Troy's Multiple Sclerosis Experience

Off Topic but Important - Proposition 8 in California

2008-10-09T07:56:00.000-07:00

I've never posted an off topic post before but this one was so important to me that I have to post about it. I haven't seen a place where all the facts and sources about proposition 8 is posted and so I'm going to try to make one here and edit it whenever I come across more facts and sources.
For those that don't know, proposition 8 in California changes the constitution to include the following phrase:

"Only marriage between a man and a woman is valid or recognized in California"

At first blush this may seem intolerant because it excludes same sex marriage and shouldn't they have the same rights as everyone else? I'll explain my reasoning below.

From the prop 8 analysis in the California voter information guide: "In March 2000, California voters passed Proposition 22 to specify in state law that only marriage between a man and a woman is valid or recognized in California. In May 2008, the California Supreme Court ruled that the statute enacted by Proposition 22 and other statutes that limit marriage to a relationship between a man and a woman violated the equal protection clause of the California Constitution. It also held that individuals of the same sex have the right to marry under the California Constitution. As a result of the ruling, marriage between individuals of the same sex is currently valid or recognized in the state." I believe that this decision is more about activist judges and legislating from the bench than actual constitutionality. I'll talk more about that later but I think it is morally wrong to go against items that have been voted on by the California people unless there is a very good reason. I view this type of circumvention of the voice of the people as underhanded and cowardly. Even for principle alone, I think that if people want to change the law to include same sex marriage, they should go to the legislature or to a popular vote. It's incredible to me that we have to vote for the same thing again, we should be voting whether or not to adopt same sex marriage, not whether to re-affirm what we already voted on in 2000.

Here is why I believe this is a case of activist legislation from the bench rather than a valid constitutionality question. Footnote 52 on page 79 of the opinion from the supreme court of California where Proposition 22 is overturned, it reads:

We emphasize that our conclusion that the constitutional right to marry properly must be interpreted to apply to gay individuals and gay couples does not mean that this constitutional right similarly must be understood to extend to polygamous or incestuous relationships. Past judicial decisions explain why our nation’s culture has considered the latter types of relationships inimical to the mutually supportive and healthy family relationships promoted by the constitutional right to marry…. Although the historic disparagement of and discrimination against gay individuals and gay couples clearly is no longer constitutionally permissible, the state continues to have a strong and adequate justification for refusing to officially sanction polygamous or incestuous relationships because of their potentially detrimental effect on a sound family environment…. Thus our conclusion that it is improper to interpret the state constitutional right to marry as inapplicable to gay individuals or couples does not affect the constitutional validity of the existing legal prohibitions against polygamy and the marriage of close relatives.

What follows is data to support the argument that I have that same sex relationships are also "inimical to the mutually supportive and healthy family relationships promoted by the constitutional right to marry."

1) Research shows that contributions from both a mother and a father are significant in the development of children:

"Although it would seem that two-parent families should be able to provide more resources for children, particularly in terms of income and availability of time to spend with children, children from stepparent families often look similar to those from single-parent homes. In comparison to
step-families, cohabiting relationships and foster care appear to be even more deleterious with respect to child outcomes."

Barbara Schneider, Allison Atteberry, and Ann Owens, Family Matters: Family Structure and Child Outcomes (Birmingham AL: Alabama Policy Institute: June 2005)
http://www.alabamapolicy.org/pdf/currentfamilystructure.pdf

"More children each year are not living in families that include their own married, biological parents, which by all available empirical evidence is the gold standard for insuring optimal outcomes in a child’s development."
David Popenoe and Barbara Defoe Whitehead, The State of Our Unions 2007: The Social Health of Marriage in America (Piscataway, NJ (Rutgers University) The National Marriage Project, July 2007 pp. 21-25
http://marriage.rutgers.edu/Publications/SOOU/SOOU2007.pdf

"Are children more likely to flourish when they are raised by their own married mothers and fathers, or are alternative family forms just as good?"
Maggie Gallagher and Joshua K. Baker, “Do Moms and Dads Matter? Evidence from the Social Sciences on Family Structure and the Best Interests of the Child,” Margins Law Journal 4:161 (2004).
http://www.marriagedebate.com/pdf/Do_Moms_Dads_Matter.pdf

The consequences to a child of fatherlessness:

David Blankenhorn, Fatherless America: Confronting Our Most Urgent Social Problem (New York: Basic Books, 1995)
http://www.amazon.com/Fatherless-America-Confronting-Urgent-Problem/dp/006092683X/
This page has the author's notes on his book:
http://www.americanvalues.org/html/bk-fatherless_america.html

"The decline of fatherhood is a major force behind many of the most disturbing problems that plague American society: crime; premature sexuality and out-of-wedlock births to teenagers; deteriorating educational achievement; depression, substance abuse and alienation among adolescents; and the growing number of women and children in poverty."
David Popenoe, Life Without Father (New York: Martin Kessler Books, 1996)
http://www.amazon.com/Life-without-Father-Compelling-Indispensable/dp/0674532600

2) Extending marriage to include same sex relationships will divorce the two concepts of marriage and family and weaken marriage.

An article by Stanley Kurtz analyzes the consequences of the legalization of same sex marriage in the Netherlands.
http://www.freerepublic.com/focus/f-news/1140886/posts

Another article by Stanley Kurtz is much more detailed in answering the question of the consequences of extending marriage.
"The separation of marriage from parenthood was increasing; gay marriage has widened the separation. Out-of-wedlock birthrates were rising; gay marriage has added to the factors pushing those rates higher. Instead of encouraging a society-wide return to marriage, Scandinavian gay marriage has driven home the message that marriage itself is outdated, and that virtually any family form, including out-of-wedlock parenthood, is acceptable."
http://www.weeklystandard.com/Content/Public/Articles/000/000/003/660zypwj.asp

"What's the Harm? is a valuable resource of diverse insights, arguments, and information that contributes to a deeper understanding of what may be the defining issue of the first decade of the twenty-first century."
Lynne D. Wardle, "What's the Harm?: Does Legalizing Same-Sex Marriage Really Harm Individuals, Families or Society?" University Press of America (2008)
http://www.amazon.com/Whats-Harm-Legalizing-Same-Sex-Individuals/dp/0761843167

I find that I agree with Stanley Kurtz and find his writing quite well formed:
"Does gay marriage undermine heterosexual marriage?"
http://www.nationalreview.com/kurtz/kurtz043003.asp

3) Same sex relationships are shorter term than traditional marriages between a man and a wife.

In Dutch AIDs researchers, published in 2003 in the journal AIDS, reported on the number of partners among Amsterdam’s homosexual population.

http://www.aidsonline.com/pt/re/aids/pdfhandler.00002030-200305020-00012.pdf

They found that the average duration of committed relationships among gay steady partners was 1.5 years. One and a half years does not sound to me like a "mutually supportive and healthy family relationship."

Divorce magazine says the average length of marriage in the US is about 8 years.
http://www.divorcemag.com/statistics/statsUS.shtml

Data from the Gay/Lesbian Consumer Online Census shows that only 29% of relationships last more than 7 years.
http://glcensus.org/press/02052004.html

The American College of Pediatricians say that "homosexual partnerships are significantly more prone to dissolution than heterosexual marriages with the average homosexual relationship lasting only two to three years."
http://www.acpeds.org/?CONTEXT=art&cat=22&art=50

The Family Research Center has a compilation of some good data. I need to look more at this one, it is data for the United States.
http://www.frc.org/get.cfm?i=IS04C02

4) Same sex relationships are much more prone to domestic violence:

According to Statistics Canada, Canada's National Statistical Agency, July 7, 2005, "Violence was twice as common among homosexual couples compared with heterosexual couples."
http://www.statcan.ca/english/research/85-570-XIE/85-570-XIE2006001.pdf

The American College of Pediatricians indicate that the number should be 2-3 times rather than the Canadian 2 times.
http://www.acpeds.org/?CONTEXT=art&cat=22&art=50

5) Same sex relationships are more likely to prematurely end in death of one or both partners due to the very high rate of diseases such as AIDS.

Finally, from he most recent AIDS survey is published by WHO and UN AIDS, unprotected sex between men continues to account for the largest proportion of new HIV infections (45% in 2005 (that's 45% of 2.1 million which is 0.945 million new gay men with new infections in 2005) compared with 42% in 2002) (Boulos et al., 2006). An estimated 37% of new HIV infections in 2005 were attributed to unprotected heterosexual intercourse, with a substantial proportion among people born in countries where HIV is endemic
(mainly sub-Saharan Africa and the Caribbean).

Since the best estimates put the homosexual population between 2% and 7%, this also means that even in western Europe with a minority of 29% of new infections coming from at best 7% of the population means that the gay men are far and away the most risky group. In the rest of the world (population about 6.45 billion in 2005) where that 2-7% (451 million in 2005) represents the majority means the chance of infection when engaging in completely random homosexual sex is 0.21% for the gay population as opposed to 0.013% for completely random heterosexual sex (200 times more likely).
http://www.unaids.org/en/KnowledgeCentre/HIVData/EpiUpdate/EpiUpdArchive/2007/default.asp

6) By classifying same sex marriage as a discrimination attribute, my personal rights of freedom of speech and expression are limited.

Hate speech is a type of caveat to the first amendment to the constitution which guarantees free speech. In general, people may speak and write of anything that they wish, however there are some special cases when there is nothing to be gained by speaking of an issue. An example of this is advocating racism - people can not change the color of their skin and there is no hard facts that indicate that any given genealogy is "better" than any other and so racism has been classified as hate speech - promote it and you are subject to imprisonment and fines. Other examples of discrimination points include gender, and age. These are things that can not be changed, they aren't a CHOICE. By granting same sex marriage discrimination status, disagreements can not be put forward. In this case since it is a religious belief of many (including myself), it directly conflicts with another cherished item: the separation of church and state (more about that later.)

There is quite a bit of controversy about whether or not homosexuality is part of genetics or a choice. According to JM Bailey, "Environmental influences play a significant role in the development of gender identity and sexual behavior." (Bailey JM. "Biological perspectives on sexual orientation". In: Garnets LD and Kimmel DC: Psychological perspectives on lesbian, gay, and bisexual experiences. Columbia University Press, New York. 2003)
http://www.amazon.com/Psychological-Perspectives-Lesbian-Bisexual-Experiences/dp/0231124139/

In regards to hate speech I offer the following link where government employees were prevented from using terms such as "Marriage" and "Family Values" because they were viewed as hate speech. We should be aware of what is happening to the virtues of free speech in our society.
http://www.lifesitenews.com/ldn/2007/mar/07030805.html

Another example is the case where the Good News Employees Association prevented Joanna Hicks from refuting previous comments concerning the Bible such as "I personally think the good book needs some updating."
http://www.davidlimbaugh.com/mt/archives/2007/06/new_column_anot.html
http://www.ca9.uscourts.gov/coa/memdispo.nsf/pdfview/030507/$File/05-15467.PDF
http://www.oaklandcityattorney.org/PDFS/Opinions/GoodNewsruling2-2005.pdf

Jeff Jacoby has a very good article about why gay marriage is not a civil right and why it's different from the civil rights movement.
http://www.jewishworldreview.com/jeff/jacoby_gay_marriage.php3

7) It violates the separation between church and state:

In 1819, James Madison, the principal author of the US constitution stated:

"The civil Government, though bereft of everything like an associated hierarchy, possesses the requisite stability, and performs its functions with complete success, whilst the number, the industry, and the morality of the priesthood, and the devotion of the people, have been manifestly increased by the total separation of the church from the State."

In 1773, the Rev. Isaac Backus, the most prominent Baptist minister in New England, observed that when "church and state are separate, the effects are happy, and they do not at all interfere with each other: but where they have been confounded together, no tongue nor pen can fully describe the mischiefs that have ensued."

As described in point 3, free speech is endangered by the inclusion of same sex marriage as a discrimination item. Advocates of same-sex marriage are suggesting that tax exemptions and benefits be withdrawn from any religious organization that does not embrace same-sex unions. Jonathan Turley, “An Unholy Union: Same-Sex Marriage and the Use of Governmental Programs to Penalize Religious Groups with Unpopular Practices,” in Douglas Laycock, Jr., et al., eds., Same-Sex Marriage and Religious Liberty: Emerging Conflicts (Lanham, MD: Rowman & Littlefield Publishers, Inc., 2008).
http://www.amazon.com/Same-Sex-Marriage-Religious-Liberty-Conflicts/dp/074256326X

Marc Stern, general counsel for the American Jewish Congress who asks, “Can a group – a church or religious charity – that opposes gay marriage keep its tax exemption if gay marriage becomes law?”
http://www.latimes.com/news/opinion/la-oe-stern17-2008jun17,0,5628051.story

I believe strongly that moral issues should be preached in churches without fear of repercussions either of the preacher being hauled off to jail or fined or by the church being denied tax exemption status. This is one of the most important points to me.

8) Same sex couples gain no rights under California Law by gaining marriage.
The California domestic partnership law already gives same sex couples all the rights they can possibly have as a couple under the name marriage or not. Sacrificing the above rights to grant someone a new title even a very important group is not a good trade off. As I indicated above, I would gladly trade the title of "married" if it meant giving these rights to a group however small.
http://www.leginfo.ca.gov/cgi-bin/displaycode?section=fam&group=00001-01000&file=297-297.5

9) Homosexuals are 10-25 times more likely to be child molestors.

The number of homosexuals in essentially all surveys is less than 3%. (Statistics Canada found only 1% of the population who described themselves as homosexual.) However, the percentage of homosexuals among pedophiles is 25%. (Blanchard R et al. Fraternal birth order and sexual orientation in pedophiles. Archives of Sexual Behavior 2000; 29: 463-78.) Therefore, the prevalence of pedophilia among homosexuals is about 10-25 times higher than one would expect if the proportion of pedophiles were evenly distributed within the (hetero- and homosexual) populations.
http://www.ingentaconnect.com/content/klu/aseb/2000/00000029/00000005/00225154
http://www.springerlink.com/content/hh300395g834h386/

Another more extensive survey was done of lots of other studies. Don't be misled by the typo in the beginning paragraph, it unfortunately claims the opposite of what they are trying to show. I think it was just a mistake in the quote that they make as the rest of the paper makes clear.
http://www.familyresearchinst.org/FRI_EduPamphlet2.html

10) Same sex marriage would be given at least equal footing in teaching children as young as kindergarten.

Given that same sex marriage has been shown to be damaging to children, I believe that teaching same sex marriage in schools is at best foolhardy, at worst a recipe for disaster. Who in their right mind would teach children how to fail at life? School is specifically a place to learn how to succeed. Teaching about alternate lifestyles that do not lead to stable societal goals is counterproductive. Some argue that if you don't like it, you can abstain from those classes but a recent case in Massachusetts shows that this is not a real option. A father is jailed when he refused to leave a school board meeting until he was given the opportunity to exclude his child from schooling including same sex marriage. (It is instructive to note that the book brought home by his child, "Who's in a Family?" has 2 homosexual couples on the front cover but NO traditional families with a husband and a wife.)
http://www.worldnetdaily.com/news/article.asp?ARTICLE_ID=45594
http://www.amazon.com/Whos-Family-Robert-Skutch/dp/188367266X

The same groups that are funding no on prop 8 in California are trying to prevent parents in Massachusetts from opting out of homosexual indoctrination.
http://www.marketwatch.com/news/story/proposition-8-whos-really-lying/story.aspx?guid={5627F03A-80C6-4259-8A81-E5D73F237D93}&dist=hppr

11) Businesses and churches would be unable to protect themselves:

MY SISTER-IN-LAW is a wedding photographer and after being photographed in her local newspaper while supporting Proposition 8, was barraged by hate mail and asked to photograph several same sex marriages with the threat that if she did not do it, she would be sued for discrimination even though there were other wedding photographers available at lower rates and in closer areas. A case exactly similar to my sister-in-law's took place already.The story starts with the phrase "Act Three: A Nationwide Story."
http://www.npr.org/templates/story/story.php?storyId=91573905

The social services arm of the Roman Catholic archdiocese has provided adoption services for the state for about two decades, but said it would discontinue because it was forced to provide adoptions to same sex couples against it's religious views.
http://www.boston.com/news/local/massachusetts/articles/2006/03/10/catholic_charities_to_halt_adoptions_over_issue_involving_gays/

Canada February 24, 2000 A professional printer refused to print material for the Canadian Gay and Lesbian Archives because he felt doing so would violate his religious beliefs. He was fined and ordered to print the material anyway. He took his case to the Ontario Supreme Court and then to the Ontario Court of Appeal and lost both times. His total legal bills exceed $170,000.
http://www.catholiceducation.org/articles/persecution/pch0080.html

Canada 2001 An evangelical Christian employed as a prison guard placed an ad in the Saskatchewan Star Phoenix. The ad was a picture of two stick men holding hands, with a red circle with a bar across superimposed on them. Below the picture were four scripture references, but not actual Bible verses. He was convicted of a hate crime by the Saskatchewan Human Rights Tribunal. The judge suggested that using Bible verses in a newspaper ad like this could be construed as hate literature. Thus, there is now legal precedent in Canada that the Holy Bible is hate literature.
http://www.catholiceducation.org/articles/persecution/pch0080.html

Additional resources that I liked but didn't fit anywhere in my particular argument structure:

Stanley Kurtz on how same sex marriage is the gateway to polygamy:
http://www.traditionalvalues.org/modules.php?sid=1505

A story about a Brussels threesome who want to get married.
http://www.brusselsjournal.com/node/585

An article from Robert Knight the person who helped draft the federal law, the Defense of Marriage Act is quite good.
http://www.cwfa.org/familyvoice/2006-05/marriage_may_june.pdf

I found some good information from Conservapedia.com which also contains quite a bit more supporting evidence.
http://www.conservapedia.com/Homosexual_Couples_and_Domestic_Violence

Stanley Kurtz article:
http://www.weeklystandard.com/Content/Public/Articles/000/000/003/660zypwj.asp

A very well thought-out and well written article about same sex marriage. Although it is long, I strongly suggest reading it.
http://www.janegalt.net/blog/archives/005244.html

Finally a very good discussion concerning same sex marriage from Rick Santorum, Senior Fellow for the Pew Ethics and Public Policy Center and former U.S. Senator
http://pewforum.org/events/?EventID=180

I have often heard the term "Equality" used in connection with Proposition 8 and I think there is a problem using that word. I'll explain. Everyone whether gay or straight is equal under the law. They may all get married whether proposition 8 passes or not. The difference is what marriage means. I may have a cat who I love dearly and enjoy being with but I can not get married to that cat, not because I don't have the right to marry but because that relationship is known as "being a pet owner" not getting married. Gay people may get married, everyone can, it's a right that everyone has. Gay people may not, if proposition 8 is passed, call their relationship with someone of the same sex marriage just as I may not call my relationship with my cat marriage because that's not what it is. It's a civil partnership or in my case, a pet owner (by the way, I have no strong feelings for the cats that I own, I just used it as an example).

If proposition 8 is about tolerance, it's about tolerating people who believe differently from the gay and lesbian activist groups. Tolerance in my mind is about allowing others to choose as they will unless it involves negative consequences for oneself and even then annoyances and negative consequences must be examined to weigh the differences between what is gained on the one hand and what is lost on the other. Losing my right to voice my opinion so that someone can gain the label of "marriage" is not reasonable to me. I would gladly give up the right to be labeled married if it would give another group the right to free speech.

Many of the same points are made by Dr. Laura A. Haynes who is a physiologist in Tustin, California. Her paper is also full of plenty of sources.
http://www.journeychristianministries.org/CPA-SSA-marriage.pdf

Conclusion:
Proposition 8 in 14 simple and straight-forward words protects me from all of these negative consequences. I am a strong supporter of proposition 8 because it's the right thing to do. I can't conscience the spilled blood of patriots from the birth of this great nation being spilled in vain, I believe what they fought and died for is still as important today as when they died for it. I believe in the separation of religious and political institutions. I believe in the freedom of speech for all. Without these pillars of our society, we risk disintegration, chaos, and destruction.

Current Status

2008-10-01T19:12:00.000-07:00

Well it has been quite some time since I last wrote and many things have happened. Chiefly, I have had significant headaches and when we checked the the spot in my head, it had changed. I went to see a neurosurgeon about it. The spot is very close to the third ventricle which is where your spinal fluid goes and so he hoped to be able to get a clue about what it is by taking some. He took a LOT of CSF (Cerebral Spinal Fluid) in a spinal tap and ran lots of tests on it unfortunately with no results. On one hand, it's good that there aren't cancer cells or infection indicators running around in my spinal column since that would be very bad, but on the other hand, there isn't anything at all so I'm no closer to what it might be. I have another MRI scheduled for later in October. Hopefully that will give some indication about what to do next. It's in a very difficult spot to reach (although he has apparently operated there before) and so we decided not to go in and take a piece of it unless there is a good reason for it. So we will see what happens. In the mean time, I have to deal with the headaches which are pretty consistent. I have started having a headache sometimes over my left ear which is pretty intense at times and pretty extraordinary. I didn't realize until I got that headache that I never had a headache in another place than pretty much the front of my head. Anyway, I'll try to keep things posted.

Liver - Shliver!

2008-03-11T10:03:00.000-07:00

Thanks to all that commented on my last post. I have thought a lot about what the value of Tysabri is for me. With PML as the only possible side effect, it's a little funny that the choice would be easier: if I die, then too bad, if not, I'll have the best medicine around. On the other hand, liver trouble is somewhat more like the thing I'm trying to avoid: a slow decline in health. It's less decisive, less appealing somehow than a quick clean solution like PML or no MS. On the other hand, liver damage is a pretty common side effect. I don't consider liver damage when I take tylenol. When I consider the alternative, MS symptoms that I KNOW happen, I can clearly see the quality of life difference. On the whole, I am pretty sure that Tysabri is the best solution for me. Thanks for everyone's comments and concern.

7th Infusion

2008-03-08T20:38:00.000-08:00

Last friday I had my 7th infusion of Tysabri. My neurologist called to tell me that there was some evidence that Tysabri caused some liver problems and so a liver test will now accompany my infusion each month. It seems there is never a treatment that doesn't have side effects. It makes the choice of what to take difficult. It probably seems funny that someone who already decided to take the risk of PML would be more worried about the liver problems but I never really considered PML a possibility I don't think. I have found that I'm quite a bit less tired these days. If Tysabri can stop the progression of MS and give me back some of the energy I need in my daily life, does that make it worth ruining my liver slowly? I'm not sure.

Carnival of MS Bloggers

2008-03-08T20:37:00.001-08:00

MS Awareness, Blogging Friends, and a little Link Love

There are at least 137 MS Bloggers out there actively discussing whatever suits their fancy. Below you will find many of these suspects....wait... I mean lovely blogger friends who happen to have multiple sclerosis.

Remember how I mentioned a group project was in the works? Well here it is. As the founder of the Carnival of MS Bloggers, I'd like your help in spreading the word, and in doing so we will strengthen the bonds of our own little Multiple Sclerosis Blogging Web (and share some linkie love with each other). If you are not an MS Blogger, but are a regular reader here, please feel free to help spread the word too.

Here's what you do:

Copy the entirety of this post
Create a new post and paste this content
Visit 3 of the blogs listed below which you were unfamiliar
Leave a comment on their blog encouraging them to participate
Please add Brass and Ivory to your sidebar, if it's not already

New editions of the Carnival of MS Bloggers will be presented bi-weekly at Brass and Ivory. Previous editions will be are archived here and the button below has been revised to include the new link. Please update your sidebar.

Names of the Blogs - Name of Blogger (if known)

and # of posts in 2008 (as of 3/5)

9 Brand New MS Bloggers joined the blogosphere in 2008!!

New! Carole's MS Blog (Carole) 49
New! Great Mastications (Orla) 37
New! Movin' On with MS (Sammie) 26
New! Me, Myself and MS (Emma) 10
New! Being Ammey 8
New! Blogbuster (Daniel) 6
New! Etsy Crest (Shelby) 6
New! Serina's Blog 5
New! I'm Beating MS (Michael) 2

Most Prolific MS Blogger - so far in 2008!!

Jim's Deep Thoughts (Jim) 231

Top 10 Rather Prolific MS Bloggers - so far in 2008!!

A Stellarlife (Diane) 109
Merely Me's Multiple Synchronicities (& Sclerosis) 90
Friday's Child 70
My Journey - Living Well with MS (Diana) 69
Sunshine and Moonlight (Kim) 65
The MonSter Ate My Branes! (Natalie) 65
Queen Mediocretia of Suburbia 60
Brass and Ivory (Lisa) 56
Brain Cheese (Linda) 52
Maybe I'm Just Lazy (Julie) 51

28 Moderately Prolific MS Bloggers - so far in 2008!!

Maggsbunny (Maggie) 48
Living with Multiple Sclerosis (TC) 47
MS My Way (Callie) 43
Bugs, Bikes, Brains (Shauna) 39
Dancing with MS (Lazscott) 37
Trying to Catch My Breath 37
A Florida Journal (SwampAngel) 35
Now We Are Six (Tish) 33
Reality Check (Michael) 32
Access Denied (Herrad) 31
Multiple Sclerosis Blog (Charles of MSBpodcast.com) 30
MS Activist (NMSS) 29
Self-injecting Chinese Hamsters since 2007 27
Shirl's the Girl (Shirley) 27
Disabled Not Dead (Anne) 26
Life with MS (Trevis) 26
Living with MS (Blinders Off) 25
White Lightning Axiom - Redux (mdm) 25
Stevers! 23
Word Salads (Have Myelin?) 23
Danieldoo (Vivian) 22
Caregivingly Yours (Patrick) 20
Deo Volente (Lisa N) 20
Down the MS Path (Vicki) 19
Do You Have That in My Size? (Denise) 17
Jenn's Nook (Jenn) 17
Fingolimod and Me (Jeri) 16
Human Life Matters (Mark) 16

51 Mildly Prolific MS Bloggers - so far in 2008!!

A Life of Learning with MS 15
Behind Blue Eyes (Zee) 15
Katy and Mike's Adventure (Katy) 15
Living Life as a Snowflake (Sharon) 15
Mandatory Rest Period (Kim) 15
MS Maze (Mandy) 15
My Journey with MS (Christina) 15
The Multiple Sclerosis Companion (Pat) 15
'Tis Herself (Kell) 15
A Short in the Cord (Joan) 14
Blindbeard's MS Blog 14
Bubbie's Blog (Cathy) 14
One Crazy Chick (Chris) 14
Pat's Pond (Pat) 14
Rants and Musings (Cutter) 14
G and K's Mom 13
MS Toolkit 13
Newly Diagnosed with MS (Andrea) 13
One Life (Stephen) 13
MS Not Just a Diary (Doug) 12
Rayne's World (Jayme) 12
Chaos Personified 11
My MS Journal (Jaime) 11
Purely Patsy (14 yr old Patsy) 11
Victoria Plum - Technician! (Victoria) 11

26 Less Prolific MS Bloggers - so far in 2008!!

Broken Clay (Katja) 10
Mark Pickup (Mark) 10
My Chain Driven Ride through Life in Alaska (Michelle) 10
Deborah Does Navel-Gazing (Deb) 9
Funky Mango's Musings 9
Inside the Mind of a Squirrel 9
Living Well with MS (Michon) 9
No Time for MS (Courtney) 9
Sorting It All Out (Michael) 9
Travels With Lucy (Virginia) 9
MS Caregivers (Prudence) 8
Can You Hear Me Now? (Donna) 7
Irreverence is Justified 7
Multiple Sclerosis Notes 7
My Tysabri Diary (Lauren) 7
Chris Has MS (Chris) 6
Diary of MS X (7 Divas) 5
Electrical Disturbance (Stephan) 5
Know Multiple Sclerosis 5
MS in the OC (Frank) 5
MS News and Notes (Deb) 5
MS Recovery Diet Blog (Ann) 5
The Endomorph (Ruth) 5
The Jaws of My Life (Jaws) 5
Time to Deal with MS (Homer) 5
YodaMamma MS & More 5

38 Barely Prolific MS Bloggers - so far in 2008!!

Some of these folks have multiple blogs or co-blog and are loved none-the-less!! Let's help spread the love and let them know that WE know they are appreciated.

Carolyne's MS Odyssey (Carolyne) 4
Defeating Illness (Chris) 4
Intent, Context, Perception (Chris) 4
Libbi's MS Journey (Libbi) 4
MS Recovery Diet Blog (Judi) 4
My Autoimmune Life 4
The Life & Times of Sancho Knotwise (JM) 4
The Zen Pretzel Trick (Zen Angel) 4
When it's Raining... (Keeley) 4
Kebenaran - The Truth 3
Montana Homecoming (Sister Jane) 3
Ms Quill 3
Reality Chick (Keli) 3
Catch My Disease (Lisle) 2
Clods and Pebbles 2
Dissonance 2
Georgia MS Advocates 2
Lazy Dog Public House 2
Looking Forward with MS (Pamela) 2
Surviving MS in Alaska (Michelle) 2
These Pretzels Are Making Me Thirsty (Trrish) 2
Troy's Multiple Sclerosis Experience 2
You Me and MS (Judi) 2
Camille's MSadventures 1
Comment Column (Virginia) 1
Erik's MS & Lyme Blog 1
Hop Bloody Hop (Philip) 1
Jenn's Journey with MS (Jenn) 1
Living with MS (Cyndee) 1
Mismorphic's World of MS 1
MS Musings 1
MS Real Life Stories & Issues (Kristin) 1
Postcards of My Life (Sherry) 1
Rebooting Times 1
Shoester (Doug) 1
The BS of My MS (Heather) 1
The Perseverant Pincushion (Trish) 1
Tysabri Help (Deej) 1

Having too many items from various posters to count:

LJ Users with Multiple Sclerosis

And finally - 26 MS Bloggers who have been silent in 2008!!

Angst on a Shoestring (Gina)
Dandelion Wine (Lynx)
Doug's MS Journal (Doug)
Imagine Bliss Butterfly (Suzy)
It's Not All in My Head (Optimist)
Just Above the Abyss (Heidi)
Life with MS , seeking a cure (Karyl)
Managing MS with Tai Chi (Joel)
Managing Multiple Sclerosis
Marciarita
Michele's Blog
Mike's Place
MS - My Scene (Virginia)
My Complications (Amanda)
My Demyelination (Tina)
My MS Experience
Object of My Injection (Michelle)
Say It Isn't So (Mouse)
Talk Story with Kimberly
The Great NetXperiment
To Be Continued... (Jaime)
Truth and Beauty (Baraka)
Tryin' to Imagine Bliss (Suzy)
What is MS to Me (Dave)
Willy's MS Rants
Wind Among the Reeds

Hard to categorize:

I Have MS (Tim)
Huggins' MS Pages (James)
MS - A Personal Account
MS Protocols (Jeff)
MSB's Podcast
MSing Around
Multiple Sclerosis Blog and News
Multiple Sclerosis Sucks
OUCH! It's a Disability Thing
Squiffy's House of Fun

Thank you for helping to build a stronger MS Community.

Illness and MS . . .

2008-02-19T09:25:00.000-08:00

For the last couple of times that someone in my family has come down with a cold or a flu or something like that, I have noticed that I get extremely tired. I don't usually get sick but I do end up spending the day/weekend in bed, fast asleep. This past weekend, I slept nearly the entire day on Sunday (I got up for a shower, went to church, came home, ate something and went back to sleep). I slept Saturday night, Sunday all day and all night. The next day, our youngest came down with diarrhea and felt awful. In the days that have followed, other kids have had it for an evening/day. Is this a common symptom of MS? Other people get sick and the one with MS just gets tired? It's happened enough that I believe that there is a definite correlation.
My wife and I were speculating about the mechanism. For instance it may be that your body is so busy repairing the damage from the disease that it leaves off repairing the MS damage? Your immune system kicks up a notch or two upon discovering the intruder and doubles it's attack strength both on it and on you? Just curious if something like this has been noticed by others.

My current plan . . .

2008-02-04T11:15:00.000-08:00

It's been quite a while since I last posted. As was obvious, I was pretty upset when I last posted and it's been a while getting out of it. I don't have answers to my questions, however I do have a renewed desire to move forward with my life. I am still on Tysabri. I think that it's better than what I have had previously. I'm also taking glucosamine (the "joint pain" pills that you see advertised in all the stores.) and omega-3 fish oil. I'm also taking a multi-vitamin (centrum) and Celexa. Every morning it's a pill extravaganza as I choke them all down but I think at least some of them help so I keep it up.

My sister in law sent me a link that suggested wearing copper to reduce joint pain. I think it's really only for arthritis and even then, it's probably quack medicine. Just the same, I thought it would be fun to make so I bought some copper from a manufacturer and made a copper arm band (think Egyptian style - my wife calls me Ra when I wear it despite my continued assurances that I'm cooked.) It's fun to wear even if it doesn't do anything.

My fatigue is on and off. Sometimes I think things are all better and then I have a weekend like last weekend when I slept most of Saturday and all of Sunday except church. The results of my last two blood tests indicated that I was slightly Anemic and that may be contributing to the fatigue. My wife has me on a new diet with lots of meat. I really enjoy meat so I'm not complaining. Last night it was barbecued beef, potatoes and vegetables. It was delicious. If my tests come back not anemic in the future, I'm not sure that I'm going to tell her.

My 5th Tysabri treatment is coming up next week. The nurse at the infusion center told me that she had attended a conference where there was apparently some evidence that the efficacy increases until about the 14th infusion and then levels off. I'm looking forward to more treatments in hopes that I can have a little less fatigue.

Nothing new here

2007-11-05T12:44:00.001-08:00

I don't have any new information to present or insights to share but I have been having some new experiences that I need to talk about. It's sort of a long story but I'll try to present the ultra-condensed version here.

I was diagnosed with MS when I was 3o, that's 4 years ago. At that time, I was really optimistic and looking forward to everything. I had a lot of faith that things would work out somehow and that God had a plan for me.

I was diagnosed with Cancer when I was 32, that's 2 years ago. Testicular cancer (like Lance Armstrong but not so advanced.) has a low mortality rate and something like 99.9% of folks who are diagnosed before metastasis as I was are completely cured. I was completely cured. I chose to go through Chemotherapy rather than radiation because some studies indicated that it may be marginally better and that the negative side effects were certainly less. It was rough but probably more on my wife than on me, she was conscious the entire time and had to take care of me (which she did without complaint very well.)

During this time, my wife and I became foster parents. We had one biological daughter when we first got married but had bad luck since then (not for lack of trying, I assure you.) We could either go through the infertility route or the adoption route. After prayerful discussion, we decided that the adoption route was best for us and chose foster care as the mechanism to bring that about. For those of you who don't know, foster care is full of children with heart-breaking stories. One little boy we took in watched as his mother was taken by police and cuffed for dealing drugs. He cried for hours wanting his mommy back and being worried that she would be "cut" in jail. He was 6 years old. We really tried to do our best both in helping other children and completing our own goals of increasing our family size. We adopted 3 boys (siblings) who are more than wonderful.

The foster care system is administered in California at the county level. There are LOTS of problems with it. Nearly every other week, we got new social workers or administrators because they were undergoing yet another reorganization or else they were revamping some program or other. Most of the people that we dealt with were incompetent or their hands were tied and they couldn't do their job because of some policy or regulation that was in place. The kids were the only redeeming quality of the entire system and that's why we stayed and put up with the other junk.

In February we had 4 little girls in our home from foster care. This was a lot to us but we had prayed about each placement and felt it was the right thing to do. One had been in our home for about a year and a half and we were very close to adoption for her. The parental rights were terminated and if our social worker had not just gotten married, we would have adopted her already. The other 3 girls were siblings with the youngest being a brand new baby. They were also proceeding along the adoption track. It was an amazing time for us. We had our hands full taking care of them but it was so rewarding.

Tragically while I was on a business trip to Washington D.C. the baby died of SIDS (Sudden Infant Death Syndrome - for which there is no known cure or prevention). It was shocking in the extreme. I flew home on the next flight. My mother in law and my mother both flew out as soon as they could. It was an amazingly difficult time. While talking to the kids about what had happened and where the baby was now, etc. I felt that things would be ok, that somehow this was part of God's plan for us. It wasn't over though.

The next day the county (which had been involved all this time) came and took the other 3 girls away from us, telling us that it was a temporary measure they always did when this type of thing occurred. In my life it is customary for a family to pull together and find strength with one another as difficult things happen. Having the girls removed made it harder for us. After they had been gone a week, I was finally able to get through to the social worker responsible for one of the girls. She curtly told me that the child was no longer under our care and that she would be adopted by another family and then hung up! I called back 3 times to receive tiny tidbits of information before she hung up on me again and again. We were overwhelmed to say the least.

It turns out that the county had determined that since the child had died in our care, they couldn't allow any other children to ever be placed in our home. They were seeking a revocation of our license. They had also published our names on the national child abuse index as being guilty of "severe medical neglect" so that not only could we not be foster parents but we could also never adopt again or even help out in our children's school classrooms.

We prayed a lot to try to understand what we should do. We ended up going to court to contest the removal of what we considered our children. I had strong feelings that things would turn out right and that the girls would return. I put my whole soul into doing what I felt was the right thing for me to do. In the end, after the longest court action this judge has apparently ever had, she ruled against us and for the county. This was devastating. A couple of weeks later, the child who we should have adopted had our social worker not been getting married, was adopted by another family. All of our rights with regard to the other two girls were terminated as well.

I write this not for sympathy or even hoping that some avenging angel will read it and stick it to the county folks, but to try to illustrate why I feel the way I do. Since this time, I've had a really hard time understanding the situation. I felt that God was telling us that we would get the girls back and now I can see that they can't possibly come back. I feel that the compass that I had to direct my way, my assurance that things would turn out in the end is gone. If the message from God had been, "The girls won't return, this is part of the plan." I would have accepted it but I feel that I received the opposite message and then as I followed it with all my faith, discovered that I had just stepped into empty air.

I don't have any faith in the future at this point. I don't know what will happen or have any faith that it will turn out for my good. I have felt feelings that I associated with God's communication to me throughout my life. I have to reexamine those feelings now I feel. I feel aimless, like it doesn't matter. My love of life has run dry it seems. There are things that I should do around the house (fix this light, install a phone jack in this room, help my wife with this or that) but I'm just completely without interest.

Has anyone had an experience that just knocked the air out of them like this one and if so, what do you do? If you read this far, you are a real trooper, thanks for listening.

Photos of the spot in my head . . .

2007-10-09T18:39:00.000-07:00

I finally got the MRI photos of the mysterious spot in my head. Here is the spot from two different angles. As you can see, it's right in the middle of my head. My neurologist wins the understatement of the year when he said, "It's not a good place to biopsy."

All went well!

2007-09-27T14:28:00.000-07:00

Yesterday I had my first infusion of Tysabri and it all went very well. I had no reaction at all to the medication which I think is a good thing. My wife came with and sat by me to keep me company and to help me (her support is invaluable.) I don't feel different than I did two days ago but from the material that I was given, I think that's a good thing. I feel hopeful about the future whereas before I was scared. I feel blessed to have been given hope.
I also had a PET scan yesterday. They injected me with radioactive sugar and then I lay very quietly while they ran me through a donut that looked much like the CAT scan one except much quieter. I didn't get to see the photos but I'm hopeful that they don't find anything interesting. It's a little funny that people who go to the hospital want to be exactly the same as everyone else while when people go to other places, they want to be seen as individualistic. My wife thinks that my body matches my personality in it's inability to blend in. I've decided to consider it a compliment.

Tomorrow is the big day . . .

2007-09-25T09:15:00.000-07:00

A lot has happened since my last post. As part of the preparation for taking Tysabri, I had an MRI of my head taken. My MS hasn't progressed much in terms of scaring in my head (which is good news) but there was a spot that was a cause for concern. When I had my last MRI a couple of years ago, there was a spot near my hypothalamus that showed up. I spoke with a doctor in neurosurgery and he scheduled another MRI for a year later that somehow didn't get done. Anyway, the blip showed up again and this time it "took the dye" better than last time. There is good and bad news about it:

Bad news: the neurosurgeon that we spoke to said, "In my 30 years of neurosurgery, I have never touched this area of the brain. It's just too risky." So basically I would have to have very serious side effects of having something there before they would even go in an look at it.
Good news: it has not grown between the time we saw it last and now. If it was cancerous, it would have grown and been the source of numerous problems (double vision, serious headaches, and cognitive disfunction which is code for trouble using my brain at all.)

So at this point we'll keep and eye on it and hope and pray for the best. In other news, my cancer doctor (I had cancer a couple of years ago and went through surgery and chemotherapy) noticed that one of my Lymph nodes is somewhat enlarged and requested that I get a PET scan. PET stands for Positron Emission Tomography. I had one once before. I think this is how it works: They inject you with radioactive stuff and then watch it and take pictures of where they are interested with the "light" that results from the radioactive decay. It's a little freaky because they put on this suit and stand behind this thick metal shield to inject you (standing there in your underwear) with this dangerous stuff. Then they get away from you so that you can incubate until it's time to take the pictures.
Tomorrow is the big day for everything then. I'll have my first Tysabri injection in the morning and in the afternoon I'll do the PET scan. I'm a little nervous but I think it's the right thing to do. Hope all goes well.

Tysabri for me . . . ?

2007-08-07T15:38:00.000-07:00

I finally spoke with my neurologist today, prepared to do battle to get Tysabri rather than Copaxone since I have been feeling that Copaxone hasn't been working as well as I would like. Dr. Danish was wonderful. With doctors like that, I don't feel like I will ever switch from Kaiser. He was extremely reasonable. He of course wanted to know why, I explained that I was quite a bit more tired and having new symptoms (my newest is numbness in the tips of my toes) as well as nerve pain in my hands and joints. He indicated that the anti-depressant that I was taking (generic Celexa) sometimes causes patients to feel more tired and sometimes the other way around (which is strange I think but believable somehow). He suggested ways to fight the fatigue include changing from Celexa to:

Wellbutrin (which I unfortunately already tried and switched to Prozac because it gave me headaches)
Prozac (which I also tried but since I was having trouble sleeping but still feeling fatigue, switched to Celexa)
Effexor which I haven't tried.

He also suggested that maybe using Provigil when I have a very difficult time with fatigue (so not on a regular basis but as needed). I need to read over the pages on Effexor and Provigil up to see what the side effects, etc are and talk it over with my wife. I'm very up-beat today because I feel like Dr. Danish was so helpful - the way doctors should be - willing to take time for me and eager to help me in the best way possible. I think he could also tell that I had done my homework and that helped.
Signing all the forms to sign up for TOUCH and Tysabri is pretty scary - they want to make sure that you know that you might die if you take it and that's a little intimidating to say the least. I have read about several people who have been presented with different views on the uses of Tysabri from "only as a last resort" to "everyone should be taking this." Dr. Danish took a reasonable approach. He explained that it's better at stopping MS than anything else but that it has the potential severe negative side effect of death and so he only recommends it when other medications don't work. That being said, he was more than willing to allow me to "take my life in my hands" and choose it if I thought it was best for me. I can't say how glad I am for his wonderful attitude! I was able to get a time slot for an MRI for Sunday and so I'll be off and running in no time at all.
I let my wife know that I had signed all the forms and she had mixed feelings. I think she is more worried about me than I am. I had cancer a couple of years ago (Testicular - I'm half nuts but not likely to win the Tour de France) and I know that she was very worried about me then, more than I was worried about myself. I wonder if this is generally the case with caregivers. I know that when my kids are sick, I sometimes have to take a time out because I don't know what to do with myself because I'm anxious. She and I are going to pow-wow tonight and say some prayers to try to decide if Tysabri is the right thing for me. I have felt as I have learned about it that it is but I think being specific and asking in prayer is never a bad idea.

MS and thinking clearly.

2007-07-12T12:52:00.001-07:00

The other evening as we were sitting down to dinner, my wife asked me some questions (I don’t remember about what.) As I was trying to answer, she said, “You aren’t well, you can’t remember the name of anything lately.” I realized that she was right, I had been struggling all day trying to remember the name of different objects or the right word for a particular sentence. I haven’t had that problem before. I’m not a very garrulous person but I don’t have to stop in the middle of every other sentence to try to remember the name of something or because I can’t find the right word. Recently I’ve had a very mild relapse where my right side has been hurting and by thinking back over it, I realized that the problems I’ve had with words have coincided with the pains in the joints of my right hand and ankle. I’m scared to death that MS is affecting my ability to think clearly. I’m a scientist and I have to do that all day long every day. I’ve had it on my mind almost non-stop since my wife made that comment.
I’ve always felt that the physical problems that come with MS were just “the way it is.” Since I’ve never been very physically active (I’m the guy who reads a book rather than playing soccer with everyone else), the idea of having physical limitations hasn’t bothered me more than the feeling that I will miss playing games with my kids and building stuff with them. When I think about being intellectually weakened, however, I’m horrified. I wish I could make a deal with it – Take anything you want but I must keep the ability to think clearly.

A good weekend . .

2007-07-09T10:05:00.004-07:00

This past weekend was quite good. Although my right side (right hand joints and right ankle) continue to hurt (going on 2 weeks now), I didn't overdo like I do most weekends and I was able to go to church on Sunday and have a very good day at church. On Saturday I helped move dirt for the terraces that we are putting into the back of our property. The kids and I were able to move quite a bit before I was so hot that I knew I needed to go in. They continued to work on it after I left and I made everyone some yummy burritos for lunch/dinner.
I put in a call to my neurologist to look into Tysabri as a new treatment option for me (I'm taking Copaxone now). The promise of a stop to the progression is too much not to at least look into. My wife and I are worried about PML of course but the risk seems quite small and the payoff quite large. I feel compelled to look into it anyway.
At church it seemed everything was directed to me. Speakers spoke on the importance and power of prayer. There are three possible outcomes - yes (feels right), no (feels confused) and no answer yet. Everyone agrees that the last is the hardest but one speaker spoke about how not yet really is not yet and that if you go forward with what you think is best, God won't let you go too far before telling you that your chosen course is either right or wrong. Mens group talked about the importance of faith and how it is by doing that we receive confirmation that something is right or wrong. I feel in more than one area that I should go forward with my best guess at what is right and then see.
Today was our kids first day of summer school. My wife and I took a walk together after she came home. It will be a real treat to be able to take a walk together each day before work and after the kids are off. It think exercise is critical to doing better with MS and I'm overjoyed to have a chance to do it with my wife. Hopefully we can have some good talks and also some good exercise. I'm hopeful about the future today.

2007-07-06T13:36:00.000-07:00

I continue to read the blogs of other bloggers with MS, Living With MS - had several good resources to consider. One is the role of exercise in the progression of MS. She mentions yoga as an very useful and gives a couple of links. They have yoga classes here at HRL but I've always been a little nervous about going to them. Probably I should get over my anxiety and just try it out. She is also quite vocal about Tysabri which had initial PML scares but, as she points out, is a good choice for a first line of defense against MS.
She gives a link to some good reading material.

More getting up to speed on MS from other blogs . . .

2007-07-05T10:28:00.000-07:00

I've been doing more reading of other blogs from folks with MS today. I have a plethora of things to look into:

From My Complications:
Plasmapheresis (Plasma Exchange)

From Shoester:
Pubmed has RSS feeds which I will subscribe to. (Broken at this particular moment but I'm hoping it will recover and that I have the right link.)

Quite a few people have discussed and switched to Tysabri with quotes such as "if 2 people hadn't died of PML, it would be the only drug on the market." and 66% effectiveness. I think the right thing to do is to talk with my neurologist about it first rather than other, non-FDA approved things.

Links from Other blogs

2007-07-03T12:29:00.000-07:00

Today I have been reading from some other MS centered blogs and learned some interesting things that I should look into further:

From Mandatory Rest Period there is a story about Tovaxin undergoing clinical trials. In addition another drug, MBP8298 is undergoing trials but only for people further along than I am. Also there is a link to that trial in the web site sponsored by the national institute of health where you can look up trials that are currently recruiting for patients. I'll have to first check out all the recruiting for MS related studies and then set a watch for new ones.

From Erik's Multiple Sclerosis & Lyme Blog: Alternative medicines: Evening Primrose Oil (EPO) and Fish Oil.

First post - some background

2007-07-03T12:28:00.000-07:00

For my first post, I should probably give a little bit of a history of myself and my experiences with MS. I'm a scientist doing research in the areas of photonics and information assurance. I currently work for HRL Laboratories. I got my bachelor's degree in physics from BYU and my master's degree in electrical engineering from Caltech.

I was diagnosed with MS in the year 2004 (Age 30) after the left side of my face went numb for a short time. I have had problems with pain in my digits and wrists for a long time and took multiple tests for arthritis (which were all negative.) After diagnosis, I was prescribed Copaxone. I give myself an injection each morning after my shower. At first I was terrified of needles but since that time, I have grown calloused and can give myself a shot without even blinking now.

After diagnosis, I could finally explain why I felt suddenly very tired sometimes and also why, at times, my hands hurt so much. I felt empowered and spent quite a bit of time on the web learning all that I could about MS. Since that time, learning about MS has basically stagnated along with the progression of my MS. In the past two months, I have felt it's effects more than in the past and probably as a result have decided to renew my education of MS and look into some other alternatives that may help me increase my health quality.

I plan to use this blog as a mechanism to help me track my learning about MS and also progress (or lack thereof) as I try different things to reduce it's impact on my life. I have heard "rumors" that changing my diet, exercising more, and trying some alternative medicines may be in my best interest and so I'm using this blog as my journal to keep track of resources and events.

Most recently, I have heard of a drug called Naltrexone that was approved by the FDA in 1984 in 50mg doses for helping heroin and opium addicts recover. I hope to be able to convince my neurologist at Kaiser Permanente to give it a try.