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MsC1210

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  1. Impaired Gene Helps Nonsmall-Cell Lung Cancer Resist Drug 03 Oct 2006 Lung cancer cells with a defective version of a potential tumor suppressor gene are highly resistant to attack by a platinum-based drug commonly used to treat the disease, researchers at The University of Texas M. D. Anderson Cancer Center and The University of Texas Southwestern Medical Center at Dallas report in the cover article of the Oct. 1 edition of Cancer Research. The gene may provide a potential biomarker for selecting among chemotherapy choices for non-small-cell lung cancer as well as a therapeutic target for restoring the drug cisplatin's punch in treating resistant forms of the disease, says senior author Lin Ji, Ph.D., associate professor in M. D. Anderson's Department of Thoracic and Cardiovascular Surgery. Researchers at the two institutions, working under a joint National Cancer Institute Specialized Program of Research Excellence (SPORE) in Lung Cancer grant, have identified three tumor-suppressor genes on chromosome 3. The latest paper refines the impact of one of those genes, NPRL2, on the most common form of lung cancer. "NPRL2 has potential predictive value for care," Ji said. "If a patient's non-small-cell lung cancer lacks an active NPRL2 gene, then cisplatin likely would not be a suitable chemotherapy." Researchers started by analyzing NPRL2 expression in 40 different lines of non-small-cell lung cancer. They found that 21 lines expressed the gene and of those 15 lines were sensitive to cisplatin. The other 19 lines had little or no expression of NPRL2 and 15 of those were cisplatin-resistant. Follow-up laboratory experiments with resistant cell lines showed that NPRL2 expression with cisplatin drastically limited cancer cell proliferation and increased programmed cell death (apoptosis) of cancer cells by 2 to 3 fold. "We also demonstrated in a mouse model of human cisplatin-resistant non-small-cell lung cancer that gene therapy to restore NPRL2's function makes the tumors once again sensitive to cisplatin," Ji says. The team packaged a molecular NPRL2-producing machine called a plasmid expression vector in a nanoparticle - a fatty sphere so small it's measured in billionths of a meter. The nanoparticles are injected into the mice, find their way to tumor cells, bind to them, and the NPRL2- producing plasmid cassette is taken up into the cell, where it expresses the gene. Mice with a human form of cisplatin-resistant non-small-cell lung cancer who received both the NPRL2-nanoparticles and cisplatin had a 90 percent reduction in tumor volume compared with those treated only by cisplatin alone or by a combination of cisplatin and control delivery systems. The overall number of tumors was 67 to 77 percent lower in the mice who received the gene therapy/cisplatin combination compared to those in the other groups. Ji said research continues on the possible mechanisms by which the gene kills cancer cells in combination with cisplatin and the gene's normal role in DNA damage repair and apoptosis. Interestingly, mice treated with the gene therapy nanoparticle alone showed a 40 percent reduction in tumor volume and a significant reduction in number of tumors. Research also suggests that the NPRL2 tumor suppression pathway operates independently of the p53 pathway, a major cancer detection and destruction pathway that is often disabled in cancer. Ji said additional preclinical and toxicity studies in animal models have been planned to develop a treatment protocol using the NPRL2-nanoparticle plus cisplatin for future clinical trials in lung cancer patients. ### Co-authors with Ji are first author Kentaro Ueda, M.D., Ph.D., Hiroyuki Kawashima, M.D., Ph.D., Shoichiro Ohtani, M.D., Wuguo Deng, Ph.D., and Jack Roth, M.D., all of the M. D. Anderson Department of Thoracic and Cardiovascular Surgery; Murali Ravoori, Ph.D., and Vikas Kundra, M.D., Ph.D., M. D. Anderson Department of Diagnostic Radiology; and Jim Bankson, Ph.D., Department of Imaging Physics; and Boning Gao, Ph.D., Luc Girard, Ph.D., and John Minna, M.D., of the Department of Internal Medicine and Pharmacology, Hamon Center for Therapeutic Oncology Research, The University of Texas Southwestern Medical Center. Research was supported by a National Cancer Institute SPORE grant, U.S. Department of Defense TARGET Lung Cancer Programs grant, W.M. Keck Gene Therapy Career Development grant, M. D. Anderson's Cancer Center Support Grant, and a grant from the Tobacco Settlement Funds appropriated by the Texas Legislature. Contact: Scott Merville University of Texas M. D. Anderson Cancer Center Article URL: http://www.medicalnewstoday.com/medical ... wsid=53148
  2. Hello and welcome I am sorry you had reason to find a site such as this but glad you have posted and told us about your dad. I have no real advice but wanted to say hello and let you know that this is the best site for finding information, advice and tons of support and hope. Let us know how we can be of help, whether you just need a place to vent or need answers to questions. We are here for you, Chris
  3. Hello Mike and welcome I have no answers for you but wanted to say hello. Please keep us posted and let us know what happens with your mom. Sending prayers that the spots are nothing to worry about. Chris
  4. Ry, I am submitting your announcement to the 2 local papers in Berkshire County, Massachusetts. Thanks Chris
  5. Bobby I heard someone on the radio this afternoon make a statement. It went something like, we HAVE to endure the bad times and things in life in order to fully appreciate the good. What your sister is going through with treatments, the cancer itself is the bad, definitely. Think positively that for all the pain and the ill effects from the chemo is simply the road she has to take to beat this disease. The good will follow. She is so very fortunate to have you in her corner. Her faith and great attitude are such a plus in this fight. All of what you have described as feeling now is so completely understandable. I believe that most everyone here will tell you the same thing; we all have that roller coaster ride of emotions. It comes with the territory. Please keep posting, let us know how your sister is doing and how YOU are doing, too. We are all here for you. Chris
  6. Hello and welcome I cannot add to the good advice that you have already received here but wanted to welcome you and say hello. This is a great source of information and support. I am glad you found us. Chris
  7. MsC1210

    New to this board

    Hello Jill and welcome, I am so very sorry to hear about Joe. I can relate to pretty much everything you are saying and feeling. My friend Brad was diagnosed last September and gone by December, 3 months from the dx. I think I am still in shock almost a year later, but I can tell you, the pain does get bearable. Like you, I really thought there would be much more time in one way or another. Please continue to post, let us know how we can help you through this. Know that we are here for you, 24 hours a day and will do whatever we can to ease this sorrow for you. My sincere condolences to you and Joe's son. Hugs Chris
  8. MsC1210

    about my dad

    Jodi I am so very sorry about your dad. Please know my prayers and thoughts are with you and your family at this very difficult time. My sincere sympathies and condolences, Chris
  9. Major Cancer Study Aims To Identify Protein Markers For Early-stage Disease 02 Oct 2006 A team led by Bay Area scientists is one of five nationwide to receive a major grant from the National Cancer Institute (NCI) to refine and standardize the technologies for identifying biomarkers in the blood -- specific proteins, and the patterns they make -- for the early detection of cancer. The grants, which signal the NCI's strategic shift toward studies aimed at early detection of cancer, are designed to lead to the discovery of many such biomarkers, the scientists say. The grants have been issued under the NCI's Clinical Proteomic Technology Assessment for Cancer program, part of its five-year Clinical Proteomic Technologies Initiative for Cancer. The team is directed by Susan Fisher, PhD, UCSF professor of cell and tissue biology, director of the UCSF Biomolecular Resource Center Mass Spectrometry Facility, a member of the UCSF Comprehensive Cancer Center and a visiting scientist in Berkeley Lab's Life Sciences Division. Co-principal investigators are Joe W. Gray, PhD, associate laboratory director for life and environmental sciences at the Department of Energy's Lawrence Berkeley National Laboratory, UCSF professor of laboratory medicine, and co-leader of the breast oncology program at the UCSF Comprehensive Cancer Center, and Bradford W. Gibson, PhD, a professor and director of chemistry at the Buck Institute for Age Research and UCSF adjunct professor of pharmaceutical chemistry. The team also includes key co-investigators at California Pacific Medical Center in San Francisco, M. D. Anderson Cancer Center in Houston, and University of British Columbia in Vancouver. The team will work to establish the best method for conducting mass spectrometry in the context of cancer biomarker discovery. Mass spectrometry is a technique used to detect and measure the precise molecular weight of proteins. A critical second step will involve consolidating the data and analyzing it, with the goal of piecing together the fragments of proteins identified in the research into recognizable molecules, and identifying patterns of proteins within given blood samples. The need to standardize mass spectrometry is great. Currently, the technology produces varying results in different labs. Research in one lab may suggest certain proteins are associated with a given blood sample, while research in another lab may point to other proteins. The capacity to detect proteins in fluids is of intense interest to cancer researchers because cancerous tumors "leak" proteins and other molecules into blood, urine and other accessible bodily fluids early on in their development. This knowledge is already being applied in the clinic: Elevated levels of prostate specific antigen (PSA) hint at the presence of prostate cancer, while elevated levels of cancer antigen 125 (CA-125) suggest possible cancer of the ovary or other organs. However, both tests have "false negatives" or "false positives," making them unreliable. If mass spectrometry can be refined and standardized, scientists say, it could revolutionize the detection of cancer and lead to earlier interventions with current therapies -- surgery, radiation, chemotherapy and targeted drug therapy. The technique could also be used to monitor a cancer's response to treatment and to detect the recurrence of cancer after treatment. "This is an extraordinarily exciting endeavor," says Fisher. "We truly believe in this project, and that it is going to help people. We think that the methods we're proposing will work." The UCSF component of this research initiative will be carried out in two phases. Initially, scientists will study blood samples from mice that have been transplanted with human breast cancer cells. Later they will study blood samples from patients with various stages of the actual disease. The researchers will focus specifically on a phase in protein development known as "post-translational modifications," which occur after the code for a gene has been translated into a protein. Initially, the protein is a "naked scaffold," says Fisher, but over time it becomes decorated, much like a Christmas tree. This is the stage of "modification." It is known, says Fisher, that cancer cells decorate proteins very sloppily. "We want to use this knowledge against cancer cells," she says, "working to purify these poorly decorated proteins so that we can identify them as biomarkers in blood samples." Analyzing the complex data produced by mass spectrometry using advanced computing techniques - a science known as bioinformatics -- will be critical for making sense of the information, says Fisher. Part of the challenge will be the need to piece together data on fragments of individual proteins, rather than whole molecules, a result of a limitation of mass spectrometry: The instrumentation is not able to weigh an entire protein. The protein must first be cut, with an enzyme, into pieces. Once enough pieces of the puzzle are inputted into the database, it is expected that order will appear. The result could be the identification of biomarkers associated with early-stage cancer of the breast. ### The UCSF-led grant is funded for five years at approximately $1 million per year. The start-up funds that enabled purchase of the instruments were obtained through a grant from the Sandler Family Foundation. For more information on the NCI's Clinical Proteomic Technology Assessment for Cancer program, see: http://proteomics.cancer.gov//. UCSF is a leading university that consistently defines health care worldwide by conducting advanced biomedical research, educating graduate students in the health professions and life sciences, and providing complex patient care. http://www.ucsf.edu/. Contact: Jennifer O'Brien University of California - San Francisco Article URL: http://www.medicalnewstoday.com/medical ... wsid=52918
  10. Hello Donna and welcome I am sorry to hear about your fathers recurrance. Please let us know how we can help you out along the way. There are so many great people here that are more than willing to offer up some great advice and loads of hope and encouragement Chris
  11. Hello Joe and welcome So nice to meet another survivor! Chris
  12. New Cancer Drug Extends Life For Lung Cancer Patients 01 Oct 2006 Lung cancer patients treated with an experimental new drug lived over a third longer than patients treated with standard chemotherapy, according to data released today. The phase II study, carried out by UK biotech company Antisoma plc, looked at 70 patients with non-small cell lung cancer (NSCLC), the most common type of lung cancer. Patients treated with AS1404 on top of standard chemotherapy lived over a third longer (14 months) than patients treated with chemotherapy alone (8.8 months). This is one of the largest increases in life expectancy ever seen in a trial adding a new drug to chemotherapy in NSCLC. Looked at another way, patients getting AS1404 had a 27% lower risk of dying during the period of the trial than those who received chemotherapy alone. Lung cancer has one of the lowest survival outcomes of any cancer. In England and Wales around 25% of patients are alive one year after diagnosis and this falls to 7% at five years. There are over 26,000 deaths a year in the UK from non-small cell lung cancer. Safety data from the trial were also encouraging. The addition of AS1404 to chemotherapy was well tolerated. These findings extend the positive data announced at a major US cancer conference in June 2006 (click here to get PDF file), which showed increased tumour response rates, longer time to disease progression and enhanced survival. Antisoma plans to begin a phase III trial in lung cancer. Dr Mark McKeage of the University of Auckland, New Zealand, one of the principal investigators in the AS1404 lung cancer study, said: “It is great to see this large survival benefit with AS1404 in lung cancer patients. This makes me feel very optimistic as we proceed into phase III testing.” AS1404 is a world leader among a new class of drugs called Vascular Disrupting Agents (VDAs) These work by selectively destroying established tumour blood vessels, thus cutting off the tumour's blood supply. Solid tumours rely on a network of blood vessels to survive and grow. AS1404 is able to distinguish between the tumour's blood supply and that of healthy organs (the capillary network is more permeable and less well organised than that of healthy tissue). It acts directly on the lining of the tumour's blood supply. The lung cancer study is one of three phase II trials of AS1404. Positive response data were recently announced from a trial in prostate cancer and encouraging early data have been presented from an ovarian cancer study. Antisoma is currently in talks with a number of companies with a view to licensing AS1404. Commenting, Glyn Edwards, CEO of Antisoma, said: “Survival is the gold standard by which cancer drugs are judged and this news is therefore very exciting.” Antisoma disclaimer Certain matters discussed in this statement are forward looking statements that are subject to a number of risks and uncertainties that could cause actual results to differ materially from results, performance or achievements expressed or implied by such statements. These risks and uncertainties may be associated with product discovery and development, including statements regarding the company's clinical development programmes, the expected timing of clinical trials and regulatory filings. Such statements are based on management's current expectations, but actual results may differ materially. Background on AS1404 AS1404 (DMXAA) was discovered by Professors Bruce Baguley and William Denny and their teams at the Auckland Cancer Society Research Centre, University of Auckland, New Zealand. It was in-licensed by Antisoma from Cancer Research Ventures Limited (now Cancer Research Technology), the development and commercialisation company of the Cancer Research Campaign (now Cancer Research UK), in August 2001. CRUK had supported two phase I studies in the UK and New Zealand. Background on Antisoma Based in London, UK, Antisoma is a biopharmaceutical company that develops novel products for the treatment of cancer. Antisoma fills its development pipeline by acquiring promising new product candidates from internationally recognised academic or cancer research institutions. Its core activity is the preclinical and clinical development of these drug candidates. Please visit www.antisoma.com for further information. Background on the trial The AS1404 phase II trial in lung cancer was a randomised controlled trial which enrolled patients receiving first-line chemotherapy treatment for stage IIIb or IV non-small cell lung cancer. Patients were randomly assigned to receive either AS1404 plus standard chemotherapy (carboplatin and paclitaxel) or standard chemotherapy alone. Seventy patients were evaluable for efficacy, 34 of whom received AS1404 plus chemotherapy while 36 received chemotherapy alone. The trial was conducted at hospitals in France, Germany, Australia and New Zealand. Background on lung cancer According to the latest figures available, there were 37,699 cases of lung cancer in the UK (Cancer Research UK incidence figures for 2002). In the UK, 33,044 patients die every year of lung cancer (Cancer Research UK mortality figures 2004). There are two main types of primary lung cancer which behave and respond to treatment quite differently. They are: -- small cell lung cancer (SCLC) -- non-small cell lung cancer (NSCLC). Of all lung cancer patients, 80% will have non-small cell lung cancer. Non-small cell cancer There are three main types of non-small cell lung cancer. Sometimes it is not possible to tell which type someone has. This is because when the cells are looked at under a microscope they are not developed enough. The three types are: Squamous cell carcinoma, which is the commonest type of lung cancer. It develops in the cells which line the airways. This type of lung cancer is often caused by smoking. Adenocarcinoma, which develops from the cells which produce mucus (phlegm) in the lining of the airways. Large cell carcinoma gets its name from the large, rounded cells that are seen when they are examined under the microscope. It is sometimes known as undifferentiated carcinoma. (CancerBACUP). Phase 1, 2 , 3 and 4 trials There are four phases of clinical trials. Phase 1 (phase I) These are the earliest trials in the life of a new drug or treatment. They are usually small trials, recruiting anything up to 30 patients (often a lot less). Phase 1 trials test out new drugs or treatments in humans for the first time. Phase 2 trials (phase II) About 7 out of every 10 (70%) new treatments tested at phase 1 make it to phase 2 trials. Phase 2 trials are usually larger than phase 1 (around 50 people). If the results of phase 2 trials show that a new treatment may be as good as existing treatment, or better, it then moves to phase 3. Phase 3 (phase III) These trials compare new treatments with the best currently available treatment (the standard treatment). Phase 3 trials are usually much larger than phase 1 or 2. This is because differences in success rates may be small so that there is a need to have many patients in the trial to show a difference. Often phase 3 trials involve many hundreds or even thousands of patients in different hospitals and countries. Phase 4 (phase IV) Phase 4 trials are done after a drug has been shown to work and has been granted a licence. The main reasons phase 4 trials are carried out is to find out: More about the side effects and safety of the drug; What the long term risks and benefits are; How well the drug works when it's used more widely than in clinical trials. http://www.antisoma.com/home.asp Article URL: http://www.medicalnewstoday.com/medical ... wsid=53052
  13. New Roche Web Site Features Latest Clinical Information For Oncology Healthcare Professionals 28 Sep 2006 Roche, a leader in oncology medicine and research, announced today the launch of a new, state-of-the-art Web site for oncology healthcare professionals. RocheExchange.com/Oncology is a virtual, one-stop-shop for the latest, scientifically balanced clinical information about Roche oncology products, professional and patient educational materials, and peer insights. A new Web destination, RocheExchange.com/Oncology is the first phase of RocheExchange.com, Roche's comprehensive Internet portal designed exclusively for healthcare professionals. The portal is designed to support the medical community's commitment to maintaining the highest standards of patient care by providing them with direct access to recent, relevant and credible medical information at their convenience. "As a leader in oncology, Roche is committed to providing reliable, cutting-edge clinical information that will enable oncologists to deliver the best possible care to their patients. And, we know that oncologists overwhelmingly prefer using the Internet to access this vital information," said Lars E. Birgerson, Vice President of Medical Affairs, Roche. "With the launch of RocheExchange.com/Oncology, healthcare professionals now have a comprehensive, 24-hour online resource on Roche products and research that houses the medical information and educational features they seek." RocheExchange.com/Oncology was developed to address the dynamically changing clinical landscape in the field of oncology by providing information in real-time. Designed based on input from the oncology medical community, the site includes current Roche oncology product information, a comprehensive, searchable database of product research; breaking oncology news; professional education, including continuing medical education (CME); and downloadable patient education tools. Roche also offers a Web site available to the general public with information on its clinical trials, http://www.roche-trials.com. RocheExchange.com/Oncology also features PUBMED, a searchable medical journal resource, and live news feeds from the Doctor's Guide. As an added convenience, RocheExchange.com/Oncology can be customized to fit specific user preferences and needs, and is a unique resource that is easy to use and accessible to all oncology healthcare professionals, including physicians, nurses, pharmacists and medical technologists. About Roche Hoffmann-La Roche Inc. (Roche), based in Nutley, N.J., is the U.S. pharmaceuticals headquarters of the Roche Group, one of the world's leading research-oriented healthcare groups with core businesses in pharmaceuticals and diagnostics. For more than 100 years, the Roche Group has been committed to developing innovative products and services that address prevention, diagnosis and treatment of diseases, thus enhancing people's health and quality of life. An employer of choice, in 2005, Roche was named one of Fortune magazine's Best Companies to Work For in America, one of the Top 20 Employers (Science magazine), ranked as the No. 3 Best Company to Work For in NJ (NJ Biz magazine), the No. 1 Company to Sell For (Selling Power), and one of AARP's Top Companies for Older Workers. For additional information about the U.S. pharmaceuticals business, visit our websites: http://www.rocheusa.com, http://www.roche.us and http://www.RocheExchange.com/Oncology (for medical professionals only). Roche http://www.rocheusa.com Article URL: http://www.medicalnewstoday.com/medical ... wsid=52858
  14. Hello Guy and welcome, So sorry you had reason to find a site like this but glad you have posted. I am not able to offer much in the way of advice, but as Katie mentioned, please read through the other forums, especially the SCLC and SURVIVOR's. You can find a lot of great information as well as HOPE in those. Please keep us posted and let us know how we can help you through this. My thoughts and prayers are with you and Debbie and the children, Chris
  15. MsC1210

    Nice!!!

    Maryanne, Wonderful messages in this, thanks so very much, Hugs Chris
  16. Hello Tracey and welcome I am definitely in agreement with the others advice here. I think waiting this long if your MIL is in that much pain is a bad idea. Please consider a 2nd opinion. Keep us posted and let us know how we can help you further. This is a wonderful group of people here with lots of warmth and compassion as well as information. My best to you, Chris
  17. MsC1210

    I'm Buyin'

    Congratulations Kasey Wishing you all the best for continued good reports Chris
  18. I received this today and wanted to share it in case it is applicable to anyone here. Chris New Warning Added to Avastin Cancer Drug Genentech Inc., the maker of the cancer drug Avastin, had added a warning to their label stating a possible link between a brain condition and the use of the drug. The company states that less than .1% of patients have developed symptoms of reversible posterior leukoencephalopathy syndrome (RPLS). Avastin is a monoclonal anti-body used to treat colon and rectal cancer. It is given by IV infusion, generally every two weeks. If you are currently taking Avastin, talk to your doctor about the risk of developing RPLS. Although the risk is slight for most patients, it is a concern for many. More information about Avastin
  19. Hello Donna! Great news!! So very glad to hear this, Chris
  20. Chris Just adding my thoughts and prayers, Chris
  21. Hello Laverne and welcome Sorry you have reason to find a site like this, but glad you have joined us. I am sorry, I have no answers for you but I am sure you will continue to get a lot of great advice. Please keep posting and let us know how we can help. Chris
  22. Welcome Marianne Glad you have joined us. You will find a lot of great people and advice here. Let us know how we can help. Chris
  23. Combining Targeted Therapies for Thoracic Cancers Name of the Trial Phase I Study of Romidepsin (Depsipeptide; FK228; FR901228) and Flavopiridol in Patients with Advanced Primary Lung or Esophageal Cancer, Malignant Pleural Mesothelioma, or Lung or Pleural Metastases (NCI-05-C-0010). See the protocol summary at http://cancer.gov/clinicaltrials/NCI-05-C-0010. Principal Investigators Drs. Dao Nguyen and David Schrump (Protocol Chair), NCI's CCR Why This Trial Is Important Romidepsin is a new anticancer agent that belongs to a family of drugs called histone deacetylase inhibitors. These drugs can turn on genes in cancer cells that regulate cell growth and induce cell death (apoptosis). Unfortunately, the protein product of one of the genes activated by romidepsin, called p21, also interferes with the drug's ability to induce apoptosis. Researchers think that combining romidepsin with other anticancer drugs may improve its ability to kill cancer cells. The drug flavopiridol has been shown to have a weak anticancer effect. However, when administered to cancer cells treated with romidepsin, it suppresses the expression of the p21 gene and increases the anticancer effect of romidepsin. Laboratory studies that combined romidepsin and flavopiridol demonstrated that the combination was up to 10 times better at inducing apoptosis in lung and esophageal tumor cells than either agent alone. In this trial, patients with advanced thoracic cancers (cancers of the chest) or other cancers that have spread to the chest will be treated with romidepsin and flavopiridol. Researchers will study the safety of this combination, and how these agents affect gene and protein expression in these patients. "Based on our preclinical studies, we believe that combining these agents will dramatically improve the cancer cell killing power of romidepsin in thoracic cancers and potentially in a broad range of solid tumors," said Dr. Nguyen. Who Can Join This Trial Researchers will recruit 48 patients aged 18 or over with advanced lung cancer, esophageal cancer, malignant mesothelioma, or nonthoracic cancer that has metastasized to the lungs or pleura. See the list of eligibility criteria at http://cancer.gov/clinicaltrials/NCI-05-C-0010. Study Site and Contact Information The study is taking place at the NIH Clinical Center in Bethesda, Md. For more information about this trial, call the NCI Clinical Studies Support Center toll free at 1-888-NCI-1937. This call is confidential.
  24. Thank you all for the kind words. Randy, Denny is my "insurance policy" as my 18 yr old son has recently enlisted in the military. All his life he has always wanted a Dachshund and so my way of making sure he will always return home safely was to get him his little dog. Denny will be "moving in" with us this Saturday. He is 7 weeks old. In my mind this made perfect sense. Thanks for mentioning it. Take care all, Chris
  25. Gwen Well I had neglected to mention, either here or in the PM I sent you to remember to INHALE, EXHALE and repeat, lol. I am glad you got out of the house and away from it ALL for a few minutes anyway. It does help to stand back from it all and remind yourself that sometimes you just have to take things a minute, hour or day at a time. Definitely not easy, but it IS do~able. As for the collection agency/paypal? UGH. Stand your ground is all I can say. I think you are on the right track with that!! Let me know if I can help, Chris
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