Saturday, April 29, 2017

National Lab Week 2017 - 6 ways I've used lab testing to work for me in weight maintenance

Top 6 ways lab testing helps me in weight maintenance

























Happy Lab Week 2017

In real life, I'm a lab professional. I've been one for 29 years. 30 if you count my student rotation back in Indiana.

Shout out to ALL lab professionals. Tough hours, tough conditions, high stress at times. Great payback to the patients and to the docs diagnosing and the nurses in patient care.

An extra awesome shout out to phelbotomists because they are awesome when they draw my blood, both as a patient and as a paid blood donor.

I've worked a lot of weekends, holidays, and fill-ins and call ins during my 29 years. And I've provided a lot of good lab data, too. I know I've made a difference in the Hematology-Oncology, Coagulation, and Quality Professions.

As far as weight loss and weight maintenance go, here's how I use at home and commercial lab testing to monitor my health.

What's working for me now

1.  Home Glucose meter, fasting & 2 hrs post to determine type 2 diabetes risks with meals and foods.

I can eat carrots, Brussels sprouts, onions, green onions, summer squashes, raspberries, blackberries, and blueberries, and 85% chocolate with post 2 hour glucose readings 98 ug/mL and below. My fasting runs anywhere from 68-82 ug/mL or so.

Since I have the genetic predispostion for Type 2 diabetes (not diagnosed) I need to test. It's not my fault, but when I was obese for 40 years, my type 2 risk sky rocketed in 2000, post pregnancy.

2. Home Fecal Occult Blood testing, as provided by my employer near my birthday. Negative colonoscopy in 2016. Staying away from high fiber grains keeps my colon running BETTER!

3. Paleo, Low Carb, sometimes Keto food template for good outcomes with glucose & GI health

4. Occasional urine ketone testing just because it's fun. LOL.

5. Periodic lab testing for screening for insurance discounts and thyroid testing for medication dosing.

6. 23N Me testing with the Promethease HTML report. This is the single most important lab test of my life. I will live longer, in less pain, for much less cost. Owning my own data = super powerful.

What did not work in the past

1. Not monitoring glucose at home post potatoes, winter squash, and moderating Skinny Cow Icecream sandwiches. With M&M's spiked on the side. 5 WW points doesn't keep me from developing Type 2 diabetes. I now know my glucose spikes high and stays high when eat the SAD.

2. Shying away from wanting to know if I had fecal occult blood AND shying away from the idea of a colonoscopy. I've seen too many people not get standard polyps snipped out and who have died in their 50's. Very good treatments, individual for colon cancer now.

I must say that eating high fiber grains really did a number on my GI system. I was afraid I'd have long lasting effects. Thankfully, I stopped pumping my body full of oatmeal, Kashi, Fiber One and magically, my GI system got A LOT Better...

3. Calorie counting and Points counting did not work post mid-30's for me. In my late 20's yes. In my mid 30's and older- all the NOPES. All of that helped me get and stay obese for many years. Nothing fueled my Food Addiction more.

4. Not using low carb as a tool for weight loss and weight maintenance.

5. I avoided going to the doctor and avoided taking action on some really high HA1c's. Sigh. Better late than never.

6. Not owning and taking action on my own data. I just wanted to stick my head in the sand.


Okay, who else uses home and commercial lab testing to optimize weight loss and weight maintenance. I know a lot of our bloggy friends do. :) Kudos.

PS- one of our bloggy friends has requested a topic on GI health, specifically, stool health. Whooot!!  Post up in the next week to 10 days with how I keep my GI system pretty smooth, after years of too much and too little. Don't worry, there will be no actual photos. LOL

Saturday, April 22, 2017

Congrats to Prof Tim Noakes and an "oh no they didn't" Starbucks Unicorn Frappuccino - April 2017



A bouquet of flowers to Professor Timothy Noakes from South Africa for being found NOT GUILTY of professional misconduct for instructing a new mother to feed her baby- gasp! real food! Meeting Prof Noakes at a LCHF event is on my bucket list. Just saying! 

 Also thanks to Marika Sboros for the incredible coverage of the trial. 

Dr. Zoe Harcombe describes the Prof Noakes case (before the verdict at Low Carb Breckenridge). 

Here's what really is working for me now for my Paleo, LCHF, sometimes low Keto food template for long term weight maintenance and how it relates to the Prof Noakes case

1. I got better (putting obesity and food addiction in remission) by following the tools that Prof  Timothy Noakes,  Dr. Gary Fettke, Jason Fung MD, Dr. Zoe Harcombe, Jeffery Gerber, MD, Eric Westman, MD, and Barbara Berkeley, MD have provided. World Wide Subject Matter Experts ROCK.

2. I'm able to use the information and apply my learning from the information presented by subject matter experts to my own genetics and outcomes to avoid diabetes, obesity, and diseases of inflammation. 

3. I'm not waiting for the US government to change to change the food guidelines to get well. When grains and high carb, high processed foods failed to work as evidenced  by painful joints, cystic acne, food addiction, morbid obesity, I took matters into my own hands. 

There's absolutely NO SENSE in waiting for any government to swoop down and pronounce something. There is a HUGE benefit in seeking subject matter experts in the areas where I know I need to improve my health and taking massive action. 

Kudos Prof Noakes for staying the course. Kudos for those providing valuable tools to those of us who need help now, not in 5, 10, or 20 years.  We all need the Prof Tim Noakes of the world to speak out and provide their valuable clinical experience. 

Little Toot needs to tow the sugar boat away!

Now an "Oh no they didn't" entry

Okay, click through to the blog entry. The Gomer Blog is like the Onion for Medical types, so please take it with a grain of salt. It's satire, okay.

As the mother of a teenager, the sugar consumption at all coffee houses is a concern to me. Frequency, amount, your body will need to do something with 59 grams of sugar. It has no choice but to protect your heart, liver, kidneys, and eyes. NO, sugary coffee drinks are NOT an occasional thing for many in Jr. High, High School, and College. It's the dose and frequency. Sugary drinks have already created havoc in young kids.

What's working for me now

1. Black coffee at home and at Starbucks
2. Coconut milk for a coffee whitener, on weekends
3. Stopping sugar substitutes to lose the "sweet" palate

What didn't work for me in the past

1. Getting Low Fat Lattes and thinking I was awesome. I wasn't, I needed to be dairy free
2. Using those flavored creamers thinking I could get into top health with a chemical add-in.
3. Using tons of equal in many cups of coffee thinking it would help me get lean.


Onward. Any thoughts on Prof Noakes and Unicorn Frappuccino's? It's okay to disagree.


Saturday, April 15, 2017

5 years , 2 months in long term weight maintenance 2017 update

May 2011 and April 2017





















May 2011 to April 2017

























Starting weight 187.4 lbs
Goal Range 113-125  lbs
Current Weight 114.4 lbs
Keeping off      73.0    lbs

Time in maintenance 5 years, 2 month

Age 51
Menopause 3+years
Height 5'1"
BMI 21.6
BMI ave this month 21.7
BMI ave last month 21.9
Glucose (fasting & 2hr post this month range 68-95 mg/dL)
Glucose (fasting & 2 hr post last month = 68-113 mg/dL) ! Shingles caused some higher readings

Food Template:  Ketosis- mild and  LCHF Paleo, AKA- NSNG
Abstain from all grains, sugars*, dairy. Nut free, artificial sweetener free **
* 85% chocolate 1X per day
** Tiny bit of stevia in my Natural Calm

Food Timing or Time Restricted Eating Window or Intermittent Fasting 17:7 or 18:6

18 hours fasting (water only)
6 hours eating, 3 meals
Eat 6am Stop eating at 12 pm

Or 17:7, I change it up a bit

Auto-Immune Hashimotos 1997, 100 ug Synthroid daily
Food Addict in Recovery: 5+ years
High Risk, but never diagnosed Type 2 diabetes

Walking 13,000-14,000 steps per day

Weight lifting : I took about a month off due to the Shingles, starting back today for 2X per week

Sprints on the rowing machine 1 days per week OR stair sprints 

Stair Ave/day for the month 14 stairs (Apple Health Kit)

What's working now:
1. Abstaining for the WIN!!!!

So, so, so incredibly grateful for Food Sober Living the last month. I've recovered from the shingles almost 95%. I need to bring my upper body strength back online and a few skin areas to heal up. 

I'm being very mindful to get back to my normal self and not let food addiction back into my life. If there's anything I have learned it's that I can take one or two bites and have a lapse after a big illness or life stressor. So, I remain food sober. 

And for that, I am very grateful. Thanks for anyone in the past that has helped me abstain. Kudos. 

What didn't work in the past

1. Moderating all food within a point value. Calories in Calories out really did nothing to keep me food sober. In fact, it kept me in food addiction for far too long. 

Graphs, got them!  You  can see the Shingles 1-2 pound bump! LOL. 











Saturday, March 25, 2017

Shingles, Weight Maintenance, and Food Addiction Recovery 2017, hint, there's an anti-viral for that!

*** If you have shingles or think you do, go to your doctor, get diagnosed ASAP!!!!!***

The accounting below is based on my own experience. Your diagnosis and treatment can and will differ.

Here's my scoop on the latest in my weight maintenance challenge: Shingles. Yep!
Early in March 2017

QUICK DIAGNOSIS : The short story.Due to fast action on my part, I went to my doctor and got diagnosed and on anti-viral meds (Valacylovir for 7 days) within 8 hours of the rash appearing. Rash and most of the mild pain went away in 14 days.

Pain: The pain has been mostly mild to slightly moderate. I have not taken a single pain pill. Doc was going to put me on Gabapentin for pain, if needed. Early use of the anti-viral probably saved me a lot of pain. I suspect it will save me from PHN- postherpetic neuralgia. If I can avoid long term nerve pain, I'll be very pleased. 

Research Pre-Diagnosis: After I saw the nasty rash, I was 99% sure it was shingles, so I made the earliest appointment I could with my PA.

Mainstream: I googled ONE mainstream source of info: NIH Shingles  I will trend to a 85% use of mainstream medicine when sick with common, treatable diseases. My doctor or PA and I are the top decision making team together.

Take-away: Get the anti-viral meds since the rash was <72hrs old.

Paleo/ LCHF/ Keto: I googled ONE article that was written by someone on the internet who used mainstream medicine and functional medicine and had a prior Auto-Immune disease. Back Country Paleo shingles information.

I'm picky and choosy when selecting off mainstream medical advice. Too much woo and down right miss-information on the internet. With Back Country Paleo,  I liked how Sue navigated her shingles case. And I had already decided to use an anti-viral, so I was interested to learn from Sue. I grew up in a rural area, next to a small-ish medium sized city, so the rural fixes are of interest to me.

Take away from Sue: Get traditional treatment, improve your gut bacteria and inflammation later via your regular Paleo/ AIP food template.  Exactly how I like to roll. A very good example of combining mainstream with principles that keep your immune system well. I have to keep my GI system running  as part of a low inflammatory life anyway, so this approach fits well into my post shingles living.

Dealing with my existing diseases: the Food Addiction is still in remission
You'd better believe that my food addiction voice came out to play a few times. "You're sick, poor thing, don't worry about your food template right now....." "You'll be in pretty bad pain soon, eat whatever, go easy on yourself, it's okay to eat extra carbs". WHAT!?

Good news. I have trained myself to recognize destructive thought patterns. I did NOT give into food addiction. I told another living person I would not due to the acute illness or potential pain management. That I would get through this disease without "using" food.

So far, so good. As always, my food addiction voice can show up without warning, even after the event. Knowing I stay true to my abstaining food template  24/7/365. I can ask for and get support with the same speed keeps me well, safe, and in remission.

I weighed in daily, just data, no big deal. Really I just cycled between 2 weight plateaus within my weight maintenance range. It's very interesting to me how things like viruses effect my weight.

Had Shingles early March '17, small weight change

Post Hashimoto's Disease and Shingles:
So far so good, I'm taking great care in the post acute phase of Shingles. I'll be 20 years post Hashimoto's disease this summer. Generally,I try to stay as well as I can as I age to avoid another round of a different auto-immune disease.  Hypothyroid is a super easy treatment for me by using the synthetic thyroid hormone, Levothyroxine- AKA Synthroid.

How I dealt with Shingles:
I've now gone from the acute phase (rash, teeny tiny almost not there blisters, fatigue, some cold intolerance)  to the more chronic phase (mild pain) and am on the mend.

Working: If I were contagious, for only a few days in my case, I was completely covered by 3 layers of clothing at all times while out of the house. I had almost no visible blisters that healed up in 2-3 days. This kept small babies, pregnant ladies not previously infected with chicken pox, and the immunocompromised (treatment and or elderly) safe.

We are talking teeny, tiny, almost couldn't feel blisters.

Since I don't see patients in a hospital or clinic setting in my current job assignment, I arranged to work at home until I got onto the anti-viral meds. I stayed clear of all kids, elderly, and any child bearing females.


Eating: I kept my same food template, adding in chicken broth, probiotics, and I ate some tasty sauerkraut I had on hand. 3 meals a day, 1 Tablespoon of the Diablo Sauerkraut seemed to keep my GI system running well, despite the disease and the treatment.  The day I forgot to eat the kraut while on the anti-viral meds was pure misery. Of course, it could have been the meds, the disease or both.

Batch cooking: I had most of this in my freezer already cooked
Beef off the bone and chicken broth broth and sauerkraut all help my GI system, seemingly. I cooked up some beef short ribs in the Instant Pot and put them on romaine, with radishes and cilantro. Tasty!

You or family WILL get sick. Prep food before that happens so all you have to do is microwave.

GI stuff: I needed to eat sauerkraut at every single meal while on the anti-viral. After the 7 days, I tapered and now eat fermented at one meal every 2-3 days.

I also craved salt before I got the rash, so much so, that I finally ate salt out of hand a few times and salted my water with pink salt a few times.


Other symptoms: I had some cold intolerance and fatigue. Both mild compared to Hashimotos like 1/3 the strength. I could still function and never fell asleep at dinner. LOL.
Long beach walks helped me


Other Treatments: Exercise if you can
Walking: low to medium to medium high intensity walks helped much of my nerve and skin pain. The first 10 minutes was a little painful, but walking seemed to decrease my skin pain for 6-8 hour blocks.

Short Showers: My showers in the AM increased my pain so fast showering, moving to washing my hair every other day helped decrease skin/nerve pain.

Gym: I had some weakness, so I took a few weeks off the gym and kept doing home pushups and stretching.

Of course, I'm thinking about prevention now: 

Root cause: 5-6 medium stressors that appeared one by one in a 2 week time frame in Jan 2017.  Nothing that is unsolvable, nothing that I couldn't or didn't ask for help and got it, but perfect storm conditions.

ALL things that were outside of my control. ALL things that are dealt with now and are humming a long just fine. And I was meditating, taking long walks at the beach and thinking I was going back to normal. Nope!  I really thought I was doing well. What a kick in the butt. Sigh.

All the sea glass collecting in the world wasn't enough to keep me off the edge, this time. Infections happen, squeaky clean food and living or not, sometimes you get sick.

Contributing cause: Going against my gut feeling in Sept 2016 and NOT paying $200 out of pocket to get the shingles vaccine. My insurance doesn't cover the shingles vaccine until age 58 (I'm almost 51), so I made the decision, in conjunction with my doc and good health, to wait.

The vaccine won't prevent a Shingles outbreak, but the severity may be lessened. I tend to react well immune wise to vaccines. Guess what I STILL have to do this Fall, yep, get a shingles vaccine and pay out of pocket. DANG IT. Even if you have had shingles, the vaccine may help future outbreaks.

What is working now:
1. Early Diagnosis so I qualified for the anti-viral Valcylovir
2. Keep other diseases in check by eating in my food template
3. Batch cooking, with a special emphasis on beef, sauerkraut
4  Priority on exercise sleeping and meditation and, setting limits
5. Getting any other vaccines and prioritizing my extra cash for prevention, insurance or no!

What did not work in the past:

1. I didn't always go to the doctor when I needed to go.
2. I almost developed type 2 diabetes as a result of my Food Addiction being out of control.
3. I bought "sick and comfort food" like frozen dinners, icec ream, and candy. Ugh!!!! NOPE
4. I said yes to all people, no matter what. Couldn't set a boundary to save my life.
5. I ignored my gut feelings. Poor risk management skills.

Have you gotten shingles? I know many cases are much, much worse than what I had. I'm very fortunate.

Saturday, March 11, 2017

Weight Maintenance 5 years 1 month check-in, not answering the food addiction knocking on the door...nobody's home


May 2011 to Feb 2017

May 2011 to Feb 2017





















Starting weight 187.4 lbs
Goal Range 115-125  lbs
Current Weight 115.6 lbs
Keeping off  71.8 lbs

Time in maintenance 5 years, 1 month

Age 50
Menopause 3+years
Height 5'1"
BMI 21.9
BMI ave this month 
BMI ave last month 21.6
Ave glucose (fasting & 2hr post this month = 73mg/dL)
Ave glucose (fasting & 2 hr post last month = 71 mg/dL)

Food Template:  Ketosis- mild and  LCHF Paleo, AKA- NSNG
Abstain from all grains, sugars*, dairy. Nut free, artificial sweetener free **
* 85% chocolate 1X per day
** Tiny bit of stevia in my Natural Calm

Food Timing or Time Restricted Eating Window or Intermittent Fasting 17:7

17 hours fasting (water only)
7 hours eating, 3 meals
Eat 6am Stop eating at 1 pm


Auto-Immune Hashimotos 1997, 100 ug Synthroid daily
Food Addict in Recovery: 5+ years
High Risk, but never diagnosed Type 2 diabetes

Walking 13,000-14,000 steps per day

Weight lifting 1-2 days per week, 

Sprints on the rowing machine 1 days per week OR stair sprints 

Stair Ave/day for the month 18 stairs (Apple Health Kit)

Oh boy! I've had an acute illness this whole week. Sigh. Separate blog post about that very soon. Happily, I have not let my food addiction back into my life. The FA is still knocking on the door, but I won't let it in at all.

A little voice that says, awwwww you're sick, it's a little painful, you should treat yourself to.....  That's when my recovery brain steps in and says you WILL treat yourself to FOOD SOBER living. And with that, I'm brought back to reality.

No matter what, I refuse to regain, to entertain food addiction and I stay on my food sober template. I need to  live free from FA or I  will die having let that disease back in is simply not an option. I won't let it be. All the nopes! There's almost no gray zone here. It's clarity vs disease in 60 seconds of slippery slope thinking.

Sometimes the food addition is more mentally painful than the disease and my acute disease is physically painful.......

I do think I'm transitioning to the chronic phase of the disease. March is my birth month and some of my birthday gifts to myself are books. I also got myself a membership on My Heritage (like Ancestry) for geneology. And, as luck has it, moderate to light walking really helps my condition.

I'm reading the Secret Life of Fat by Sylvia Tara, PhD.  I'm only a few pages in and I could have written the book. Seriously, that was me as a teen.



Follow me over on Instagram and watch my videos for chapter reviews. I'll blog about the book soon. I have a camping "papasan" chair (Costco <$40.00) that I call my chair of wisdom.

video


So all things given, I'm very fortunate. I choose THIS! I choose to eat well, move well, sleep well. The only thing is stress which probably got the better of me this time. But hey, I can and am working on that, too. I thought I had stress in the bag. Stress may take the most time for me to manage.

What's working 

1. Staying on my food template, even though I'm sick.
2. Taking time to sleep, read, rest, do hobbies that I love
3. Continuing Education into my obesity and Food Addiction diseases.
4. Fermented foods, helped me a lot this week.
5. Daily weighing and My Fitness Pall recording. It works. It's the lock on my food addiction door.


Here's what didn't work in the past

1. Using illness as an excuse to binge eat whatever I wanted- pooooooor baby, I deserved that Hostess Snowball and cinnamon toast. Doing that kept me sick for many years. I'm not a baby and to stay well, I need real food that is low inflammatory.

2. I didn't sleep enough or prioritize me.

3. I did work continuing education just fine, but I failed to prioritize my recovery in food addiction and weight maintenance.

4. I binge ate everything carby- toast with cinnamon and sugar, oatmeal, and it made me more sick.

5. I didn't weigh or track if I was sick. I thought a pass on the scale was treating myself well or kindly. No, it was sitting down and making my food addiction a cup of coffee and having a chat. It was slippery slope thinking.

Onward, to my graphs. I had a 1-2 pound weight gain with the illness and the drug for treatment. Still in my preferred weight maintenance range. Going low in my maintenance range has had a good outcome for me.










Saturday, February 25, 2017

Transition complete! From weight loss to weight weight maintenance Feb 2017 one month, steady state

Remember my post, the one about transitioning from weight loss to weight maintenance being short and well defined? Well, I've reached full time weight maintenance at a weight that is better for me.

The time period: It took about 1 month or so to really lock things down. Now 35 more years of weight maintenance. to go. LOL. Really, I just can concern myself with today and things will be okay.

In real life: Likely, I'll have to cycle between weight loss and weight maintenance many times, although, I'm aiming for a long time in between unintentional gain. Like a few years. or months. I'll take what I get and I won't throw a fit.


one month of weight loss, one month of weight maintenance Jan-Feb 2017


Now the real work begins!

Seriously, I see so much bad advice out there for weight maintainers. Advice that will absolutely result in weight regain. Intentional or unintentional, I'm on 100% constant vigilance during the next 6  months,  entire time of my remaining life span. 

Here's some fool proof advice: Choose your monitoring tools wisely. Monitor your weight, food intake, movement glucose, ketones if it helps, strength, blood pressure, inflammation markers, sleep, and stress relief. Choose  enough tools to identify and reverse a gain trend so that weight maintenance is simply weight maintenance.

Choose tools carefully. Choose weight maintainer seniors carefully, too. This is important if additional roots of obesity have not been addressed.

HINT: Develop habits around measurements and frequencies for long term weight maintenance. The focus will have to shift, so that new habits become sustainable habits. Then, when the next habit set (main habit with subsets) can be learned, practiced, sustained. 

That habit cycle will need to happen for each root cause of obesity. Toss some self growth in there. It's like fertilizer.

Unless you want to yo-yo!? After 40 years, I needed to stop yo-yo dieting. 

Good News: It seems for me to get easier (metabolically, emotionally) since I stopped cycling back into the food addiction or the bio-chemical mess or the stinking thinking that was killing me (or making life miserable) in the first place. 

Habit changes, one by one, only in the direction that will give me weight maintenance


Here's what is working now: 
  • I keep my monitoring tools handy, 
  • I check often (but not too much), and 
  • I'm way, way, way honest with myself and what I tell myself
  • I check in with other weight maintainers in real life.
What didn't work during other attempts:
  • I did not monitor the correct metrics for my obesity root causes
  • I did not monitor enough
  • I was not honest with myself and my weight gain, getting food high was more fun!
  • I didn't go out to find other abstainers like myself, stayed with moderators too long.
How long does it take you to transition between steady states? Have you ever strung together 2 months or two years of steady state weight maintenance? For me it's been 5 years +/- 10 pounds, and only 2 years +/- 3 pounds.

Very interesting....  I have to say I love steady state weight maintenance.

Friday, February 17, 2017

Quick- Open Comments to the FDA on “Use of the Term `Healthy' in the Labeling of Human Food Products.” Feb 2017- Speak UP!!

A big thank you to Michael Moss for tweeting the link to the open comments at the FDA for the use of the term "healthy" in US food product labels.

Here's the tweet
READER Assignment:  Please leave your feedback for the FDA.

QUIZ:  2 question competency assessment quiz. Y'all are a smart bunch. I know you'll pass my 2 question "healthy" competency quiz.

A photo speaks 1,000 words. So here is my experience only.

Question A: 

 Which photo looks "healthy" from a metabolic disease stand point? In 2017 or 2011?

2017
Eating while consuming Zero Food Products labeled "healthy- Feb 2017




2011
Eating while following the "healthy" labels on cereal and grains Feb 2011







































B. Question #2

Which food template photo allows me to maintain a 74 lb weight loss over 5+ years? These are actual food diaries for me. 

Eggs and Kale photo #1 and nutrition info:


4 eggs, kale, raspberries, olive oil, coconut oil, pink salt black coffee, 2/17/2017


























2017 Nutrition info for photo #1

Nutrition Info for LCHF 2/17/2017 breakfast, Normal BMI and weight, BMI 21



















2011 breakfast photo images-#2  Photos (with credit) and Nutrition info
Healthy labeling claims, highly processed



















Photo credit
https://images.kglobalservices.com/www.morningstarfarms.com/en_us/product/product_4509827/kicproductimage-125340__0011_sausagelinks_3d.jpg


Whole grain breakfast example, SAD diet













photo credit
https://images-na.ssl-images-amazon.com/images/I/910BDcVaPoL._SX355_.jpg


2011 Breakfast 

Nutrition Info for "healthy" US Food Product Claim Low Fat Breakfast , Feb 2011, morbidly obese, BMI 34

Please let me know in comments if you want the Quiz answers and/or if you left a comment for the FDA.  Onward. When we know better we do better. Hey, they had me at cinnamon roll... LOL ;)