On Sat, 30 Dec 2000 10:16:35 -0000, "Christine Glen" <christine.g…@btinternet.com> wrote: >Don/Gary >Thanks for this. It isn’t the same as the stuff I’m on, which is called >Flixonase Nasules (basically Flixonase is the UK name for Flonase). It’s a >liquid that comes in pre-measured amounts(in squeezy ampoules), and you >squeeze it up your nose, and adopt a kneeling-with-forehead-to-floor >position for five minutes. This manoevre too is supposed to increase access >of the drug to the frontal sinuses.

That is very interesting.  It is a slightly different drug and delivery mechanism, but still exactly the same idea of delivering liquid or partly-liquid steroid to that tricky hard-to-reach frontal area by bending over for 5 minutes. Actually I am very interested to find out that those ampoules exist.  They sounds like an excellent approach to deliverying the drug to the frontal recess and sinuses. > I’ve had it prescribed for severe polyps >combined with sinusitis in my frontal recess and sinuses. It’s supposed to >reduce the size of everything prior to a fifth ESS in January. We’ll see!

A fifth surgery- that is sad that you have to go through with it.    Very best of luck with it!

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Don Brady <dbr…@pobox.com> wrote: >He said Flonase can be more irritating.

I am using Flonase right now. What is this other spray you are talking about, and how do spray it in, then get upside down because I don’t know how one sprays upside down.

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On Sat, 30 Dec 2000 21:40:59 GMT, Mike D <gojun…@mail-.com> wrote: >Don Brady <dbr…@pobox.com> wrote: >>He said Flonase can be more irritating. >I am using Flonase right now. What is this other spray you are talking >about, and how do spray it in, then get upside down because I don’t know >how one sprays upside down.

Dr. Kennedy suggests Nasarel if your sinus openings are currently open. Otherwise he suggests Nasonex, if they are not.     Flonase should be ok too, but he just said it can be irritating. These are all nasal steroids that are mostly very similar, though.  The choice of one over the other is going to be a second-order issue,  I think. Different otolaryngologists seem to have different views on which one is best. Personally, I trust his experience and judgment. To a degree, I think it may also depend on which sinuses are in what condition. In my case, he did a complete  spheno-ethmoidectomy, (-ectomy means removal), including removing all of the bony ethmoid/sphenoid partitions, so I think he is not too concerned about the sphenoids and ethmoids any more.    And the maxillaries (cheek sinuses) are clear and open now too.   Actually all my the sinus openings (even the frontals) are wide open now.    He actually makes sure they stay open by very frequent follow-up visits in which he keeps pulling off scar tissue that forms etc. until it is stabilized.  I have had a *lot* of visits (I am almost starting to feel sorry for the insurance company!).    If, in your case, they did not give you frequent enough visits to keep them open until they healed, I personally think that may be (or border on) medical malpractice.   Maybe the medical director of the Otolaryngology Clinic on the University side would be someone you could talk to about that. But they cannot easily do direct surgery on the frontal sinuses, so they are hard to fix if they are affected.   Mine are – I have frontal sinusitis too. In some people, the sinusitis has not reached the frontals and sphenoids yet. By leaning over for 5 minutes after spraying, with a partly liquid spray such as Nasorel, you can let it start to work it into the frontals, if the ostia are open.  Probably the same for the ethmoids and others.  If you lie on a bed, you can at least spray sideways to a degree if not upside down.  I think the FAQ has some notes on irrigating into the frontals that may explain better.  It would be a bit different but based on the same anatomy.

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Everyone is different. I have allergies also and I stopped taking antihistamines. My allergist said they only work on the symptoms anyway and don’t do anything to help my sinusitis, so I just don’t take them. I don’t like the way they make me feel either. Barb

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> let my allergist talk me out of it last time I saw her she likes >Flonase. I have tried it for six months I don’t.

I don’t like Flonase either. It has a perfume in it that smells bad and drives me nuts. I use Rhinocort aqua. It seems to work great, no perfume or bad taste/smell. Barb

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On 30 Dec 2000 04:07:50 GMT, collgra…@cs.com (Gary) wrote: >My opinion is it is one of the best steroid anti-inflammatory sprays. It comes >in a pump spray it  is actually Fluinsolide hope I spelled it correctly at any >rate it is liquid. I hang my head upsidedown for about 5 minutes after I use >it,.

That is very interesting that you also do what Dr. Kennedy suggested – hanging the head upside down to roll it into the frontal sinuses, provided they are open.  (If they are not open, he suggests Nasonex instead). Did you learn this head down manoeuver  from the U. of Pennsylvania or somewhere else? >I let my allergist talk me out of it last time I saw her she likes >Flonase. I have tried it for six months I don’t.

He said Flonase can be more irritating. >Hope that helps.

It is very helpful to get feedback from others.

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Don/Gary Thanks for this. It isn’t the same as the stuff I’m on, which is called Flixonase Nasules (basically Flixonase is the UK name for Flonase). It’s a liquid that comes in pre-measured amounts(in squeezy ampoules), and you squeeze it up your nose, and adopt a kneeling-with-forehead-to-floor position for five minutes. This manoevre too is supposed to increase access of the drug to the frontal sinuses. I’ve had it prescribed for severe polyps combined with sinusitis in my frontal recess and sinuses. It’s supposed to reduce the size of everything prior to a fifth ESS in January. We’ll see! Christine

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My opinion is it is one of the best steroid anti-inflammatory sprays. It comes in a pump spray it  is actually Fluinsolide hope I spelled it correctly at any rate it is liquid. I hang my head upsidedown for about 5 minutes after I use it,. I let my allergist talk me out of it last time I saw her she likes Flonase. I have tried it for six months I don’t. Hope that helps.

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On Sat, 30 Dec 2000 00:02:33 -0000, "Christine Glen" <christine.g…@btinternet.com> wrote: >Don >Excuse my ignorance, but what is Nasarel?

I did a web search and found http://www.pslgroup.com/dg/5FC6.htm among other hits. >Is it a liquid version of flonase? >Does it come in a squeezy kind of ampoule? I’m wondering if it’s the same as >something I’ve been on for the last month or so (which is called something >else).

Actually it is still a nasal spray much like the others. However, Dr. Kennedy says it stays partly liquid, and that I can lie face down on the bed afterward for 5 minutes and roll it into my frontal recess/sinus, which is the most difficult to reach otherwise and also the hardest to heal. He only suggest Nasrel for those with patently open sinuses. If they are closed, he suggests Nasonex.

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Also here is an excerpt from Dr. Tichenor’s site http://www.sinuses.com/faq.htm#180 ====================================================== Can I use antihistamines to treat sinusitis? Under rare circumstances, antihistamines are used, but only if allergies play an especially prominent part in the symptoms. Because of the fact that antihistamines tend to be drying, we usually try to avoid them in treatment of sinusitis. The mucus in the sinuses may then get dried out and is plastered up against the wall of the sinuses. The bacteria love it because they are trapped inside the sinuses with nowhere to go. They reproduce like crazy and since the mucus is dried out, a blockage in the small drainage canal can occur and so mucus remains inside the sinuses. Unfortunately people feel better initially because the volume of fluid in the sinuses initially is reduced, but eventually symptoms return. ========================================================

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Don Brady <dbr…@pobox.com> wrote: >Also here is an excerpt from Dr. Tichenor’s site >http://www.sinuses.com/faq.htm#180

Thanks Don. I woke up today itching a lot on my head and neck. It stopped after an hour. I definetely am sensitive to something but I am not going back on zyrtec. I feel much better today than I have in a couple of weeks. My nose doesn’t feel as dry and tender. I think that zyrtec was really bad for me. I have an appointment with an allergist so I feel good about that.

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Don Excuse my ignorance, but what is Nasarel? Is it a liquid version of flonase? Does it come in a squeezy kind of ampoule? I’m wondering if it’s the same as something I’ve been on for the last month or so (which is called something else). Christine – Hide quoted text — Show quoted text -Don Brady <dbr…@pobox.com> wrote in message > For people with open ethmoids /frontals, Nasarel was recommended instead by U. > Penn’s Dr. Kennedy,  since it is partly liquid and can be allowed to wash into > the frontal recess.

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I stopped taking my antihistamine this week. Today is the 3rd day. I stopped on the recommendation from people here. I was worried about drying out my sinuses, especially now that I have a nasty infection. I am a bit unsure about the whole thing. I have seasonal allergies so I know what an allergic reaction feels like. I just don’t feel that now. I do, however, feel some itching in my skin, mostly on my face and head. I have sneezed 6-7 times, nothing unusual. Don’t really know if I need the antihistamine or if it really hurts me when I do use it. If it’s harmful what will I do this spring when all the pollen comes? Seems like there is a downside to everything. Should I ask my ENT for NasaCrom? Should I start back up on the antihistamine but be sure to use saline nose sprays 4-6 times a day? Will that prevent drying or what? Thanks

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On Fri, 29 Dec 2000 00:55:00 GMT, Mike D <gojun…@mail-.com> wrote: >I stopped taking my antihistamine this week. Today is the 3rd day. I >stopped on the recommendation from people here. I was worried about drying >out my sinuses, especially now that I have a nasty infection. >I am a bit unsure about the whole thing. I have seasonal allergies so I >know what an allergic reaction feels like. I just don’t feel that now. I >do, however, feel some itching in my skin, mostly on my face and head. I >have sneezed 6-7 times, nothing unusual. >Don’t really know if I need the antihistamine or if it really hurts me >when I do use it. If it’s harmful what will I do this spring when all the >pollen comes?

From what I gather nasal steroid sprays are the best control for nasal allergy symtoms.  If you use them, you should not need anti-histamines. Anti-histamines have other side-effects too. In ternms of nasal steroid spray, I was told that Nasonex is less irritating than Flonase. For people with open ethmoids /frontals, Nasarel was recommended instead by U. Penn’s Dr. Kennedy,  since it is partly liquid and can be allowed to wash into the frontal recess. – Hide quoted text — Show quoted text ->Seems like there is a downside to everything. >Should I ask my ENT for NasaCrom? Should I start back up on the >antihistamine but be sure to use saline nose sprays 4-6 times a day? Will >that prevent drying or what? >Thanks

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I just went to my ENT for a follow-up to my sinus surgery in August.  2 weeks after he removed the stint from my right frontal sinus I began having headaches and earache again.  Today he did the scope thing and said that my sinus is blocked again.  It was scar tissue before and probably has grown back.  He is perplexed and I am beside myself with frustration.  Has anyone had this problem before? Sherry

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Hi Sherry, Unfortunately, post-surgical stenosis of the frontal ducts can happen to patients with severe chronic frontal sinusitis. Some patients are also more prone to scarring than others. I am experiencing exactly the same problem. Some surgeons prefer leaving the stents in place for a longer period of time in hope that the mucosa will heal more completely before removing them. However, I have heard other claims that the stents themselves can cause inflammation as a foreign body. Was the drainage adequate with the stent in place? The modified Lothrop procedure is another alternative where the inferior floor of the affected frontal sinuse(s) is completely drilled out endoscopically and the posterior septum taken down if you have bilateral disease. The inter-sinus septum is also drilled out in the process to join the two frontal sinuses together creating ONE single large opening. However, studies have shown that this surgically created oversized ostium can also gradually close off with time. Besides obliterating the frontal sinuses when everything else has failed, there doesn’t seem to be a mutually agreed surgical procedure to deal with recurrent frontal sinus blockage. The frontal sinus obliteration procedure is an external procedure that is much more invasive and morbid than functional endoscopic sinus surgery and carries its own risks in the long term. I would obtain a few more opinions from reputable sinus surgeons as to your next step. Cheers, Michael Muloin Vancouver, BC, Canada Sherry <sschn…@hsonline.net> wrote in message

news:37fd5496$0$79682@news.hsonline.net… – Hide quoted text — Show quoted text -> I just went to my ENT for a follow-up to my sinus surgery in August.  2 > weeks after he removed the stint from my right frontal sinus I began having > headaches and earache again.  Today he did the scope thing and said that my > sinus is blocked again.  It was scar tissue before and probably has grown > back.  He is perplexed and I am beside myself with frustration.  Has anyone > had this problem before? > Sherry

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>I just went to my ENT for a follow-up to my sinus surgery in August.  2 >weeks after he removed the stint from my right frontal sinus I began having >headaches and earache again.  Today he did the scope thing and said that my >sinus is blocked again.  It was scar tissue before and probably has grown >back.  He is perplexed and I am beside myself with frustration.  Has anyone >had this problem before? >Sherry

Hi Sherry, I recognize this problem. This doesn’t happen a lot, but mostly due to removing too less tissue in the first place. My guess is your ENT was "too" careful in removing what was necessary. Wim

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Is anyone aware of a procedure where silastic stents (flexible plastic tubes) are inserted into the patient’s frontal ducts during surgery, after the surgeon has opened or widened the natural canal?  The special silastic stents are apparently left in place for a period of 6-8 months to prevent post-op stenosis (closure) of the frontal ducts and allow drainage from the frontal sinuses until the healing is complete. I have spoken to a sinus specialist at the Georgia Nasal & Sinus Institute claiming that the success rate using stenting on selected patients with frontal sinusitis is quite high. The headaches are also alleviated. I welcome any comments or personal experiences regarding this procedure. Regards, Michael Muloin Vancouver, BC, Canada

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Wow, does this sound like it may have possibilities!!  After all, stents have been so successful on so many other avenues.  Where is the place in GA, please?  Or, do you have any further info about the who and where aspect? Thanks, Susan – Hide quoted text — Show quoted text -Michael Muloin wrote in message … >Is anyone aware of a procedure where silastic stents (flexible plastic >tubes) are inserted into the patient’s frontal ducts during surgery, after >the surgeon has opened or widened the natural canal?  The special silastic >stents are apparently left in place for a period of 6-8 months to prevent >post-op stenosis (closure) of the frontal ducts and allow drainage from the >frontal sinuses until the healing is complete. >I have spoken to a sinus specialist at the Georgia Nasal & Sinus Institute >claiming that the success rate using stenting on selected patients with >frontal sinusitis is quite high. The headaches are also alleviated. >I welcome any comments or personal experiences regarding this procedure. >Regards, >Michael Muloin >Vancouver, BC, Canada

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I have heard of this procedure….from my ENT, who was going to consider something like that if I needed it…turns out I didn’t have frontal sinus problems on my CT scan, so I didn’t ask more about it or try to research it any further (I had my hands full researching what was going to be done with the other procedures!). I don’t recall him saying that the stents would stay in that long, though. Sounds like an interesting concept.     I did have FESS in May — with GREAT results…feel better than I have in years….but didn’t need anything done with the frontal sinuses. Michele

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The Georgia Nasal & Sinus Institute is located in Savannah, GA and is headed by Dr. Frederick Kuhn who is one the leading specialist for frontal sinusitis in the U.S. Chronic frontal sinusitis is especially difficult to cure because of the tendency of the narrow frontal ducts to close off during the healing process.  My right frontal ostium was opened to 4mm during my last surgery, and three months later it had virtually closed off due to neo-bone formation and scarring.  Nonetheless, I believe that stenting offers some hope. However, I would be curious to find out from other contributors in this newsgroup who have had endoscopic frontal sinus surgery, what to expect for surgeon’s fees in the U.S.? Regards, Michael Muloin Vancouver, BC, Canada ssohni <sso…@frontiernet.net> wrote in message

news:7oqeau$ld8$1@node17.cwnet.frontiernet.net… – Hide quoted text — Show quoted text -> Wow, does this sound like it may have possibilities!!  After all, stents > have been so successful on so many other avenues.  Where is the place in GA, > please?  Or, do you have any further info about the who and where aspect? > Thanks, Susan > Michael Muloin wrote in message … > >Is anyone aware of a procedure where silastic stents (flexible plastic > >tubes) are inserted into the patient’s frontal ducts during surgery, after > >the surgeon has opened or widened the natural canal?  The special silastic > >stents are apparently left in place for a period of 6-8 months to prevent > >post-op stenosis (closure) of the frontal ducts and allow drainage from the > >frontal sinuses until the healing is complete. > >I have spoken to a sinus specialist at the Georgia Nasal & Sinus Institute > >claiming that the success rate using stenting on selected patients with > >frontal sinusitis is quite high. The headaches are also alleviated. > >I welcome any comments or personal experiences regarding this procedure. > >Regards, > >Michael Muloin > >Vancouver, BC, Canada

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Michael, I am always curious, but especially about this, when people say so and so is the foremost authority on a topic or considered the best, etc.  I would like to know by whom?  IOW, who said that this gentleman is one of the leading specialists for frontals in the US?  I have had lots of dealings with the medical community in the past year (more than I ever would wish for) and have learned to question everything.  Have also learned they are usually the first to blow    their horns…their own horns. But don’t intend for this to sound snippy.  Really would like to know who is doing the evaluating? – Hide quoted text — Show quoted text -Michael Muloin wrote in message >The Georgia Nasal & Sinus Institute is located in Savannah, GA and is headed >by Dr. Frederick Kuhn who is one the leading specialist for frontal >sinusitis in the U.S. >Chronic frontal sinusitis is especially difficult to cure because of the >tendency of the narrow frontal ducts to close off during the healing >process.  My right frontal ostium was opened to 4mm during my last surgery, >and three months later it had virtually closed off due to neo-bone formation >and scarring.  Nonetheless, I believe that stenting offers some hope. >However, I would be curious to find out from other contributors in this >newsgroup who have had endoscopic frontal sinus surgery, what to expect for >surgeon’s fees in the U.S.? >Regards, >Michael Muloin >Vancouver, BC, Canada >ssohni <sso…@frontiernet.net> wrote in message >news:7oqeau$ld8$1@node17.cwnet.frontiernet.net… >> Wow, does this sound like it may have possibilities!!  After all, stents >> have been so successful on so many other avenues.  Where is the place in >GA, >> please?  Or, do you have any further info about the who and where aspect? >> Thanks, Susan >> Michael Muloin wrote in message … >> >Is anyone aware of a procedure where silastic stents (flexible plastic >> >tubes) are inserted into the patient’s frontal ducts during surgery, >after >> >the surgeon has opened or widened the natural canal?  The special >silastic >> >stents are apparently left in place for a period of 6-8 months to prevent >> >post-op stenosis (closure) of the frontal ducts and allow drainage from >the >> >frontal sinuses until the healing is complete. >> >I have spoken to a sinus specialist at the Georgia Nasal & Sinus >Institute >> >claiming that the success rate using stenting on selected patients with >> >frontal sinusitis is quite high. The headaches are also alleviated. >> >I welcome any comments or personal experiences regarding this procedure. >> >Regards, >> >Michael Muloin >> >Vancouver, BC, Canada

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This is the opinion of two other sinus specialists that I have spoken to. Dr. Kuhn teaches advanced courses in endoscopic sinus surgery and has written several published articles on frontal sinusitis. You may be able to find some of these articles on the Internet. Regards, Michael Muloin ssohni <sso…@frontiernet.net> wrote in message

news:7osgtt$10o0$1@node17.cwnet.frontiernet.net… – Hide quoted text — Show quoted text -> Michael, I am always curious, but especially about this, when people say so > and so is the foremost authority on a topic or considered the best, etc. I > would like to know by whom?  IOW, who said that this gentleman is one of the > leading specialists for frontals in the US?  I have had lots of dealings > with the medical community in the past year (more than I ever would wish > for) and have learned to question everything.  Have also learned they are > usually the first to blow    their horns…their own horns. > But don’t intend for this to sound snippy.  Really would like to know who is > doing the evaluating?

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 My parents swore on swedish bitters for just about any illness and I had astonishing results with them myself.  Sooooo…I figured I’d try some for my sinus problems.  In the literature they recommended to put a nightly compress on your forehead.  (Swedish Bitters stain like crazy, so I haven’t tried that yet…also, they were referring to frontal sinusitis, mine is allover the sinus cavities).  I have however started to add a tablespoonful when I do my sinus irrigation (that is for about 2 cups of saline/baking soda solution).  I’ve done it for about 2 weeks now and my sinuses are better than they were the entire 4 months that I was on antibiotics.  The only other thing I use is a spray of Vancenase after the irrigation to keep my allergies down and prevent re-sparking the infection. Swedish Bitters are a  really safe natural medicine that you should be able to get at any local healthfood store (you can take them internally and externally). I was wondering if anyone would be interested in trying this out and giving me some feedback if it works for you, too. I’d really like to know if this is just co-incidence or if it’s really the swedish bitters that are helping me. When I did an Internet search I found a site that has quite a bit of Info on Swedish Bitters ( http://www.survival.com.mx/herbs.html ).  Admittedly…the stories in there sound a little over the top, but there really is some truth to the value of them.  The brand I use is Swedish Bitters by NatureWorks, that seems to be the one most commonly carried by Health Food stores.

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- Hide quoted text — Show quoted text -AAyu wrote: >  My parents swore on swedish bitters for just about any illness and I had > astonishing results with them myself.  Sooooo…I figured I’d try some for my > sinus problems.  In the literature they recommended to put a nightly compress > on your forehead.  (Swedish Bitters stain like crazy, so I haven’t tried that > yet…also, they were referring to frontal sinusitis, mine is allover the sinus > cavities).  I have however started to add a tablespoonful when I do my sinus > irrigation (that is for about 2 cups of saline/baking soda solution).  I’ve > done it for about 2 weeks now and my sinuses are better than they were the > entire 4 months that I was on antibiotics.  The only other thing I use is a > spray of Vancenase after the irrigation to keep my allergies down and prevent > re-sparking the infection. > Swedish Bitters are a  really safe natural medicine that you should be able to > get at any local healthfood store (you can take them internally and > externally). > I was wondering if anyone would be interested in trying this out and giving me > some feedback if it works for you, too. I’d really like to know if this is just > co-incidence or if it’s really the swedish bitters that are helping me. > When I did an Internet search I found a site that has quite a bit of Info on > Swedish Bitters ( http://www.survival.com.mx/herbs.html ).  Admittedly…the > stories in there sound a little over the top, but there really is some truth to > the value of them.  The brand I use is Swedish Bitters by NatureWorks, that > seems to be the one most commonly carried by Health Food stores.

Were you experiencing sinus type headaches and were they alleviated somewhat by your nightly nasal irrigation.

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I actually do my irrigation in the morning.  I didn’t seem to get any headaches anymore since I started any sort of irrigation.  After I came off the antibiotics finally, my mucus went back to the icky yellow/green type and I lost my sense of smell again.  Since I started adding the swedish bitters, the mucus went back to being clear, my sense of smell is back, I hardly ever feel blocked up anymore and my postnasal drip seems better, too.  I have an appointment with an ENT next week, I hope that he’ll request another CT scan, because I’d like to see what it shows.  They want to operate on me because all the antibiotics didn’t do much at all, but maybe there is hope after all. By the way…when you look at the Swedish Bitter bottle, all  it says is"Gentle and Stimulating..promotes regularity…for healthy digestive function" (at least on the NatureWorks bottle).  Don’t worry…this IS the right stuff!!!  Read up on it on the web

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