?

iSesulV;lJ to tell your dCic~Ol' il:

~ YOU are pregMfitor pIrul to beDome pregnant

• yoU are breasl·feedi'llg.

• you haV€ daytim€ s'loopit'f(!Ssfrom ill ~~ dIsorder ~r ~oo_nlRS or 11M 1Jrw::pectoo sr:eeplf1@ssor ~rods 01 slijep While Ia'kil'lg Ri:QUIP.

~YOIJ' arala!o'Jing any olDer IPras.cli;pOO.n or O'II'er·lile-GGumer lIl'le.::iicflles, .Sorne al ~hese iIfIIlrloilfies may iiocraase your

cnarlGes of gellilflg $Ide effects !fttJi1e IEiki Ilg AE.QU II';: .

~ you start or stoJl!.1'ldFlQ ~her mediCi oos vmil'E;! ~u are ta:~ng FlEQUIRTlilis may i oorease YQur o'hances 01 ~liFiQ Side

effecls.

• ycu Mart or slop smo.'klrrg white :!lOt! are la~lil1g REQUlP, Smo~ing may decrn9S>eJ 1L'he lrea1rMnieifOO! 01 RfQUI P. ,. YQu·1ee1 diizz~!.Il(iLJSealed. $L·teal~, (lrlalnl. wJlen yQu $tand uplrom ~[tffing or tying dQ!.!lIl,

~you dnnk aloo1lo1ic iDMrages. Thi;s may fooreiil(i<3' your cnal100s 01 b€tcomirlg dl'ONSY or s1e9W while la~il'1g REOUIR

:How shQuilill I~ mim REQUllPror R~S,?

~ Be sure 10' 1a~ REOUIP e:.'(aelty a'S,dlrecleci tnl your doctor or ooa1lhcar.e pl'OlJider:

~ The IU5~al my to take REQUI P LiS OIllJ;! i'IlllMe E!lJ<E!rring, 1 to 3 hours IJ;ewue bedllme,

~ltlurdOO1arw:iUI Slart y{l1J fin 1l. row dose or REQUIP. Yom doG!or may blwige'IM oose tmbU ~I!J are ~j[H.J 'Ule amount of lIliMItr:int! lJial Is rngill for you 10 (ionooll yrmr slfI1lpkuns,

~ ~LI m~ ret!t~ tI s!ar1irtg ltiil wil~ drj~ nrMd by day. rIlG prllsilllhfs IQ:t SloWly il1trS;]S!Jyour d~i1y dr)s~ ~rlim~ so '~ht!1 you aM YOI.!!" dootor lmay oomrmioo what ~hei besl. dO'se is lor YOU, Dillere~t peop~ r~pofld dnerel1ll~' tOl Lhis medicine.Y.ou mdl! nol.11l€!'OO the h[g'OOst dooe pJlIl ~n Oils ~lI. or ~~ may need al"l ev.el"l hlg'OOr 00:5910 relMyour svrnp. 'loms, YO~~lUrd carslu1~y follow yQtJf dQdor'$ ed\!1l~ Of! U1s ~s~,aI1l1[s ~l.

• If VOl! ,miss your dosel do no'l diou'ble Y'OlIr McXl: dose.T~o!!'!~ YOW' IJ.l9<LII!'I 00891 to:3 hours bedore YOIJ" oo~ beodlirroo.

~ Contact yom doctor, II' you Slop,'la'lliililg AEQUIPlQr a.rt!IreaSCIn" Do nol restart witihQl!JlOO!1S~tirllJ yom doctor.

~ Ybu can lake REOUIP wfi:h or wilrioui, IOcd.ToIki~ REQUIP wJbh Jood may dec~aboo cnallCSS of feeTIng nal.lS~aled.

'Whail :aJre' Ule' ij;ilOssillre :side e'ffie;c:ls 0:1 AIiQUIIP?

.. ·Mos!. peop1t1l~o,1:am REQUIP I)]~ral~ ft .,m~IU.Tihe; mnsl co.mmonl¥ ~I~d sid€! ~Hl;lcls in p~opr€l ta:kirl!] REClJIP br RLS afe nausea, vorni~lIg, difzzIness,.and drwlS!iness or s'loopiOO$5, lilU sIlolJfd be c.arelul tlll'~1 you ~ow t~ REQUIP alfe.cls your ability to remainatert while doirrg nolilTlaJ daity a~lWlIl:ies, and ycllJ soolJld 'Wi1Itrn for'lIre ~l'opmenl 01 signrli:cam d1iy11lrr'lE! s'leeprtleSS or epiSOOes, olla'lli t'ig as1eep', It is possible that you cobJl'd fall .i±iSreep, while doing toolirRal aclJvities such as O'~,lnga Cal', dolflg Pc'llfSlcal ifliSks, or usim9 ha!zardOli'!s ma-ci1itneryM"ii'le ~ng REClUIP.. YOur ci1allCE's ol1a_UWig. asl:Esp' whirs dbLrr:g norma1 acliMUies \!/.twTIs t:a~11lQ REOUIP are grea!€'r il ~u a~e takirl;g olher trnedioioos Ihal caQIBsd rol.'fslrleSs.

,. VWlilI'l you sIan taking REQUIP orwhe-n:y<l! k.cr&ase your dI:i.se,yoo I'M! ~1·diny. lI1aussaloo, ME'a;D1 or lalnl" wilsfI'! ~r:st standirlg up bom sitNrlg or I:1JiIl9 down,. 'Therelore, do nol stand ttJP q~iGlrJ1y aller sittfirlg or lyirlg dowll, p,articUlarlly ~: yuu ha.W! baen~ttill!J or tying dowll for a ~ong period of ~jme"Tafffi: 11 Irrrimrtesitting on 1ihe edge of lhe bed ordilarr bek.lM: you gel up,

~ :Scme pattel1l51a'king npinirol'e' n<!'ll'e s'lxMm IlIgeS to behave' tin o;l way IUfllJ$m,! lor them, Exam~ olttiis are all ~5'lJJwal urgs to gamble or increased sewalurges arKltor bei'lavi.ors. ~ yOIlJ or ~r filimilYlnol1ces thai )lQl! !lire ~inQ any tlrlLlsOOl bal'ia'!lJors, 1E:lk. !oYOUf doctor,

~, Hall~oin3~ons ~unre<!l sOllJnds,~~ifins, er sens;ati(i.JIS) n:;l'l;'e I:!ee!l reporled in pabients,!a1t:ing REQUI P. Theoowere Wloommon in ptlbiGn~ ta'kflflQ REClUIP'lor RLB.Thtl ns,'k. is grr3<liter 11'1 p.:iliol'lls 'I'I'~n PaootlSolll'S di~!\l:>G wno' ;:ira ~kk::rtYi !aking REQUIP '!'!Inh l-<lopa. orm~lng h!gh~r doo€s o~ REClUIPlhan reoJm11l€'Jided lOr ALB.

ThitS S nol a ())vr!plela fISt of side' g:Hicts and soolild 11101. 1m 1m place of discLt5S00ns wf~h '!iOur M~care prwoors. 'YcllJr cioGklr or pllarmaoisl can g'Me yo~ a mora OOtmp~.et£l [list 01 possll:lle @de elloctE_ Th1k to yourdoGiiar ahout an~ side eff'eolE or pfo.'l}~etmS you may have.

mt'aef Intb.rnrril3liol1l afb01ll1 AEQUIIP

.. Stw[es of P€op~ wi~h Parildnms diS€a~ smow toot·~ may be at an ~ncreaS€{j rt'ilk 01 dMroPIng DrlifJti.i1noma. a Iorrn 01- skin oaJIC€r, when c(lmparoo to, iD€olPlewl~ooLit Pa~nso:n's disw.sa, It is oot ~J'loWll1lif 1tiif5 prol:ilem ts a&Sotia1~wUh PalikillOOn's \flSease ortlre medidnes IJSB(i to treat Palikinoon'sidTooase, A,EQUIP rs OIIle (lr ilfIe medidines lJ$edla tre~t P;:uikinw.ri'$ di$ease.Uie:relora. pa:~ient:s o~in'!l]ljeated wilh REQUIP $'oo~ Illave pernrn;lfG skiin ~t'!llr.a'lol'l$,

'" Take AEQUIP 8XaG~ as YOl.!r docklr preootbes ~I .

.. Do nol. stlare RE:OUIP wroh otMr~19, €lIeri rf ~~ ha.ve 1119 same S'yllllptQrm YO!!! hM. '. 'K€~p REOUIP out 01100 reaoh of dhMire:J\,

'" ·Store REQUIP' at roomlemperature Q~ ilJf direct llQ.lnlight ~ :Keep REQUIP ~n i!!I.1Iighlf¥a:osed DCIIllainer,

TIiis teaHelsuflIITlarnzes imJxntanlinlrmmahlona!xl!j REOUIP.' MeliaiMs ala soliTlelimesprescribei:ikIriPUfllases o~lh1in tl»oo ~!stoo in Ihis ~Irel. Do, oot take REQUIP b a oolldi~on b whtoh iI was rial. prescnilJ>e<L For more inr~lioti'l. tal k \IllUl yotIr cbclor or p'tmrmaclst They can gve you irllorma1iooUioI!.!I RE,ClII P Unal is wri~ b heli~htare prolG'ssiooofs,

G!laxo$mliithIKliine

Gr~GSmilhKfioo

Flesea~ch lrn1lnlg1e Park,. tile 2170S'

~ 0' r ,'~i~I~I!r ,.~ pi .Wki,~ n ,.....I

~, .. a);.'Q"'IIAiJ mjfle, j'!j~ ,'~IIWl r85le'1 ~,

October 200Eii OO~L1 5

o©2OClI5. The GIW;oS:m~iflK6n8' GrollJP or C<ll'll,Dilnt&s AJI rignls reserved

Piinled in USA. R0P895RO' October 2000

Deaders rx:Di~est

F'OU~DIE:.F!;S DEWITT WALLACe, AI\! D LILA ACHESON WALLACE.

IEd'itor·il1rC:i1hmf Ja(";ql!!!.'~i.l!!eL(!!(l E~(!cllti¥<t!iEdtitij)~ Mar(:~a Rucb'lrOfld :lr:lesT:I1in I!Hr~~tor ,&'1''''1:1111.1 u;i~ W<!lshingmnl B!lff9,m Chlirlf WrU~i.ill"l l].c:u:ua~ WQS~ CilOl:S~ E:dilit:M M!I..!~ Gr.Qllt.

:He<l1th Oir(:!Cbu j!.I~ie I!ain

:PlfElCil\Q'~ of~1i!I'Qf'iilng <!l'~~ Iil'~OI~h :~btil.re M. O!s;pe!" IMlulOIgi f'I!j: Edjooll' L;J.w·reilce Md.lIl~ire

'1f~::!~ulfQ!; E:ditll~l).r.!lula G, Ibn!.:!!:. G.~ljl A. Sledge :SQnli1:i,w Stan Elliril:o.r~ M:;I(lri!<.'H M~~lill)·.

Itld.y LR'I)We~a. ,lEd. SI).;1Iluh:Lnl

Se.nior Wlki:~ lm~rk~1 CI!I.ftlB. (RD Livill'g):, Andy Siunl[mJ:ru! {H,tlm~r)

'Selli(l,r W,~iter Ke·.lImeth MHh~r

:Staft! W,r:iIJe,rr Cynth!::) Dernmd}'

:5il'lnllor Co,py EdillQr' Pm.l.~ Silve.m'l:;1~

C!C.~ EiI!itor MdislW De.Meo

:R:~p!JnImi c,1fili Kil !.Irml,m II (N~Jdmr.tli Agi.! f!;~J, 1Q!ilC ph K. Vet teir

:Sii'!ililll~ FI£!~(!.;Ull:lh, ~tlilllQlf:!: FH~ei!!: Ie L@~t}'S,. Necna £'Iml!lc~ 1il',;:;~~,!;1~ Mlli'~or' Nm:t;::y (.:o~ell;::y

;Re5eli!.~ ,A.ssoeiifl.:e' Ed:i't,ors L::U.l.M McClure, llri..:il,gel N(l~ootl

,lI!rll}lr-e~I)IH Dearl Ab:1llem;rroo

:Direewr ofPihQW8ra.~h¥ [Ii ~I. BI",cll,

,~$:so~iW! Ar,t. Di~Cl(hr V~.ct!'l~i<L N.I,Sh:li.U!~pl~C

,A/:>5i:l!L<i i'lt ,A.r'~. D;rr~k!f 1'1.11 liil :t.itm'F'

:l?ih'DW Re5e<1rc'her' Linda C3l!'t~r

b~ollt A.~~k:I.ailt J~~ ni fe~ K~('j;.t

IM,J;ii!!:a:2iinl! Rjgh'b51 $~l!Icl!".:J ~Corl'l~ick .I'.m~ UJill"o!!'Cr:!lI')!, 11Ilr,1 Zade:;; •. 1:tc~if!l;1 S<L!):lPO{!!l<1

:Il.ilbrilry Ann Di:CI.:.lmru {ticaa ,LibmrilJl'l )'" S.'usa~l Duijemus, Ihlw~rllll. Gtlirilh::ki

,Ed:itoriill, A;S'Sislilnls Cnrt:!. :Sprirl~1' ClIxil\i:'mi!.l'~l Ke]~~l' (;00<1:., miz.1bel~ Keny.Mol'liq[.lIc tlJ~g5-G!:IYrlO'r. Lim:l~:I' M.i~klr, A!c:-;i!>MiJd:'l.(.'~.~ e . 1I:<Lt.hr.Y~ll)rir!lI1- .. kl. El~~.n VII;!i'dj

C(l~'Umln~15, Maria lil:l.fUrmUQ, MidJile~. Crowl~1'; JC"IIl1r1('l! Mm:.i~ Laskas, DI..'!IH Ornlsh. MD, Ml.!h:me •. C. Oz, MD..

Co F. Payne. Malr), Baaen. Mkh:aeD 1~. RQh~e~. MD.. wm.sholto:

,cr.().nhiiblJ:~in.!lIr!dil'l;!rs. Mmc .. AIC'"~!I1dcf. Al!lit~ H,;Inho~,ollt;::,,'i" E~it!ie llr:m, C~["~ M. Cal'lll.O~. DQi,t[l ()n~ ~ig;:ln, M::u'y A. f~schc r, Cathy f~~e..l;ro:llil:lr Ge,oo~. L"'\'-~'etlce Otis 'Gl'all;01.1U. Mi mi T~~~'s H~w~ Wmiru", M •. 1.-1:C.11~~.!i"Y~. A~iiUlnil Na.'>.~l,. Richrnrd Reeves, .l]'Ilrl l~~ni.ni, DaDe Van Att~,l..:'IllI:rn Va.nlill.erl.am. Gail C:;u'LwmnWcsrou, Laura "{oike,

Sacb.ll Z~l];m.l~rlllililli

Thill Oig~t ~p.uDlishi!!.dI in 50' ~:Itj(ln~ in 21Ianguiligll!l~.

in Brolll~ en al~~~tl:e·.ln Ia!rg~ prInt, 31'11:11 in a llIillil;;t!1 ve~i~m

PrMidlmint. GrOll11l' ~ubli~h!i!lirr Edvamllan

Gr@up A;sso~ii'lt~, Publi5her. Milrl!ieting'V:m,es.1iill Rood AodI"Il:~I!IS!il'llli DlrGc:to,s Ed ProS<Ollto, HelMy Sallis Aid'!;\erti51ng S:aIe5 N~ York Lc:;~ie U<!~cl.win,

l;.:_O;:~ie .Bcq;en. Sytv.t.1P;ikmtl!lllll. K31~~ 1f'~'~!<L~.

And!!, s,lPiftcnli. Cinlc~o SeQJtl A:;:h.m.1lIll.!,.IL!rillfl U!i'igm31=!l. I.-k~~.hcr G~eM. u~ S~hl~'lM~hlc r O.iltr5ll ·fu~.d :r~l!tld n S::!iI F(;3ne;i~!t(lMIke O_~[(e~d. Nm~n]Qmil;;u

Cu~t.@m 5iDlulll(lmi, Mmr,ll; Ma!!lIl::Lfli,

Kil'll Hu.ey ::iiteilt~J, .LilJa Monon

MialriI!iG'IIi1g Pntt:ll .!logic

E!!~~i rHi~~:i onj,i .. iIi: Je~ D1~~i CiJjdLl~~, Gi::lll:i!? M3itii'f

VII~~PtMildvn't. C(!iI~~ n'1l~:r ,M.arloiioting Cam .L, S('hlru]~, ~!i<!llil 'S~I~ Di!vl~ Msi.re

Mar:k-e'lina: l.;n.lr.l~ :Lcvmlsellf

Pi:!.n n Li1~ Chri'l:topl:i.er Ga}rJo.s:

C.r-eal,ll\!\e' .Ke.ooct:~ 1I.t Il~rown

C.h'i!i!lf F,lilal!ltl:ii.,1 Of!kJi!lf StcpllUl W. Simo~ Sii'!nillii' FII MI'I.O~ 'mrn~tor J~SLI~ C~pr)te

Dim.QlIOf ot 'Opilli'<ll'ti(ji'l~". U,:S. M:a!ilM11 Mti Stc ~It~il It. B.c!st Aod\!er~isin8 P,r(lofj'u'Ction Mil nager' Cam] Bt'uhuil

RE.AINiR'S DmEST INTnN.A]"ION.AL OOI't.~ria!· ~ioo!I:Jtol' QlU[;I<B Kil,'l:!l~ot;!.i M~niil.Eiing Edikiir R.:liIHO MlJo/S>Il

S!Il'nl,g,rr 5'tOiU E.dJ~I~ J~n;1I;! c.ol!Ld~

Ed:licnliil A~I~l:iln~; Le i1;11. V. Trmm

RU.O'ER'S DIGEST ASS'OCIAJIONi IINC. Pl'eril'dleifllllmi Cllll,ef EXe'CIi~'Tv.e O~~I~f ~!a1l'1 G.B!.l1'9.tlf

Pr~i(C!i:rlt, Ilnternil~!~nl~1 'rhl!)lJlll!:;; D. Gill\.~ D1ll:f

Pr~I(C!i:nl. H@rn~ &. Giilrden, H~llh &. We:il'ne~5 A~y~ ,A~Slc!il Pr~I(C~.rlt. 1iIi'1[i Iln~l'li r;;l'llon' EYOI :Di~~on

~:i!idenl, :S~~~~'i &. IEch!mliQn<l1 5<li:r\li~esMi!;bae~ s. Q~t~ mel!' Pr~I~!i:rlt. if'9(!;ld .& [lIlJeri~ilining 5!.1z,,1UIlA.l M, Grime~ PtMi.d!~iI~, DigJib'l, Ihl:~!iI~~ rj)d~ Ka~'11l

PtM!dMt, Ni;I~llh ,A:rnl)'r~iI Ci;li'l!iiiifli!jd!~~rl!:ll'ting .ibwn M Z~('r V:!~>@ PtMrdi!i'!:~, Glg!b~I' c(!ntI.i:l'1l~ili~!i!,gil:!i. Ui.~l A.~I!~r

V:!~>G P'rMrdll:i'!:t, HI'UmOlII R!JgoQui'iC1Mi U,'l:.l !!,. Cr,h.9r.i

V:!~~ PtMrdM~, GIl~~r.a1 COllil;:Q1 A~i1l.r~,!1 N~wht'l'r~

Si', 'lii~iIl PIft!'.sKlll:i'I:t, Global' C,~ra~l'lI'n~ tll]i~ert L J~crr'u2.·:.m Sr: '\Ilce Plle5ldie,nt, OhTdlnJorflil!iltion omcer Jill Irey S. SP.IIl:

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After surgery.women wlth early stage breast cancer now have a more effective treatment option than tarnoxlfen. Fernara,"

Afl inw!I'l'l!tiollal di!llh:;a.~ s!ludy ~rw{}iv,i!'lg morn ~an ,e~ooo pos.:m'\lJ'!opal.!~1 'Ij'I(Ii::l(m,iMl ''!'rim horl'll@J'!@ lni!mpEOr=poliiidi¥e early st3,g,el!ireast C3f1,Ger sI'Low.sth<it ~~ reduces; d'le cnMlc;e 0$ Ci'ln;e:ejc' wmlng back afW~ ~u~ry. l'n1a.ec:;,mter :24 mQlfld'I;S; of lil"eatmet'li, dlllr,~!~01111 1\~111J1~1[;S iShoIWWB!~ ~miilrn 1:iO mom eft'ocOve ~~n ~iJ'li:!lJ iU, l!"efJ!.!dllglhe rI~k of bl"!ea.'Sl!: cancel! comilill8 :lback.

I~po~~ ~r:a S.d~ty Ilnf~~oo YOY !l!IU'!iS'~ im.e Ji)mwe~O;~!l!~salI 00 I;;!!~g remOl!ra Phy.st'Ciam: ne~dI to dlls'tussme:FI;eed ifor ilJtlIeqw!IIe biFID COWiJ[JFO.1 measul'>es wl'th WOfi'i!en 'Who have .Ei1t-e pO Ui:lilltiaJto become prqgl1!OIill't. 1r;dk~o yQiur donor ilf YOlcl'~ 1I1111ilrgk to fema.1i'i2J 'Or 3!1l1)1' of ill! ini"!rlif!nrs.Y:O~18Ii1oullid IFlot t<!'i«) Fl:mill11l, if you :~'Il~ IP:reUl~t ~ lit mar 'UillJiSlefeml harm, Some women

repoo,fte;dI fau,ue' iiilltd ,diizzil'tess with F~m:lil'i:l. Unti I' you !mow how it. a'filleru you, IU~il ~lJtkiln beIDliel drivill!g, orope:rn.till,g iTIiI.chln.ery. Som,1il pil,tie:nl:5 tilJdl1lg lFeJfJiarn hadl an ilmcrell;'le !111 (hoh;:$ter'~I' •. AdditioM'!' 'rc~llow-up r~ Ileede~w Q~tef"J!llliJ'!~ ~e rJ~!k of bO'l'le,rn~w"e !moc'fu>Iildl wim

Comp:iftt:iill W1IIlh l::ii'i'i.Ol(iffll\, ~1'il"I:if:i :5[gnifi~mJy l!lilduwdllhe ~k ,or ,~c~ "Onl!!rt\!: b::lok b1 ;1;1, ~ditlQIf!iO!J 2:! %.

FrcIT!l:liI'3J .:lJ.m, r~d!lliC~d the ,chm C,{l of

ClIlIilQl'lF ftitLllrnin,g ~o :Inome:r p:af't of tlhe: body by 27% ,'II, !M(lIu,taf "1,,003: patililll:ll.lll:llk,1 rl,g. Fe:marn ~X!perienredl 1r'e;cullfrliH1Ce ,,"~, l.:j~ OllJt 01 4,,(;01 ffilitil!O!l'l~,tiilkinig ~mQ.\l",;!fen}. Mer 2,.4, months Q~ tlr'ei!M!!!l!lt. the~e '!'fern ~~I!" deatths 'for 'WO:m(!nti!kiTi!'l8 Felmlr'a (Hi' Q~t of ~!OO:J) ~Iili:ln ''!NOm,~1m taliliflll! 1t31'i'10!l!~f:e;1!!I :( I '92 of 01111: 4.007}1, Mwernll' lI!hi~ difreFef'lce cines not pro:'o"e, tlmt Fenurn. ~s better milJFI aiITlD'xirenl ilt il'Fe"enling dearOn.

• ~~. ~'b·o:~ale taIlllet!1l)' ii.!l ,~~ m:r tIiI~ adj!Jvan~ ~r(l!r,gwi~I~~nr) ~~t ,!!:If IPI;l~ 1111t~~~tmwilJ!lh~~~

_ ...... ,"""_ 11.. __ -," '. ~- i._~....La- _Ill ~--- ,.

~·.,1' ~~~ ~ I~ IlfIIC ~ W ~ Inl

d:Jlillc;a;l bb!s' are based en 24 nm~ m~eIiI1:. FUi'iI:IlIer .~ 'will deta1iinlne ~, 1resu'Jts" _tymlU effim&J~~'lM1l oot~the~ of,~·reb.U'rlingil1l:all ~

F,r)! mOJle fnfomwtiol\. mIl ~ ·866-493;3627 ot m.l!!:wrww,@mClm,mm,.

,Common;I, ~IlOFted siille effecl!S wete :fIeFleml~y Inldoo mo~bl.r<lJ1)e. Side ,effecits mat were ,wmpl'lr<lbf,e :betweefl FemaJ'lll. andl tiliimci!C!H1en rnd!iiide~ night sweats. weigfult . pfilll!, .niilU~~' and dl\~dlll!~s!; .. Sidll! ~f(~~ ~I!g~ 1'Ilt0'1"I(! @hlln wi~ t<I!!lI!l~ifgJ'! vg;!1"~I!!1~ ~rn:w<! W~I\!) IhQtll~~~!!lI'!dI Yo!iT!li!IIb!I!l~i.,g- Joo.ll'!t ~arifl vn!!; IWii'Jl'I{lrp~n~l!ld mO~r;) a~l:lfl wim Femars. versus mm~fieii1l. The in~jdence, of SlCI'dke watS I., I % 'For women on Femara 3n~1 1% for women 'On mrn:o:x~rel1i. 3nd~e liliddenoe of' omer ard~a'll'Uc)lJlar ,eyeHt!i 'MIIll ,6,6%, fur f,emOJ.~. VllNiiIll.s. 6,2.~, for 'rnmo.:(ihm. Ttlfle: l~e"!tcemrL:age of ¥tOmei'll ",llpo:itin~ as;leop<lro~is w~ 2% far ~m\ilra v~rs1l,lS ~.I % (twC!m!O)lifim.

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Fem!lJ#i (reLrmlJ{le tabrets) ls Ilrldicaled f©r the adiuwlJTt IJe!llme nl ©J PIJISIT1LefiOpaU5aJ women \'Iilh ,hO.rfllmlne receJl!lm pooiUliJe earVy bHll1~1 cancer {see Ct/WIGAI. STUD1ES in the tlill jHw,cribir:rg illfQilnilfirm},

Tile eiffecHvames'S or remllrn lill ea Fily brem'ft cancer r5 Iii!sEid (I n 0'1"11 8ntalysls O'r dL~eM~·h€:e sUflIival In, ,lJ'a'tients, ue~led 1~r a medfall 01' 24 mQ~lhs :IImll(:dl!lWedr~r 11 I1II'edfM 0,1 26 lI1~rllhs (,se~ C'H1JICAt Sro,IJ'fS II'! UI~ fUJIJ proscr{bln'J) tnrO{rmli(J~}, 'F@[Co\'Fup .. m~tysEls 'ii'illl determine IM~Herm olJtc:~m~ r~r Ilol.il saJe'tyand ellica~r

'~ONrRIIIN OleA T~ON,S

Feroora* (f,elr>G20iIe 'taMets) js COnltmrnd ic-tlitea i!1 paJienls. witl1 M GW,nhyperse ns i~i\f,it~ 'to Femrurn or O'I'11Y or Us ex.oi~ients.

1WJlRl'UrHiiS

Elre~r:JlanI:Y: ,FemaraQ!; (lelrcm}'le tllbfets,) m1lll oaus!!! feta'i tI~rlT:llJthei1' ~dminlstere.u t~ Ipregnanl W(]Imen, Siurju!;!s in rats at doses equ~ t(]l ~r greaterUlilin (U10-3 mg:(kg (atlOul ~t1IJ{IIlllI~ dS1UY l11i;1::!ilmum reCQml'l'leRoed HIllman d~se min (I mg{m~ basis) i;u1minls:teretl (luring: the pe ri!Jtl @f (l'rgan@1I8J1elsi5.ll<!llle S~@WJl thai: 'eiroz@te j,s, emblYl!Jt~xic .mdMljto)l..i~. as 'i nl[ileated by inirn ~teriJle llfIortanty, increased reSiliirptiolll, 'i~ereased pocsti mpr.lfllilUml roos. dee!'eas~d n IJ mb.ers or ~~\le' 'tetusesa:nd r~aJ ~_nl!Jro'Ia.l~es Ii ne Iud i~g ~bc:Sllioce ii1nd sMrte ning cd renil~ j)'api lIa, drla:tiQI'Q 01' 1I rele r, e<iema O1~d ~nc.Qmprele ossJjjjcallon 0-11'1'0 ntal sku II and metlllaFSilr-s. LelrO:l:ole WitS 'terallO{j8Ilic, ~nr:ats, A US mglkg tlooe (abootU10 the daily ifi1(:(imum rElcommand'ed hU!1'Ilill dose on Q mgllfl2 Ilasis) c~usOO lelil~ d~m!ild Ilead Md cef\!icalJ cemlrum verteb:rnl iusian"

Letmlole is ~mtllYO't®xJC" at dQiS8:i EH1,ua'l to or greater lhan (HIm! m!;llk(l and r~t®IIf}>liG time n (ld mi nister6d 10 ratl~1ts (llI11]2: mg!\It:(I (a:boul1 J1 OOJ)OO 3nd 1110,OO{l 'the d~£ly ma~'lm!Jm r'l!iI)Qmmelliled h U Illinl d{lSf! 011 a mgfnfl~ !.Iasns. res~ecL1~ly)., Fela'i !lJl'O'maJ~e:;;, inCluded i n~mp 191.6 ossilica:tilOrl Clr 'tile sIIull, sl~mebrne'. and, fore· and n in d legs.

There 3rene studies in' l}~najU Wemen, Femara ~s Litdlcal.ed (0' PQS'bTleti'!J:PillJlsal WOmllill. u Ihere is E'l~iPosure I.if) relrozot~ dwrJil" jJrilQ' naJley, the plitient S110llltd ce a,p"pMsed IGr. Ihe p~lentrallha2~rd 10 Itlerellus and pOlenljal riskror loss 01 the pregnancy,

fREG.AUWIONS:

SinGe i'atigue 3in!f:l di1zi1l8SS 113~e been I1bsl!'rl.I.ed wftlilhe use' of lFemara* (letrmo~e bb~lets)alld sllmn{llenice was Im~omm~n'I'I rep~Drled! taUtlil'!1J ~ a.d'lllsed Wilem drii'lJng ®r using mllJ;ll11i1E!I1j.

~alloraI!D!!1J Tesls~: ~o dose- rel~t~o erfeGt Qf Femara. 00 any l1e lTIlato[.[I~ IG or cilln[c!;!1 cftlemiS'try plilram~ter was ev]de!llMfl{le~te deueai>13s [nl~mpl1oGYte. oou nts, or u noortain GHni(lllil sjgnnfL'O~ftlQe. t'lere ~l1sl3l¥e£I' in so me· j}iII!i8nts rec:elving ifelrora 2:,:5, mg,. Thls de~res~ion ".,'as ImrliSi!l$lI. in <lb0d: haBr Oir I~ooe' .:vrf~led. Tw~ pal:iel1'l,s em Fll,mara dellero,ped Ulr(~mbQ;)~liQ,penla; r~la'tlo:n~11ip 1,0 tlHil stlHly drug' was uncdear. Patie nt l'liUl 0 rawat d UelQ laberalllly.aIl n{Jlrmaritl~s, wlu!lher ra lated 10 stuDylJI33itme nt or not, was inrrequent"

l'nCrthlS~'S I n 813m, BGiPT,a nd gilm ma 6f ~S limes 111e upper jimi'! ®r nJ(Jrmail (IJLN) iilnd 01 ,btliirubinl ::::'1' ,5, times Ule U LN w~re mOcst orten asoocrated willl metilS't3lic: d~sease in 'the ~i'l'e r, Ab'Out 3% 01 Slud~ ,patlllC ipa:!1lS rece i\fi~g Fe i'fJam Ilad ilion oirrn3'lilie£ il1lin1er C:lleml~tliles mm aS30GI1IIed wllh, documenled 1!1lIlIQSLa::;~S;. I]lese i3!morm!lin~es mal( na'll! been related ttl study dmg~herap!i' In the megesirl]d :;Ice'l:ale GomparaUlliIlstudy i3b~ul. 8% ®i p;aJtients trei3led WiUl megestrdl ac.elate 'Il~d ab!l{lrmal1lnes ill .u~er I:!llemi:;;tri:es tl1(11 w9,e 1i1<l:!itssooiatecl with dOCmfl'illilled I iller meh'lSIMeS; lin Ihe amioog'l utilll1 imide sludy ilitl'OLit 1 0'% OifamJn®grl.i~thimid"'"treal,oo patierliS ilat! abn(lrm~I.iti:cg, lil'llwer cilmmistllies 1'101 ~riilled wilEl he,p\'llfic m~'tastrlse$,

1i1J m~ adju'lranl sem !l,g" an h'!c rease 'iQ'J t~ta] el'u:HesL'fJroll {g~rle ralty Glen-Jasti'ng) ~!'I :p';1~i~ i'!ts wM had llaS~line v~[ues of tolail seru l'1li ch~reSlei1lJil \o,Ii:thfn Itlll iIIorrnaJ fange, amllhen sul.!se,quenlil~Md illi Increase in 'tOI~ serum c'liofesl.erol 01 ts. UUI WitS 17313200 (5-4%) on ffllrmola \ii!l, 40/3224, P .2.%) on 'IilImo:.:ilie.n" Upiu [wsring metlf;cal'ions W8 re use,u b~ tS% or patle I11'S Gn telrD:!:Q1e an tI '12% em ~m(lltit'i!n"

liloH8J Er'!ec~s: In 1118 e:.:lell ded .adJuvant seUln'!J I prel11i1lill!ll)1 resu'lls (moo i~n dur:atloo oJ tallow· UJI wa~ 20 .!nO nUts) rrem the Imne ~ub-~Iudy (C1J'lclum c500 mlJ and Vila min D 400 III per da!{ m~lIdaleJ)'; iJ,ispno~phonli!illlS rlOl alt~wed) oom®nslr<lited that ,at:2. jlll<lrs lille mean dec ~oo comp.'lilld 10 llasetine ~!1 111 ip BMD in Fe mara iXII~ie nts was 3% va rsus Q,4'%r®r p laceb(l [P .. Q,Qt!lS}. The l'MaJl dec reas~ frM1 ir.l'8C II Mill BMD rlllsuHs. h~r Illelumilillr ~p In61112. yearn'tms FtiTulJft 4,6% fJecre.L'lse ami .~cl.lc€'bo 2,:2% (P=GU:t89). Ccmsidemlilorl

sh ourtJ be {l~'t'en LO mom il!O'ni~" BMD.

nl!mlg, ~n~8irr,il!di,nn~: C.ltlD[C~~ unl:e ractllJon studies wt.ttl Gimeilidine ~ntl WI! f1i[lriin Ilndi'clll:e.u tllal the' CIJ3;O minlslratroH of 'Femara \'leUl, I'hes!1! drllgs d®!;ls ROit res u Ii ,in c'lln iGaU~·si!iln ifiram:t dr!J1lI tnt~raotj~n5! (~CUMCAL ,PHARMACOLOGY in .th~ lui' prescritJing {fjf.o,malirln.)

CoadmirristratilJnof femara and tamlil)j,iI'en :20 mg dClil.Y resu~leJj ~rI 11 redudH:m gf letrCDZlJ1e IDlasmil ~e'ofers, l:J.y 38% {m 1lvernge.Hm'l! ilS, 11(:1 c:~inic~ e:r;perience to diille ~n the U~ Cli Fema.m rm C!lmbiM~i~n w1i1~ olher IlInliCilJiCer agerll(l,

H8ipia'lill i mSlJlm,~iI8 r:m~: $ubjoecls wiith c[rrll1lS'S (lind s~wre ftIe,p<lllc dysi:u rlcLq~m (SfJe. .cUNlCAL PHAlhi';..tA COiOG~. SlJ8araf ftJput<JIi'om;; in Jail (uri fJ!'escrilJitr[J' klrormiitJan) \'.rJ11:I \'reffi dosed willi :2.,5, II'llIJ of Femillffi experienced ap,wm:1m:llte~lt tWice too e)J pooLi re 10 Fema ra lIsheaUhy 'l.l'olullleers, witll normai I iJ,f'llrrun(ll~iml TftleJ!1!rore, 11 dose reducli{ln ilS reromnumded for tllis pilltienl J}n~ul;iljt[[fn ,The ellect ~f !Jep;;lI!IG ~~lIIlrment on Fem!lra e:l:p;I)Sure ~n >ca!lG~'!r palienlswlt~ erwated tlmru'tlln l~e:ls 'Il~~ 1101 been delermlmYl_ ($ieff DOSAGE AND' At}MfNi$TRA nDN,)

D~ulglL:aborl!Or¥ 1ieS!~·lfll)e ri3'cl:ia iil!S: Me ne oD:serveci,

l(lar,ci fl,a 9 e fll!l$is:, M U1I!1m'e,ne'sit,. !'un,p'i'!i ~l'I'Iemi! or fel'li lir:y: A CCim'!l'eilli:OM~! Cilfcin~Qenes[s study i n mice at tloses 0:1 Q.® 1.000 nr,gJ&t{lloay (a:boul1 to ~OO Urnes lhe dsi~V maximum reGomml!n~ed human l10se Q9 <II mg'tm'~ baslsl administered bY' oral gl!Wage for UI) to 2: years, r8'1re;:lreda d{Jse-rer@ted inmB3se In the. ina;idence of ben ill n wsrfan stroJ'Ila'i turnor$_lile 19~jdencB of (l1)rnbiood l1epat'l)cell[urcaf ~Jdenom3 ~nd ~3m[nQom!l :;;imw8Q a $tgnWl~aflllfen{j in Iema[es when thJ;! ili.gh, d'1;IS8 grQu[Il was 1!l<(;I!I(k!d due t{ll,ow~ul"!Jh!'al" ln a S'eJDaraLe slludy,. Jl~1lSma AU,c~121i1 I~ve~ inillice at 00 mgl.kiJ/diIY wm' :5-5, umes hvgh~r linin Ih~ l'tUlC-CH14ltl1 ril'!ld ill Immsl cancer p~lil:'inl.sallhll raceramel1dGd dOoSe, The: Ciircfrlogelllc'i~ :slud~ ~n rats at ©ral ccses of 0,1 IUD ~O m{llkg/d1m~ (about OA to 40 'tlmll~ 'the d~il~ m<l))iflllllm reCQII1· mrel1dad 11 U 1111'111 dllse: 011 a ma!m~ oosis.) for LJil'to 2 yiMrs, illS!) ~roduc:ed (In rl1(;ru~e i i1 the I~ci del'lce ol' belli{J n ovanan sl~mal tu m~rs at 10 mg1kogJd~_ (hi<il,rM hyperpla:s:iil was !lb!8eMillln r~males a:t dos~ e~uallll Or gr'9:MIiiF t~~i1 OJl ing/k:(i!tliI:{. At ~I) :!1l'i!lrf;:g!tla.~, p~ijlSrna A.UQ~4hr levers in rats we re 8fll:im~shirJhe r than I:he t;[!vel l n tlreasl cancer p~ttenl:s at [lle rec(fJllmernlied dl}S!i!~

f"emilfa W;lS mot mutagenic in. in lIil'l:'O'tests fAmes ;jlll~ f. ()oJJ ba:clerl:3!I'[esls) ~ ut w.;IS {J.~sel¥el1~o be a :p o:te91lal cl@sktgl!!n In In vilr()' 3Ss:ays (C H:O K1 and CiCl 6~ Ch!rl8:±:e h3 mster @!OI'ary ceUs). letr®z@l!e was, nol: ~ias;b))~e nlc ilP ViM7 ~miomnuC'leus, tesl: in rals],

Sllloias I~ IrM~sti.g.]lE! tM effect o:f IIW020I'e on rerlilvlY ha~ 1l®II.ll'len cOfld'uclad; Mwever, re~ea:~d (Jos:ff'lg caiJ~fJ sex.ualll'lactwJ'lY im l'emares ~n d ~trophy or the rll,pro':lucl'ive If3C!t ill males t"ln~ lef'l1\3!lesa'l doses (!Ir O.S, 0, ~aJld (1,00. fn(Jtk~iDl mice. rets ami dQ'Js. reseeeIli~Jl~~ (:'IIH'Iut one, lilA me:! 0_4 'tM rlally malumillfi Ilioommanodej 11Uf'M11 diMe on a mgl~ hR!lils. ['e!lpeCli'olE'ly).

pn,~nlanl:i1J: .Pl:IliII.lJa.lJ!.~ Cal'l'l'g,lIry fJ (See WARNINGS,)

Nt:! ~ing MOlhers; I't is nOI,~now,fl1il1e'trmote is l'l~crell'li[J 'il1 11 U nan milk BeCilus~ many drugi are excre'telJ i'l 11 U man milk, C'.tiulio,n $:nourtl ,b~ cxen:;fs!i!d whan Ih::lrOLm'IEi iSi;l,om inlst!ilred to a nurs iog wo man (5~ WARNfNGS {1mi AAfGIJ.UTI(')}J!S)"

Eledia~~il: LIse: Tile salilly and efi\eotilofenes~ in ped illlria: I1'!IIr,enls .ilave mot 'been establ'is he£!.

l[lje1riall'i,c Use: The medr:illl age O'r pa~ie 11ts ~ n ill I iSli!(Jies elf nlllt'il~l'!e ~"~ secolld·ri'n:a trealme~'t li)f metasta:tic breast cancer \'las &rH,5 ~e~r8 •. ~lljJ'ut 113 ~I m~ ~a:tients were: :a: 70 ~ears Ot1:i, In Ille 'fUrsH~lIe. slull.~, pa:rients ;;;: 70 )lean; ~I.aglili' e~er[llllt:e(j ~oliQer ~ime to tu mor IWlIgrcssioll mmillvoher reS~llllSe FilI.es n18:1'1 patients <70.

Fm lIJe erlended suJllVant setUng. rnOrlll than fi,,10(lpi!lSbrllmOlNll.Isa'l t'l0men were' enrolled In lbe {/linltil~studlI9 tQlBt 4~% ([if !lI!Ilie!l!$ wen:: i!I~d 6~ ~eam ar orfJer a:l ill Ilwllmen~. Wllll~, 12:% were 7;5, ar ~lId~ r. III Ihe e:dended lIt1.i~'Jl:ln~ senlRg, Il ~ onrllll (Iitie FeIIJ;;e:!l i~ S.'Irety or e'fILoCl1t:r ''!eril O;biSlliV'Cdbelweenl Ihese older ~tielllS !il11,(j youn"er palia 11'bS, and 01 hu rep:orted cl[n iC1nl1 e~pericllce: aas dlOI. ~den'tmed diirlere I1ces lil'l reSpMS>e!l bel.wooll the' et(leruj' ~l1d )ll1lunger pa:tieIlIS, but g rearer serlS'itivlily or S0016 o[\Ier ~ I1d~vidl!Jls can n-ot :b:e ruled out.

I n tile adjl.l~r;ml s81tl1l~ ,. mQJe Ihll !l.mm postrl'1il!IlQ~usai wom~n we re em rlJ lied in Ule oEi!ltGal :;;~udy. In l{ll:a~, 3fi% {I,f pal)ienls. w,ere s,ged 6.6; years or @Ider at. en roJtrrrent. Wh~~e 12.% were 75 Of !lilder. More ~,dlleHi~ e~'enls we re generi:lll¥ rep,ijrtel1 ~n e~oor~y ~!IItlent's imspective Qf study tr'l!atment l'llioc<llilm. i{[)we!ofe r, ~JI co ll'Jij}iilfirii@nbD lam{lXiI'e~. n@ we r:al~ drifere noos· witt! fE!l;Iards; to Jill! s<lJelll and eflICilCiJ p ro:fil:es \~re obse_rved bel.ween e~dilrJ~ Ilalier.ls <'lind younQet pa:tle nhS.

ADl.IUSE iREACmlONS

FelRllra:* (t.eIfOi:()Je 'tahl'ets) w ... '!: allilleral~y \W!II tnl'eralM ~'!: adjllliani trel'lii:l11,!p,nt Generally, Ihe nllS€I1i'e.D [:I(Jvl\!r!iE! nl>l1::li~ns ms' mfld 0,[' moderate ]0 maIIUH!,

Adjuv<l n~ T'r:83lrrnenl 01 Ea'riv lhl!ast Cam:l!r'in Pos;~liblenopau£aIWOIlilHn: The: mEld i~ n d u rafiull of i3f1juvanl tr:eaITIbl!nl was :2:11 monl~hs 8 nil Ill!! met! Ian duration or follow·upfCf s~f.ely was 26 mo nlhs ror patiemts receMn~ ~Fema ra aocl l:am~iren.

Certain aJdverst! evenls \'lI!re JlIrospectivety spec.il'ie;d for amrlvsis. b~sed on Ihe known p Ilarm2lc@t[)l;Iic pf(l,pe rtfes ~ml side effect ,porofi:les 011111e I,W!:! drugs.

PldllefSa evenls ware <lllaly.lerJ rrrsspecl'!'f19 IJif whal:iler a symplfJ m was press!)l: :0 rabs9 nl: ill Ibasen ne, Mosl: adVa rsa el(9 nts repented (82%) were grada ~ er g rillde 2 QPplyJIl~ 1118 Com mon Tooic il,y ICime ria Varsilon U. Tl.lbte 13 dl'lscni !las adva rse e~en:ts, (g r3des ~ -~) irrespective ~r rr::'lati~n:shril' I!!:I slucy I Fe1l1'f'rOO 11'1 tn Ihe Mljuva n'l BlG ~ ·98 lriai (Sarely :POPU~fllioli1, du ri ng 'tre.'Jlmtl1t OF w~thi n :30 d,}~s or st~Dpina l~tme!1_t),

T;a'l]le 13

IPal.i:8n~s ""nnl Allilvers'8 IEvenls (Cli~ IGi~ades 1'·41~r,~8specli,,"!8: 1~~R!~'I!~'!~onshiIPI ~ClIS~w,liIy Drug~1 in ~h8l1diuwmt :S~wllilll Bililli 1-!l1I

fUjar~ ~i!IlmICli:tnen fiem;;na~

N,,8W!!]1 N..:3.!:I!BB N,,3973'

II ~%~I Ii, 'I%~I II (%)

Ho.' iFr;'iSheslFI UiS!t.eS .Arll1 rnfg ialAr1hrf'Hs NJgll:t Swea'ts Wetgl1t Im:rei\S8 Nausea

Patigue ~Lcltlilrn~, IMar~ise, Aslrlenra) E!1~ma

Myitl!l~a

11338 (33.7) 1515, (3<9,,0) 0

!MQ (21U) 535 (13,4) M (2,2)

5i1lli1l (t4Jl) EfiS~ (Ui,.t) 0

425 ('~O-7) 5~~ P2,9) 21 (D,S.)

378 (95) 4116 P 0.4 ~ ® (0.2)

333 (804) 345 (8,7) 9 (0,2)

286 ('l J~) 2il!7 (,/,2') 5 (OJ)

255 (SA) 243 (6.1 ) 26 (O})

!.amillilite,n iM-:319i118

o

49 (1.2')

(I

.!I4 (1.1)

']Cl (11,3)

9 (0,2)

2 (41.1) 'H~(k.4)

(Con'tin wed)

T<'!lJte'13

Pl'lli,entlS w:U!h' Ad\lCfSC Itva nls (CT'~ IlEfi'ldes: '1;·4, 1.IiiPfl~.~e'i:~~\i1e IO! R,elal[of1shiplo :SliUI~Y Dliiu'm ~I in t~c Adjuv;anl :SliU'~y IJlllEi 1·98

Femillfa0 l'l! moxj!!en Fem:a ui!!'

N .. 3,'9ii5! IM:;3t9\B8i IN .. 397'5

Arn~IB 1i:!l8! E'IIe~'1 In ~%) ,n I~%i' In ~I

Buae :FraGtures 22.3, (liJ5-) ,] 58 (4J;l) 76 (t9)

Vagllm'l Bteeding ~n (lL5) ili11' (Hl3) 2 (odU)

l1Ieaidll'ehe 1141 {S.S~ 12& (3.2) '12 {O.3)

Vaginallrril<1Jiion U9 (3.5~~22 (3:1) ® (0.2)

VOll'lillin'lg ~Q9 (2'.7) 11013 (:2'.7) 6 (0.2)

[)iu,in~slLi~h't·Headedness, 00 (:2 ... 4) 11110 (2.i!1) ~ (<0 .. 1)

OS\ell P nrlJlSl~, 7'9 (2,(1) 44 ~ t. ~) 6 (fl.2.)

CoJistilJ3Hon 5'9 (1.5,) 95 (:2.4) 1\ (OJ )

End{l melfili31 Ptlill[iferaLit!n: ms~rdl'!n:; i(l ~ll3) 7'1 (U!) 11 (.dJ.1 )

EJld'olmlrial Ca.nc-er1 7"3~89 (Q.2:) 112.l3~57 ((1,4)

Other hdo,metrfal ms~r(jers ::3 «(1.1) 4 ("0."1)

Myoci1Ir(l!al 1'llf<'lrdiclfI 117 to.4)U (114)

Cereb,rovas{;~~ar!TliA $I (1.1) 41 (1.0)

,l'Ing[nll 27 (0.7) 24 ~(l.e)

Thr'(lFll!iboM!'!'I~olicE!lenl 4!1 (Ll' m9 ~2.7)

OHler CaJdi()~asoular 261 t6,6) 243 (6.2)

~61}nd Mailr.gna:n{;i~~ 1&~'m3 (t.9) 90}4Q01 (:2',<ij

o

]5 (0.4)

43 (U) H (0.4)

29 (0.7)

97 (2.4)

~3mo~flenl N;;;3t988 n I~%)

45 (11.11)

7 ((L2) 6 (0.2) 3 «0.11) 8 (0.2) ~ (~.2) 7 (0.2) 11 (dJ:1l)

'~2 (Q.3)

1 1<0.1) n (Q.3) 40 (U) '7 (0.2) 79 (2.0) n (11.8)

1~d ij)n Siliflilly p~pulaU(Dn 0)((; Iud illg pa:tio1!nis 'i'l'ilijJ ~{ld uride Fg[lile h~ler'€C'lOiI1t'{. I,imij Imoo: JS8M !tine [ft€r I1JIclom i~I~Qin: no en:

gmde~ coll!il~I.e-d (~~£~lQ re~p1Jllm:)

2BMed 011 the ~n'teliil:·IO-IH:1!i1 p;QIpul:i1!t~M: lime Irdim& is any Illme iiirier ri'.lliidomi~tloUi; nO GTC ~r,ade® eo letted (yes.lri® r.csp~r1oo)

Wmen cons id{lrin~ all grades, a Ihigller irilCide.noo ef ellenl$ was, seen fur femara re~ardi ng fri:lC!'u res (,Ii 7% v::; 4%). :myocardial rnfan::' tlol1!S (~.6% YS ~J.o1%), and mtlulllgill. ~21 ,2 *' 'ofS ~ 3.5'%) (femafll v5.rnmo:xUf€11' res~ecll'o'eJy), A h~~oor iil'!eidenc~ W'l.5 seen 10 r I.i'l:nmx.iifen rll~r1ling Ihl'Omib'Oembo-IJc: eventS (1,2.% 'lIS 2.8%). e~ldometri~ cancer (~.2% vs 0.4%), ilJnd endomelr'al proJliJerttiOil diso.rtlers ((I.a'%; '1181,8%) (,Pemara vs.lBmli)xVr~n re®~ecl'i'lld.~).

01j/EAi]![IS~U

ISOl{llOO C<l8e!(l ®f 'Femara(!!! (1Ietrm;dle 1:alJlet:;) @1{f!rrlu:;:I:l halo!1l ;be{ln rellofifd" I n I'hes~ inslanQlls, the big Ilest slngre dose ~ngesl:ed was 6~1;i, mg or 25l;ail;ilets. Whrle.no serious ~dverse Hvemts; were re!l@r!Ed in Ihese cases, heeause @[ the Itlfi.il:e~ da~ !I\Ia~l~bte!.If!.{l1i11ll H!(Om mendatinns for trealmenl C<I nile maJ!le, Howe~'e r, emesis ouu Id Ile iindll~ed iIthe! pffilent rsallert. tn (Jene.rm. S lI,p P [Jrl:li.!'e care .md I'r~ulil rll: mtJl1il~nillg eJ v.il1li srg niS I.lrlli ar® lIPP'FO p,niate, hi si ngte dose sl'ulilies. Ihe ~ igh~~t clO:~ilIJS€d \ws- 3{1 m(J. wh ich was waU I.oh::lf" [[;eel; ~n mulbpte close Irials, 'thl3 largest d~*a 011 lQ mg was 'Nelll.IQlemted,

mHilAG'E AND AD MINiS1RATiO M

Ad~n a ~Id Eldel~~ratielillts.: The reo[lmmellded do\S!ll ®fFem~.rjj® {~elr(lilill1e ta:l;i~el:sl ~s (line 2.~ mg 'labfel ~dmllilislered (I nee a day. W[llUIUt regard to ,meallB.

1iI11;h.e a.dllJ'll~nl seHing. DIE Q~;t[ITlal durali{lJl Q1f I:rmaimeni w.ith retrQ~o~e. lis unknown, The ~l<'1n.ned ()ur~:liQn oi tre<lI'l'l'l'erd. ~n [lIs· sl'ud~ is 5 ~llltrs. However, 131 me lime of a.1'I_al~sis, 1M ~df.'l" dUr.'Iitiolt '(I.·r Lre.1Jtm~llt was 24 memhs, median dum~ioll orroJ~OW-1!p w&!l2S monUc1s, ;ami 16% OIr U'R8 Dl'iliefiLS 'hive, bileli1 heilledr~r 50 ye'Ji(S, Trealrn~l1t fhou~d ~e c1isc>Orlllnued at r-e:l~ooe r~ C.UNICAl STUDIES m lfje ljjfj pros.cfibmt; mtorrmrlron).

~o dose adjustment ls rel1llliMd IiJir e!l1er~ pal]enls. Patlents trgalB~ WWl Femara do nat reQuire gllucoGorttco[d or m[nera[m:mtioold re placemenll!Je rllIIY,

R,enO}lllIiIp,aiIffillenl~~ (&."'e CUNfCAL PHARMACOLOGY ffll"~ trill pt~smblf'jt; mfOrfnllli()fl.) NtD :c,ooa,ge' adiu~til1~f1t is FeQulr€d 'ror pallie~ts witil ('en:;!1 im]l'ai rl'1l"lenllf n reiJlllnine c[earan~e ~:s ;::11 ® fIlUmi n.

HI8p3li(llm~3irnlillllntNo doQage :;Jdjusl:m:ent r.s rEC{lJnmended I@r Il\1illenls lo'lilh mild to m().d~rllte ihepalic [m~lIirmen;t. alrilDlIgh Femara btlJQd IIDncemtr(l~i~nIS VIe Fe madesl'lyinareased ;in:;; u'D.ver.:ls wtth mDderate i1epallc i rn:p~irment due 1.(Ii Gurril@s.is, ne dOJ5ljl (iir ,rem~.r!l in ila.'~erlls witl1 cirrl,*,is ilnd severe lIepa:ttc dysru nctiM sneu Id ~e rei!'.J llCceeJ Ijij 50% (SfJe CLINICAL Pt-tAtl'MA CO,l.08Y in liM' fuJJ prfJscritJirjtJ inf'Oml.81JOn). 1I1e rocommende1:l dose· oJ remal'.l for such IMJtPerUs is 2',5 mg adrnini,stereil evelY o,'t~er' clay, ne efrec'l or hepatic fmptirmenl.cm Fenrmru'.llpoouFe ~n n!:tf1c[rrlullic CIIllcer Ilfllfen'ts, ifi'~th el€li.dteclli}iliru!ii:n ,lavers ~;'IS nQit beell determined. (!3e..e C.fJNICAt .PH.4.R'MA:C·OLQG¥ ill Ille flllJ fJ!fJSCrrJJJllg fll{JJ!millJr,W)

St()re~12~C (lrF); eXQursions jl!l!rm[tted m Hi,~G·3{y"C (59~f·I3j}"F), ~See USP Co'ntm1'IBd Room femJleralure~

Pri nlaJ[i l n USA

Nruarti:s P,llarmaceulim~lIls. Carpor~tt{hn. EasL Hanol{er.N:.eIo'olJersey 071336 @,~Jl)uarliis

Two Lives Changed

THE STORY of Ashley and. Donald. was a wonderful example of cross-e ulrural Iove ("Dral.1l!f]) Together"), I just wish it were pos sible to cure Ash! ey's muscular dystrophy and find Donald's mother. Alld yet, as theauthor soheautifuJly suggested". the dignity and s e]f-tespect that DCH:I,ahi needs to survive ma.Y' not have come to him. any other

way. Whata wonderful storyl

F.l'OS I E. N A.S H, Bt!ri'l~"l ~prl~ Michigan

YOU SAlOl IT.

LETTERS, ONTHE M,AY ~,S,SUE

TI,ELL Pf;lO[)Lf: if they Come

to. Greater Binghamton,

New York, they can ride the Carous el CircuH~six wor:king Herschel] carousels, and {h.,ey are all free (#,26, Best Spin, Cyclie). George F. Ichnson, founder o.f Endicott Johnson Shee Company" donated. them to the community between 19'1'91 and ]934 with, the stipulation that no one ever has to pa.y to ride'. Severalhave their original band organs. CA U"i: E 6 R' UI ru L Il.J. 6ins:hi1lrTillo.l'I, New Y.grk;

Murphy Oil's generous: gift to

OIJl~ cemmunity-eto send local

hlgh school seniors to. college for free=ls the biggest thingtohappen

_" ~ .. ' '"

shrce the oUbo om (it·S 8, Bes t C],ass Act). Makes me proud to. live here.

TANDY MENEFEE. EJ Oo!'<!ldQ, Ar'kiID~

On a fa.milyvacatIon, to Washing[011. D.C .• we saw Typewr.iter Em:ser,.. Scale X in the Sculpture Garden of the National Galle,ry Q·f rut (#39, Best POop Art). My six-year-old son turned to my husband and asked, ·,jDaddy. what's a typewriteri"

MOLLIE PEH.E'I"IER,I<I'i!crs. SOurllhCarolirJa

I met Ale'xHaley years agoat an American Library Associaticn convention. where he spoke about his upcomingbook, RiOOl:S (#85~ Best lasting Legacy). We shared a. taxi, and. I askedhhn to send me an advance cOopy because :1 was writing book. reviews, He was so charming. I will never forget that encounter, even thl)iu.gh.] ended upbav.ing to purchase the bookl

CA R-r.n. S T R AU'EI, Penf!5wrs.Penl15'flvaniEl

19

RD I JULV 2.007

]':'0 (:om:mei':i1Clf1.JJ,e the 30tbanni'V,er~ sQ,ryofR:o ots, Rli.'GI,Q,er'~ Digest 11 as

" L,t~~,~ ,,,,A ,i'\,'~ " '1[111, 'I ' --,., 'T')h', '~'" ,-C

pUu I"t!)t~€!t,~, >l"uex fllalll'~y. , , te i'o'll,On

Wh T,L. 'dlA- '-·""R. '

,i (I! .race ,mell"llCa s ,0011:5.

CI coll:ec,rlon of 11,[s wri ti ngs j plu:s a. bonus DVD, ,For more Information a:.r:td to' purtha:se th.isc:IQs5i:c~ go to ,-d.,colfl/mots',.

A, Human Chain

M' Y SON was one of the 3] kids '" " ,,"rescuedfr~nl.~he Le~rni,ng

" Zone Day Coo e Center on

November 15~ 2(1)6~ after a. tornado demolished the building (Everyday Heroes: ':AIter the Tornado"). His class had, been piaym;g in the Fun Zone when it hit I read this article to my $,00. He recogaized theman in the middle of the pictureas the one: who. pulled him. out of the

20

mess. no you know his nnme? [am, forever g,r,a~eful for the people who risked their Uves to save: rhos e kids! esp ec iaUy my SOIl.

KRISTII IeAIN. Mon!gomer),. AI!lIbolma

The .heroes blthep.h,oto oi1.page 27 are. left to' r,i:ght; Steve Worlh~ JJ ]ustissJ, LeWIS H arrison~ Bin Marcum and Edd~e Barlow ..

~"ll(i ng of the, R.oad~"

I LOVE C.I'. P~I']'je'S back covet; Looks exactly like my brother,

lim Phil I ips. on [li::; Hader.

If'A.UICltl. TRQGI!.EN. C!rl<!~. Ti;f.n~M!

Looks just like nIY uncle.

TONII KFlEI,r, Ri!i!'itI\:im ~. Wi~I)jl&i1

That dude 0.]1 the bike is me!

Every line. nook andcranny;

SAM PRElZA.ro., ~:.'\'ilr.c, ~chl8M

With the except ion of the largerthan-mirre nose, it was me.

R0811f'!.i D. A.Di'lI.MS, DQ.rlr,Phai'1\. M~aurrl

That picture is my husband in

20 years.! n"ORI SUGGS. BQUln~ l<Jk-e. Washl~lg!,QrI

Cutting .. Edlgle Cal1e

'I~ .. '·,:,·:;h,,;',',:~.l,',~, ',~,:11,":~~~ M,th, e, ,,~~';;;b,'~,.,~,ut

toxic shock syndrome, wlthtears in .m.yeye:s. I'm the teen who W'dS treated for TSS at Lehigh Valley Hospi:trua year ear] ier,

On October .211, .20'03" I, was sent to.

IL.LlJSTRATEO i1iIr F",9., II,U,jE!LL.EFi

YOU SAil [)i IT!

the hospital with a m5'~de,g,ree ternperaturea rash and dangecfowdy.liow blood pressure. I spent ten days in a medical coma, hooked. up to a ventilator. Dr; Matthew McCambridge and the leu nurses saved my life, B e~ cause they had treated IDe, they were ah]e to quick].y diagnose Stephanie and save h .. er [00, It makes everything I went through. seem worthwhile.

ERlIC.A l'l'SOE, o~ ~lrIsyl'l0r11;l

mon sense, This, has led to the o,v'edysim.p,]istic zero tolerance policies. I'm concerned about the implieaticns for kids and society .. This is a social experiment, a.f1d the ending is uncle ar,

pAUL R. KUNDE. Cerrtral H!~h Soc1lO[1i.

G'!'<l!"IC: i-I<IYeo, McnlE!'8fl

Fior every parent complainiIlg about cutrageous consequences and how unfair'zer<Jc tolerance is. there's another parent complaining about how the school was outrageously leni ent wheni r was their child who was harasse d. ] a.ru.w.illing to take theheat :for .making a, "wrong" choice rather than risk the safe ty of tile' rest of lIlY student s,

IRENE ¥USKA. ~r:lli'(!t1f'i Park. Illfncl!l

As A HIGH school principal,

I'm co,nstandy amazed at the zero tolerance stance (That's Outrageousl "No Me.rqr, Kid!"). Educ ators have [orgo,t ten kids make mistakes; it's their nature. Rather than throw the 'book at them! teachers and parents should show kids how to. handle difficult situations,

I made plenty o,r mistakesas a, student. Back then, administrators used common sense when dlsciplining us, Today many educatcrs lack pat ience.jmderst andingandcorn-

Stopping this nonsense would take sehoul administrators or politiC]HnS with. the. backbone 'to stand up and say that this policy is outrageous. Unfortunately; backbone is in short supply in both. groups.

RICH.A.Rnl FARIS, Dian'} Pi){nl CdlifQ€Aia

H OW TO R EAC!HIi iUS

Only 1:40mgl of sodium per 8,,0.2:. glass. Pl~us {] wiho,I'9 lot of veg,eruble! rl,utrwtiion. lWO~lJll :serv'in,g,s}io be excH;:;i, COllddl"ve hadl OJ V,8~"

"'Sodium pe~a'Qz:.servjlrlig: Low Sodillllrlil V8~ lAO mgl; ~killil mdlk.~()3·130 mg [varies, bY'V!llriety).

R:ecommen!cl(lJlioll~forsodilililli!areffrom 11.'500 fir1;9 to 2400 I!iflg per day" depeiiild~'liiIgo;fI ~i5kfocto~s, ~2 ser(imlg~ ,of'¥egellJlblQ$ - ~ OUlp'. @2007' esc Br(!l'Id~. LP.

RD I JULV 2.007

Welcome to Channel Surfi'n'QI 101

FOR ']'HOS'E h.eading off to college this fall (and proud parents packing the cad. here's an importan:t reminder: Remf.mbe'l'to bring the

remote lII~""r·",,·"'''''d' more televi "'"J' on programm "]']]C1P' is

'. "'., , .. .:;.l''II'11 """" ,.,,"" L"" .. IC:;Y .. "' · 0 "' .. ""0 ,..,

find lng it s way Into unlversltyccurse catalogs. This spring" for Instance, MIT's Comparative Me eli a Studies program offered a. clasacalled American. ProWrestling, The purpose; to c,riticaJly analyze tbis important facet of popular culture (required reading included St,f,el Ch,Q.k t~) the Bead and

Ser, .[ie.'i,. and flea dloeks).

Nearby Tufts University; me:anwhile.]ooked tOA.BCs: prime-time s cl1,e:du]e and came up "vith The Future Is Lost: Economic, Social, 'IechnclogIcal Impact of ,3 Cult (and CuhuraD Phenomenon, Then there's Geo.r,getow.n University's Philosophy and Star Trek. We'.re guessing' that one's for more, urn, enterprising students.

Eli!lie M!cL.e'an 'For :5 cOllunga h ole in one whHe h:~tting 'the links im Cedi'fom~a 'thts spril1lg:, making: heir, at 102:, the ,aH::Iefrt ,eVler to reg~is~ef an ;aC@~UIIQ Us, ands or

, putl:sabout it.

,1:"

, .

_,

....

,Ma xcfllii Foruts beery TV ad 'wi~h rPlFO J,o~n QaWJy (knownkm' ba:ttling boolZe) touting its ,go,~~ Iba~ls. eBS Ib.anneal tine ad! in wtll icfn D,a,lygm!ls what suW\e.~oolks ,I,iike iii drnft 'whrn:~e diriv'~ngii!,

caJrt Sbeer elear, 'VII,e say.

Andrew Cuomo Fbr using hi~S pastas lNie'w York's a:ttorn~ gel~ ~ eral to ,expose qtlesUona.b~e dea,ling-s in the' 9; 85 billion student-l o8nind lIstlrY. By insiistiog: th8lrt ,a,id O'ffi,c~a~s. put students' i ntt€!lr,esb;=not sdh eels' =fijlrst,

eLi erno moves to' the head of the class

24

U.S. D,ep1!: •. (lif Agl"lic:u:IU.IIre, For wave-sUng. viaa puillic o:nliine diataiba,s,e, 'the Socrad Securjit:JI' nll.!mber~ of 39\0100 p~op ~e €iF1l ro~:II@dI in its IPIFogmms.

I-i opefu II ~!t~ those wO'mkswo:F1I 't see tlh el r 1P1il!1i"S'on;;l:1 data h1!:!,rvesi.@d bY' UJtlhi€,v€S.,

RD I ..IU LV 2001

Calli It No F'un A.'loudl

F -. =ORG.Ef HO['IDING your breath on the

. Til[~A~WhirL Now you'd best hold your I tongue. At the Scandia Family Fun Center in Sacramento, ]0·C&15' gripes mean riders can't scream OD. the Screamer roller coaster. In other noise news. an Ohio youth baseball league has banned most chatter e'We want a. pitcher, not .3. belly itcherl"). What's next-no'~bo,mbs a.\~my" beforea csnaonbal ]?

GRASSROOTS

The Doctor Is Back In,

I 0 CASUAL observers, Pike County Memorial Hos. pital In. Murfreesbcro, Arkansas, is a modest; 3.2-bed facility~ But to the local people who rely

on it, it can be a Ilfesaver, Wlli eh is why the January announcement that the cash-strapped hospital was losing its three staff doctors. and might have to dose, hit the rural area bard.

That's when Dr. Hiram WanL the hospital's 81-year-old chief ofstaff" dusted. off his stethoscope and began treating patients again, ·~I came back so our hospital would stay open," says Dr.Ward, wR1o'd retired frum his regular practice in 1'99'8 after 45 years., He plansto care for

Pike Memorial's patients until the hospital hires a new staff.

In recent years, patient rolls have dwindled as loeals travel to larger hospitals in Hot Springs, Nashville and Texarkana, Stm,

in the]2 months ending in September 20U5, Pike Me'moria! admitted 560 patients and registered 21332 ER visits. And. says Dr. Ward, it remains. criticalfar theregion's sick and in~]ured: ~'Qllite a few of them would lose their life if the hospital weren't here." Thanks to him, it still is.

26

,

,

,

to !-i:e'tp Sustm. Jim m'ld the kids

have therr'firn~ reall co:iI"II'e:rsa~ron In days.

~IW\IH 51'OT' aJl~ ~MAIH CHQE'CES M~DE EA$Y ~1Il!' Ir~~m:lr1:!i Q'r·np~jOl. 11!le. m~T'm):S. m~ Il;ioIJD!M QiJ(lEl Tttlt,'GS ~I'IW~ .I\T nlli:ro.~l'lm.s ,~Je !1,~.d~II'l!Jj'k~ ,u$ed !:!v !"fl!!!)-L!l,'I', I!le. 02(l(n ~Jite>-l.l!I·V ~0I11'1 "'Rl~~I~~, !ile,

liD JU LV .HHl7

CAUGHT IN TH'E A,CT

INle,alr G'alives:Joln., leJ(3s" Iilearlysl!:lrfelrs: !Use ,al m01lo:rboalm '.cihase dOWIn Sl!:I,pelr" tarnkers j:111 tlhe Ilocal, slllippiiMg 'clllall11l1let Tlhen they ~id'e· the huge 'ves:selis" wa~e waves" wlhii€:1II cain r,eaclll five ',eetalFld C31flry 31 sl!.Irfell' two mHes o:r mo,lie. HlerFe" John Benson (fo're~round) and PetelF D'av~s shallfe at tanker wave. CLSElJd sUffer James Flulllbfiiglht gll,t sJuck. driviingtlhe motlld)o'at..) .AIIII in al!il"a swell I way to,s:pelFld 'the day.

Maldng 'To,lll Cheats Pay

Phantoms haunt the nation's tollbooths! ,21.5 more and more drivers whiz past wlitlhout paying," Nlo:wthell'1€ are slgns the ]oydde mayendli. This month. for UH~first time"the lrrternatlonal 8ridlge, 11mrl1e~ and Turnpike Association wW meet to disclUss ways 'loright. th~s !highway robbery. In De]aware, a half-dozen habitual o:ijenders (over $J"QOOilifll vio'la:Uons) face fe~ony charges .. And inFlor~dat where tILlrIl1Ip~k€~toU~evasi()1t1I losses hilt. :$.22 million

last year, authorities have addled blltle Ilng:hts at plazas to alert cops 'When v~olla;tOIr5 blow 'tlhrough,

Exp~rts .. ~!Jnk the soofl'la.w surge 10 U~@: spread Oir

e ~ect.ro" ie-co.111 ectjo:t1l. ,~an€!s Olll the cotUlrntry 15 fi'i2:44

m il es a"r ta,~11 mad's. Wha:t's handy 'fnr honest dr uvers aliso appeals to' cheaters, some of 'whom use special sleevesandsprays 'to, Ihide ·11~cense plates from to~~plaza. ca mera s, Great-A lI1Iew rea son foil' road rag~.

28

RD I JULV 2.007

R D·s pie «s. fm' g re.i;l.t ways. to SI)end ycmr f,vee tiI1U!' this rm:udh

4I!'ii1fiillil~·· ••••••.••.••.••.••.• _ •• _ .•••••

- !

,

:

Ma;rsha~ Matt Omon i

rides cutef the West

.21,S the first season o·f G·.lIn~moke .. one aftb@ best" I o:v~d series from televislon's ha~Gyon days, arriv,e's j n asia-dlsc set..

01'1 S9Jle lu~ ];

James Blalke has overcorre a .~ot,. im:ludl~ng a brok.el~ splne, to beeorne at b')!p"lran[l«!d tennls !pro, ln B.ro.a.k.inll' Back: Now Ilosf Everyfhinl ,ana WaR B~k My .l. ii>e, he recounts h~saga.~rII'st-a.IW·

odds s~olJ'y. OJ'! $<II~ JwilylO

GAME

W.anlt'llQ1.tallk?' Get gabb~ng with Talble:J()p iC5, the game of "'q;uestions

I that start great co:nversa:tion s:

Samp le. " ls inlel[ I[i" genae or common sense more lm pertant?" A sUmrula:t· ilng alternative to board garnes. 'i::;!bl@lop[cs~com

_,_,--- _,-- _._---_._------ ----,_ ----,

,

~

,M.e.ry,~ Streep!, ~

Vanessa Red~rav·e, arr1ldi CI,airre Danes (I[eft, with M amle GlUlfTImer~ Streep's diaug[hter) shin e in Ev:en.i.ng, sbout a dyirng womall1l"s

emot ianai jo'U rney through the memo- , ries of h erfirst lcve, ~

,

In ~1~112f~ JiJ"Itll 29 ~

Com~I])I,J"QI:; " lINDS.A¥ M 1~.Il.ER :

YHEROES

HEn. w:nmmNG was just six

\¥. _~.-e. ,~:~. a. 'w. "y.j ~.a ~.IU.d ~ . .tI.1 .

ScbmIdt.19, could talk of

little ,e;]se."We'.re' gciag to Crescent City for our honeymoon," she confide d excitedly to co-worker Theodcre Lidgett eneFriday night last Febru,a.ry. The two worked. in sales at Orchard Supply Hardware ill Redd ing~ California. 1. idgett, S9',

a grandfather of MOl, sm ile d and told Schm idt, "That's a one-t lme deal. Take lots of pictures,"

In tll!,e parking loti they said good fJlightJ and. Schmidt unJ", ekedher sHverMercury Tracer and got in, But before' she' could close: the dOOI,

Good th~ng '1113~od()tle Udg:eH wall'ked his (lo~workel1' to~lhe painklilllg llot~lhail n~glnt

a dark form app eared at the driver's side, It 'Was a hoode d man ill a black ski mask and gloves.

Schmidt's heartbeat quickened, She wondered. if one ef her brother's friends was plia.ying a prank, Then the man, six feet tall and ]60 pounds pulled out a ten-inch serrated survival knife, ·'Get over,' he ordered,"Give

me the keys,"

"CanI get out?" said Schmidt. sprawledacross the passenger seat, "Nol" He dosed the driver's door.

33

RD I JULV 2.007

A slender five-foot -eight, Schmidt bad blonde hair swept up ill, akfin,tj with a pen still stuck there from ~ott.i.ng notes at work, As a. girl, she'd

Iea rn ed from .~"',"' me ioth "'1'" 'N''''''''''''''' gJ'F'>,

.. ~ .. ~ _-_ " .. _l.l .[.~)C;.:.f I.U~. 'I;;;: ''!'- ~V'!.i::::d!' ,\..II

with a guy against your will. A],ways scream. Alwaysput up a fight.

She quickly popped open the

was a. knife, a girland a slasher,

He' turned and groped in his car for his ste el thermos, to use' as a cudgel, But. itwas stuck irll:s:hie litis lunchpail. No time' to get it loose.

'Whipping arrmnd, Lidgett faced the hooded man again. Again. the attacker screamed, f,'Get a.way,!'~ then pulled t he-knife ,away f1'O'111 the- young woman's throat and held it up to her face, Slashing at hereheek, he made a small 'cut below her right eye,

Lidgettlunged, grabbing the man's knire hand and

l ". d h . d hi ld

-,'.' ,.~, .~ ,-.', --, '-,' '~-:r_-'-.'ii,'- I' .~. 'J ",-'_'? '-" __ "iii ~", _'-,

PU!;i, 1J.mgll towar '. Le WIn s le...

Seizing Schmidt by her jacket, he strained to pun her out of the car; But the attacker bung on tight. He sliced her cheek again, then st uck a gloved hand in her me uth ro keep her frOom screaming and stabb ed her hard in the Iower left].sg. Whe.[], Lidgett finilly got her free'! the young woman slumped on the ground.

But the slasher wasn't finished.

- "- .

'The man sliced her cheek then stuck a qloved -

hand in hler mouth tOI keep her from scresminq.

passenger door and dropped the keys on the asphalt, That would keep the man from taking the car. Terrified, she wasrelieved to see that bel Irlend Lidgett was sUU 111 the next parking space. "Te dl" she screamed. wI'e:dP:'

Sea,t ed b ehind the wbee,li of his Ford Tempo, Lldgetr sawaglint of llght flash inside Schmidt's car.

A masked man w.a.s· holding a knife blade at Schmidt's neck, The hardware salesman !Jumped out of his car.

The: attacker glaredat him. through the open passenger do or. ~'Ge[ fh!e [expletive] .away 0'.1' I'll cut bet [,fxplet.ive] throat," he yelled.

"Oh, no youwcn'tl" Lidgett shouted bade

At the store, be was known for bis fund of knowledge about hardware: Fixtures, Iocks, too]s. you :nmne it~if a customer had afli:x~]t problem, Ted Lidgett could-usually solve it, But the problem nnw

34

S ehmidr scrambled to her feet, and lLid:gettpushed her behind him .i n the narrowgap between the two vehicles .. The masked manleaped our of the car, Facing him head-on, Lidgett noticed something odd: A cable-s-the kind.used to' Ioekupa bicy.cle~waJs tucked under each of the guy's sleeves, The ends peeked out from ins cuffs,

Raisingboth hands over his head. he stabbed Wildly at Lidgett. But

the oldermanhad sharp reflexes, He' held upan arm to shield himself; .

Quit smo~ing and prevent the damage It causes to your race. Slap now and discover the results of 11ealLhier skin. Get Serious. Get NiooDerm.Ca..

RD I JULV 2.007

then threw his full weight Qinto the open car door ~dtl!lmling .it onto' the sl asher; who let out a surprised gasp o.f pain, Before he could. wriggle free', Lidgett slammed the door again, then a third time.

By now, otber emplove es inside hadheard the fighting, Darting out from behind the car door, the' ma.[1 took. off. The store'sassistant manager jumped i]) his pickup to chase him .. But the attacker ranbehiad the hardware store and. disappeared into some, thick bushes.

Ten dayslater, police arrested Joseph WilliamDuncan, 27. and eharged him witkattempted kidnapping andassault with a deadly weapon, A police dog had tracked the assailant's scent toa rosebed near the scene, There.an officer found ahlaek backpack contalniug a knife, glo.ves,ab]ackneoplMme maskand bicycle cable-e-items sh-w:iJar to those: identified by

w it nesses,

Duncan told police he was infatuated with J udith Schmidt and hadasked her out several times. Every time, she'd turned him down. A]though Schmidr was unable to identify her attackerbecause of

his disguise, she acknowledged that she knew DUJ1C&O,. T~]j,ey had

met in a chemistry ,dass at Shasta Col]:ege. Once, sbe recalled, he'd gottenangry when she refused

to gOo out withhim, yelling arid punching a concrete pillar,

According to. the police report, Duncan had told people that he planned to kidnap oil Shasta student he: caned Judith so that she would have to marry him. The day after

the attemptedkidnapplnghe reportedlyasked friends ifthey'd heard about the incident, One noted that Duncan seemed to know details that weren't in the' newspaper.

She caned the police ..

Duncan has pleaded [lot guilty to. the charges, He told ponce he was ata movie that night.

As for Schmidt, she: needed seven stitches tEl, her leg. Fortunately the cuts on her face weren't that deep, Of Lidgett, she says,I"He saved

n:I!Y life.] couldn't have guUen .away bymyself,"

Six weeksafter the attack. while Lidgett and his wife beamed fi~om.3. pew on thebride's side, Schmidt walked down. the ai sle of Faitb. Asse:mbJy Churehwlrh her new husband, The bride'shair was swept up under a snow-white veil. her

face picture-perfect. The scars didn't even show:

BIE.TTIE IR TO I<IEIE.IP :Q um lET

No one' knows better than hnmorlst Tom Lehrer Just how much things have changed over the: years .. '''lnm')r youth, there-were certain words you, coul dn't Si3Jy in front of ill girl; now you can say :the.m j but

yQU can't say "girl.?'

36

Thousands of truckers are on the road ~Ue,gaHy. And your safety is at stake,

T .. ~l., .. , •.. "' .. , .. ,R .•.. M.> s .• ,:]. ".R'.' 0 .... _ N .•. G .. E.,am .. _ .... -' .• i.lf ..•.. _.".,:e ... vel knew what hit them, Hdw.ard

was behind. the wheel of their earwithhis w]:fe~

Mel lssa, next to him and ten -yearold daughter and six-year-ol d 80.n :in the backseat. Traffic was choked to a new: standstill 011 the stre tell of Interstate 8:] in. Te:nnessee.Bu[ one' driver apparently didn't notice

th e appr~)achil1g snarl.

Nasko Na:wvj aJ], illegal Immlgrant from

Maf:edonia. didn't hit the brakes in time and his tr aetor-trailer plowed into two idJing vehicl es, one of them the Arm~ strongs' car. 'NO' one' in the family survived the horrible crash.

Adding to the senselessness of the tf.age:d.y. officials s~')on learned that

N az;o,v hadb e en driving his truck

wltha bogus commercial drlver'slicense '(CDL). The suburban Chicago resident had obtainedfalae decumentselaiming he was aresidentof Wisconsi.n (where he took hls driver's testrand had gettenhelp from a translator on the answers to a. written exam. 1]] . .2006~ Nazov was sentenced to four years In prison ..

In recent years, 32 states .have reported cases of commercial license :fraud.~vith. busts ranging everywhere from F]orida to

Ohio to Colorado, A 2006 report from the U.S. Departmerit of Tran s~ pcrtation (DOT)

ident Bled about 15,OOO'~Sll.SpeCe~ n-

cense holders in ,27 state S, over a third of whom ultimately

Mk':hael Crow]Jey

15. a Slenior editor at The" New .Rep uhUe,

37

RD I JULV 2.007

hadtheir CnLsukenawa.y OJ vnlunt ari]y gavethemup,

In Macon, Georgia" according to aninves t igatl ve report. by the

CI-' 7i 'b truck dri .

, .. - .-.'.' J'- •.. >-. _c -I e ', ... -,.,,~ .• , .. 'I'

_. UCQ,go. u une" Ollie (I ucr .1VTIJi:g

school paid. private "thirdparty"

',.. ~

testers to falsify the exams of

623 students, When Georgia. offi{;ials

rials for signs of fraud. N asko Naz,O'v~s Wis,eo]]sin address was the s arne one used by other l]Unois residents app,]yin.g for CDL certification.

It's no mystery why licensing scams are an increasingly bigger problem, Since ~980! the number oflnterstate trucking firms, has

ballooned fnJ,m, .2 0,00 0 to

:5 64,,000, thanks largely to deregulation of the industry.

These companies llave drawn more and more peeple to their relatlvely Jacrarive Jobs-pa.ving the' way fOit shady operatcrs to move

in. Often. the culprits are private testers hired. by overburdene d states to 'certify t ruck drivers, Due C21 se involving an immigrant dri ver shows bow it can work.

In. July 2003. Kenneth Kerr was taking hiswife, .~~met, and three children fro,:m, Wilson's Mill1s, North Carollna, to visit relatives in weste:FD Pennsy]valll:sl. As the Kerr family made [heir way'alorug Route 8, .. a 16~ ton tractor-trailer driven by Ejub Grcic came barreling down, an Intersecting road and plowed int 0 the Kerrs' ca:r. setting il: ablaze, Janet and the children were trapped inside andburned to death. [(enneth died later in a hospital,

Investigatcrs said Grcie had been speeding and had run a stop sign before the crash. A check of his credentiala led to Utah. where Grek, a B Q:::;nl;anwho could barely speak Ef]glish~ had received his CDL. It turned au t his skills had been

State officials sold licenses tOI truckers who

'flattened conies in Idr'iv'inlg tests.

uncovered the racket and ['ladaH those students retake the test, only 142 qualified,

According to safety advocates, there are probably tens of thousands of t.Il'UCkeTS Q1n the road with sham licenses. It's bad enough that we're sharing the h.ighways with these risky drivers.But there are huge homeland security concerns too. After all, some truckers who get ph.onyncenses may wind up :h;tlu].ing deadly chemicals 0.1' other bazardcusmaterials that could be' used as terror weapons.

Industry representatives point out that the o'Vl:':'lwb.dming ma,]ority of their drivers (and thereare ah out 1.5 million on the road. at any given

t ime) are: hard-world ngand res p 011- sible, "We' have a very strong safe'ty agenda," says American Trucking AfTsociations spokesman. C]a.yto,:n Boyce. Clearly, however. more trucking companies nee d to. examine creden-

38

certified by one of threecompanies contracted by the state to' administer driving tests to truckers.While the feds never proved den.II:'1i.ithre.].y that Greic hadbought his credendais. they did uncoeer that tbefirms 'we're- willing to certify a, trucker's d.rlv.i.ng skill for a payment of a.ny~ where: from :$500 t 0 $1~SOO. A few hundred more dollars bought the answers to a written test.

E ~mE •. ~~.·· •. ·.'~.'i .•. ~ .. ].I: ... ·.·.t. t!s .• ~~ •. r~ .•... ~.:. ~.r .. ar •• C .• :: ..• ~s. res

hy the very people whJo are

I supposed tube protecting us. In Illinois, state officiaJs $o]d hundreds of phony licenses to. unskilled drivers, incliudJng immigrantswbe couldn't read. or speak English and people who. flattenedorange pylons in driving tests.

The fraud came to light after a driver who knew littleEnglish f~iled to understand radio warnings from passing truckers 'that part of his tailpipeassembly was ]!QOS(!. The piecesflew off and were run over bya van, plercing the vehicle's gas tank .. The van exploded into Hames! killing six children of a Chicago minister. Invesrigatoes determined rhe trucker had bought a sham license from th.e state. So had another driver who killed ten people

j 11 a . .2004 Texas hi;gbway crash.

The probe went all the way to Illinois: governor Geo.r,ge Ryan;

''l;-'ilho was imprisoned. last year D.n corruption charges.

U]]benev.ab]y~ only II states auto-

mat j,caJl y n.otify truckingcompanies Wllf:[I. the! t: drivers an: c itea fora. driving violation-ethe rest le ave: it IIp to the dl".hren to' tell their boss tile bad news.

Trucking eornpanies are further hamstrung by not ha.vin.g access

to a national database of drivers' records.Jnstead, the .o01"s one: centralized database has oIlly bask informat ion Iike na:me~h,ei.g:ht and weigbt, and directs you tostaee DMVs for data on offenses, For their part, the' states Me' often slow to put citafinns into their computer systerns, especi aUy if a viola tion occurs in O[le state and the trucker's, li cense came from another. The lag' enables some drivers torenew their licenses lbe'fore their bad reenrds can catch

u pwith them.

More1o:ver, s:a:ys lerry Donaldson, senior research director at Advncates for Highwayand Auto Sa.fety,

a. trucker's record doesn't include any citations while drivingb:[s person al ear unless: {h.ey resulted in his pass engerIicens e being Btl spende d or revoked, Someone could bave run stop signs or been caught speeding while driving his own car.but if he kept hislieensa.no e.mploye.r would ever know about it.

So these' dangerous truckers remain b ehind the wheel, hurtling aJm.l,g the hIghway ill. their IDa ssi ve rigs. It's high time we put the brakes on this scandal

Dutroged.? li\lrite to Mic.na.e-j' Crowley at' outrage,ol:fs@rd.(.·om.

39

GET SMART' ABOUT YOUR BODV WmTH DR. ROIZEN & DR. OZ

IEnlergency! What to IDo First ) -

~, fe~~ in my boat and cut my leg !badly" I stopped tine blleedirrilg with a towel, but ~t made me rea~nz:e i need ,21, 'f,irst-aicili u,pa!a:te, What should I have done?

Seeing blood can be a, scary dling, so

it's no wonder people don'talways remember what to do an-era cut, gouge or :gaping skin sp~it. You did the right thing by using a to'we] (as ].0 ng as; it was clean and not covered, in fish s cales), ¥ou shou]dn'[ usea tourniquet unless that's the on]y w,ay to stop 3, senous geyser.

Once' the blee ell ng has stoppedwash out any dirt or gunk that's gotten in .a Then, whether the' wound hurt S Of ]]0[, go to. an ER 80 docs can determine whether you need antibiotics, stitches O.]!' a tetanus 'booster shot. Torelieve the pain, try aspirln, Our rule is tbis: Don't 'Put anythin:g on

a wound. that you wouldn't put in your eye. So that means water and saline solution are okay; Ointments and whiskey; not so much,

THE BUZZ

IThe omeg,a,':3 'f,a:tty acid D HAt may h€:~p prevent AI.zh e imer"s disease,

2TIh~ cost o,'f trearing

heart disease ~n 20100 was

I $62 bUUo:n"

In .2004

it w,as $90 billion.

3 pe. oP.lle .Wit. h synlp,tonlS

of dellression are about 600/0 1~1 ore m kelly to develop typ1e: 2 diabetes

than those

who don't have synl pto rn 5"

4- An€r wat~lh~ng

ccmmereials 'fo,r

food, kl d:s ate 840/0 to 13:4% more than '~her'y ate atter seel ng toy commercials.

5 TWle City with the

. cleanest air: Cheyenne,

Wyoming., l1f11e dirtilesf? Los Angeles. ~

HOW TO MANAGE M:USGLE PAIN

THE. EMIER.G,EINCY P~HYSICIA.N fHE .A'LTER.NATIVEME[)IICINE DOC

84% of Americans say they've recentlly suffered musele pain.

O NeE YOU'.RJE FJ!:EUNG the pain, app .•. l.Y. a.· .. c.o.,]d co ... m.p'.res.s fa. l' d1!!2 _ firs t day or two! use an Ace

bandage if there's swe1]i.fJJg,. and take ibuprofen (if ifs too tOUgbOl'JJ, Y<HllI stomach, try acetaminophen). Give your ~I!(:;hing muscles a rest f(Di.:Ir a few d,ays too, The painm.ajf get

worse before itgets better, but if ycu're still hurting after three or four days, see a dnctnr, It could be

a .m.Cire serious inj Uly. JAMES F. G~GLlO. MO

ah~~~ til Emer.geocjl' Medioirc-e. COfu ~<l UnMll'Sll~ MM'C21 C(1Illf!1. N'Q!o!I fujI!:

THE ,ACUPUN'CIURIST

AN ACI!JPIU NCl!11U lUSTWiH

try to bring h]ood flow to

the area torelieve the pain. He: may do this with acupuncture! electri calst imulat ion, topical herbs OF even acupressure .. These techniques can cut thep ain and soreness

i~ half.

DANiEll N. HSiU, LA.C, OA. N~ ~k

IMPROVING lYMPI.JAT[C Fl..owwin help prevent muscle soreness. Poods rieb in. bioflavonoids, such as greeIDI,]eafy vegetables and green tea! can help, as can stay.ing i1.ydrated (drlnk 8 tOo]2 glasses ofwater a. day). Incre asing

your .fiexibmty with y"Og,:a and st eetchingexcrcises win. also help.

GE~AILD I.E rill O.ILE , rill [I

Director, Cenler [or I nt~E'i~i';'e H'eallh, ah,~iml<l Care, Wiinri.n&IDflI. lJeIiIWare

TH E IRIll LIIFIER

R o ... ,r..._F.IN .. G.- .. '. S a. £o.'.,n.I.l of deep connec-

.tive tissue' manip-

ulation, so we work on the muscles and. the tissues cormecting them, It's often used to' treat chronic pa inbut mavalso help with soreness after exercise, especially if your regular workout routine include s

• • • C' idi bik

repetmve monons .. .nnmg' a. 1;'''::,

running), BOoth massage and Rolf] f:ig can help ease the ache by stlmulating: circulation to the raus cles,

RON SPECIH ~ER,

~lIli@!;!l !«JIjr~ ~~ COWl'll)!. ~ kIm

G~ntly stretch iii sore mUS1c:~e. Theugh tender at nnilt, it wi'U re~alt( the tension ssthe rest c,f tha day is more ecmmlrtab~e. Plus, you prevent injury "9ml inad'llertenUy p:ull~rIIg.13 Ught musc~e as you lunge t:o answer the phone. Take ibup:r~~n or .aspirin right after a workout that migjht cause sereness, to prevent. ~lnflammation that l~ead5 1.0 pain. • ........ ':I.L:1::tu

In di nicm I studie''s, tillflter i ust on:e YEM::II" on BONllrVA, 9' out of '110 WoO.en h.a,dimpl"6ved bD.n e de'l1$!ity.·

IMpCldanlt safely ,lnlfotl'lilatiol1,:

BONIVA i:s r'llf I he mo,flijogel'lllsl'IIl of pos'~m enopa uSia I Ds'te'opom,sis., YOll she uld flIotl;ake prase: riptic,1'lI BON 1M', u~ yell' 1m'\I'El low blood cnlciu 1'IlI, C{lni!ll~t s,nl or !01(:!I:ldwr ot leIJrst 60 minute!>, ~{]ve :se\!~r~ klldF1ey d~~ease, or {]~ C1. 11,1 ergiclo BON IVA_ $1(11 P t[] ki rig BON IVA Clrnd leU your heClllheCHe prGlfid\er D~ you ~pEH'fiem:e, d i~~c:u'lt or poi I'll fllJ I swol,k::iwiflg, ches't palin, or ;lie:vere' or «lrlliin'uing heclrlb!,.I'Fn. 0:0 ~heliie mew be sigFII.io<ber'iOlIo!l.~ iJPper d ~S e~lij",e problem s, roll f/}w~he iDl'iI eemQI'lI~hly BON'IV'A ]510 ms dos,ing ~n~I'fulction$ ~alref'uilly 'to Iowe'r 't~e c~QMlce. o~ l~heiSe w,*!ilIW~ Oi;cLJrr~n9. Side eHe,et:ll c:l1I"Cscl'lh2mlly m~ld or moderale,(:ulld mo,y indw:lie'drolrrheo, pain in the O!fl'nS-Or leg;, o,r up.:;et sltomoch.l~yol.!l develop severe bOii1le, ~illf; cmd/or muscle, poi:rlI, contaclyour ~eah~c(:Jre pro\!lder. YOllir ~ealllwCire provider may Cill!! OfE!CO rllIl'llend 0' €.okiuf'l] and V'ilcIITI~rIi D iSklpplemenl.

HJ8I'@"~ alii W - - _-gy to Q~t s;tGlrmd on ,I . : A !i'k your dodDr"fal")fDurf,i'rs.t"'IiliIQn~hfree i!riigl 0'1" ea'll 1'-1'88, •. 362:-2544. For rna~ li1mr'i'I'!QiiiOn abol,lli-BO N I,Vt\ ple(JISf:' vi$iiwww.BONIVA.ca:frli!.;

"As meQI,slLJ!l'"ed {lIt llilmbar spine~ rrdtoll hip. or ~fo~hClnl&r; J ~1I1' of 4 Olt the flB~or'(jll 1il8'ck.

Pilease II'e>t!d '!fie ,PGliienl mnfOrrmg~toli11 ,1iil:1iI tih.6 1iIf.':l!;I' IptIiIgtl'.

PaJl!iie'l11IJt I!'!'ro~ma(]cn

i3iO,NIVA-' ~oorH~]~>va] (Ibandrol!llal:e :e;odium), iABlEl:S

fit:.:: (Hlililf

Read 'this pa;~lerU inrorma:tlol'l, caref,un;y oorore you stan takfngl ,ElONIVA. FJea.dJ I,hfs palf>ePlt ~iilIOli1mUo:n eaen tl~ !IOLJ gsta Ir'sfi'lil lor 'BON I VA, Th~n€l qy b!3' !lIew irrforllflallQ!n. Til1itS, mrormat[on ~S IilOI: El'lIery'ohl ng yuru lIleed! to Ik!llOw about OONIVA. It d0i38 !'I!:;1t !~~.€t me 1l1~JCl;l' Qf

tal.k .• n,g'o'l,'i.ti:l. your lle~~lhcal'El pfO'llid(lr ~Qul yoo r

co.nclillQII er :yQI,U' li'l:l@tmtllt:ll'1l. T0l11'1: Il~t 8QNIVA YiIl1ih your Ihs\3U h care ptOViitt@r beflOm yOLJ 81:3.14: takingl i~, ~.oo a1vour ,rEtgUl.H ehedk·uj:)5"

W~.rl: 1:6 'lJiln,e Imosllll1fl!po1l'tant Ilmrl'o~mation :i :!ihollll!cli 'know abolii:1 BOf.!IVA,?

BON 1'!Jl1!. may cause seneus ~ro-hrems ln the'~tomach ;am::!' the esophagus (Iihe IliJOO loot com·Feels: yom liTtOllJth aMI st.omadh) SuCn as Irolibre 5W'a!II~w~ngl" neMt'mrll, aM IJr~r:s,(Se@ "What ,1iI~e the pos511:ble siide Mf,C'Ots, [)if BONiVM'').

You' must t'li'J:.'.c 80NIVA. IilxllIc:liIi!l!' as ,p~escr,uood f'Cl!~ E3!O,NIVA to workklr ylOi~1 andliO lower the chamoe of seriaLJSSld!~ effeds. (:300" t:CowShoul~iJ1l ta'ke B'O'NIVA·?'1'.

WI~~t is BONiV,A?

80NIVA~s a p.reSll:rfp'HoDl medicine' used 10 I.reat or prevent O:5blloPQrQ;Si!iO ill WOCiIt'eIl' 8fter !iI1'@1l0~!lJ:S'iI'

(:;ee "W~'i!'t 15 Q~t~];!'QofQl1ii~?")" . BONI.VAmay reV@lf$!E! oone IlDss by sloppillgl more loss Qf I:lOO{l alld! il1c:r~8$11l.g l:lOflfl Il!las::;. in most wam~f11 wlilO take ~'t" evell lil1oog11 they wcm'l !be, able, to see or 'fee3 a dPffereiiloe, OONIVA may he1p ~O!!Wilr ltie cli1anoos or breal<ing bones ~fracl!!Jres),

For BONIVA to tr~al Or pr@'If!Inl osllilUPOfO$~S, yo~ have-Io t.aka, ~t <1;1; pro:J5'eriimdl, eONIVA, wJli nol wopk; ~1 '10iL! !st¢p takingl il.

Wlmo sliilould .mi.ot Mire BOiflUVA7 Do not I:aH1)~ BONIVA [f you:

~ Mv@ ~OW" I}Jood1~kiLJf1ii ~hypOCll~OEi:mra)

~ eannot i!111 Q:r standi ~p I'or all~::;J$1 '1 hour (60 minuteS!) ~ na'¥'e Ik,dneV<5 1l!1a:t wor!!. wry poorLy

~ar.e a[l~rgic 10 ib::u'lljFo:nal~ :!Oodi 1,1111"1 or an,y of 1100 Onll'.r

I Iilg,rec:l'lenl.s: of OONIVA, (see the' enci Qir I hlis P'a~ie I'll I,nlofrnaool'l ror <I HcSt Qi~ all~ tne ingr'EdleitllS ~rl 'BONIVA)

Well YlOl!lf he .... lth can pl"OV1~der bellore 1~61ngl BOi~IVA,

~ uf you are preg nsnt or IPr.mnllf1Qllo be<o~1.e jfJI"egnant It ~s nol: Ikll'lO'Wn rr 80NIVA can tiarm YOl.lr' ~.lI1oom baby

~ iJr yiOl,I are bre8:sI.f!llooingl, It lis not frJilDwli1 ii' BONiVA p.t;!SiSliiS iilla. yQu r mrlk arid lif i~Qail ~ilI nrn yo:ur OOby

~ ir 1'01,1 Mv.e g,wallowling plttlrarns or Othll3f proo:lsm~ WiltlM your e'sO'pllagw;: (11'1e ~uoo lti1al: cOl'lneC't!;: vour moot!'! and stournaoo)

'" iJr you 11a\t€ !<liC.1'Fley prOOl:ems

~ ~r YQI.I are p1anl'1ingl a de,nla~ proced!l,He IH.Jocn as Weill

ex.ir'actICln

iell ,!{Olllr health cam :pro¥ilde~' (inl::illudoliilr clll.ln1iiist) about a'll th0 'nnedidlmes,yo~ indllJJ!]ingl prescrip1iDn.!;ImclllilQIl·pre:;cri;pliQll ~il1'Ujli;l nil'S, viil~:f1ii[ns, :tine.! st!~lemei'll:S. Some P1I1edicine'5. es,pecEally cerl:aln viiIS'!llin5:, ~uppt6me n.5:, and antacids, C,fI1l stop ,BON IV1\ 'rr-om Q,eltl:ng to! YQL!r ~nes" Thl~: c:an ha~en Ir Y(}L!ta~ oHler mooi:aiIl@S:loocr.(l~ to Uhlll' timel tl'l:.\lt you lliik.iji .BON J:VA(:$BfI U How .S!lil!ould I tlilke- BON.~VA?").

How slillOlJ!td I take BON iVA.?'

~ T~It:.€I BONI VA ID:8.ctJiV <lis lllslrut~d by you r hillilillih 0;1 re pr:ovt'd~'F.

i Ta'ke BONIVAftlrsl t"lng ~iI"i 1!Jle' 1!i1.Orl'1jfi~1 at reasl.1 hom (60 ImUlllrtS$) OOrOF!ll you 0<;11, drink allythi ngl uthi!r than po1aifl w~l'8r" (lrl~:k8 ~Il,)" OthB! Qra~ IIlMldrdn!!l,

.' Ta'ka BON IVA with 6 10 S Q1.l!'IC!9S (aibocn '1 ruil~ cup) 01 p'lal n walle', Do not Ia~e It wJlh any 01111;: r d'Mln~ beslcfes p.!airl water, Do fHlIllaike it l,\I\ilh Oilier d""niks, sud, as

mni n@ra~'o'I,I'OIlEr, Sp~rk.1i ngl~~t""r, l(:~ffM,. tea, d<'!lJry drink'S, (suo'h as IITIllk~. or ~ult€l,

• Swallow BONIVA \"'hor~. Do Elot(;f1@iJN or S!uc:K Uli~ 18br~l or !keep ~t ffI yom I1I'lOLlli"llo ~nelt or dissolive.

'.' Aft@r taking BONIVA. yOLJ muS1 waiit Oft te13sl 1 hom (60 min LItes) before:

~ Lyi Il9 oOWin. YOu may sit" siaM, or ao Il.tmlfl.a~ atl]~'~es: ~I Ke' reild Ihe newspa~r or ta&le a wal k. ., EaI~jI"j9o.r dilll'l1<iIi"i9 a'rIlf~I'1 ngl a)OO>9p1: rOf plialln w~.t9i'. ~ T~inQl O'Uher o.ra~ medkifne's ~iilcrl.l(flngl VliI:am~iilS" t~tDjum. or 1;JJnlactld$, Take- ~I'(}LJr vill:~mill:S, ealdLI(J1J,

o;I.ndl ~tJt~okls at ~diU~rellt lirnfJ (If ~'h<J' clay from tthij' .Im<l whl3ll you 111I,~ BO.NIVA..

• If you ta_k9! too mudh BONIVA. drill'll!: a h.m g1ass of milk and ca~1 you,' loea'! pariSen, ccmlfoll Q~ mer or e mergeFlcy roOltr1 ri.glMt away. Do noll1Mk~ '1"00 F8€11f vo.iTIf:t" ilo InOi

~6 cow,n" .

• Keiep lalldllg, 'BONIVA Jar as ~o1l9 as YOLJrl'i8§ll~tJ earll3' provide r tells ·yO'll. OONIVA WllllI1O't worn lif you .!iloJJ 1l:l1.;:IlIgl iel.

.' YOur l'Iea1lih care' proViider may le'lll yo'u 10 eXerC1Si2' andl Illik:1ij' call;<I~,nTl ~Iild Villam,ill sUlPph13m!li:JlIS 10 f1€i(p YOI!J r osteoporosf",:,

• ':(Ol,Ir 1lt3i8~11h GarB pmllld"lu lIliIijjJy [1;0 a t@$tll) mn~::;J£iurJ;t lJ"!e IlhJetrless (densily) or your eenes or d'o olhe r te",l:s la dlilld YOl!Jr progr~<s"

What mil Imy BONIVA 1i!!;:!6iJedul!3r?

Sc'he,ei:lJ!l!efor takJrlilg BON~VA ~5Q! mgl oliloe mOIil~ttI'lly;

'.' Tak~ oniS< BONI VA 150'1iIli9 tabl!el allte iii monlll, .

• Choose, OIle dale! Qif 'thai ~n11l (yoor BON IV!\' day)i1!ha:t you 'WIlli ~'rnt:Bmb€lf andllnal bBstr.ils, )'-aur sMedure to lake your BONIVA15(}mgllab'Jet

• T:tlk€! cmE3' OONIVA 150·:ni'i91 laIlll'el ~Il' the mo:rning 01' your QilOsell d'~y (SlEl~' '~How sltliour.d 1111i~.e BONiVA?!~j"

What 10 do It II mfc6s a Il!I'1iOIliltllil'l"Y dose!

• II' your ne){t .$oo8(iI:.J'Ia:d1 OONiVA cray 1;$, malll'lihan

7 days away, ta~e ooe. BONlVA1S(}.ifIIIQ tablet r:n, lI"Ie morl1[nglrollowJng 'liI'I@.dOilY th01llyau Ul'lll;J;lWj'bll3f' {;fa~ "How s~.oull!dI'l1:ake BO,~IVA:?"). Then, re1tllrl'i to I~kingl QIle BONIVA150.1I1rI9I tiilbll,lll ilWry' mnth, in 1M morning: QI' YQUF cl1.Q~1l ~ay' 8tt(l.ri(!ingli(l your migi 1l!'I~ SQhllld'ur.6"

•. Do not take fi.lo'Ol50·:mgll:3lblets Wllli1in ~h~ ~1II'tiji w.s~k II YOLU neX't sdhe(!Ii.i'ledl OONIVA (fay ['$, o.ll~Y1 101 days away,. wal~ IJnlllllyour 00)[1 scnedu'led BONIVA day 10 lake your lablet, Tl1e:n re1turii'l to takfnglone BONIVA 150-mgl 1:ab18'l 1W@1'j( monln: iii l!he I1i!O.i'lli1l9 of yoo r C~SIiHl dlal{, ~;Jj;:(:OrdilllgiID YlJiur or1ginOil'i scinedLJI'€!.

,.' II' "yoy aue not sl.I!rre wha:l: to 0:01 :!if "Yo!!.J miSts a: dose, contact YOWi~' IIil!:eaIW, CIiI,~¢ Ip.ro,.,J)dle~ witi1liowli'iI b~ I!iI:l!G to ad\liiis:e you.

ScJhed:Ili!I:ellor takillli,g BON iVA 2.5, mg O:Iiii.>Ce dlaHy:

•. T~1<.e 01'119 BONIVA .2,5.mg l.ablel: once :a day [j r:Sl Itllng In, 1M, IlTiQ('Iling Oil r~8t 1 Ilour (60 mill LJhl~) b8lblB y9!iJ i3iS1t, dr:in'k o;mytl'llngl oll'1eor lihal'1 plail!l w:at9r, or take :;a,FI)' CI1!Iler g.Ja~ 1ITI!lI(;jiCiniS< (seg ''iliow S,HniCula1 I tai!:e aONiVi!?").

What t.o do if! mil$:;;, a daily dose.:

i Ir ycl<l!forg:e11.o l:<:Iike yoor BON IVA ;2,,s"mgll.aJbrel fn the' ~orll1i ng\ do I!lilal: l:a~ll' ~t Ilater lin lihe c:l'ay. ,Just ,re'tunn to your normall schedule <'uld ta~,e lJ;ab!lel. the' l'Ie>;;1 mrlo.nning'" DOn1!:ot tal';.e two t~bl!~1S on:ltilfi Sal'ifl!ij! day.

-I.I. YOU are :1101: S'!l.!re wlllal:to do I' you ml~:s a: dotoe. c:O,lIiI'lact ytlil!llr health care 'Pwvide',' Will'll ,,:illl be atJlle to aaiYlse YOI.

'What $'lIould I avoid w,llllle t,akillll;!lI] BONI'IIA.·?

.. Do 1001, t:arKe olner medlc1ll1e!5. or eat or drinlk anythi'flg bul prahl WBt@rb@rora YOLI 1<1_ BO.NIV'A, ana for all!Hl;St 1 nour (60 11r1[rmles) alter YOLI 'tali:e, IlL

" Do not ne down (OJ at t~ast '1 bou r ,(00 m[m.ltfis) aJ'mr

yool I.a'ke' BDNIV.A.

What IHe 1he pos;sil'blcsi:de effects of BONIVA? Slo po ta ]j;mng BO:ft,I;IVA and ca'lll YO'l!lr 'li1.ea'nth ca ~e 'provider lrig:nlt I!'Iway'ili' YOill, Inave:.

- palin or trou'ble wi~l1, siwaillowing

OJ c'nest IfJlliin

" very bad hesrl!b:l!iI'n Of liIe;arllburilil tha'[ dres not

gel ]lbeUer

80 NIVA MAY CAUS~:

~ pain OF trol.lbfa swiil~[owin\) (dysp'hllg1a.) .. tiearlbu nil {e!5ophag[ils)

• u'lcers in your slDliliacn or il;!lapnagus (Uhe lub{llihiil.t

COI!'lnects your mo-ull1 ~:I'ldl siomac!h)

Common side elleds wbtll BONIVA Oil re: " dla.rrhea

.. pai n in e>:tremlUes (aJIII'iS, or legiS) - d¥speps'i<t (upset stomadl)

Less cOill1mon sidB elh3C:ts wilih BONIVA arB snortla:SIII1QI. mUd liIu-fll!ie symp'toms (usuaJly fmprove aftenhe' '[irs'! dose), Tllese are not all the' possibre side elreC'~ or 80N IVA. For m{w~ illfollill!ltion asll. your il~iiI!1lh can~ provider or pljarmacitS't.

Rarely, palUen'l'S have reportedl severe bane'. f,oinl, afldl'or m~lildl& pain :S1E.rtlng] wi<fhin Orle dlay kl sewra~ IIll.OnihS aller beglnn[ngllo take, by moutti. bfsptlosphooa'le drugs t,g tFe'a!' osl;eoporwf.s (tl1in booe~}" This group o'f dl'1l!QS im:::tooes, BONI'VA. Mosl pati@nls, @)IJj)ElFlie!lCoo rei i!3f a.f!@r siopplngi the' drugl, CQI'Itact your hea,1th care provJd:er 1'1 you deVElop lI'Iese symptoms after' startll'1g BON IVA

Rare~y. pa,u'B1nlS takfng] l:Jisphoopnona.tgs nav,B F@POrtOO 5EH'1l0US Jaw problems associaled w 11'1 dellayed Illeall[ng alla hTfsclio.n. of 11m fI)~lowmg dlurt,all prOCSdl!.lrll'S SI!.IP1'l as, '1'00'111 omracliJo.n. If )IOu eKfl'!HllenclQ jllw probjl3ms. pleooll contact !{OIJF ll@aUh CaUl p!'ovidltlr a.no denfist,

What Is o.steo,IX!J'IOisls1'

OsLeopOrosis us iii ai$e,a$6: that caasea i:lon!ll$lo ooOOm~ '~l1lnner. Hlln eenes can brea&: eJOlslly .. M:osl peoPle lihil'lk 01' their OOflBS a$ baing] sona ~i'k:8 !il roGk~ Acll.Hiljl!:l', boPl~ j;s, IMngl I~ssue, just IFke Oilhe r ~aFl5, ollhe' body, such as !fC'ur heart brain" or 5ktn. BOfie ju,sl hap,pe ne to be, a h:;!rd'er type of IilSSIlJ8 .. E!oml lis !iIIways dl<lngi:rig .. Your bodiy' keeps your bones stroAg] and nealll1y by repl'ac-ll'lg] old bone WJjln lIlew OQn~,

Oslooporosls C8US8S ih8 b:Jdy to r@nnOlle IiIlQrliI' bone

I an ijl rep1ac'Els. Thls mearlS that bones ge1 weaJil;er. W!3\EIk bones are mo:lr'e rjkel!;, to break. Os'teoporO$i.s. is iii bone d'ISlJ,a1l8 Ihat Is quit!! commolliin wom@n IIflPBr

!me f1(lflilI!lS8. At fir;St, osteopoOrosis, IhiiS no symptoms" 1:JLJ1: f,leopre 1MlfI O:5teqporos-ls lmay de'liefo'p ~O'ss or hergl'l't aM are Imom: ~ke~y 1:0 bril1il;];;' (fracturlll'l '111811' txmes, espec;i<l.Oy

the badk 'spJn8~, wri!Sl,. alnd Ihip 001l6S,. .

Osleoporosis am 00 pr@\!'@'JlI!3c. alld mill, pfOil'Br

therapy can he IJlBai~d. .

Who is, ilt riislkfm osteoporosis,';!'

Talki:o yoo r heal ill care provfde r aJbo.UI you r chalflces 'for gettingl O.sleoporosls.

Many l!hings pul. people! a:1 rEslk ror ooteO;:tOrosis. Th,el Ibillowillg] p~op!I!l' :hav~ a hig'hilF chancel of g,el~llr)Q oSI.eoporos S:.

Women who:

• are giilingl rJuough OF vt.hiJ liIr@ past rnt@llopausoe

(Kll'le el'lange'1

.' .ne wllttlli (Call.lcasi>an) orMian

PMpJihs, wIlo=

,i <Ire tllln

.' hilve a fruni~ member willl osteO'po(Qslis •. do not g:@I: BnoLJgh c.akimill or viitllmin ID • do net s!Xe else'

.' sm.oke

• drin'k; ar .. ol1ol Cine n

• take boo@ Ilhinni I1gl IfIsdfpflBS, (tikB PFl3d'l1t.50nlB)

fer ii, long 'Ums'

Gener;11 Inhnm;1'lil!o1il1 al:n:ulI't SIJ..NlIVA.

Miedlcil'1e($ ate SO.I'I'!e'!I!lIr1eS prescrIbed! rer condjUoos '[1'10'1:1 iiI.rliI :not msn!ijooodl ln pallellt rnf(){lllEIli:oo'. 00 not usa BON IVA lor a co:ndiUon 'for which ~I was not prescrf1:led, DonO'! give' BON IV'Akl oUhier peo~le'I' EF .... an ijl' they have, Ihe sall'lle' s,yrnpto<ms you have. II ~1 ha ~m the m

Slore BON IVA at 77"F (2::5"C) or <II room lemiO'E!rature b-elwee n 59 F a'.l1di OO"F 115"C ilIna SO·C),

Keep BONIVA and! all Illsdictn!!8: aut ollhe rea.Cih of dl1l1d're n,

Tilis s:urnmar~zes. 1M IiIiiOst impor18nt il'lforma.1'Ja.n abeut BONIVA. Ir you vo'Ould Uk.e more il'l'lormatlon. Iillk rMlth yom' Ilealllll care j!)I'ovidier. YOI.! can ask your l'teaUh care provide r or pharm<lcist for illfomll!llkm aOOut BON I VA Illat is ",,",MillBl'I ror ilJB!ilDih pr:ofeSlS io.nals..

For morn' inrOrllil1lE1lfOIil aoout SON IVA. call t-ssa- M¥·BON IVA. orviiSii w"""",,,lmyooniIYl!il.com,

What iUlli thiilli'!119;~ei{jjllllll.1:s of 8iO,.NIVA.?

BON IVA (acUve' ingred1erll): ioo.ndrO'na:te sodium BON IVA (Inactive' IngredJeflls}: lactose' Il'lonahydrn.'!e'. p(lYidOlne, mlcl'OCIYstaUi ne cellulose'. crosp.ollioone', puriflecl stearic acid. Co'J!Oill~ sirjr;on diollide, and purified Mter. lille tablet ffim ooa~ll'lg cm'tailns l1yproms-Uose. IJiI~Jnium di'ol"loo. talC. poiV@lllyillnlB gJlyco.16000 and puriiried water.

BGNIVA is a regflSlered 'ti<!l.demark 01 Roche The.ra,pe!JUcs IIiIC, IDOIil'i!MM !o'I:

AiXiM LalP:!~Ii[(lr1!!:!J 1M. 3 .11 tilI1lj1l1m;:lS1nol;t

NiUUIl'f, NIl"'Jc~ !J711(!.11 D!;I

~~~ lbh!~k!!I.!!!ld

e a<l!~~Sml~I"!ii]jmi:

~~. ~fmiililllliill i\ur:ii. Ni::ZJ1.rtill

Copyright @o2:007 by RociHl' Labor.ller es Inc. All rug'hls reserved.

BV DE.AN ORtU.SH, MD'

~. st . M· '. 'th IG· •..• t . 8.'. _ .,~ ,fit) l!us a vtn, e a eenen

FEW SUBjEC'fS ~Jl:nrbor more myths and

,m isco[lcclPt ions than mitrltion, Som.e of the most common!

"~towi-€atnmeans 'f'!,beaUhy.:~' Lo,w4a;t foods can be- healthv, but runt alw,llY.s. The plfob].e,m.?' Many proc=

e ssed foo Cis that are low bl1 fat are high in sugar. which gives you extra calories and may cause wide swings in your

blood sugarlevels, This makes you gain we igbta.m:l Iose enc,rgy, and

may raise youllllisk of seeeral diseases,

Some people believe "low-fat" meansrEat aU you. want,"

I remember a dieting patient who was puzzled because be was gain:il1J~~ weight

He mentioned he was eating a low-fat cake. Wile'n. Lasked him how much! he replied, "Oh, one or two," .,' One OIL two piecesi" j'No, on€!

or two cakes]"

An. ideal diet i~ low in fat and low ill S ugar, .Most people can enjoy h.igJru.~suga.rj[1.igh.~ :fat tre a ts on oecaslon, but if you. Ind ulge one

da y. be's ure to, ea l: healrhier the next.

Canned ffuits ,PlOd! vegetables aren't :nutl'i:Uous. They CarJI, be. A recent review

a,f studies found that nuttients are generally similar In. comparable fresh. frozen and canned fl'uits and yeg~ etables, Many parents. have told me that. knowing this, they might b emore likely to cook at home rather than eat Jess nutritions meals at restauraats,

Redwme, notwhlte, prevents heart d:bii,ea:se.

47

RD I JULV 2.007

Yes, drinking red wine llQlay s.ignifk:andy decrease the risk of heart d isease.but white wine m.ay be just as protect ive, atIeast in. rats.

Resverarrol is a h.e·w.thy substance found m the skin

of red grapes. It's bighe:r in concentration .in red wine than white 'because red wine Is fermented with the skins. allowing it to .a1Jso;rb the r·e~rV'e.r.a:~ trol, American and Italian. researchers recently found that grape pulp extract (white wine) was equally effective

in pro'te.ct]]:1Jg rats fr()iID a head at tackasgrape skin extract {red wine), Also. most of the

ant ioxidanth enefits

of wine come: from the grape itse]t.not the fact that It's fermented.

Studies show

~:--- ......

that ,sp end ing

ti.me with friendsand fmnily may reduce the

risk ofma.ny illne sS·C:5.

People who lmbibe rna d. er:ately often do so in. the company of others, and. these psyehosocia) factors maybe as powerfulas the drimJk itself

I neither prescribe not P reserfbe alcohol, burt if ycm,~re going to drink, have no, moee dun one or two fourounce g]asse's of wine, one or tWOID eers, or one Of two ounces of liquor. More than that, and the toxicities 0.1

SUMMER DIET TRAPS

-- - -----

aleohul begin tu Qutwei:gh .. ally of its potentialb enefits,

Jui"::ie :lis less .h.ealt1Jy than. whole fruits. Not alw.ays.i"The vi!e'w that

pure fruit and vegetable juices are nutritionally inferior to fruits and vegetables, in l'e.lia'tion

to chronic-disease rl sk reduction, isu.r.Jilllsti~

fled," concluded arecent review of st u dies, The Impact of antloxida nts

OIl disease risk maybe more imp ortant than the ~.

-e

amount of fiber.Whole ::Ii

G:i I!.I

1;;;.

"" :::1

fruits and vegetables do have: more fiber than

~'

most juices, and fiber ~

£:I

has .m.any b::~JlefiH;. It fins g

""

you upb efofe you get ,ill

Cl

too many calories, and :Ii

::!.

It helps regulate blood ;fil'

SU;~l'. Some juice com- ~.

.<Ii 'If) .::1

"'"

paniesare preserving the pulp (whichadds

'to. the fiber) orare even putting it back in.

res the season fbI" nave]., day trips and. meals on the run,anci it's easier t han ever to eat healt hyon the road, At airports .. lioo~{ foit fresh fruit and packaged salads. Dip your fork in the dressing instead of pouring it on. Amu sement parks are providing healthi:erehoices. Disney win eHmin.ate added trans fats fmm its

pa:rks by the end of t:h:is y.ea.r.and kids' meals. 'Willi]lclude ~ides like applesauce and carrets-e-not fries. Some fast-food places offer better choices, too, so you can eat welljust about .3I'J!Y'\ivhe~re.

·48

IOlu,llb~am about an ad!d.-o.ntreatm.ent: olptLon that could he:ljp reduce 'yourpardal slei2ures~

Get this FREE Information .ICit.

It couldlead to more control.

Complete land, return this card tOlday"

9896-~OG99 S>i NOISSliN :33NMVHS ~,(;'86;3 X!08 oa :JNI bl3ZI,:jd

33SS3r1.:!OaV A8 a I~d 38 111M. 38'dlSOd

S>li NOIS8111\1 381NMVHSI1'68t "ON 11~!:I2Id lliV~ S8V1l0:LS!:IL:I

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J=o

Q) 0 16:. W 0

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o DlCJ

Just think, what a lif',e 'wit:h f',eweI' seizures could mean for you.

l,ea,m abeut a 'ueatm!ent option. that CQu'd Q'ive' you m!ore, ,c'ontrol, OV'!iI'YOUI :st!iizures .. ,

Wh,at 'would more controlmean for you? More time 'with. family and friends? Working? Driving? r.r.M~~!! _ _..._- Even hoLding at. baby? A Ufe 'W1thfewer seizures means something different for e'v'eryone" Fortuna.t,e ly, there is at. medicine that may help,

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MIV PLA,INE:T'

Dinner Party Debt

even g]jghUy kidding here, "Genna start with oysters with lemnngrass and ablood orange ,graflih:;,. then. a fish plate wifh halibut and pres ervcd lemon! a little cauliflower soup, pasta wlthanehovy sauce, Meat course, rm thinking bavette steak

'W-' -·'l· .. :n .. , ·'·."·I]·'t'· tebe .... ·." '" .", '[1' d .t:"" [1'[1' "'" 11 ~ ..J

. ,L~.l '''' I.. ,,,,: ""'01 .... ;;>.".,. ].t: ... "",,~., .!l:.IU.

eats beef, right? ]f ]]ot~E'U whip him.

T!1 . .,>

up some nai snapper.

50th birthday dinner for OUf friend We happen to have a Thai cook=

Sandy-thean8wer was, and I'm, not book, which we use constantly (for

propping up the Tex-Mex cookbook). and it has a recipe forsnapper, So I happen to' :LC]]OW this isn't someUhll1;g you "'w hip up:' It Is something that whips you,

I ,~I\- The sbopping alrme would

~,J , ,re:qube.a, mo~~h's ga~ban-,.

"~~~III!I!ii~'~J A.s ] know from.

OUR nUEND Dave' loves to cook Dave win call us n.p and say, '''Hey,. co'me OI:rJi.

over. I got a leg of]amh"n as though, it had [ust sort oflanded in his lap lln~eaA.y ball, Dave talks very fast, which 'he needs to do to-answer the quest 10'[1 "What're you making?" ] n a. reasonable amount of time .. The las t time we went to Dave's=fora

Wb at's tkkli.ng ¥mll" ftlnny bone? '\Vrltc h} I\,lful:y~(I;[Qjch ~t' fi,~p.klJi'le~@rd . com,

51

RD I JULV 2.007

our Scrabble dictio]1J£try. ka .itS what the ancient ,ggn:l't]ans called. the soul. Who sells th.is?What sort of knife does one use to chop HFe e.n.e.rgy?'

Ge:fJJe.rosity ]]k!e' Dave's is difficult to reciprocate, I once tried to cook for Dave and Kate, It was, hwnl]iating, I made 2l.[I:gel hair pasta with

need only surpa.ss those of Mr. Top and his ramen,

But Ed was right. I knew exactl y hewmany times LOll had been over.

Lastweek I e-mailed Dave to. tell him I'm wriringacclumn about dinner party debt. Dave was 1 eaving ona business trip [hat afteIrEJi:Qofl. "Have a. good tripl" I wrote, '·Whe'n you get back, you']] be eating at OUI house for the next yenr andahalf .. ~'

I had aaricipared some reassuring reply, something: a]ollg the lines of~ "Oh, Mnry. I cnok for you. guys because Llove to cook •. ami Llove you. In fact.what are you doing next Saturd ay?' I gota school of tuna,"

However, Dave wrote: "Gotta rU]1. Lo ok forward to coU ec t ing,"

It's true, Everyone keeps track, We owe Dave, we cweSteph .. and Jetl-Yj we <-)oWe BiH and Adair bjg tim.e.We:actually sat down and made a lis t, It was SIlO eking. What should we dot said Ed. Can we offer them thecash e qllival.ency!· How can we ever erase suchan enormous pile of debtt Is it possible to declare dinner part)' bankruptcy? There should be a system in p]ace: that allows us to collect credits for feeding' Lou, credits that W~ can then a pplyto Dave and. 8Hl and. Steph,

If I could, I would sell Dave

my soul to repay his kindness and generosity. And! know for sure that he'sgor the right knife to chop it up .•

How can we erase this pile of IOUs? Is it possible

to' declare dinner party bankruptcy?

toasted walnuts and som.e variety Q..f cheese that had not showered ]]) a while ... When I tried to mix everything together, theangel hair pasta. .simpliy movedaround the bowl ina solid. lumpen knot, "You forgot the conditioner," said Ed, who has since qUietly absorbed. the cooking duties on. the rare evenings when we're' not eat i:n.gat Dave's,

I have tried to. convince myself it's okay that Ed aud I have not properly reciprocared by pre·pad.ng22 sfxCOUIse eli nners for Dave and Kate. "He understands that we:'re not up to it," I said to .Ed.~'Besides:. he's nor keeping score,"

'~Evet:yone keeps score," said Ed.

"Howmany times lrave we had Lou over without his invitingus]" lou is one ofa s.mall group of bachelors whom. we sometimes invite over for.a meal at the last minute. It is never int imidat ing to co ok for these' men, as your cu~inary talents

5.2

Hellmann~s~ Made wi~h eg:gs. oil. vinegla:r: Naturally rich in Omegta 35. No trans fat. It',s time for real.

IfYOll have a. history ofsmoking and brearbing problems, it (Guild be: CGPD (chYo.f)ic obstructive pulmonary disease}. COPO includes chronic hronchltis a nd em physema,

Ask your doctorsbou: 5PIl?r~" beause«:

A [5 the only once-daily, inhaled maintenance prescription treatment for capo .... Helps you breathe better For a full 24 hours by keeping airways open

A ts not a steroid

SPtR[VA does not replare bst-acting- in balers For sudden symptoms. Do not swallow the SP[R[VA capsule The most common side effect of SPIR[VA is dry mouth. Others include constipation and problems passing urine. Tell your doctor abou t you r mea iei nes, :i nduding eye drops" a rrld illnessesf ke gllaucoma a nd uri nary or prostate problems. These may worsen with SPIRIVA.lf you have vision changes. eye pain, your hreat~ing suddenly worsens, you get hi'ves, or your throat or tongue sweUs,. stop talin~ SP[R~'VA a~d contact your doctor.

SP[R[VAis one ofmany treatment options .[0 consider with you r doctor:

For more information. call .~ . 877.SPI R[VA or visit spi.riva.com

PJ!l'ase see llrief SlImmary !)lliUli Prescriblng Inll)m1alllon on the lollowlng ~arles,

,., .

~ ,SP'IRNX HBndlHaJler~

Make.a. Ihabit oflbma~lling beUer;..'&(rthiIDPium lbllmide inheffiatton powder)

,",

A SPIRIVX [Handii'Hah!~r~

~(tiotroP~Urni ,bfl]:n1i~8 inhalaJtiml1 ~OM:8r) Sp'l:lriva ~ Ha,rlJ dli,H a I,er-

~l!IinrQlllmTllln~mrdeli!iltl~tIlfl;ln 1P0'i'l'd1!f)

IFOR QRA1~.INHALAlI:oN OND!"

IBrief Sum mllil" Qr IP,lesoribin:El: ]n'[orml!'tnoJi njl)fCA.'TIni\l~ MIl USM'E

S!p!IRIVA .fanailia!lE!rr(I~~.rnpium blti'm'l~e in'ha'<lUan IIlG!,Itde Fl' is.lndi· ( ... 00'ti ro~ Ille· IIOit;!l·I.e,rll1l o:nce-dalty, Ima1nl~na[lCE! Itm.l!m~nt o:r Imim· dlD-:Spa~m a~ooi:iIEd ~~ith (!n~i'il~ Ob:~~f!,ldtWi! IflilltmonaiY tI1~~~ (CQ,PD),int:IIl"lii!l1l ~hooJ11c IPrlJlKhit~ ~ml emlPhyliemil"

CQN1IIMIN OOCATIO!NS

$'PlRfIIA I'I!a.MhH\:l~r (llo.tropium IbromifJ~ in~a~~I.IM 1[:!([IW(;Ierl 'i~ eonIlr:t'inci lealed In pallient$ wilt. a hlswry of hyIP~t.!;Eln~'liv1'ly 1.0 iI!rn:pln~ Q.r 11$ ~rilialh!e$. i9i;r,udin~ lpl"a!JiO.piufil. ol"~ :!in~ Ci;:ilnp(]~n[of''i:lil~ pmxlW~I:.. WAfiiNUI,IGS

5PJR UVA, Ha ndi Hil~eJ ~fIOitl'(l:pilllm ItJro:ml!:le In'hallalitlR Ilol,!','lje~'} is 1'n1.emled as ii' om:e··diI~l!i' :millnlenilm::e' Ilreii!tmerll .ft! r CC Ptlam! is. net llndlcalm rorU'le li'1ltial !'rea~ml!:nt of ~U:l'e ~Jii5mlt!Si 8!f lblitililtnCl<5F)aSm, I.E!~ IrElSQue lhe~aPlf,

,lmfTledial.e Ih~l)ersem.ltMly reaclicm;. ineJw!!:!'lng ~nEli[ledema, m~:.' oc.cu,r illfler .adminislfillia·n· !lr SI~RIVA., If mEh a re.aetia n QCEI!II'S, Ilhel1!pyvilth SPIRliVA, :5ho~rt1 be Sl~p,ped at Of)CIOl tmc ,ailerniltive treatmeats ~'houl(j !be· con'slae:r~tt

In:ha~~J m~tllclrill!~, Indwdii!l;!l SP'UUVA, lmay eausa par~delilcail bmn· ttiJC<!ipar.m. U !!hls OCCUif5, ~r~O!I!Iner!l; W11!h SP:IEHVA :oIhw'h:l Ib!Ol :lill}JJ~tI 0100 0 tr~r lfe<iitmei1!:5· I:tln:s;ld!'!i\!rl,

IP:RECAiOODt!S

Genelll'l

As <lJnan[h::hi)m,n~fgl~ drug, SlP'[RIVA. WO!ll;f,pl urn Ilm;llmldE! I'nftlalalh~n :plJ!II.!der)' m~'i l[lfllp.n'ti;II~ wors:P..n !i.ljmpl:oms and ;;;ig.''';;; iII!".~fld.;r~d willi Ifjafj'(Jw~i'lg1E!~:i!Ji:fim:ll. IPUJ~l::ill~ Ihy,p!!!tlP'la~l~ ~I' ib'lad~i'-i~DI! Qb5~flletiorl iilDif fihcllrl:i Ib~' lu'~edIll11J1 ",UtiOIl in p<fll~nL::; 'I"I'U'h iiln~ elf Ith~e conl:i!IJ"n~.

A~ .:I IP re[!:offllnanlly' I\i!;ilall.,. I!kCr~tE!d d~i:lg, pali~nl:!: Wil.l'l mMeral.e Ito Sli!!o'4!!1E 1~i:1a I irTl:pall1"1\11!ltL ("!;;~!i!~llnlne tJI~iira'n~!:!' or s:5li niU:mln) IliFelllited 00111 'S'ptIRJ\I'A 5!iOU~ Iile mDnUJJllI!!dI (:IJJl~ety (tee (lIllN~CAlb 1~f!\!!tiRMA.OOl.OO'ii' IPh~nnacekln~C5.i Sillecilll IF'o.!,w!iJliQn:>, IitMl111yrmpolfwj Palt.oo rS).

:Ini~um:al!loo 'fb,r IPatl~ nt~

n is irn:Jl!ili'la1nl r(ll' IP~tl~n.ts '00< 'liifid~~tantllntl'lt :ll[) (;()fiECU'I' .:iidlm1nu.IE r :51P1f;:IVAcaIP~'IIt('tS us,] ng '!.he H:a;nd'iH:lter in'h.l'latlQf1 de ... i!)! (~e(! il:':a~i!int'$ ]n5~Jl!ctk!!~i!i, [or U~t "SPlIRliVA ca~'S~res sho~~d on~ be admin~l'Ered viii ~he li~nodiHiiI~er !:tevfc~ <lr!d the IHiimd1!1<1'er de",toe ~ihQurd nol Ibe ,u~e-d fOJ admlrdS'leJiIlS tih:r medi,allom"

CapJ.$~te~ ~hoUld atwily$ be ~liO!f~d In $E!a'I~(llill~lA!r~ lii:erng,.ve 0i1~~ Me c~p$lJile' bnm~iai.e1y tiJer'ofe 'Li:~e. OJ ~t~ errll!ctlven~~ ma.y Ille IfeltlWICed_ A~dilionill tilPflUliilli lihOll i);f\l ~etl U~ ilil~ (I.~·., tnol intemtetl FI:IF Immediate ,use) :!<holilld Ibe' di:SCilltleod.

IE!I'e lP'i!ii:n or discomf~xt. ti)1t.lrlled vis']o n, visual hallOs. QI" !COlored lmaEl.Els In ~55'DC10!I'JO<Il wiLh ,(""ed e~es; fwm teniu ntl.h"iI~ ~oll8estion <lnd oo;fllle<ll ed~ma Im.ly lo!!' :signs. ()Ir ~l!u'le lIIali'rl;lillf'.aln~i!· gJI.<I~ma. 5tiou~d an~ o'r' llhe!;e s~m i!!~d !)y:mplQllls deweJop" w.r!'!lllill illP'hY5~!i!1l immediatel".. :Mlo tic !!~i! drO\P~ <KIm};!!' <Ir~ ool I:(] nsld!!red to 'b~ !!Ir~cll!o'e 'I!rE<ltm~I1L CiilrE! m u5i1 b~ tii!ken ,nlJl, IQ ilil~O'I'\I' UI~ polNl:l~ r IL~ erlte~ i nLo ~he e~ ii!5 ttl!;. maYl:iIIu~ ,bhminlllC'Fvi51an afll:i ~liJ,p1l1:iIJatlon.

:SJP!~rvA Il'IlanclHa~er 15 ~ oli'lee-tl:iiily m;lint~n:lnce b~~!M[JlllaIOir ~l'Iti :silc·urd nol be 'u:sed For lmmediille w:eUef of I:i r~al:hitng ~ fQ,blem~, l.e.,

as·;'I:re$iC'i:ie ~'icaUOi"l. _

IDfl1lJl ]nrerlllcti0ll5

5 PlRIVA l1i1s Ibeen used ooncOmiLanti.Y wi~h Oi~heJ g 11.185 t.:ommoJ'! I!l' 'u~e'd 'Ilil CO:PD wl~h9iJl Ili'ICrE!:liSE!$ In atl"'~i'Se d~ug IreaiCil;i~n:!:, Th!!~ In.;!lude S'l'llDpalloomlm~ti~ IbKHI~hQ(I1II .. 'Lo.~. rn~thyil;J;anlihlne5. OInd [}'r.I~ ~nd l,nMled !leroldsc. ~iJwE! ... et. !the (Q.adminiSitratIM or s,p! RNA w1:!!h lJ't~e:f anllcoo~lnergie-eIJnl.alnllll8 drUS.s (e.g., Ipralroplum)' ihas oot. b~n ::;1'L!dl~d <lnill i~ lih~{erore tnQt .r~comm~nd!!:d.

ID.i'iiQ;lla'oofillory"leSi'l. ]fitE!r .. c~;oi'lS

tNooe· tu!OWIl"

CarQnq~fl1lsis,. MiJta:ll~n~S1l$~ .Iim,pair,ment Oil' F~ ~t1llt!l'

lI\Ioe~iden~e O'f~!.Imor~nl!:it~ was oo:;ewed In aIO~!''M'e1';1nilii!~ii!liQn :!illudy In rilt!; ~l tiol~Opl um l:ioses ~Ii' lo O~O:59 rn8ikg!doy, i'n <ln83~'k In~jjf.IJtioii :S'M~ llii '~~nHi~~ iiilke illi. do~C:ll up 11.'0 0"145 iffiWJkgl~oy, ~nd !'n a :!ell-weer.:. lllnar.;,lia,n s~LJd~ If! :millie' mkeal OOISe5, ,u,P' ,t.O o..OOiil:

Im:l11t(gfda'f- ThEiS;:!! [lases cC.rresjiiJ nd 'to 25, ~:.! .ai'ld {I,5 'limes ~he IRec.ommem!!ld Human [lO!jD~ 1D.iJl>e ~RH OD'} Off! .. imRfm2Ib<!lsi5;,. JeS~ec:& tMl~. These dose mtlltltples ma~ be' o~er"e5tfmared due ~o di~IlcUilies In meiO:liurlna de,jJofilted dtl:sesln iln'lmiill Inhiill<ltlon ~Wd'i!~s;. TkINQ:pll1m Ibrcmkle I:i~monilitraled Ino e'IIlde:r!l:e of mlilagenlt1l.'l' Q r «la~ILl:ige9IeILlI In ~h~ f(][lolr.+i'I~a~sa.,.~: ~he bget~ri31 ~1iI~ II'IlJItalion ~~, :tIle'V19 Chinese Ilam:ste:r ~~U mlllliilgel!le:sis iJ!5'Sa~, the chll!J;fJK!l-

:~oR'l<1i1 ab!!!mraL1on 3S:!l;!l~ I'n hiJIm.:llFl ty,n'lpiJOI)'I.e;!; It! ~~ ~nd mt:I i.I$O! m'li:ran ud~rn; Jormatill'n In!i'fw., !i!~d 'Wle IU n'~'hliltluled DNA :s:.ol1llhes"i5 10 prlmory fat tlep<lIClq'le!> 'n I;IlllO !:Is"Sa~.

In ta:t~. d!!!C:u!.1i~@$ ~ii ~h~ In LI nnl;~~ of l:o<rpota Mea~lIlfi ~nil!! IPEl.r(~Rla,S.e 0'1 mpP<lm't5 W~ re oI'!ate(j <!it 'Inha!iiI'liom l'OL!rOp'!'um dQS~:S 1:111).0711 Imyt<,glda,o ill r ~<I!Sr (ail~K:ii<;lm.1I;ily 3.5 Urnes Ihe lii:HIDD on illffiil/m2 Ib<l,is). NQ s'~I:iM effects llrere ob~eNed at 0,009 mg/'k8/i:lay «!~Ilro:o:i' m~l:el:.' 41lmes ~han ~he'RHD!D on a mgtffii! ll:Ja~lsl. The' rertililyindex. thowll'\J\e'r, was; 1'1 Cit ,!'rr~clEd ,H. I n!'!a !OI!lIon (JC\lse~ up ilo j, ~~'" 'm8lil!Wd .. ~ (illilproidmil"te1y 7~O limes 'lhe' IFHfDD en .~ meJm~ bg:s~t These' dose ,n; ultiIP~e~ lmay M g,\!":Br~SltlmiiiWI d~e to :ci'IIi~~1Ue;~ In m~1iIi5~rin:!l deposiled ~ in Ollnlmal h!'hilna;tiDn 5it9!'!~e5.

I~regll!;!ncy

"':f:!JlJ"t1f1zy C~OIJI'C

No evkien.ce of 5iLI,uc~ural alllelaltliJ<l"IS was observed In rats and ra!libits ;lllnh;l1a:tkln LloLfiQ"p1um t!@~ 9i u,p' ItQ L471 and 0.,00'7 mgl'k;g/~~~ Ife~pE!C;ll"'E!,I't- ilihi!l:5E!' d(l(se;s O:Hi'e.SponJ 'tt) <lIIIZiu'Qil;imiiitetv 660 aln~6 ~:imp.!i lihli!"I~mmended !human d.ili'l~ fIo<s;~ (IiiIH[l[)) en 8 mgl,mr: 1l:J@S15. HO!He'l.l'ef, in rats, 'i!elO!l :re51:1 pptio n, Ili~ber kl<ss, oocrea5e5 ~n the tn um'bel"" a,r Ilive III up~ 31 !:ill'ln <In>:! t~e meen 1[:!,IJjl' 'wejBhl~, iilml <l ~~:.' 1n IPllli1I $EW!I2i1 ma~ur<il6c.[1 WE! rl! ~~Jv«I at in'ha1al!lan tiot~"Oplum dose;!: of ~\.(l:71l Im.grftg (arP:p~!dma:tit!i!y 3§ LillTll!!$ ItilE! 'RH[)[) Oii i:I IrTlgll'I'I"! ba~~:!i). llil riltPb1!il; •. ~n 'Incma~ '1i1 po~"'rTIp~:lI'narh:m ~~"!l5 "'iI$ .o!!mlVed at an inholrlilUa-n ~e:' oro.:!! mgi\kWday(~ppro:o:imil!le~". ~6(1 tlmes Ille' IlIH DD on a mglnf bi!tsls) .. SuCh elfen!> were' net. obliewe,j ~,t 'Iilti:l!~~'tloi'l ~ MOflOi;laln.m up Ito< Cb()llS m;likgi'day l,n t:ll$ a,nd Ifab~ Ib il~, re!:pE!cli'o'l!ly. ThE!se dc:~e:!l (JCIr~~OtId It['j appfl»;:I'm~le:l:t to aMi BO ~llfIes ~n(! RHOD (iii a 'mg/m2 ~a!!l1:s.If1!s.:JlKJtl~I'J'. Th~~E!daselmLimples m&, be OMe.r~timaltetl due· 1.0 dirlicull.ies 1" me~~uri~1I deposil:ed

coses In anhmll "n!1i!O!~on studies. .

Th~re ;!,re noa;deq'Ua'l!l and welh::ont!!l[I'Ild ~t~'le$ In pregnant w(l'[l'Iefi. 'SlP"lRl.IoI.·'A ~I1Q!lIti!ll:ie u~ 'WtiIFlS. preB!la.nc~ on~'11r Uliii' pOLen·· t~I'l:ienl!mJU$:Wi)M' U'II! poit~liIliaill~l~lt!D 'tne r~t!.l$.,

11lIl!ie In Ubo:r a nd'I[)~I~i)'

Th~ ~r~w aind e'rJettl\!e'l~5'1i .of SPlRWA Ihas :nol !ilI~en 51Uudie:l:l iIllllrlnll ~a:bo r ~nd d~l.ye!y.

INwq ers,

iMm j'j ui3'l,ngwo.men ~oiW!d !.O tlolmpl Urn are I1iQt a~ on ~<irC.iLaitlf'ig IrocI!ili"lt $~udie$" Itiati'!:i!plUiIn Is i!II;1;'r9IM 1111.0 Ibreast milk. II. is Inot ~Down whelihe~ 'tlOIirO,pilim 1~ el'lcreted in ~1 uman ml1k. b ul i!J.eetluse 1'!li.1II)" dJwgs. are eroreLed In hu Inail m~11!; i.!!Ild gi.".~n the5ie !1n1:1 il!l~ In f<lt5, ~<lUtiI!J.lI ~hlJu~tllbe ~ rl:ls~ilI iF :SPIRI'IIA is atlrninl:!ile,red loa :n ui:Silfl~ I!OOma,n~

lli'ediaMc IU!!:~' .

:SPlIRIVA HatndllH'<J!ler 1s ilppmved [!til' use' In the :mil!in'Lem)rn~ treillrnent (l'F brlJncho~p<!ilim as~ocjaUld wl'th chronic ob5llr,ul:itive purmo~ tnar!J' di~e, 1r!cludins dh rome bra ncnitis .a:nd e-mph1l'5.t!Ou!. This dlsi!a~!:! dOi!~ n~l. i'iO rmally O(i:m lillMdrl!i'I. The ~r~l.y .:lind. ~rr~~I"'"en~_g$ o:~ S'PLRIVA 11f1IPi!'dialJli:; p~L1~nt~ h~ Inot bel!!lfI es~hl~h!!d,

GflIl1i1bri~IId!i~ .

OfllJ;i! L(liai ,i\lllm!)er or ~li9;nl~ whC!lli(!cei ... ed ~S'PlRLVAillllihe l·~ar cli~iC1l1 hkl1~, 426 were <615 ~ea,rs, 37S were' 6s.-,~ YJlO!,!"S and :105

'OI,Iere ~75 years or ;;ige_ Wilhin oe'.'Iph ' P. ~ne~ \\II!! re ,1'1(1 tllf"

f~~i'I~.s II:i~h·jE~.n lIn!!! ,P;O~CHi!lan (II i~n adYE!r~ e~E:!nl:S. ill

'tnl! :S!Pl~NA i:l!nd Ui~· cQmps,ralQ,r o~t i!yeiil$.. Dr.,. m~tli

~ntrE!a'~~d willi .1:gE! in U'iE! SP.~f;:J\!'. ii!jf(] u:il' (tIlfferen(E!$ 'rmm pl\aci!!bo were 9',,00;., 17.1'lIO, and] 6.2:'lf.1:n 'Lhe afweme~liQrI~d <J®e' ;s'ubSPJIIP'>h A.1'i1i1!lh~r rreq<oonC;y or COi'l$ti~l1OIil .. lid 'i.J:riBaI)l ~raCl1I11f~Clioiil$ With 1nm~~ln8 Ili~m'i:l o!;~'Ncd In liJic SPIRIVJ," lIi'OlI!,j:!' Intllc' p1~~o~fllmI~ :!l~1!l~_ Th~ [mrel'e:nc~f!. 'fmm Fl!~~CE!b@ i@f oon:5Llpatlo!l"l ~E!re 0"1';" L!I%; and UI".I!o ror :M('h or' too ~~,e groui!l.:5_ lihe tilrre renCl!!!5l from 1P'lace:bo rm ~'rlMI)I Hacl inr~"LiQns 'were ~0.6%, lj.~% arid 4,5*,. INo ~i'ilill dlfie~ncp~. iii erre.c:tN-ene$~ _r!!!' ob~rv«l~mo.n~ ~1;~ gftlUp5. !6ii15le'd QrI iI!'o'ailiilllre ilI~la,. tnO ~djl!~tmlml .or :~pg'Rl\I'A iIl!Q~gi:' ir! ge~i<I~ricp<lltiM!~. is wa.n;!l,nl,ed.

AO\i!"EFtSE REACmotl.lS

OF lihe 2,.663 pmienliS 1tn the' four l.·~ellr <lnd lwo &m(l nlih controlled olimlCilii ~ri~lls. 1,3o;a ','!fere U,...,Il!i:I M'th .!jP]RIVA (J~IJI!rQ,plun1 DFQn1'ide 111~a~tion :powder) <ll U1te Ireromm::!ndeill dQ;Se of 18 me! once iI di!l. 'Pa~I!lnl'!:wlth ii.arrow a~ .~uoQi'IIa, o-r' ~PI~mallc p.I'(i$!allc iflWl'.r. 11!Iq:lt!ycr M~~r'cult~tolli5~U~LiI;lFl ~I"E! E!~ILided irom ~he$@ !I~I~

Th~ m051 comm adwrse d~L!.R lIliICitw n W<l!5 dlry mow~n.

ID.r~ mQiJ'i'l'IWo!IS 300 (linen ,r~$.Ot1f,oo durllig CO.nUn u~d

tJ!ea~me.n't. Other react 115 relporled In indi'o'iduan palients ilind coo·· ~iS!Mt wUh II~Sl5ib1E! .a!illdl!lliirliE!~lc: e'rrec!:s Inl1i!Dde.d ~oru'!lp:<liUoo. liic rea$etl th~d!rl r'II~.!. mllw fred ... isl[)m, gI\;llil'OO m~. :uriMry oifficl!ltl.f,. ~iFld

:u riIIa.!), ,r~lPnl:1oll_ _ ..

IfOiJ:r m!!J11:1cEl'lt~r, 1 "~:r. cOIi'lIt(!1t!!d :!i~udlt!t!: ~",a~~i.eiI SP~RIVA liII j]llllen'ts wllih OOPV. i[3b~e 1 :;lhoVl5 !i!U at!verse e"'~nl:!i Ihii!t ~umcl wi~h .:Ii rreClul!nc.,. ~r ~3".Iii In h! S Pi R1V:A~fO~p, In ~h~ l·ye>lr" IPi.1· c~1;Q,.con'l!Iotleti Hi:i~ w!'i@ft! th~ r'ai:e:!lc In Ithe, :S~]flIVA glffilill ~i!ooed IP1~-'I!1Jo til.·.· l!:l'!ok. The 1'~III~nc' 0' corre-.!:'jloi)'nding eif:l!nt~ In 'the liii'il:UO,P~:u'J;'G(] ni';O:I~ed I!rians is il~tuded r(lr (Iilin~i'lS(nh _

pliii:l~:bo-CQn'~t()!I,I~~ii'iiils

SPIJRr'l.l:A illlOlube

~in' ~ S5QJ In, ~ 3,"j!~1

11pi'i1~ropijjIfl.c!liii~l)Iil~ lillia'ls:

SPIIiiWA ~jl<F:;I~~piu m,

~in, ~ .3'5611 ~nl" 1:")'91

I!OOY a~ <11M1o:1~ Aot::~den~

Com.tipillion

n II :5 III
7 S !i :2
5 ~ 3 s
S 3 6 6
4 2
16 3 1.2 6
(I 5 1 1
II! ~ 2
iIo 3 .to J
4 3 3
" 2 2i <!
4 2
'l! 1 1 ~
IS S 3 ;2
11 9 :3 :2
lol J' lo3 35
or. ~ '2 2
7 5 Ii 2 Gm;~roint~~~mll Sylilem IDi~order5 j!l,bdominal F'",ln

MlliI<cul~ke:letal.S)!ilem My.aiIIJ!~

R:e5li::lt,lnc:e' ,Me,.h~!li:;m Di~or'lilliil,r:; .r.Rr~tkln

R:e:s,lli!'lIltl<l)!' ~5tem (I!p.~e,r) IEp~5ta:!:l5

:SinUs.iti5

S~~nl .. n!lil AJj:I,PI!Mag;e IJJSillrd~t$ IFIa:~h

Urina.ry System,

Lir In air;' TriltllnfKltiD.n

NtiliriEI$. coughlng,al\d lilnLil!'I'I~:II~J! :!1't.i'I'I~ll:HJil~ oe~J!i'ed~t. a t~~ of:8% in ~h!!! !lPt.r.tl1!JJ!, 1tt!~:Ili'I'If,lnt.~l(p\ but Wi!i'ij < 1:'!Ii. ln ~:!; of iIJl~ IplaCEbo gitKJ~ Ollll!~ ~nl:$ tha~ O{~w,rlE!d in ~he SMItLVA grn~p' ;I~ ar~q ~~M~>, ofl-;,li".l!o In Ih~ pI'a~~~rJiitrQItecl ~ra~$ wh~,~ !he ,rate~ ~OO;:~ME!d ~lialt In ~he !I:I;I' ceoo~Jit:UIP in.diu(l.e; 8r:rt1y 0.5 (l' Whill~"- .a[loef.gk I'e.<lGtiun. ~e;g jl9'lIi'I; ,C~rroj (MItJ Perlp1;JifUtJl N~t't(J,tJ.5 5yitfim~ (Iy:SiiJi'lOIfl!.;l, IPiilr~l!he;sla. ,Gtls,ffl1ll'lie.5t1nal Sy.;r:em DP.if}ftfrm;: 81l£llroin'Le&limll di!;{Irde.r not o.tilel'Wi5e; specified ~fIIOS.). gJ<nrGemph<lg.e<li Ire'n'iJl{, Slomatlltis ~inl!;ludilll'l! uhceriltiore :.tomalilis}; M.r!i.'!lar:yiJ'c (1/ld IY,tlj'ffflMtlr {)j~id= h~pe~hD4l~$'te~r~mla, lI,pi!'tS,DyC@IIYIi;i; ,!jfu~I>!~~aJ S)'!lfem DJ~d&$~ $ker.eta~ ilaln~ ,CardklcrIiM,tl:~ ~ngli'1~ pr.:'totl~ Hn91w"li~ ~BlIr~leg o:i'nsJn;; ptClo:!~I~; P~f~M"~J.»i'd'm ~il'rt~=!i:!n1/nt£'~I'M;; lllii:fFJ~ Z9nCt, ~l:Sp1ffit~~jCI'IiI OfE1fiw (.t/:ppc/): ll:li)'ngitlSi; v.i!l1o.r:i Dis.c:fI'J,('I; C9!.<i'l<IoeJi:,. fn ~ddiII:iQn,. OInlClng 1100 .adYE!,t~e ~n't!i Db~~-~ 1,,, ~hl! d,inir.a~1 Ma1s with-an ~ntldl!nce olf ~]"iQ weroa~i~1 fi~riU~tDo-.n. ~!!l,p.ra.Yl!!lfIllf'iQiJ~.lf ltich.,.eai'tlia. an.~tlema. O1IfId ,urin::ll'y' ,t@oon'tkln,

In ~he i-year 1J'ials,.ltile lm:;lc!enee of dJ;!! mO!lJt~, cgnstipmlon" mOO un na,!}, Imd; infect~n mreased 'Wilh • (see PRECAUTI;Qt!Js:, Geri.o~l'Iic Il!I5.>e), iWOo lfI1ull1c:ellltE!r. fi;-mCl.n~h. aUl~r()!lIeD !ltoo iE!$ e ... atuOIited SIf'~lRruA. lin IllilltienlS J,!j1~h CO,F'{). The! atl"'E!6'S.e eventsalild ~nE!' Indtl.i!:ncl!! r'l!es WE,r~ simi~.oIr 1:1:1 thc<!;e !>!len inlLtile l'ye::!r cont~ ed 'U'ialls,

The rollt~iWlli\!l ~vl?r~ ~ac~lOfi$ h~ illeen ide.nHAiI!fI dur1ii~Wt:I.fMwidE! Ijl~l"alil'p~...:i~ ti~ of SPI!l:I'VA: tII~j!irl~~" tI'fSP~:i(!li:i. ~1ii1!.taxl$, Iloar.!ll!!· !i'I~$$, l'fi~Llria~ ~1)~liIuc~tIQfi IMI'wdllil~ lrof!oLJ~ ii'iiliia~'I'll~. in~raQ':u'lalr ~~:!:~r!! liiC'rE!llIsE!~1. Qfilll ~~n~itll~I~.Il .. tJl~l:atlM~,. pmri~!I~". ~Il~artlb.!. thID<ll

irlital!oJl. a nlll t.nilICilrlil, .

DOSAGE AiNU ,I"IDM]MISTIiI:A.TIO:H

1I'lhe' reoommended ool5~e of SP'JRJVA 'H'i!!n'!:l!'H'<I1ler ~tid~roJill!.!m lb ImnKle lrli)~1<ltio n ,powder) 1:; the lln'hal!aUoll Q;F tbe' oontent.5 (if one s..1lt,RJ\I'/I

C~- nce- lIn Jt!iIlHandlHat~r Inll~~aUtln dmrioo (see patl~Il:~·$.ln~lt,w(l't.iQfiSrQr Use).

C\I nll~ ~l!Ilrl'!d r()~ gel'i"lric. Mlilatlcaml'i'·im;p:OOlred. Of i!!'I'I.aIIy"llIYIl!l'Iir~ palie,nL~, HG!W~.r •. paLlI!!,nI:S ""itll iilode.r~te 110 Sl!!~trl

re_naillm,llairmentgl ... en 5PIRIMA ~oufd be' monitored clo5le'I!I' fsee·O~IN]cAL IPHMMJ!l.COlOO,Y. Ph::mn~co'kinetic:s. :Special P(lipuli!lic<nili ~nd I'REDvnONiS~_

SP.lRUIJ'.PI CQIIlSUr.~, are f'llr inhilfiltitlrl on1~ and rnur.1.mn ibe ~<llIc~". HOW SUPPLIED

if1h-e 'roT!low1il~ j:lad:~~ ;:I~ava1Rall'l~:

"D~n f:~;mt~lning 5 SP~EtLVI\.e;;I p5~~~ ~ l~nil·dt;ls!i! ~l~~I~r card)'i3nd 1 ";hn,jili:J~Q,r Inh<l~~iI;I.n di!~iI;)I! (NID(: (I$97-00jl'S-7S), ~a~((In G(iilta'inlng 3{1 S!PlRIVA capSdlol?.s {3 !lnlH:iO$i! Ib~liS!Eir' calfit'lSl' .2nd 1 ,Hi<lndl'Hailer ~nh<l:lditian dE!VI(~ (Nne 0597 00l§",r, U canon cont~injnE: 00' S!PlRIV'A Co1p5lll1e.s {9 un1l~o5'e Ib1iisle rcarosl ~nd 1 IH3ndi'Hailer 'Inh .. I<IItw n de ... lte, (N,OC C597 007~5·1i7)

S!V,I!S (lQ-{l£} i;i~.z6JiUSJt

1~11-:I' ..... Boehrm:ge'f ~~II!II!~ lI1Jgelh:ewm

CailleX 'Ointment's mQicS~ulriizin,g fCllrm'IJI"a,C10nta1illl:s natural ,em'llZ)'1mes 'm ,e:xfollia,te lakjing",~ry Qr dliickenedl s~inl on tees, selesand heels,

Pepp,erllJunre.-soElrited CaneX Oiwrutment 'is diabe'do-fri'endly and free ,of ilrritatirIIg addis, so it willi ne.v,'Elllr sting or burn. -

~"'~d;" _'~I""

t&r~~.Ao

Gm

-~ ji;,~"",,,,,,,

IKERR DRUG '~

Toll aoo.se8-600S 'WINTtIt,.xllnllliM;ofl'i ~

W'HEN ], wxsauniversity theater directes, IlLl}' wife wasasked by

a cH!en[ about her plans for the upcomarg weekend .. ;'::1: think I'll watch my h.lIlsband·lsp[ ay~j~ she replied,

"0 h." said the client, "How tnany do YUll[

have?"

!!'They ~salid it"s not ~lheh' f:alullt tlhechil!d feilll in, blllt~lhey'lre wii~Ung to give him baek h1D e~challilge 'folr rnc:iQ'li'bilkes.:'·'

PRACT]!CAU;Y bOli_m.dling into the ad.ve.[t~8].rDg department ,ofhls newspaper, my husband announcedthe great news; '''We"ve: reached our ad sales target! ill [ust sel d the last spot."

"July?" anotherrep asked excitedly;

"No," my husband gloated .. '''.E didn't have [0,"

CE.lIIA NOTlH

I N ~:)Rb,,1rlt'IlO pro cess a medical claim, I asked a patienr's mother to send details ,of her son's accident '~O me at our hospital'sbusiness of nice. The boy bad suffered a. broken arm,

so the file was coded "Treatment (),f lirub,"

Apdy so, m thought. after reading her description of the 3cd.dent~"My son was running through the' yardJand turned intoa tree," IOMBERLY:5If1ERR'iElLl!.

59

RD I JULV 2.007

"WILLTHl! l~:A.R'1~'l\ii,i:hO lust $5:,000 with. ,a yellow rubber band. around

it please come to' the Informa t.]{~'n b Doth:'

d eel ared a VO,] t,e OV€'lf the Las Vegas. airport FA system, Though I was eshaustedaftera day of meetings, theanneuncernent got[uy attention, Then the voice added, '~We have

your yellow rubber band,'

Is yOUl1i' busi1ness not 'gettingl noticed? T,Ihe n you need a caJichiy Ilogo:

.' Our~aca~ window tinters 'l'ell~ U:IIU{€ ;it is: i'We

sticlk. i~wh€r€ ~he sun shines." M~CHIEU:: IV'I' DAVIS

• A propane 51li11pply store ~Stril''t shy about ,r~eal~illi1l~ wi~e,re ~ts he'alrt: ~Iies: "Tanlk heaven f'Q:r

I,unle girm~ls." ER~C KIIEI-iIL

... A P,aJ5lSilF'lig ~~t~c se rvicC!i' teu c:k d~clalred

!f19,5,oO Ibs. of ,e"ygros5w,eig~hrt.." DR~AN I'IANNAtil

W HEN~,TOC'K my Wc,cd Eater back to the horne .. and-garden storeto get ][ fixed, ill was asked if ~ wantedto W!l][ uIf.I1H the job was done,

"How longwill it take?" ill asked .e

The clerk answered, '''A. day or two,' DI\VID'.ABEII,.

I WA S l.N 111.£ l!A:CK (I·E ~}tIT ambulance tendingte a patient when we: slowed to it crawl, must ahead of us' I a huge semi washaullng a house.

"Don't v""u 1,· ... "'''' "'n .... """ "'''''I'.J! ''''llf .J,,,']"'e·r' "'·W"'·h.cr.n

.. "l1;"li1, . ,II.. ,J' ",1_ . j.i!j.l.'6 L.U .. I,~I,l~ ~I£II; U, 'ILI'!~' '.' llU.!L .. :'!"" -/~I '.," ... L.' .

people ate s]nl,ply too [;:tzy to pack," A.rnHONY AOKIN'S

ATE FOR a seminar and unable to find

I parking, I pulled into. a

spot behind a church.

It was onlyafter Fell gottell. out of the car that

I spotted this, sign: '~N 0' parking .. Fmg]vell.ess is our b .. isiness, but don't make it ha rder than it

already ls." ElRIAN MARTIN

Fo.l.l..OWH'lG his motlvaHon al talk at aWeigh.t WatC'hersmeeting,

my fat her noticednne client's small son elhnbingnn to a scale,

"Don't go on that.

Joey/I warned theboy~s slightly olderbrother. 'on makes people cry"

CARTER DuallERSON

Your favorite new joke ()t' one .. liner

60

STAND]N cin 'front of her Spanish class, my {dendi, 11 s'l,lbstH1!1~e teacher; warned" "I only knewabout ten word.s In Spanish, so please don't ask me For help, Yo'Uall k:rJl.o.w more than I do:"

Onestudent rej cieed:

"I'mfinally in the right

W!NNIIE uu

A. CUSTOMIIR stepped up to my bank w]udow reqil1!tsting heraeeoant balance.

"Sorryt I told J:H:r~

"O1!1[ I'm afraid our computer is down,"

'~t~' she said understamlingly."Term]nal depression," ADAM PARR¥'

rr<iU er Vi'ew' The filmversion of Stephen Kjng's s:ho,.nsto,ty'·1408'~~aboutahote] .roollIvvid:ru.a supernatural presence and. an evll past=errlves in theaters on F.riday, July 13. Are you brave enough (0 complete this quiz witla words from that story?' We'U see, Answers .0]1. the next page.

12. dEsconso~ate adj •. - A: hopelessly lu:'Jlhappy. B: broken beyond repair, C:shQckingly rude. D: biased.

U. enmneratev:-

~------------------------------------~

l., ,iJI.PFJlillr'ition 11.~ 7~ trifle' n.-A: a,efect-A: to. lead 0.]). B: name

.A·. '. 1'."'. "'·'.m.'-.'I. ~. ; vi ;!I",. '.1'. B' '. sm all """"1- ,....,' ""'t one by one. C: hinder,

OJ... lll.. LIl"" .I. ;3,.:'-',. _ ,il ... ..: ""',,.U.l •

D: visualize, B: drugstore, C: ghostly C:group of three'.

appearance. D: detour. D: outburst. 14. v,apir!11 adj •. -

........ ~~~~~~~~~~ .......... r--------..:........, A: w-eH-fc!1..mded. 8: fas t-acting.

C: unduly proud .. D:].acking liveliness ..

15. persrilidu~.ty ar1:j,.~· A: fussy; Braeutely discerning, C: everlasting, D: gossipy~

Uli. Il'etLdant adj. ~

A: courageous,

B: destructi ve .

C: unreasonably irrita-

ble.D '1'1'

,.e. . .: lUl,Wl .lng.

WORD POWER_®

3 .. , aspi Ii'e' ~I. - A: to ,Come co the end, B~ seek

. ambitiously: .. C: assign .. D! discover,

,4. OIuhm u S t!(:1j,~

A: reflect ing Iight,

B: deep.].y mallcious, C: unlimited in power. D: portending evil.

,5. le.dora n.-A: shallow

a" h u m ~do It ,fI~.-,A: large metal bowl B: witty person, C: bullfighter, D: container .60r cigars,

g" fa PIPOft rI.-A: goo d. b ehavlor, B: opposition. C: ndations.mp. D: seheitation,

person, E: sof] felt hat, 10. rancor fl.-A: relief.

C: greatwealth .. D: back B: bitter resentment.

of the mouth, C: irritation of the

,6,. wir'angl)e ~J.-A: to. dispute fiercely 13; pravent fromfinishing,

c: barter. D: wander about aimlessly

skj]). D: agreemem.

11. denlu.' ". -A: to. take part in, 13: all ject to.

C: wlthbold. D:daim as a right

Ovel!' the course of his: ca,reel::;. S'h~IP~~n King has provid~d plenty of material 'for Halillyw'Ood~o work with. Can y,QU uilscralmbl,e h~s ,Q'tirnE!,r pageto-screen tiUes'? .Answers Oril the n ext paie.

R,EACIR

HET NINI,GHS y:s,n~ME

T.E PAMT,RYASE

ETH R'EGrNlllE LEMI SLOEORO BARI:tC:rNI'EO

61

12. dise,onsD late-tAl Hopelessl 11 nnha PP}t; inconsolable .. AftJet the sm.mDin:g play-offIcss, the nome team's farils le.f'~ the stadium d;i .. u.",();~o~a:te'.

.-----------...!......,.....:lI ...... --------.I 13. eIJnln1'elr'ate~JBj

To name one by nne, Th,e boy went on to en,um,e-Mte all d'll.e reasons why llls parents sh,ouJd rarsehis allcwance immediately,

14.'uapid{D j Lacking inliveliness O.r spirit, dull, She \IIi'3S .h.appy to leave the party" :5] neethe nlght had beenIille d with notbing bu,t 'V,apid !~aU1;:.

JIl5., perslrlie I:<ety-{ .-l} Ex.eessively particular; .nJSsy., Her persn;;i:ckety supervisor censtantly rearranged the paperg on his desk.

16. petu lant~[ Cl mtempered; unreasenably ir.ri.t.able.\¥he.n she beard, her petu1'C1ri:t niece's whinIng, shewas relieved that her .own daughter wa s

so pleasant.

RD I JULV 2.007

ANSWERS,

1 .. ,alllIllarition-lCl Gh()Slly appearance of a. person or thing, W'hat he th.()ugbil:

W<1.S an appa.rido.M: was ,only a. $neet di'yin:g on a clothesline.

1~ bifle-fiU Small, inconsiderable amount. This birthday was special, so sheexpected .. an expensive gift" not the ttlfte he

gave her .

3. asp~l'ie-UU TolQng for; aim or seek ~lmbi~iollls.[y. She has-a.lways a.o;;pir-tl'dl!o become not just a movie star,.bll!t the most famous one ~.fa]t

4. on~.ll0US~(DJ Portend[ng evil or hlarm:f:~Jr,elb oding;.llne,at,en.ing. The picnicker kept 'OIl!;; eye

en the om lUOU.'J: dark cloudsasthey gathered 01.1 the boriz:o.n.

. 5. fedo~-fBl Soft felt hat wi th ;;i ,cU!fV,ed brim. AltllO:ugh ba'~!\O we're aut

of fa.smQIl, he never faile d to wear his black fedom.

16,. wmIflQlle-[AJ 1'0 argue .or dispute, often noisily ot<ii.ngrily.Evcl:Y Friday night, the children would wl'tifl:gleover w'ho gCl'tttJo pick which shows they w:;:l~cbed.

a .. humidortD~ Container spe'· cial.[yfiUed to ke'e'p ci;gats Inch f. He kept the ex pensivc.hand-rolled ci;b-1l:r~ in a locked .fiu midurat the !bad of the store.

9. rallp:ort-lC1 Relatiensblp, especially one fha.t' is harmonious 'Or 51H1lpa~ thet ic, Begin.ning with. her first day 011 [he job., she e.njoy'ed ,a .good! rapport ,,,,lith her co-workers .

1D. r,3m::or- [.8] Bit~et .resentment or ill w.iU; malice. The events ofthat disastrous day left hhn fined with m .. ~()()rmw:ard his former friends .

11, •. demuli'-CBJ To obj,eel to; take eXCleptlOJ1 to, Af1;er briefly de.ml~ rrmg, 11[s boss agreed to accept rhe offer of <it ride home,

"W1I)CABUlARY RAn~IG!!! 8-111 Good! D-U IE;(!cell~ent 1.4-16 IEx.·Ciep~iona~1

j[iltlUoq~II3I':) ~oloa 'illl! N u~~\.l!D ~~ ·.!l!~~I!\'IUJ;!!S ~3d ·1!.l~S!W '~w~U!lIS ~'l.Il·~!J'!e:) :SJa'~ SJi!JLI n.jJJ. ,!liBel

Fer more vocabulary-building ~WI and games cnllne, go to wordpower.com,

6.2

Packed with reil~ fruit taste, it's ...

The cookie that thinks it's a fruit.

DQ

o

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When you look good you feel good. Take care 1~~~bl~!li'I~~11 of yourself and "Keep 1t Clean" wrth W:a~11 tilrnp[lle~the orand used by professionats.

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lO'rnce~i:! yom' FR~E iooo~, "'S'~nd'liOUIf RilE AI [) mCleiplar.orllill: with YOUt Mme, addressaFild phone number by AUiglicSt: 15. 2007 Wi fiileade:r!s Dilll~tlRI1iE Am S!kin Care, 260 MadisClnA\!iE!nlle~ 5,thl Floor; NY, NiY 1(){l']6, Attful'il! J. H'~s~ing,.

"'VlJ'hils ii>up,pIiB'i> h,m. Reader:!; Digest fttServes tile night to·!;!JIh&t.iWl'e :ano~hi3f' book of ,eq!.ta! 'IOIalue.lPrealS.e O)lllow 8-nl weeli;$ fuf(/;eHv.e!)'~ IRe'lai~ vallue :$24.95.

BEFOR:El: I could visit my daughter at her navalba se in [apan, 1 was told I needed to supply her ,"v]th some important lnfbrmatlon. to giveto :lH::c1l.ld:ty,.

The list Included

the f~)nowitu:g; passport n umber, height, we]g.l.l[. year oflbiI~h and anticlpated hair color at time of arrlval,

D~XIE McrllRLAND

DURn'HJ areview of :rada basics, I asked. some Coast Guard sailors~ '·What'$. the difference between a 2D radar and. a 3D radar?"

The genius, in the front l~OW answered,

~'lD.!<! BOB KIPKE

ILU}$TFilA.T·!:O By RAL~H Hl!.GE.N

- -UMOR. IN UNI.F'OR.M I~

A [t"f.I!R AN exha usting fI.llHtary .mal1.€l uver, our celoncl collected his of:l]cers and told us, "ill ~n.tend. to go hornenow, open a bottle of wine ana, sit with my w]fe in

fi9Qint '0$ 'the fireplace, m suggest you aU do tile same,"

'iOkay, sir," shot back one officer; !~U you don't think your wife will m.wcV·' STEVEN w. CHAPMA.N

b RE WAS-N'T already aware .of the dangers inherent in l1lUHa:~:y li.fe, things became prettyclear for :my son with one lookat bis Mar~n!e1JQ(JJt camp .ltl.nerary. On. one ofth.c first da.ys, ]B,ayonet Teclmiqueswas

sc hedule d! for the moming.FClUowi.ng that

Beginning First Aid. TOMM" SIISSON

VOUlt' favorite new joice or one-liner

65

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I\mlm ~.e wlb' fie!. bt!p1!li(,!l 'f{IiJr c>jl~JI1!l8$ 01 wlMli:1iil- Sw~~I,'!!;ti:d;.e~ h Djl~t! W re~i!lL re:siJ::k'lkU; i!l9~ ~ I ~n(l (l<1iIer IIlllill ~.s~ ilJ!;!i!'m~m ~ OIl1ii!llll:):25e~S:'llil'5. SWEl8!!l:5!ti!l~ElS ~I{I~ 1111 :;r{llli'_

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. . (Bszopiolone}€

u iWm 3, MG WLRS

Please f41M Ihis Smlllm.1r:{ ,or iiil(OrmiUiOFi aliool LUNESTA beJor.eyou lal k to your doctor or SIru"I using LUNESTA", ~t !is. Mt 'Mealill totafre tlile: ~Iace' 01 %I u r diilCtm's il1!S'truc'tiolls. ~I YOUlll1WJ amy cnae:sHons abeut LU NESTA lilJlels. b!! su re 1.0 a5:kYQu r d'oomr or pha.rmati5;t.

LUNE:STA is used 10 Imal diEJerenit tYP(JIQ el sleep I1rob~ms, illUCJl as d'irr'lcou Ity liiI f\'lil ing JSIMj). dimcully iln III'!Jin:truning sroop duringl tile nigllit, and waking liP t(!<o e~rly iiil the morning, 'MoSJt~l)ple "'li~1'I insam nia llia,v.B Iif'I,OrB' ih!il11l ona ~r th,BSB prob~~ms. You Sh(}u'ld I.a~, LUN ESTA :immed'ial:ely 'b.efore {j{lingi kI blE{[ b"HlalJls~ or the ris~ ijI~faml'lg,

LUNESTA, oomOl~GS to a yrull!P' a;! 'tvlOCi ieiloos B,mwm ao;"'I1!y,ponoliCS" or, ;si mptt. sree p med:ic iiiles. Thiiwe are mruilY [JirI'erenl: s:leep met! iei nes aVl1ilal.l!il: 'to Mi,I) pe;Qp~ s 1@81) belter, ~ MOlin n i<'liS, oWm tr~115telill anD, inltermitlenl. ~t uiSllillly requires 'treatmel1ll lor omty a short 'lim!!!, u::;lIs!l~ llJo '10 days UP to :2 ",ree~, ~r~u r tnsemma does, nli)t improveaHer 7 to 10 days Il~ treatmemt,. sl1:~:fOur dootor,ll!i!c:m.!G!l it may be a sig 1"1 o!l iiI1I undcrtyln.:g' contiilioi'lJ. Some people have chronic s!eep prol.l~!if1s tMl may require m<lre I!r.c1lol1geu use, OIr sloop meciicine. H()weve'r, Y()U :s1'ii!iJliIci !l.ut usathess lrillt!dicililllS rlClr JOIi1\J P!!lr.io(ls wilhiJul t~'Ik!lng will"!lyou r d'ocmr aboul 'till!:! ri5,'!!S and ,tl:enefits of proE(}n.ged u~e"

s,~[u'= E'II~CU:

All meu1(i nell ,hllve std'e elrecls, TIiIe Il1h'JSCt eem mO!il sl~e, el1ec:ts O'r (lleep iMOCiicines aile:

'" Omvrsincss '" [)iuiiiless

'" l.J1gl'lltheat:iedrn9:Ss

.. [Jilfim.ulty wi.1.hi (loo[)oollllilLiol'l

S:leep me[J'oc:inils, cam rmlke: y(lu s'ieep.~ eu ring, Ihe d i;1y- Hi}W ([r(!w~y yQureel ilIllpem!s upli)n h~'i'!' y~llr bOtly r~OCIS i~ i!1ie' Imediciine, which sle~p ltr'Ieci icliile .~'ou IIrelilkliilg, and h~i 'larQ~ :;'! dose )lour doctor has prescriil.etl, I);]yti m~' Om'i'l'Siflles8 Js, !l>es,t a'l/o1doe(! by ta~ing Lh:e Iw.roes:t d'l)Se possiMI'! !hat wi IISLili :hil~P you slee p al mg'ltL YOIn d{l(;lor will wor~ willn you to Hntl tile do~ o·f LUN 89TA. ttmt is be5tfor ~u, SQme Jl>llOllle' Ia~ing LLlN~STi\ 'have reported n1l:t1H:iay s~ill~inll!l~.

To mM\)Q~ Ihe.se s,ioe· ei~reCltHljll1~ VOO are taking Ul1s mMiciroo:

'" W'htln you first s:t.lrl: lakil1~ LUNESTA ~r af1l~ iDllui3r sheep meti'idne., un;til you knnw whether the med'icilne wiU sU11 hav{! some erre~t t'l1l1QU Ihe IIIl.>::t d<:lY. lise extreme c~re willile dQing amylllln.g 't~~l reguire$ complete <'I~rti!!e;!Js, ~ehl as. dfi~ng a car. oper-.1tin,g mochiiilery, (J r ,i>ihllllilt~ an aircl'alt

iO 1)0 Inot drill~ a:lool1ol vlhenl you are ll1"'illQ LUNESTA or alloY ::;Ieell rnedkine_ 111.1001101 O~1l lncreilse [he si~e efiecl::; or LUNESIA ilJr amy oiher stee.,p m~dlGime,

.. 1)1) not I.a~e: :;IJ1lY Qthe r m~rJkljl1les wiUwut aski nil' you r doc:tQr 'n rSl. Til is incl u.d'.es lrI.!lill,iciiile$ YOUI c,'ln :buJ!

",ilhaul, ;i} Pfe&Cfiplion. Som~ :medicines can C'ali(lf; drowsiness and, aIe! bes:t 3'11'ot-d'ed wh~le Ia.King LU NESTA.

• /lJimrIjs take tile exaet dIOSe of LUNESTA Ilrescfliled tly yOu r do~t(l\r, Ne'l!1;! r IOhaD!1I1! Y{lU r d{liSi±!! without talking to your d nlc:tor Jlirst

S;pi€cii! I Concerns

Tl!!ere' are! 5'O«Ie Sip:eciaJpr6ble ras U1!lit 11t'I(I~' ~CCU r 'o'l'ltife Iilkilil9 s,lee.p rIl~d iclru:!!S.

~a~o~,PrQbl,~n1s

S[,eep medicines m:a~ eausa 11 ~peciallypl±!! or m!f!,mory loss or ''ammesra.- Whel'l Unis oceurs, a p~rs'ol'l ma.y 1I{11 remember wltat has 'h!ll~peliled lor severn'llmu IS aller la'kiniJl'he m&llcll1le_ TIllis is, usually :nOI, 8. prolD 1!3 m s In~ :mo:u iHllllp'le rail rulielilP .a:rler liI~jing tlil~i me~ici ne, Me nn,ory hDM C'.'I1i be 11 pro Qlle f'IiI. hOlrI€Ver, vrllerq slelil.j) mefRdnes ilr€ taller! ~'lhil~ travel iMl, such as; IlU rin~ am airlll;me. l'lighl amd the Ip;e[s'Ilm wakes up ,lH!rlOre Ih.iI!! eRect o~ Ihe medi(;jlll±!! is gOIl.e. This has !:lean c:a!led "rave~r's, arnmI1!S"'_~ Ml1!mOlY pnljl}il!lllls ma\i'8' bean reported 111 r~I'i Ily pa:ti~ IYIS taki I1g LU NESTA lin, clinical ~tlldie:;. ~ I1i most Gffii'BS, memmy pml}lelillS min be [wldeti 11 you lake LUNESfA omly wile n you are abt"il lQ gel a rlllllllighl t'I~ ~Ieep befQiFe y.c;u neetd' lill be< aC:live, again. Be Sure .t:Q talk 10 your d;o,ctor i'l y.a.u lI1 ink you are lriavin~' memory pr(lb!el'll1s.

IrJ18rnlll!:'ll

W~elil S:leep meuic'intl' art use~ avery ni~hl, f:or more Itum Ii re'l'l vree'ks:. Ihey mii.:J lose Iheir e'~rtlcl'ive~ess ili'll1elpiii(J y,Q;u :l!,leep_ Tlnis is !!mown lIS "tole ranu," Ile-.relopme nit oHoIera.no;e IQ LUNESTA ',1.1<1$ not OOsen.l'~d im a c'limOC::;I'i studY' {If 6 months" duraLlo n~ l'ncS'Qmmia. ls oll:eJ1l lr.mStilllll a nd ~nteml~lellit, alild proOwn!iJsd usa of steep me~ic;infS ill ~l1IBll'IlIy nel, nBGllSs3ry. S~m(:l' people, I 110U:D 111, 111i1ve Clhroiilic: su:ep proO'bil:ll'lls IIml may re quirei more :pro-IQn:l)e-d! lIM oi s~eejll meld icine, Irr yoor stoop pr,ob!ef1iN if:Q:n:~i!Juoe, tMsuit :tOur rjOC:Wr. wllo ~ill ,m~ter.min:e 1o'lI~.el:h.er olllll!f measures are mel!:l:lMln overr:Jome,youf s,leep problems"

,{)~jmn~fj"c(jJ

Sklep meillicin.es, can cause dep~J1I(!.en~' i n some pe.opfe. especial~ wl'i:en 'thes& med ie i nes are' IIs.e(i reg U !t1rly lor :I© nger l'hIa.l'l a r.e!o'~ "Wee ks, Of ;;It high dose:!;. [Ie pellld'emc.e L~ till!! n:eed' to coolin~!! ta~killg1l, medfoi ne beGaus~ st@pp~ng ills u njDle<lsan;L

'l.lVlu:m pe{lo,~I~! de1.leloll' d'epend'e.m::e, stoppinlJ' the med10ine slldden1y ma~ cause IInp~a&'Iiill s.ym,p1toiills. (Me ~UldmWdr I.leklw). 1ih~y may lind Ihey Ihml~' to ~ee p la~in.~ lile med iei ne E: ilher a:t lhe (lnlSCr i!Jed dlQ:Se or al: irlcreasinQ soses ilust 'to avoid withlllrawaJ sym,~klm5.

Allp'l!{Iple taking sleep medlcin~s have same nisk, Qf ~©mimg clepeno'enl Or] the medicinJ~. Hmvever.~(lpI9 who !lave been l!Iepe n.tI'elill on a~coino'l 0 r OI.IHU drugs :i f'II111E1: past may 111lve a higher ohance: or b~oomin.g m.lci~led 'to sl~el) Inedlicllil~. This ~ossib.ility rnHUSl b.e ~sidereiJ bellriFe usimg 'Ul.es~' 1OOi!l1ci:nl:ls rl[lrnoon;! than 11 levi lffllB ks,. ~I' YoOU ha1l'~ been [i,ddia:ted to a:iJ:lohQ,1 or dmg:::l im Ih~ past, lHs im lJ·orta nlllo 'Ie II yPU [ doa:t~r befmil!!'iitarlillg LUNE'SlA or amy sr.eell me;!i~im~,

Wl'1'fd'nH'I'8J

W~thldravral S1mpl.OI1llS may occur when st~efli medttines are :;;topped su~demty ait~r being used dl'dlyfor a 'Ieng lime_ ~m

s.oo1€ cases. 'these srmpl~ms. elm OCCl!F even ift~ liI1iild!cin-e 1m been usaater ~n~ a week or lW{l- ~n lII1ilili cases. w,iU1drawal symp.toms: may ineJud!e I.Ill1p!eas:anlfe.elin.g'sc 1'1'1 more sel.i'l!re cases; abd\lminilll and muse!!! IC ram ps, vomilil1l(l. sIIM(!atimg. (lh':'&iililliiss.and, flIr~'y, s€!il:ures may occm. Thes~' tm(lfl) severe wiUto'rawa] sympl!HIlS arll ~ry uncommon. A1lhiQlJlJh w:itMI1I1.'.lal s.ymploms, have net b~en ~ooerved 'if1l 'lil:a: rs lalive Iy ,lllnilml ~GIlILFQllfld trials e~p>erien.c8 Wlll1 LUN I?,f,lTA., Uloere! is, n~uerthe~ss, tile ris,k of s ucll evellils ill associa~om wWhl Ihe! ruse: or an~ slleell medocillll!! ..

Al1Iothilr Jlroillem !bat may Ilo~ur wll'llFl .~ileeprmm:i1cine:±: ~JIl stOPPB!I;I' ~ fliin{IWn as "relmu md inS{lIill nia.~ Tlns means thai II P!1!rson 1'Il!l'i ha~ iIIl'On'!' traul:fJle sleep;img thelirs:trl)W ml\lln'ts a;fler' !he med~ine'is stop,P'flU I:Ililrll JJ.erOor-.: still'ting lhe medicirne. Ir you should e~Jpe riemiB r-e IJClu nd' linSiQrrllil~. 1CI0 Jf1:Q!I get l1iso:lImt'!iild:. This pwlOlJlel1ll miOually g CEiS awiXY 0111 its owtI'Il1ler 1 or 2 n ighls"

Ir~u Iliave beenl tnking LUNES'TA Or any olMer stilej; med'iclne [.or more' thml or 2 we(tks., do ",(It SlI'iP taj:Jn{l it OJ'll yOiJ r OIIIQ. Always tonl)W you r doclQr's directtl)nsc

t:l1anges 'n fJe/Iii!vilJr AnD" rhin1<fng

S~me p~oiJlJle usl'l1l!l' steep miWl{)il1l(!s 'have eXclJerllllll;;ed umusual changes m Ihelr thln'~1n.9 a~,d'/or Il:Mlhavig[ Thess eU~Ls are mgl (;o'rmmlln" HIl~"leW!r!. tlle~ Iliffile imllucfed:

,., More: I)ulg[)in.g or aggressive. behavJllf ltIaili nomnaJ

• Cofllru'sion

• Strarnge be,ltaviCIr

• .Ag.il1ilion

0, HOlllucilllatimn5

•. Worse n il1l!!l 01 de jJresslolli 0, Suicidal tlmughls

H(IW oll£lli thest! elfllc'l$ 0(;£ u r delle n:ms Olli seve ral lac;tors. such as apersolli'S generaJ Ilieaitta. till! use gj IJth~r medl(:,irn~:s, ami whtcihl s!ee,1J rnedttiine i:s; IHlilllg US.!lill. ClinlGilI eJ<ller:ience 'i!1il:l~ LUNESTA st!gg~:s'ts. that iI. is rar'el~lassocia:too with Ihll'OO beh!t'lvi© r C'h!t'lnges.

It ~'S als.Q important In reall:il.E! tt ~ rarely clear wh..ether tilof!5e bliflulVi~ r e 110!1lQ!lS an'! C'<1nSI3<i Ily I he f'oorHcine, are (:'<1U3oo, Ily an illl1l€ss. (lrhioJllf: QCcllrr€d of'llhelr Olfin, ~111 faci. sleep ,pf~b'h:ull!l 111>",1: tic nlll impmVeFl1lily- IJi! mile hll inlmmss.es 'I:h'll were' ,presef1il: bJ;!'fme ~he med icine was USBU_ ~r you or YOllr tal1lli~ IlIJllce .my changes in! ytOlI r behavior. or IIYtOLI llia'IJe an:{ unusual or disturbin!J tlmU{lh:ts,. Gatl Ynlur dO(!'tQf lmmedi:1lle~r

PrognflfICY AnD' B,e'iiu;free,rJing

S!eelJ medldnes rna" ~use sedatkm (If nth:erp{ltJ;!ntial e!'ftecl:S lin Ihe'unMm Imfiy wl1elU US-el:l ilI'Ur.ing 1,111::: last weiflKS ~f prElg nartcy. Be 8U re 'liD lell you r doctor i~ you arm' preg nan'l. n you me planning 'to bacome iP'Ft{lnMI. or " you IJ,eI1:~fOO pregm3111l wh~le: lakllll9' lJJN~S-R

In rulclilicrll, ... very ISmail aJli10mU or LUN8STA ,mal{ be presealil in breas:t flililk. ~ner lJ~~ Q'~ Ihe medical'iolil. The I:l'fr.e~ts ()'rv~ry sm:J:iI illlIlOUllits 01 LUNE$TA. 11m an 1nlallil ~.~ n{lt knm,rm; tllerelore, as W1Ul all a(ller prescripliall sJleell medtcine£, it is re;callilmended: 'Ul!al'YQ u "ot take LIJN ~STA .Ii you ~.re breastrelii6in" il Ilatly.

:S:a~e USial 01 :S.leep M(l~j'iciifles

10 em5lue 'Ih~ !.lahli' tI!1id effecti'lie US€ 0'1 LU N E.:STA or a Illl !Jllilili r st€eP medtt~e, you should o!lStlriJ€ 'th~'hDllowlnn C!lllllioIlS:

[. LU NESTA ,Is a. p'1'e5cri,pit&ll flI lme>d i(;ime 3i!Jd. $1; Ciuttl be used 'ONLY as direeted by your doctor; F\1Ji1~{IW YtOur der:tors illls.trucliQms aJJmil,hiQw' t{l ta:ke~ ""'hen 110 lake, an{j! 1110\'1 ~Qng 00 til'kc LUNESTA.

2 .. Never use' LUNESTA or ~m.W' Olher slee,p med'icine ror ~\!f1Iger Ih'ilfil direC'ie\l ~;,r you r doc:tllr.

a, If you n~liee (tilly U I'lta$II:l.1 andlor dislJU rbimg' ~hQU9'hit$ Of' ~ellavJor d UriD(J trea:tme nt w,iUiI LUN esTill, Of' !lilly olher sleeJl mei!l iei ne, oomlm::t you r d'oolor,

4.Te'11 your doctQr iIblQut IUlII{ meci1cines VIllU may be! hlkifilQ, including med ici 1iI€8 y!Ju may .buy Witlfiouta pftlscrijptkm ilf1ldl h€rllal prepar.:ulcms. You8hould aso lell y<lu r doctor if you drink aIool101. DO' NOT' use ruc·a,hell willile' ta~llIg LIJ/IJE:STA or 31l1~r Qtiner sleep lTIlooi~iIll8_

!i [){I noll.3ke L IJ/!J 8STA u n~ess you ~re allle~1l get ,8: or more homs or sile.ep IJ;elore you must 0.8' active again,

11. 1)0 mot increase th,e' (m:ser,ioot! dose or LUflESTA or arw Mh~ r ~I~€p 'nrmtl iei ne u Mess, imftnu;;Ud b~ your ilIoc;tt'lF.

7. When 'YOUI I'irst start laking LUNFSTA or al'lly other sleep l1Iledir;lne, IlIntil you lkm;lw w:hether ~hl! mE!dicin~ will still lll!!llole $Ol1Ile ene~t on you tllle n~xt day, use exIJ'I!me! care will illl! dJOiIll~ an~[~illlg Ural re.q.ui res c'I)mplete alerhless. S I,lch as dlivinij a car. opera.fi ng mar;;llIlnery. or Itl!olirng alii aimraft

1;1. Bea1l'lariil:ma:~ you ma~ tl4'lV€ morl:l sll'll1:p1ng pmlltems, Ihe 'ri i$l nigllt Of two <liter :st~ppi f1!J ajQ~ sleep ~l1e~~ililll!'.

9. Be Slife 'to ~J I your dor:I,or lif ~Oi.i :Ire: pr,eg.lWlill, !II' ~mr are planning lO IHlC'OIlIl!l! pre'fJ nant, i~ YOIl ileoome! preg na.n:t, or iI ¥QU ar~ Im±!<lslfee:Jimg a baby Wh Ue! lakil1lg ui NESTIt

10.. As wil h all ~r1]:5C rll}tlon llIledicin.(}s. n!llVllr shan LUNBSTA or I.lI'IY other S:leep I1i'Ilildicine wi~h Myt'lne' I;l~. AI'I'!Ia'{S ~IOf~ LUNESTA Or any olhilir .s~p medkine! inl lh.c or~ inilll Mn~i nCr ~M lIu,l O'f r!!!;,1Ch ~f ~h ild rel~.

11, BI! SUfI): tole'll ynur d'oobm if y.EllIslfffer [rom depression. '2. LUNEST~ works very q~k~ly" Vow Sh{lutlj· on'l" t3k.il!!

LUNESTA ~mmed]ately [)er~Jr:e Qoingl In !Jed.

13. For LU NESTA w w~fll: 'best, yoQiU ShtllJ lid n~t la'kfJ it'fliill~ or immelllilll~1y alter a lligh-fm,he8'!.'Y mea'!.

~4_ Some peo,p!fi. sueh as olDer anull$ (Le_. ~oes 185 and!

C)loi'I!f) and ~eo pfe with liVer d ~ease. Sih eu IJEI slall. withl Ihil! 1000ller dose fi m~J of LU NESTA,'I'ou r doctor 'naay Ch{l<f}.Sl! ln start ti1eral}Y at 2 mg_ ~111 gener.J1. adulis Und€T age 6:5 S'IiiOlfli:l 'Ire 1J€.tIIJOCi,'o\I ilh 2: or 3 mg.

15. Each 'ti1b,la't is 11 Sililgl!ll (liDSe; do rn~l. crushi or break

I.lle 1:.tlJ1le'l.

NII'~e: Hllis summary provides i'R~D'rta:n~ im'lomnil~ion aboul lIJINES:iliIL ~I you wmulli!ll InliiE!! moreinrmJlm1itDnl,ilsk~mlJr d'o "'Of' Or' :~ha,~'l!llac;~s;t ~olet you roadllJri.s: Pnl'!!:c ribi n,~ ~1l10rm!lna,j;J :a ifl [J1i:fte'flIIC is'CLNPl: i~ will:ll hi'ifl!IIO~ her.

'Ib,mnil~

{I SlEiP'IRACOR

AKI G AW SOM,E WI GS 5 EASY AS 1-2

(THERE IS I 0 ,3).

1. Grill dlKke1t Mn>giS (I'll< madlurn hllal tor 20 mulule!l .

. 2;., Brush wlngr.l!II!ilhi frrJn~ Red HOI· Burtlllio WIng 5mJee..

MONEY MA.I{ERS

Staying Number One

IMichae~ ID,e~1 built a successful computer business, What willit tall<~e to remain on top?'

HEN HE WAS ]ustli9~ Michael Dell started. the .company thar would dominate the industry:

The computer whiz had $J,OO() and a n:o"IJ"fd idea: toeliminate the retailer and se]J directly to the OOnSUHle:r.

At the time, IBM persona] computern sold in s cores for about $3.000.

A fler taking them

apar t and rebull d ing them" Dell reaJlized the components could be' purchased foI' oElie~fourtll the: price . Ev.e[l with added memory, bigger monitors and faster moderns, the [l'CsCQiuld still be .5(1,]([ at ahandsome profit, So on Thle· was buying compcnentsin bulk to reduce the cost. A good business declsloe, bur it meant his ro om was starting to lookIike a mechanic's shop, IfDellwasa curious kid! he had Ids parents to thank With his mother; a sto ckbrnker; and

his< father, a Houston urthodontist, dinner conversation freque'mdy turned f romwhat Michael and his two brothers we:re doing in school to discussions of the eccnomyand business o'pportu:njtie s,

"I was quite excited about the possibilitles for personal computers and how tile·y

Mar]:! BtartiroInO is hes [ and m.~nag:Ul'Ig edlHo.r of th.e syndk:a.tliid progra.wl T1!>i? Wa1'1 Stft'1!tJowi'r;I!al.Rep~)rl', as well as ho!;;~ oH:::NBC's Cl(is:in~ 1I!"!~1.

71

RD I JULV 2.007

could change socjety: M,ea~whne. as a customer, I was disappointed that when] went to a computer store, the salespeople didn't really knowabout computers, ] had this idea to se]l the products directly to the user over thephone, The Internet~" be adds, "was an unimaginable gift from heaven that came teen years],a,ter,"

CoUege plans and. bis pareuts' expectations intervened, But M:khae~ Dell was determined. He drove off to t he U nivcrsity of Texas at Austin in, August 1983 in, a, car he'd bought with earnings from :s.e]]lli1ll:g newspaper subscriptions . He was surprised that hismother W3$,[I't S:U$~ picious about the three computers in the backseat. By Novembenrumors reached his parents [bat he wasn't

attending classes, On. a surprise visit to' Austi[h~ tb.ey ta,lI.gbt their so,n, ledhanded, Mkhae]'s father read him the dot act, then asked. him what he wanted to do with his life. He told his dad [hat he wanted to eompete with IBM.

Although Mjcha~] agreed to fecus on his studies, the business possibilities. were' 'too. compelling to ignore. and the t imifllg couldn'thave been

b etter, The publ ic was 0 ecoming more interested. in computers and wanted more sophisticated. models, hut no one wa:splrodl..lCh1JJg them. Iu eiol.JrlyMaJja week before his, final eJra.:m.s:.Michme,] started De]1 Computer Corporation with $1..000. He

to ok h is exams, then dropp ed out of co].]!ege at the end of his freshman

yeaJr. It was time to try out his directto-the- customer business mode 1

Three yean later, the:' company did .. 3 private placement, a stock offering to a small group of investors, ~'By then," Del] says. "we had already achieved t'lJID ual salesof ab out $150rnillion.] was 22 years. old."

DeU. found out 800.:11. enough that necessity is. the mother of .lD.1.venUoD .. "Ilearned by doing and. by making mistakes .. And. I got smart people

to help," he says a. Today DeU [sa

$57 b ilUoncompany, with the ]ead.iD.g market sh a re in the United States.

[nM:uI:cb 2004~ at age 39~ Dell stepped. dawn as CEO Ole remained chairman) ana continued to foe III s on res earch and technology. But so on there were signs of trouble,

The cumpany beg,an]osingmmrket sharebecause of competition fro·D] much more aggressive rivals such

as Hewlett-Packard andLenovc. Del] was also criticized for poor customer service, It's .n.ow facing investigations into its accounting practices by the SE:C and a Ll.S, Attorney.

This 'past J31mary~ the struggles forced Dell, .['I.O·W 42, to return [0 the c~):mpany hefaunded, to tackle the issues head-on. In 48 hours, he'dput in a new management team ..

Of h ism arketing brainchil d=-sell directly to the customer~DeU to]d employees In an e-mail: uThe D.irect M,od'el has .be·ena r.ev.olul.[onJ• but [.f Is not a re~iglon." He intends to improve it and look for new manufac-

RD I JULV 2.007

turing and distribution models. The goal is togivecustomees what they need and make the teehnology simpler and easier to use,

Asa technology leader •. Michael Dell wants to use his positian to solve' society's b:i;ggerproble'ms~ Iike health care_i~H you go to' your gro-

Id.eaStorm, a forum fO'f users to brainstonn what works, what doesn't and. what new features they'd like to S:C'C b:1ih:od:uced. '~We take the custo.m.ees input and design the products and services," sa-ys Dell.

A.,. £ .... " •. '~lcl""iw': :IA,"',~:r the """""""]j'U"'DC iza-

~ J."'-.JI.i1.. .[.\..11 'a' r l~l:l!_:lJo ,~h.~ .JL,~,~. liWi'::~ '." ~J

lion will take, Dell s:a.ys,.i'l~ tuck us

some time to get into these cl1J!2UUeJiJ;ge-s, and. it will take us some time to. get out: (If them. I think 18 months,"

IfDeU needs any reminders that he can take thecompa Ilil)! t CI new heights, he can. think back

so,m.e 20 years ear]iel!".'~NQ' one told me that we: couldn't do it, and if they did, I wasn't listening .. " Recently he challenged employees, If they are to be competitIve, tbey wi]1 need to. make significant changes and take li}f\leU thought~out risks.~' That's exaetly what made Dell a successstory,

Dell wants tOI use his position tOI solve societys

biqqer problems, like health care.

eery store, there Is more rechno].ogy there than at YOUT doctor's office. Imagine the last time you'\'vent to' the doctcr, you. see all those files. What Is all that about? That is nonsense, Try to take your medical information from OF.]!e doctor to another, It isa SySt~H11 that can be dramaeically improved. OUf industry-has a big' role to. p].ay;'·

Dell 1.Sa]50 looking overseas,

spec ifically at the needs of the next billion :PCusers. ··We have a, n 11111be r of new things gOln1:g on in emerglng market 5 in India, Poland ,Brazil. the former Soviet Republics and China,"

Most importaetly, DeB says he will deliver the kind of SUPPO'lft Iris cus-

t omersezpeet.bcch in lI:001s and. techno.logy;. One new to 01, caned DeUCorunect, enables the tech staff roconnect to the customer's computer and fix problems on d1.e spot Dr show the customerhow to do. It. In FebruaJy~ the c(},mpooy rolled out

74

Got Q mo M!ey ql~€-S tion? Wi'i:t,(? to Ma:riia:

Ba.r~·rmm(J! at n:1I:N;U~ YlN,a:kers@rc[,mm:,

AND' FYI .'.,',

-- --------

~ Cneclk. out ldeaS,torm!, Dle:~~''5 ~11It.ef(l,~ti\l\€: orll'line community., at ]dI:eas.tl;~'rmlcom. Post youlI'i:deas for IFII ew s~rvi Q~51;11rl1 d pro.duds (all'll.d track updllat:e.s on the-ones that: DeH ls oonsiderilli'ng), i nt~aet witlh the expeJrtsa ndl vote on a:eslgns.

~. For more (~:n De~I~Co:nnect,

a w'ema,te dii,aglnlo8tk:s. ,an d re:pa~1I' too~~ go to dell.com/deillco:t:'llllleet.

.. A't stud:~odedll.C0m, iJlplo2l.d your video t~t~m:onnall$,_'fmm how-to. tips tlJ 81m amaiZ.ilFIIg gamllr1ig e:Xlperi eiFil Q~.,

LOSE WEIGHT BY ,CONTROLLING

HUNGER

Delicious Dre.!limfieldsi'-'; Pasta has S grams of 1iiIlber pe'r se'rvlng and a 65% lowef'Qi"ly,cemic iru],e.x than reg'!iJlahf pasta, A lower glycemi,e index provflcles s'lJstained erU!fgYI ,elliminating the crash .. crave cyclej. he'lp:ing yO.U fee'l fu.llionger and lose welight.

srf\G r 1 [lTI \'\!ITII OLi VI::S &. TOMAI OU'

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i1§ 120 .......... ..........,,_......._~-.............ji '-Gil'(Elrllt

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~

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For iI S 1.()Cl off «(I U p em iii nd hea Ith~' redpes.

"I [sitwww.dreami],eidsfQodls.wm orca II ~1~.800-25t-19'17

It was my idea to have a family reunion, and I called my younger sister, She

10· ve d the ~d·· e·· aa In, dt he nr· w it h out ... o ·:n-·· -

. ~!Yf_ _ .IlL .•. Q,. '. '-. 1I..11l..· ., v. , '!.,.,. _ .

sulting me, ran with it. The next thing I knew, the party was planned down to the napkins,

I. asked why she didn't include me" She said

if I don't like ilt~ I don't have to come. rm fuming. Should I stay away or go'? PIlIRT'i POOPER

,A, ~~~:~:~~~e~~aVe3,gOOd time,

secure in the ,kn.owk: age that you hada great idea .. Ge!uiug credit is nice, but a united fmnny is worth a liu]e: swallowed pride, The next rime you have a brainstorm, mow~ ever, think twice before you share it with Sis~ who seems to be suffering from younger sibling syndrome.

A- Dear Fatigued,

_- If you'repayiD:1lg the phone bill! stop funding her "addiction" '(o.n.·~ that lUIS hooked teenagers

s ince M[~ Bel] invente d the ring thing), The only difference' today

is that phones have invaded every c~)r.ner (I,f social space. My advice for dealing with .Miss Chatty Cathy is to make her habit work for

you. Draw up ,Q "phone contract" stipulating that if she can't talk to you face to. face, youwill can he'! every day at a predetermined time: to asklaer about herworries, her fears and her [oys, Keep that line of

Q :!~::~~~:=i~:~~;,~a~'~e!bt

hera cell phone for emergencies. But we'Ve found she spends an ineredible amnunt of time on it. EVe']] though she lives in out home', it's like we 1100 longer: exist, I understand it's common for teenagers to

always be' OD. the phone.bur it's Q My supervisor wears c.],othillig

llke an addictlon. Everywhere she that shows a. Iittle more chest

goes~s:to.re.wo.rk, (:o]].eg:e~thte thanmaybe she ought. Sh,e is ve]:y

cell phone is; g]uled. to her ear. We~'ks professicnal inher duties ~ndh:a$.

go by and we don't talk. What can become a. mentor to me. I'm not of-

we dor PHONE FAlIIGU'EO' fended. Hey~ I'm. a g1lJ.y .. But I actually

"'HOTO",ILL~S·TIR."'TION B'I'JOHIN CO,RBITT: PHOT'O~ KAREN MEYERS 77

communication open, no matter what the cost.

RD I JULV 2.007

think it's holding her back at work because the Wom.ell taUi and the men ogle. Is there someway lor a subordinate to tactfullybandle this

situatio.n? I:JOOI<IING our FOR HER

A- Dear Looking,

. Stop loo:king: and by all means stop tbillking about handling, She's your supervisor, It's not your place ro comment on her attire or [0 concern YI;liurself 'With advancing her career; I f you want to' talk to someone, talk to the og]ing men and tel]. them to growu.p arid get back to work.

Two, year'S. ,31gQ, my l'iIusbalind had a I'iI .31lall r, and we sepa ..

Iralted 'fa,r '~efi! days. ~co,",fided iln a Imllighlbolf wiho','d beernUnmlJlgjh ~lhe sa me '1111 iflg .. My h l!Isball'i'ldand ~ wal1lit", tOU I1Iselliil'ilg and Ipalb:l'iled il up. IL.aJ~,er ~ lealrt1led 1m)" j'·confid,ante" ha:d!splrea;d~lhe wOlrfilalt'Oul1ld. N~ow Irhirnlk. lewryOI'ilE! is,t:alilkiiirwg about.

me. l'tm(uriQJI!.I~· iilll1Idiso 'emibanais5edi, Iwaln'~ b) move. H:o,w :slholuld ~ It"€!;f)ct

REO-FACED

.Dear R'ed,

8elliev,e me, they aren't all ·ta~k~~g about. you~. Your Il1leigjhbor"s bet~.y,al OOFnPOUIIli abed you r huslbalF!ldls-but beclear about which one is sti[~ IU psett~ng~ 'You .. G,o back to, tlha.'t 'CQUIfiISe~Or and sort this thing out. It tha~ Ipatch w~th your husband! is really Ihloldillng. you don't Ihlaveto sweat the pe:ttyta Ilk,.

78

Q He.-.lP settle~. dispute betwe.:-en _ my mother-in-Iaw and me, W'bat's properetiquettel Do you have to. wricea note if you. thank :!H)meOne in p erso.f1 fo.! a gift? ]

s ayno.! M'l' dear sweet m-in ~l is okl school, She says, ''Youha:ve to send a t:ba.flk~you. letter whether or not you have kissed, hugged and said

tha.riks."Wh.o's right? ~EW S(:rlOOL

A- Dear NeVII';

Wh.CIl in doubt •. go old school, No civilization ever collapsed because people' were too civU!'

Q W'e~~ave a house rule: 1'401

_ smoking=and we mention it when. folks come over. Twice now we've invited new friends to parties and afterward smelled smoke in the' bathroem; I'm sure It's the wife of thenew ceuple, Llike her and don't want to' be confrcntaticnal. Shocld I installairplane smoke alarms in

the batbro omsr 5M 0 KE C I!.O U DS

A- Dear CJouds.

Without busting yow' new friend, give her one more shot, Next time she COlTIes over, make it a. point to showhera p].ace outside: where a smoker ntigl~l comfortably sit. If she doesn't get the hint and you. ~hl detect .smoke in the bathroem, stOlP the invltations andmeet her ina smoke-freecafe,

:Questions' a bout p.a:,rent,~. pal'tl';M::rs or offi:oepoUdcs? .E~n'l:C1 it J e,atl:~l,e .Mar,ie r.clskas at ,(101,) ice.@rd.ctJm:. Sanding gi'\i,e.o;~u~~ perrn:iss~on ~D' edit ,and pubUsh.

QUOTABLE QUOTES ~

What Washington needs is adult supervision ..

Quoted by BARACh( OIJAMA

Ambi ion is the path to success. Persistence is the vehicle: you

arrive in.

WHLIA M EAR OLE ... IV

S0l11e are born qreat, some ac h i,~,!,e U!leatness and some hire PR officers.

JAMES ROLLINS ~n Black Order (Marrow)

I

: If there is anything that is important

DANIIEL 1I. BOORSTIN : to America, i.t is that you are not

a prisoner of the past.

A simple way to take the measure i of a country is to look at how many :

. ~'h u

want tn .... antll .. ow m.an}" want out. n

u TON~ BLAIR n b

I arn olld enouqh _ to know that a red carpet is just

a rug.

One day Twoke up! an,d I was the oldest

..

person In every

room,

a) JOohn M,cCai:n

b) George W: Bush

c) B.ill Clinton

Your critics bave Information that your friends are wi thholding,

MARK DEMOSS ul Til'! LJlltlt::! R'oo Book of Wtsdlom (N'.olscn SulSinoss)

Always focus on the front windshield and not the rearvlew mlrror, COLI fill PCY/E,U

Are you hurting? Here's help.

BY MICHA,EL JI. 'WIEISS

Ouch, that ad>lng back!

If you'v,e ev,er moane d 1[1 agony from backpaia.rest 8ssured~';dbeh unaQm~ fo(tably-thatyo~ 're notalone, Alb out eight .in~en Amerieaas will sutler from it at some point in their lives. After colds, it's the No!, ~. cause 0,[ missed work. It's a rna] 01' drain on the! Amerioan e\co,n!o,m:y~ costing m,ore tban $:90 bill ion a year in me d icalb ills, Yet a cure for the commonbackache is as e lusive as ever:

Part of the problem is the comp,~,e)rity of d~!e :$pin!2',amira:cul,ouSstfux~~ ture of bone an,d cart i]age that surrounds nerves linking the: brain to the rest of the body. Thelewerbaek, .caUed the lumbar region, 'b earsmost of a person's weight em five vertebrae s;ep2lIr~:ted by disks d1Jat wurk like ,sbock absorb erstc prcvideeuslaioniag aad flexihUity. Musdesan,d Ug~e.]]J.ts sup-

ply further support. But 'Over time', the effecrs of aging deerease bone massand muscle ,elasticity~ and OOl'J!tribute to disk

de8lel1er:.atl.().n~~!eavilt1Jg the~owerb~:ck Vllhl,era.bleto [njury-,and. millloas of people susceptible to pain.

Back pain can. originate from .many sources, and trearments are [ust as varied, fro,m conservative approaches like exercises and massage, to. more

. k .. .J.. d

"IS -y prescrrprron Iii]J.,ellllCatlons an- .

surgery. Un:[pi.ftl,;mate].y fo,:r ffij.any pa ~ tients, these choiees often provide oruy temporaryrelie f~aDd some have debiHt~lthrug aide effects .

But the search for a Itl.ag]C bullet con:tinues:~and we .may be ·d:ose:r than ever. Doctors and scientistsare repOl:ti[!lg success with these newand coming-seen treat ments that can ease back pain fer some sufferers while o.f[eringl%ope' to all,

New IN,!Ultro,.stiimul:atotr

Barbara Sweeney's back hurt for 2,0 years. The 63-ye31'-old hospice

.... 1If. '" 'pc, 1-"""111 "l·· .... "lm-1 ·5-····]-1-·· .. "1' '5- n .. ~]·"""~J

\"'J[lu .• '~~ . .Il. ~:. ,v. ,'_" ;._, , 'If PG , , 'Jt",.!J.!. ·;!J·JOii!

Maryland. hadb sen on. an agonizing odyssc'y of docmrsvlsirsand

83

Mloretlhan 25% 0'" adults Ihave had IOlwe,r

hack pai n :i n the past three months.

RD I JULV 2.007

tf{~atrnent8 . ['aiukilleltS , physical ther.apr, epidural shots, even methadone:

Sweeney had tried themall, getting Iittle relief In. 200() neusosurgeon s diagnosed her eonditionas stenosis, a. narrowing of the spinal canal, which pinches thenerves, Over the nextfive ye.ars.she underwent two spinal fusions to. relieve the stress on herback nerves. But instead of].astmgirnprove·_· ment, Sweeney experienced new pains. and her doctors

WC'l'C mystiflcd,

Ha.ck pain [lad grad!:naBy taken over her life. She could noloeger stand up straight wltbout hurting and neededa ca11C to walk. "I feU Iike ] 'd grown old before 111 y tlme," she' sa.ys. "I'm a .. fighter, but it was hard not to get depressed .. ~'

Then, in the fa]] of .200'6. she' heard about

ai'pain paeemaker;" an implantable device iotroch.u::edby Me crt ronic i111'9i69 ana. mo deledafter Us heart pacemaker. Over the years, the company had refined the device, f().rmally known as a neu:rostimuJ.ator,. by making it Increasingly smaller and. .].o.[Iger lasting. One of its latest mode] s, die Re:storeAdvm1ced neurcstimulatcr, em, operate for rune years with a battery reehatge only once every four to six weeka The size of a. pocket watch, the device: works by sending mild electrical impulsesalong the spinal cord, blocking pain signals to

g4

the brain_j'~'Wflre still not sure why stanularing nerves provides n~.]i:d~ just that it does," says Richard. Kmltz!MD~ president of .Medtro.rolc Neuromodulation in Minnea.polis.

'With her options dwindling, Sweeney scheduled a. pacemaker implantation last February, Zachary Levine, MD"a neurosurgeon with the Wa.shington E:ral]]. & Spine Instirute, made a two-inch incision In Sweeney'S

righthip, where the neurostimulater was implanted. Through a smaller in cis iOrl iu the midd]e of her back. Dr. levine delicately fed alead with eight electrodes 'to points alongher spine, and down to the device. WiH'I Sweeney sedated.bur still responsive, Dt. Levi De cha tte d. W lth her to pinpoint where the neurostimulatorIe ad provided the most benefit, 'Within an hour, DE. Levine dosed the last st itch, and Sweeney experienced something she hadn'tfelt in decades: weJJ~being". "The relief was immediate," Sweeney says.uThep.ainwa.sgone·,."

Since th.en, she has dn~o'Wn .away her cane .. SbJ'.! now sleeps through the night, and in the spring; she, started a water eserclse class. ~'I fe el like a new woman," she says. "i I'm finally able to do· things IC:Qildd[l~t do for years," She pauses, carefullypatting ugentle swelling in her lower back.'~This Ut-

A Better Back?

N EIUROST~MIUILAIrDR The small I batteryap@omlt~d d@'v;~ee Stern ds mnd e.~ectlfiC:fiI,1 tlmtpulses ,13110111& the SI~l~11I e, b~oGIk.ing, plain s~g)~allsto the bra·~n.

MAGI c $PiNli: WANlO The ~S'lJ rgica ~~ech ni que pereuta neou s cH5kect:eIFl1~ mas Ib~~n campa:red to, reJe~5i ng alr frerna bu ~g;itng Urn,.

t)isk l'iulJcllel.!ls,--+":"

Herniatedi d itS!K Pif1!9'5Se5 OIF! II'H~r!fJe~'r eGlusitnl pain.

FLEXIBILE IfiUSION

Jhe DYin.esy.s :sysb~m':!'ii Hec}tible Ipl~.stic 'tubing provIdes stab~esuppolrt ,and! g~e,alter meilJlemelnt.

Probe rernoves excess tlssue to Fe Il'i eve pressere,

INf'RA,RED 'B1:!lT ---------'"'1, The lJLJ mtbar WIr.ap IU,5/El'5 ~ll1Ifr'03r,ed he~t to imllPr~ve b[mod dr-culi'!:l,tion and promote hea,llling.

Inflralj,ed de'''''j,ees

RD I JULV 2.007

de device," she says, smiling broadly, "turned out tobea miracle,"

Iinfrarred Bel,t

Infrared r.ays were discovered in 1800. but it took another two centuries to figure out how to harness their power to reduce back pain, The Lu mbar Wrap, created by Canadian insen[or Lawrence Gordon of IRWraps" resembles the black support belts worn by people who frequently Uft beavy loads.

The' device uses low-level infrared energy-the same type of heat used, to warm foo d. in resta uraats-eto imp.rOV!E: ]:']000 cireulatioa and promote healing, 1]1 a S]:lHUl study In 20()6, researchers at the Rothbart Pain. .M,an,agement Clinic in Ontario found that the Lumbar Wra.p reduced painful symptom shy half

The 39 adults in the study, who. had. suffered. lower back pain for mere than. six years! found relief'wlth daU.y the'rapy over the course of seven weeks, and reported de{;rea.sing pain ]evelswhe:n turning and bending in d]ffe.rent directions, Go.rdcm invented the belt after hurting hisown back While training horses, and says iQitlru.er back pain sufferers have felt better wearing the belt while sleeping or doing daEly activities.

One potential side effect: Prolenged use cancause a relatively harmless browning of the skin, And at $2}35~. the Lumbar Wrap isn't cheap ..

G orciOD:) is trying to get his: invention, approved asamedieal device in. Canada and the' United States, in the'

<B6,

hope that it willbecome more widely available, through doctors, chiropractors and pain clinics,

The M1agi'c Spi'lne Wand

Scientists estimate ·""·~'1I~'t· ab "'i"'r :7· mil-

LJ~. L .. )L. ~ Il.. _' L i;I . jnll..,.\; . ., L[.!lLIl. ~ !C_~., "oJ U.t, ....

lion case's of Iower back pa.in are caused. by strain or inJury to spinal disks, often striking weekend warriors who overdo it when exercising Of t aekling Jsome improve rnent pre]ects, 1[1 th.e past, treating disk-relarad pain involved physical therapy or epidural steroid in~ ections to reduce lnflamrnatton, For serious. cases of herniated, or "slipped," disks, patients resorted to 5U:fg'el~y, despite the hazards of infection and. no guarantee of a, cure,

While! some patients win. still need surgery, doctors have been developlng Iess Invasive methods to. reduce painful disk pressure on. adjacent nerve roots, One of the most advanced decompression techniques! percutaneous ruske'ctomy, involves removing a. s.ma]] amount of tissue from the disk nucleus threugba tiny puncture in. the skin. S orne compare it to releasi riga1r from a bulging' tire. Doctors can choose from. severafrecenrly introduced probes, The Stryker Dekompressor scoops out disk material througft~.a needle.creating a space that draws the disk back to its normal alignment, The .ArtbroCare' SpnleWarJld sends out an ele etrlcal charge that creates a [,igh]y focused plasma field to vap ori ~e and extract t i S$ ue.

With either instrument, the procedun:' lastsless than an hounand pa-

Each ye1ar, _

200,000

Almelricans 'with disk disease underqo spinal 'fusion surge:ry'~

tients can go :hom.e: with OiIllya sma]] bandage over the needle insert ion site. Best of all, at Ieast two-thirds of app.rop,ria~e,].y selec ted. pat ients experie nee pcsitive results,

';'The relief isinstantaneou 5:," says Nets ere' Tesfa:yoh"i;ul11es I M D, direcror 'Of the Inrervantional Pain Management Center at G eorgetown University Hospital ill Wasb:ington" D.C. ~'You know right ,away whether the treatment has w'oirked.'~

E::Ic~!Ii year, some ::mo,ooo Am,ericans with deg,e!'o.e,mt:ive disk disease undergo spinal Iusion surgery. The IP rocedure st ahilizes the vertebrae wlrh ,m~l:aJ rods and screws to allow a bone gtaft to fuse the vertebrae together.Jr can provide dramatic and Iong-term reHef. But there's a price ... Spinal fusions Hm.it a patient's range of motionandcan require follow-up surgery to allevlate stress: on the vertebrae adjacent to the fused area,

But a new process called tbe D1-' nes)fs Dynamic Stabilization System. uses bendahle materials to provide SUPP(H:'t and greater movement, The: system consists of flexible- plastic tubing that surrounds ,0, cord and spacers. During 'the :sul'gE!'ry, doctnrsatrach the device to both sides of the affec ted vertebrae'. "The goal is to restore sta-

bililE¥, while preserving motion," says Re'gillalid Davis, MD, head of neurosurgery at Greater Baltimore .Med:icaJI. Center, who's performed the surge.ry more [han 2001 times. "I've had suecess with patients from 21 to 75.n

Thee Dy,n:esys SystCIU was approved for spinal fusion by the FnA in 2J(1(l'4, but ill Europe .. where the system has b een on tbe market for a. dozen ye ars, it's most: comm.only used to provide:

ftexib]e stabilization G,f

the vertebrae without bone fusion, Dr. Davis h,3S Joined a study-involving 400 U.S. patient s todetermine it S effectiveness for this use. He hopes the, study win show the system's a bility [0 res rore natural cnnvem,ent~without the need fo·r :fonow~up surgery. "In EUIOP e/' says Dr; Davis. "the n~w mantra for treating back pain is, Refuse to fuse,"

stem Cel!ls tal the 'R,eseu!

.Man.y therapies for degenerative: disks treat only the sy.mptoms,. not the cause of the back. pain, Butat England's University of .Man.c[lester, Stephen Richardson, MD. has proposed a radical and promising approach: using the patient's own stem cells to createa healthy back. Developed in COInjunction.with German biotechnology company Arthro Kinetlcsandan English medical charity

,B7

RD I JULV 2.007

caned the Spinal Foundation. Dr, atednew tissue, And that would be Richardson's therapy uses bone mar- ita fot Iife,"

rDW cells ro regenerate damaged ln-

tervertebral disks. Doctors would. Grow a New Bac:icbo'ne

extract and mix the Dells With a special gel that's based 0[1 a type of human, collagen and then Implant the: 8UD5[anCe' during minimally invaslve surgery, The stem cells should the'.]), produce new disk tissue with. the same properties as rhe original .• but without the damage.

~~Itjscomp]etely safe

because' we're using the patient's own stem. cells," sa.ys Dr. Richard.s;OIl,who, is .9. researcher in the Unlversity of Maaehes tel School of .Medicine'~s division of regeneratlve m.edlcine .. "The patient cm.dd go home the same day (If the procedure."

Researchers hope to start clinical trials after two years an dbringa product to m,a:rket within. five years (though others think it win take longer). D r; Richards on believesthe stern ce]l technique ··will revolutionize the treatment of lower back pain'tby addtessing b oth cau ~e and symptoms. with one 1I:.herapy, rather than consigning sufferers to a lifetime of painkillersand physiotherapy.

~(Wh,at weenvisi on is a one-stop sh.o'p for treatment.v he sa.ys.I·You.!d. come in, get these cells imp]an.ted into. your spine, and end up with rege ner-

.Many e]dedy people experience hack pain from nsteoporcsis and seriO:US' bone fractures. But what If frail bones could grow stronger=as strong as new bO'D:e?' That's the Idea behind site-directedbone growth '(SDBG), A patient with diseased. or damaged ver-

tebrae undargoe S; a m1ni.maUy invasive outpat le n t procedu re arsd reeejves an 2IInabolic GIfUg: roaceelerMe natural bone growth at precise 10- cations. The s trengt hened Jicne, in turn. lessens the backpain,

"The novel Idea is [,0 target new bone to. specific sites," says Agnes Vig:nery, PhD, a professor of orthopedie surgery at Yale Unive.l!'Sity :Me:dical Schoo] who de"eloped. snsc with cliniclans at Unigene Laboratcrles in Fairfield, New Jers1ey. '·.:Most drugs affect the whole !body. nut our treatment increases bnne mass just where' it's needed,"

Already, investigators have demonstrated successwith SDBG in eXil?e:ri.~ meats hwo.lvingmioe' and rats.In :2,005 'the Unigene team flled for patents, with plans to start cli])ica] trjals involving humans in dJ!'~ nexttwo ye'ars. And though Vlgneryrefuses to speculate how soon the therapymay be

,4,4Im:iIHon Anerieans have, or are at risk of osteoporosis, a common source o'f back pal n

ready for people, she's excited about SDBG~sIPQtentia] toremedya wide array of ailments,

It.'s, Alii iilll VDlur Bed

If all e]se faBs or involves toomaay needles for your liking, considergetdng yourself a better bed. A study by researchers a,t Oklahoma State University found. that simp]y getting rid of a worn-out mattress CQiU]d. significaatlyreduce back pain. and stiffness. A scientific team led by Bert jacohson, EdD, reports that peoplewho suffered from back painexper-ienced relief by switching to a. new MaUTe 55 ,. and t[lIat the relief CQi.nl111ued .kmgafter acq ui riD:1l:g the new bed ..

"Most people treat their mattresses ] ike a rented mule," observes Jacobson, head of the Schoo] of Educational StudIes, "They'll sleep on a. bed long afrer the supp orr h as given. out. W~ found a [positive relationshipbetween a new mattress and. lower back. comfort"

In the' 2,006 study. Jacobson's ream examined 5'9' men and women of an agesfor four weeks with their old mat-

tress, and foul' more weeks withnew O'Iie5. Thien the researchers tltIJalyz.ed the: particlpants' daily assessment of their back diSCOlufort,s.plll€: stiffness. sleep eomfort and s]ec'p quality. The subjects reported improvements in each.area when the:Yd slept on new, medium-firm mattresses. Those who entered the' study repor ting the highest levels of back pain experienced thegreatest improvement.

W11.J1e it: sounds like eheerleading from bedding companics=-and the study was part]y sponsored bya trade group, the Internatlnnal Sleep Products Associat]oI1~acobson points out that theresearch ·wa.S approved by a university review board and Insists that the findings stand up to. scrutiny,

~4Here's a possibili tyfor relief with ~ out taking drugs, havi ng surgery or getting manipulated," says Jacobson. "And all you need. to, do. is trade in your oldbed," That's the kind (If painle ss trea tment rh at anyone c an take lyin;g dow n.

Wi4D !Listen to ,expert. ad:vice about back palin .iEII~ mou~loud.~oom.

YOU IHAVtIEW'U~GS~ DON'T YOU?

When you:r last name is Ang"CI.,you hear aU the j ekes, Once, .m't wife and I dropped into a chapel for a ClllP of tea ..

Aftcrwarci,\i\?ecaJHed aCiiI:b .. A hiillf· hour later, it finally pulled up,

"Sorryabout the dd;;'lY," d~.e delver Salin. "But when m read the message left on 11l1Y board, I thought it was .;;1. hoax.

llit said, 'Pick up two angels: from the

Mcll::l~o d ist ch!.u:ch:'" D'Av II [,'I ,., N GE Ii.

89

RD I JULV 2.007

c:n::HIER. sunlight fen a t a sharp angle down the steps of

I the Wise County Jail as J eny Wood walked. to his car.

The defense ]awye·r had just finished meeting a. clientinside. The prison was clauserophoblc, and it had been a long workweek .. lie wanted some t ime to unwiadaad decided '~GI take a country road home toF'o.rtW(n~th, Texas, 40 miles southeast.

Wood wore his hair 10 rig andwas a bitofa maverick, more flambcyanr than the l1S!U2l:l ,courthouse attor [I ey.

left, trying to keep control of the car, Too, late. TIle right frone tire hit gurvd, on the shoulder, and the Chryslerskidded, fishtailed and new off a steep. wooded. embankment.

The car didn't tnmble; but whirled round and round like a ride at .9. county fair, cutting Ihrough the treetops. Then it slammed into a ravine 30 feet below, lending o.n it s wheels,

Wood f ound himself sprawled in the backseat. his Iegs stretched nver thecollapsed driver's backrest, He looked around in the dusk-y light. AJl the windowswere shattered, and the doors on. the driver's sidewere caved in. Tbemof had collapsed, and g].ass

IHe felt pressure at the base of his neck,

Even after 25 years 011 thejob, he had a penchant for 6ghting]o,5t causes.

£twa.s about 6:30 on .0. warm evsning wh.en Wood got behind the wheel ofhis gold Chrysler Concorde, D usk was settling over the-rugged terrain spotted witb!]ive oak, mesquite andcedar trees along Route PM 4. Wood ,e.rJIJo,yed the e'ady changes in the fill fo.liage. He'd hunted these hills withbis two son S m.any times.

Now Wood steered through. a sedes of'curves on the remote road. He r.eached f~)rhis ceU phone to cal] his wl!e.MoUy~ a criminal court judge-in 'Iarrant CO'!Jll'ty;. But the call didn't go. through, and be tossed the phone onto. the passenger seat At the same Instant. something, maybe a white~tailed deer" darted across the road, Wood jerked the steering wheel right" th:ec]'],

9.2

and. debris were littered everywhere. The car was totaled.

A tWl)~fo ot~loI1lg limb a bout an inch thick ll:~Ul,g in frt),nt ofbim, Wood tried to shove it aside, but it dldn't reove, He' pushed again and feltpressure at the-base of his neck. He ran ah and up the splintered branch, whichwas lodged between, his collarbones :il], the fleshy spot at the base of hls throat He tugged at it, but it wouJdn't budge. Incredibly.he felt no pain .. Using both hands" he pulled harder .. This time, he gagged. The stick was embedded about an inclr and a half deep, close to the carotid arteries and [ugular veins, which carry blood to and from the brain,

Wb10d didn't panic, Ye:flJrS in the courtroom had taught him to move methodically, He' never claimed to be

the sharpestlawyer; but he: made up for H witl:l. a cool head. and a. deliberateapproach. He rememb ered 2iJl. old ]ock-b].ade huntingknife he kept In the ear's console between rbJ.!2' seats. Awkwardly he Ie aned forward and. found the. five-inch blade, Tbelimh was thick, but maybe he could. pry it out.

I can do this, he. thought He steadled the' stick with his ]eft hand and, holding the blade with his right,. began. to probe the $oftf[,es:h purse d. tig,bdy around the branch, He to okabrcatlr, I can do this.

Woodpus:hed the knife tip in and under the Urnb. After several minutes in exquisite pain, h~~d made no'

Tonight~ for somereason, she was 21P~ prehensive .. She'd ]eft several messages for Jerry over the last two hours. Now it was past 8:30 on that Friday evening, and he still hadn't responded. It wasn't likeh:im.

5bJe dialed his cell ph.O'[Ie again. and again. she got only his voice mail, "Please call," she said. "I need to know you're okay."

Molly drove to a restaurant where hel'husband often gathered with friends .. No one had seen. him. She called two of biscolleagues, but they hadn't seen him elther; She called his mother, his two 50n5· and some neigh- 11) (;H~:sno, one kn~w wh~:re he was.

A stick was embedded ln hi's throat.

progress. His pulse was racing, his breathing]ab ored, his hands uns ready. He had to do sometbing more.

He g,ripped the knife by the 113n.dle and worked the: blade up against the' braneb, With. one' firm thrust, he plunged the honed steel Into his rhroat.at the same time ]erking hard om. the limb. It ripped free=followed instantly by a jet ofblood,

My God, I've killed myself, Wood. rhouglet, m.ood covered the steering wheel and front seat, Dizzy, hype:rve·.a-' t ilating and nauseated, he tugge d up his Fshirt and pressed it into the gapj ng wound .. Theis he. pas sed out.

MOlLY JC)IN.ES. W'o nd's wife of just over a year, W1lliS; not one to worry, She'd seenalmosr everything during her tenure as a. criminal court judge ..

By 10 p.m. the red. brick Tudor hcuse Mony and Jeny sharedbegan to fill with friends and fnmj].y: "Something bad has happened to Jerryt she told them.

SOME,'I'IMIE:APT:ER losing eonsciousness, 'Wood awoke. Appa.re.])t].y the T~shirt had helped stanch, the bleeding. Hlsbreathing had. calmed ... The darkness of the backceuntry enve].oped him .. He' tried to stay calm, to get hi s be a rings . But he reali zed that thecar was;fiUed with. the pungent smell of gasoline'.

He panicked. He' werked his .sL~-Ioottwo-inch frame throughthe shattered rear window, flopped 0[1 top of the trunk lid. and droppedto the grQ'lmd. He hurl an over. Th!c o.nly comfortable position was on. his hands and

93

RD I JULV 2.007

knees. When he lay down, d1JC: pain in. his chest worsened.and each time he exhaled, he: felt flesb flapping at the wound. Fina]].y he dozed off.

Around midnight! Woodawokeam.d ]oo,keci around. Darknesabred fear. There were predators m, these 11i1]s. Gas:o]ine or no, he decided the car was a safer place to sleep, fighting pain, he crawled back inside.

Here were the facts, he reasoned: It W'a.S; dark, He was too :fa.lf off '~lrue mad and. hiddenby trecsandbrush, No one expected him to take thisroute, and n 0 one weul d, be searchi ng th i So area, It was up to him. to save himself

He groped for his ,ce.IJ phone and used its lIgbt to Iook around. the car. An he found was some chewing gum, wlaichremarkably did wonders for his parched throat .. He dug through the console, hoplng to also find 'm- 'I ~ tch "',!": '!I'~' e h ad ." pl '" n,· A:'I" d · .. ~,·1 ight

'_,. ,ulL· !l;;,...i;Ii~J .nlL . (;~.'~. ~~. _,'" .U~.:IJ •... 1. __ C~'1 ... il, :1L. l.,~

if he heard Cal's passing, he'd ignite; the g21S0Ulle andtorch the car [:0 attract attention, But there were no. . matches,

T .D.A.WN ON Sarurday, Wood awoke. In the meming light. he could. dead.y see his predieament, The carw,a.s hedged in. on every side by dense underbrush, splintered cedars and thorny mesquites, He: could hear an 0 cc asional car passing on the road above. He yelled outjbut his: ba.ritone. eoartroom-trained voice was now barely a whisper,

He levered himself back out of the'

94

car andlooked around. The logical path seemed tobe threugh the swath of trees he'd .. mowed down. He shuffled offat an angle. pushing the brush aside. After justa few steps, it hurt to breathe, hurt to walk, hurt to lift his arms.

It took a loeg HIDe befcn;e:h.e reached a barbed-wire fence ncar the bottom of the embankrnent, TI:w fence was no more than four .lC'c ....... c]] "'-:- .... It .] . · k - d reer ~.~t, IIJU~. 1.:QO.e.

likea castle wall to him, Ailel! struggling for over an bour, he fmmda spot to craw] under without ripplng himself Th.~11 he started IIp a steep in ~ cline to the road,

The slope was covered in loose r ock as sHppe.ryas ballh earjngs . Using his hands and feet.Woo d tried clawing up the Incline. Time and again, he slid down on his belly; Scratched and scoured. comp].ete.].y spent.he began to bake in (he sun. He needed rest, and the only comfortable place was: in. the car, As the a.He,rno on shadows lengthened, heeler himself slide back down unde-r the fence to. his refugee.

IB-"" ~il- 'i' 'ii"!o'-A- - r.Yjj··~E -[" ""00' '~, the " .... "'.,,'" at th I""

...1: i\ .UL> . - ..• .' J1. 0 ~ •• ". • _ ''', .m.",,;;. ""0".0;:;, .... 0;;; "'< ~.[ . .,.

home of Molly Jones and Ierry ¥lo od was one o,f conrrolled bedlam, A h.uge

search thatincluded frieflds,iamjJy, helicopters and law enforcement offli-' cials from several dep ar tments was under way; A U.S. marshal, using a. computer system, was tracking Jel',ry's eel 1 phone transmissions.

Two. friends laad visited theWise County Jail, where' Wood was last seen. They viewed the surveillance video. of his coming' and golng.aad interviewed the client Wocdhadmet. After 24 hours, th,~ywere no closer to' fincHng him.

Clouds, raIn and fog moved into. tile'

region as n ight fell.l~olly! su rrounded !by friends. was ]osing hope. f,~We']J find him in themorning," CU:1C told her. Molly wasn't sure they would,

A f'Th-· W' d

~- ..... --~ -" '''-'''-'''',r.,.- .'",: ,- -'~ '--'~-",- "',; ',"'~--:-

:r ,]Jl~ ,BOITOM 0 tne ravme,oo

settled, in for another night, His strength, was flagging, and he'd just

95

RD I JULV 2.007

disco:ve:redhbod in bis urine. Tumor:row he'd have to' :Iin.da way out or [is~ dying of intern a] bleeding;

At daybreak (Hl Sunday hepainfully twisted his way out ofthe car yet again. and decided to try another route up. He'd go dght-the brush was denser, the terrain more dHficuJt ~bul: heb e.~ lieved the: h:ighway sloped downhill In that direction, If he could push through far en.ollJgh. the road andthe )j'.avl]"JJemIght intersect.

Wood found a shattered five-footlong tree U.m.b to. use as a walking stick, He set out and eventually made' his way to a flat expanse noc farbe:]ow the level of the road, leaning on his stick, be fumbledacross it and then inched up the last few yards OIl. his stomach. Atlast he found himself on the shoulder of the roadway itself .. He was cotany spent, but he thought, At least iff] die here, they 1]. find my body:

Several vel;idesp.as.s,sd, and .finally a man in a shiny, clean. truck pulled over, Maybe Woo dwas delusional, but

covered in dirr and blood. he refused to get inside and. scil the man's pickup, He slid onto the tailgate and sat there while the .man drove to. Pa]o Pinma town fhurmiJes aW':ary.He:'dmad.!2 it.

'W" '0 '""'D' "'.)"" ........ [ ni .... I"'· davs at H"'·,·· .. ·;'"

.... ·u. "'~ .<:.1" . . .. U . .:; . "".,!' "". ,n . ,,,, .. L.".'~

Methodist Fort Worth Hospital, where he was treated. for a, punct ured lung, five broken ribs, a. separated shoulder anda two-inch gas .. h. (0. his neck. nearbis larynx. Tlrebranch and his knife had narrowly missed his carotid arteries,

The ordeal had some subtle consequenees, Once: home, Wood found hehad recurring nightnaares, but they gradually faded as he gained strength,

"I'm a criminal defense attorney. I knowhow important hope is:' Tenacity andhls methodical approach had enable d him to survive .. And. in a Few weeks, he. was back tohis rcutine-« goi.n:g to. court,m.eeting clients In [ail, fightinghop eless causes,

U)IVE IS Jl. M.AINY ICKY TIHIING

HClviug tro:uble"\)\1ith ,amOfjr? Ask these kids:~thcy'vc' ggt ;!t .aUfigw·ed Gut. Q! How do you. decidewho tr'Omi!lrfY?

A: No one re;ilJ[ly decides before they grow 'Up. God decides it an way befere.and you get to find out larer who you"re stuck with, htRISiHN, .1'0

Q; What do you think YOllT morn and dad have in commoni A: Both don't want any mo re kids,

LORI, :B

Q; What demest people do on a date?

A: On. the: first date, they Just tell each other lies, and that usually gets

them interested 16110U:gh to go fora second date. MARTI N, lQ

A stray' bottle, rocket blinds a child.

Whol~s to bllame?

Be

BY RO[HN GERBER

street, She brought ,along herseven-yearok[ gtandson, Brandon Keith,wh.o was vlsiting from New

O· ... lea -_ '.r...:;a.rJJS.

By the time everyone' had arrived, the Petersons' tradltional bonfire was, beginning to. blaze in the fron t yard .. Later that evening; the younge'r kids waved sparkk:rs. But the high] ight of the bash came when. everybody; children Inchrded, set off the Fireworks. Thefim lasted until shortUy after midnight, when the [party came toa close,

FOR YEARS, Kennon and Betty Peterson tbrew Zi, partyat their house In Pi cayune, ,Mississippi. on New Year's Eve. But that t radition w,ou]d end

in tUlgedy~ Before the

bash one Y'ear~Ken-

non b ought a large

supply of fireerack-

erscbottle rockets, Roman candles and aeriru. sparklers from nearby Joey's Fireworks. The Petersons also asked. their gueststo supply extra firewnrks for the night'sfinale,

Among the neighbors invited was M.m:y McMiJJcn, who livedacross the

97

I LU}$TFilA.T'E 0 BY:$ COT r M EN(::H IN

RD I JULV 2.007

.,"L . "' ..~, ..] .L ne next mornmg, trash covered

t.h e Petersons ~ yard. The revelers had als o dropped unused and spent fireworks: all over the property. Betty's sister, Mae Langston, helped Kennon get rid of theme 58. throwing trash-> and some fireworks that had

neverbeeaIir-einto the still smoldering bonflre. Luckily, none

of them. ignHed.

In the mean-

time, two of the Petersons' sons, a.ges eigh t and '" seven, played in

the ya.rd wlri]e Betty took care of their oneyear-ol d SOi'], inside the house,

Brandon Keith.who bad stayed overnlght at :hls grandmuther's, asked her if he could go. to the Petersons' house, She said he eould, SiO, said BlrlUlda:n1 be asked Betty if ir was okay' for him to pla.y in, her yard. Brandon said [hat when he gother permission, he joined the Peterson boys in. their game of hide-and-seek,

Betty Peterson testifiedtlrat she didn't know Brandon was p.]ril.yil1g in the y.a:rd. Kennon knew that his sons wen: In the yard,but he didn't keep track 0'£ where they were, He aJso didn't know that Brandon had. Joined his: sons,

When it was his turn to hide, :Or,aJJJ.-

donran to. the far side of the thick hedgerow thar Iined the Petersons' ddve\ilifl:1'Y~ .Mome:D1ts late:r, Kenno.n happened to see .Mae .f,oolmg aroundwith tile unused bottle roekets, She picked one up, lit it and. tossed it high in

, the air. The rocket flew up

and. across the dr.ivew:ay~ falling behind the , bushes where Bran-

98

don was bld.h1Jg.

Within seconds, the adult s heard a child. scream, and they looked around

. fusi 'N

"' 1]1 COfllllSlon. . .. 0-

bo,dyrea]ized that one of the children had been hiding behind the, shrubbery .. The' bottle' rocker bad III t Brand 011 in his righT eye ..

Betty rushed Brandon and his grandmcther to. a hosp ital in Picayune, where they wereunabte to. get help, After picking up Brandon 's mother, MkheUie, they then drove to. Children's Hospital in

New Or]eans, where an eye doctor referred them to nearby Ch.ari.ty 1-']08- pital, Doctors there finally operated en the boy. But it was too Iate, BIm~ don.lost sight in theeyepermanentlj;

Miebelle Keith took the Peters ons to court, .. arguing that the party throwers s,boiwd havebeen more cauHOllS with the dangerous fireworks on, th eir property. She claimed the

·The rocket felll behind the bushes, and w~thi III seconds, Brandon b,egan

-

sereammq,

Petersonashould have known that chihlteti and fireworks don't mix. Bet ty Pererson was aware that Bnu'JJ:-' don was in the yardrafter all, the litt]e boy said he'd asked her permission to play there, She also knew that fite~ 'works were scattered around tbe property and that the other adults were looking for them.

Thls volatile comblnadon should. have put the couple on notice thatan accident could happen. Miche]le Keith claimed, and that U1.C childrenshould have been kept a safe distance from all'llY ursexploded fireworks. She ah:.o saidthe Peterscns willfully engaged. in dangerous behaviorby th:lro,wing ignitabJe fireworks em the' smo]dering fil"e~alld by [aB:in:g to warn M,3.e:

Verdict

llhe Case of the Bottle [Rocl~et

TUE Tru:t.'!..LCOU1~,T in Miss,issi'pp~ d.eID. erl~].n. ed ... that .K ...•. en. no.,. i.iIl a.n. .. _ d Beuy Peterson could be held

HOlMe if they had consciously disregarded ,3 . known serious danger and had done sometbingreckless that causedBrandon harm ..

.B1J:tt theweight ofevidence was inthe Petersons' favor.Kennon was unaware that Bl'atldo:n was On the property, and he had no way of knowmg Mae would~glli[~e areeket, The Petersrmshad notallowed the c.bUdren to detonate fireworks at the p.ar~y w lthout superv l;slol.n 'O'[~O pl"ay wifh them the day after:~urtbermore, onl}!' the aduns wer,e responsible Fo[ finding and disposlng of the firewerks. Under the eircumstancegthe Mj sSis,sip]l]

v,au IU. TH.E. JUDGE.

langston. to safely dispose .of any fireworksshe found ] 11 the yard .. Brandon did nothing other than take part ina game of hide-and-seek, but because of the Petersons' negligence, heIost half his sight forever;

The Petersonsargued that Brandon's injury was a. tF2ti.gicbut nnforeseeable accld CIJJt. N either Een non nor Betty had any idea that Mae' langston would set off.ar.ocket. They also didn't know where Brandon 'was hiding-« nor did. Mae, .fo,r that matter. They argued theyhad exercised due care by h.avlll1g adults, [lot the' chlldren, search for the fireworks,

Shouhj tile p.~tersons be held Iliable for 8randon's acddent? You '8e the Jud~ge ..

court fOW,l:d. that the Petersens had no liabi~.ty for the ace ident,

Postscript: Mic.h:ene Keith also sued Mae Lang$ton~br her son's injuries-> and won a judgment of$3:5'O,O(]O because .lmngst:o!l didn't showup fer

the '1::J!.eadng and couldn't belocaeed .. M~chelle .Keith never collected! ,any money .Foir her son's injury

'99