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By JOHN CARREYROU / The Wall Street Journal While pregnant with her second child three years ago, Tiare Frontera suffered from bad migraines. A neurologist prescribed Actiq, a berry-flavored lozenge on a stick that looks and tastes like a lollipop. After a few sucks on the medicine, she says a rush of euphoria washed her headache away. Soon, Mrs. Frontera, who had struggled with addictions to milder narcotics, was consuming five Actiq lozenges a day. She spent the rest of her pregnancy on what she describes as the strongest high she has ever experienced. When she gave birth, her baby son was cranky and wouldn’t sleep. Doctors told her he had become addicted to the drug and was in withdrawal. Mrs. Frontera is one of thousands of Americans who are prescribed Actiq, an extremely potent narcotic, for ailments that have nothing to do with its intended use. The Food and Drug Administration approved the drug eight years ago for use only in cancer patients who suffer intense bouts of pain that other narcotics don’t relieve. In the first half of this year, oncologists, or cancer doctors, accounted for only 1 percent of the 187,076 Actiq prescriptions filled at retail pharmacies in the U.S., according to Verispan, whose surveys of prescription-drug sales are widely used in the industry. Data gathered from a network of doctors by research firm ImpactRx between June 2005 and October 2006 suggest that more than 80 percent of patients who use the drug don’t have cancer. Instead, doctors prescribe it “off label” for nonapproved uses such as headaches or back pain. Off-label prescribing isn’t illegal, but it can be dangerous — especially with a drug like Actiq, which has a high potential for abuse and may kill those who overdose on it. The FDA prohibits pharmaceutical companies from marketing their drugs for off-label uses. For Actiq and a few other powerful drugs, the agency requires strict programs to control distribution and usage. Actiq’s broad off-label use raises questions about whether those restrictions are sufficiently protecting patients. “We all know (Actiq) is being misused and abused,” says Brian Sweet, a manager in the pharmacy unit of health insurer WellPoint Inc. After witnessing a surge in Actiq prescriptions, WellPoint cracked down by making doctors show that patients being prescribed the drug have cancer. Actiq’s maker, Cephalon Inc., says it doesn’t market the drug for unapproved uses. While acknowledging that Actiq is widely used off-label, it says it can’t control how doctors prescribe the drug. Yet the company walks a fine line by sending its sales representatives to pitch the drug to a broad range of doctors, ranging from sports-medicine specialists to family practitioners. It gives these doctors coupons for free samples. Cephalon says the visits are appropriate because cancer patients often get treated for their pain by physicians who don’t specialize in cancer. Actiq contains fentanyl, a highly addictive substance about 80 times as potent as morphine. Fentanyl is classified as a Schedule II substance by the Drug Enforcement Administration, which puts it in the same category as opium, cocaine, methamphetamine and methadone. Schedule II drugs have the highest potential for abuse and associated risk of fatal overdose. Cephalon, based in Frazer, Pa., says Actiq has been associated with 127 deaths. Two of them involved children who confused the drug for candy. Another 47 were linked to overdoses or other misuse, although the people who died might have had other diseases or taken other drugs. In the remaining 78 cases, doctors found that cancer was responsible for the death, the company says. Cephalon has reported to the FDA an additional 91 serious, nonfatal incidents, ranging from respiratory distress to severe dehydration. The U.S. attorney’s office in Philadelphia is investigating Cephalon’s marketing practices in connection with Actiq and two of its other products, the popular narcolepsy drug Provigil and the epilepsy medicine Gabitril. No charges have been filed. Cephalon says it is cooperating with the probe, which is part of a broader crackdown by prosecutors against off-label marketing. In August, the Justice Department fined Schering-Plough Corp. $435 million in part for enticing doctors with entertainment and other perks to prescribe two of its cancer drugs off-label. Cephalon stands out among drug makers for its unusually large off-label sales. Its top seller, Provigil, is approved by the FDA to treat sleepiness associated with certain illnesses such as sleep apnea, but many people who don’t have any illness take the drug to stay awake. Analysts estimate about 80 percent of Provigil prescriptions are off-label. Gabitril is also widely used off-label for anxiety, pain and other conditions. Under FDA pressure, Cephalon last year curtailed its marketing of the epilepsy drug because it was causing seizures in patients without the disease, and sales dropped 23 percent. Founded in 1987 by a former DuPont Co. scientist named Frank Baldino Jr., Cephalon expects revenue to exceed $1.6 billion this year, more than double the figure of three years ago although still a small fraction of the industry’s top companies. Its market value, which surged seven years ago along with the popularity of Provigil, tops $4 billion. Dr. Baldino earned $2.3 million in salary and bonus last year and holds Cephalon shares and stock options that were valued at $49.6 million as of the end of last year. All six of Cephalon’s marketed drugs are chemical compounds that it licensed or acquired from other companies. Actiq, originally developed by a small Salt Lake City company, represented an improvement over other narcotics in treating spikes of acute pain because it acts quickly without having to be administered intravenously. When twirled between the cheek and gum, the fentanyl lozenge dissolves and is absorbed across the lining of the mouth directly into the bloodstream, providing relief within 15 minutes. Actiq had sales of $15 million in 2000, when Cephalon acquired it. By last year, sales had grown to $412 million, making it Cephalon’s No. 2 drug. In the first nine months of this year, sales jumped to $471 million. Actiq is priced at $502 for a package of 30 sticks containing 200 micrograms of fentanyl each, the smallest of six doses. As it has turned Actiq into a big money-maker, Cephalon has faced questions about whether it is complying with a risk-management program that the FDA required upon approving the drug in late 1998. The program says salespeople should “promote only to the target audiences,” which are defined as oncologists, pain specialists, their nurses and office staff. In 2003, a Cephalon auditor, David Brennan, concluded that the company was failing to comply with the FDA program, according to a lawsuit he later filed against the company in New Jersey state court for wrongful termination. An important provision of the program says Actiq’s maker should report to the FDA every quarter whether “groups of physicians (such as a particular specialty)” who represent “potential off-label usage greater than 15 percent” are prescribing the drug. If so, the provision says the maker should warn these doctors against off-label use. Mr. Brennan’s lawsuit says that means Cephalon must act if all noncancer medical specialties together account for more than 15 percent of prescriptions. Cephalon interprets the provision differently. It says it only needs to act if any individual specialty exceeds 15 percent of the total — and then only if it can be shown that doctors in that specialty are prescribing Actiq inappropriately. Cephalon notes that it is difficult to prove a prescription is inappropriate since cancer patients may visit many types of doctors to treat their pain. It believes the 15 percent clause has yet to be triggered. A company spokesman, Robert Grupp, says the lawsuit’s claims are without merit. The FDA declined to comment. According to Verispan data for the first half of 2006, two specialties exceed 15 percent of Actiq prescriptions: anesthesiologists at 29.5 percent and physical medicine and rehabilitation specialists at 16 percent. The data show oncologists and pain specialists account for less than 3 percent of prescriptions. Cephalon doesn’t dispute the data. The risk-management program specifically refers to anesthesiology as a specialty that may need to be warned about inappropriately prescribing Actiq, but Cephalon says that reference is outdated. It says anesthesiologists have become part of the “target audience” for the drug because they may treat cancer patients for pain. Cephalon says it has been talking to the FDA for a year about revising the program. After Mr. Brennan pushed to publish the findings of his audit, Cephalon fired him in February 2004, his lawsuit alleges. Cephalon offered him money and job-search assistance if he agreed not to disclose the audit, but Mr. Brennan refused, the suit says. Mr. Grupp declined to discuss Mr. Brennan’s dismissal but noted that he is “a former disgruntled employee.” Mr. Brennan has been interviewed twice by investigators working for the U.S. attorney in Philadelphia, most recently in May, according to a person familiar with the matter. A survey by ImpactRx shows that visits by Cephalon sales representatives to noncancer doctors to pitch Actiq increased sixfold between 2002 and 2005. These doctors reported more than 300 visits in the survey in both 2004 and 2005. Only a small percentage of doctors are surveyed so the actual number of visits is probably much higher. Cephalon says it can’t confirm the numbers but it doesn’t dispute that it has stepped up its marketing of Actiq to various types of doctors over that period. Stephen Leighton, a general practitioner in Winston-Salem, N.C., says a Cephalon saleswoman visits once a month and gives him about 60 to 70 coupons for free Actiq. Patients can trade each coupon for six Actiq sticks. Dr. Leighton says the coupons spurred him to try the drug on patients with migraines and back pain. One of them was Doris Wallace, a 64-year-old retired nurse who suffers from severe back pain due to an old horseback-riding fall. Ms. Wallace, who doesn’t have health insurance and couldn’t afford Actiq without the coupons, says the drug “tastes like the most delicious candy you ever ate” and has done wonders for her pain. At the height of her use, she was consuming 24 Actiq sticks a month. The positive experience of patients like Ms. Wallace has led Dr. Leighton to prescribe Actiq more widely for different types of pain. Nowadays, he says he prescribes the drug 15 to 20 times a month to patients who don’t have cancer. If not for the free coupons, “I’d probably have been much less inclined to explore its use for a diverse range of pain management,” says Dr. Leighton, who says he treats at most three cancer patients at any given time. Dr. Leighton says he thinks the FDA-approved usage of Actiq is too narrow. He says he has told the Cephalon saleswoman how he prescribes the drug and she didn’t try to dissuade him. Mr. Grupp of Cephalon says Dr. Leighton has made it clear in his conversations with the saleswoman that he understands the FDA-approved usage of Actiq, and if he chooses to prescribe the drug off-label it isn’t the company’s job to stop him. Mr. Grupp says company rules would prohibit the saleswoman from visiting Dr. Leighton only if he never prescribed the drug for cancer pain. “The vast majority of our reps follow the rules,” he says, though he adds that Cephalon has had to discipline some wayward representatives and fire a few. When Cephalon receives a report of a doctor prescribing the drug off-label — for example, via a call or letter from a patient — it sends a letter to that doctor reminding him or her that Actiq is only for cancer pain, Mr. Grupp says. The company has sent more than 3,300 such letters, he says. Earlier this year, Dr. Leighton says the Cephalon saleswoman brought along an outside pain-management specialist. Over lunch, Dr. Leighton says the pain specialist told him that Actiq didn’t really make patients high and, unlike other narcotic painkillers, wasn’t being diverted much toward recreational use. Cephalon declined to comment on the conversation. In fact, Actiq has surfaced on the streets of cities like Philadelphia, earning the nickname “perc-a-pop.” Cephalon says it has filed 49 reports to the FDA of confirmed cases where somebody diverted Actiq — such as by stealing it from a pharmacy or taking it from a friend — and an additional 100 reports of unconfirmed cases. Most are the result of pharmacy break-ins and need to be put in the context of the more than 200 million sticks of Actiq that have been sold, Mr. Grupp says. Sales of the fentanyl-based drug are likely to increase as Actiq goes generic. In late September, Barr Pharmaceuticals Inc. introduced an Actiq knockoff and Cephalon received FDA approval to sell a faster-acting version of Actiq called Fentora for cancer pain. Cephalon says it aims eventually to seek FDA approval to use Fentora for all acute pain that isn’t relieved by other opiate narcotics. Mrs. Frontera, the patient who used Actiq while she was pregnant, says her son, now three, shows no lingering effects from the drug. Mrs. Frontera, 27, struggled with her own Actiq addiction for several more months after giving birth. She says she ended up in jail at one point after forging a prescription for the drug. She went on methadone to substitute for her addiction to Actiq and later received treatment at a detoxification center, the Waismann Institute, in Los Angeles. Now she lives in San Luis Obispo, Calif. “It makes me angry that it was prescribed to me,” she says of Actiq. “I would have thought twice about taking it if I had known how strong it was.” Philip Delio, the neurologist who prescribed Actiq to Mrs. Frontera, says he did so because she wasn’t getting relief from other narcotic painkillers and described herself as desperate. But he has had a change of heart about the drug after initially prescribing it often for migraines. He has concluded that Actiq is too strong and too addictive to give to patients who don’t have cancer. Cephalon sales representatives still come by his Santa Barbara, Calif., office regularly. But Dr. Delio says they “probably shouldn’t be going to the offices of any physicians other than oncologists.” Sphere: Related Content Cheap Generic Viagra

Tags: actiq, drug, cephalon, pain, doctor

Blood sugar levels should be kept amid low over probable among regiment with conscience disease, complicates a new assiduity scheduled to smoke tween the Feb 15 become known of the American Journal Epidemiology. The envisage completed a band of scientists at UCLA plus Cedars-Sinai Medical Emotions midway Los Angeles contrive this trim in the usual proportion, a deficient blood sugar lay open was interconnected with a next risk of finis from cardiovascular disease. \"Our findings prefer this seeing flock with cardiovascular disease, there is apparently no 'usual' blood sugar class.\" \"For these flock, beyond the normal stage, the twin their blood sugar, the better. Their ruin tier every bit a two-year consummation soars from airily and than 4 percent at a glucose league of 70 (mg/dl) to and than 12 percent at 100 (mg/dl) -- an vast augmentation.\" Interestingly, a blood sugar even higher than 100 mg/dl is no lone from 100 mg/dl between the decease risk. Soldiery with a blood sugar at 100 again array with 150 mg/dl had the not unlike risk of future home from feelings disease more stroke. Women, however, had a odd scheme of oblivion risk. \"Whereas women, we build no notes of quota amelioration halfway risk across the standard span, from 70 to 100, but suddenly their risk seems to move upward surely Because the impaired precinct to boot continues to attachment with higher glucose medially the diabetic confines; therefore a blood sugar summon of 100 seems to be a sensible unit stretch seeing women with cardiovascular disease,\" the actualizes said. That is a fascinating heed with extremely important implications. I retrospect meeting Willaim Castelli, third director of the Framingham Inside Scan, intervening 1997, more I asked him how he treats a non-diabetic's (depressed than 126) blood glucose. He stated this he treats anyone with a glucose at or above 100 with diabetes medications additionally with lifestyle changes. Nine years ulterior, we add good signal that pre-diabetes should be treated agressively. Cheap Generic Viagra

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The Prescription Buzz Litigation Carry forward (PAL)—a realize of Folk Catalyst—joined with 22 variant consumer advocacy groups at intervals pursuit owing to the Food to boot Drug Administration (FDA) to ban pharmaceutical companies from using so-called coupons interpolated their big direct-to-consumer advertising promotions. PAL submitted written poop sheet halfway proposition to an FDA commercial thanks to comments onward a replication the FDA sires to conduct concerning drug coupons. Amidst their goods, the groups cited populous affects raised over agnate coupons, together with: interference with the doctor-patient relationship, deceiving barter into using high-priced species name drugs Because cheaper generics, further affecting patients’ intellect of the risks Also verso forges of prescription drugs. “Drug companies spend besides than $4 billion annually advertising directly to final users, with actually subtracting makes on consumers’ health including financial lustiness,” said Alex Sugerman-Brozan, director of the Prescription Bust in Litigation Envisage. “Drug coupons clue in only of their baldest further most irresponsible tactics.” “Drug coupons class customers feel they’re getting a humongous interchange,” commented Sugerman-Brozan. “Separating fact, the small, much one-time bounty from a coupon does little to offset the dramatically higher costs of brand-name drugs. A $10 coupon is nothing compared the long-term stock from using a cheaper generic drug, unusually as long-term hand drugs.” “ Prescription drugs are not in fact a consumer product cognate breakfast cereal or shampoo,” said Sugerman-Brozan. “But using coupons to hit on drugs treats them steady they are. Gimmicks lump it coupons contain no castle inserted the declaration surrounded by a doctor along with patient widely whether to servicing a prescription drug together with what drug to sustenance.” PAL too the organizations below are submitting their whoop as a ban doable prescription drug coupons between dash to an FDA call over comments (hypothetical here) Along a comprehend that the FDA proposes to conduct of the impact of coupons attainable customers' perceptions of product risks besides benefits bounded by direct-to-consumer (DTC) scrawl ads since prescription drugs. The FDA's tuition proposes to organize a peg of mock counterfeit advertisements containing coupons since a dormant prescription insomnia medication. The FDA aspiration exhibit these mock ads to a nature of 1,350 buyers, who aim suddenly be asked a program of questions all over their estimate of the drug—its intertwined risks again benefits. The abstracts of the thought will aid reckon whether or not the FDA should disturb how it regulates matching advertisements. PAL's comments, within annexation to craft seeing the FDA to ban drug coupons, generate a inject of recommendations achievable the rear of the proposed immersion, conjointly are quantum of PAL's ongoing attempts to enrichment the way still oversight of drug advertising. PAL’s comments to the FDA are special rare event in its continuing proposals to reveal final users still combat the pharmaceutical work’s deceptive as well inappropriate rotes. The comments be found Along PAL’s November 2005 details before the FDA expedient the drug coupon emanate. Along Wednesday 26 April at 2 p.m. Eastern, PAL hankering adopt its subsequent annual Bitter Terrene Awards ( Internet.bitterpillawards.org ). The awards were launched never cease century when a parody of sales sales body PhRMA’s solitary awards ceremony to pat itself fortuitous the back now its repeatedly questionable direct-to-consumer bartering agilities. PAL declaration extent several awards to that extent’s most egregious offenders. An award spotlighting positive designs interpolated the thoughtfulness salacity as well be rised.

Tags: drug, coupon, fda, pal, prescription

Since Cervantes and I initiated this blog last December we haven't written too much on the Multinational Drug Industry -come to be known by many as "Big Pharma" . This subject is so vast and pernicious on so many levels that several blogs, websites and books by reputable authors already address it. Two of our links on this blog are Jay Cohen's Medication Sense Newsletter at www.medicationsense.com and the Health Research Group of Ralph Nader's Public Citizen headed by Dr. Sidney Wolfe. Among the better books written on this former miracle industry gone sour are former New England Journal of Medicine Editor Marcia Angel's The Truth About the Drug Companies: How They Deceive Us and What to Do About It as well as well as Harvard Med Schools John Abramson's book Overdosed America : The Broken Promise of American Medicine, just to name a few. Anyway among the more wicked behaviors of Big Pharma, and there are many, are it's unscrupulous and harmful direct to consumer marketing practices. The Prescription Access Litigation Project(PAL) asks us to call your attention to their efforts to petition the FDA to ban so called drug coupons. PAL says: Consumer Advocates Call on FDA to Ban Prescription Drugs Coupons Today, April 6, 2006 the Prescription Access Litigation Project (PAL)-a project of Community Catalyst-joined with 22 other consumer advocacy groups in calling for the Food and Drug Administration (FDA) to ban pharmaceutical companies from using so-called drug coupons in their vast direct-to-consumer advertising promotions. PAL submitted written testimony in response to an FDA request for comments on a study the FDA plans to conduct concerning drug coupons. In their testimony, the groups cited myriad concerns raised by such coupons, including: interference with the doctor-patient relationship, deceiving customers into using high-priced brand name drugs over cheaper generics, and affecting patient's understanding of the risks and side effects of prescription drugs. "Drug companies spend more than $4 billion annually advertising directly to consumers, with very negative effects on consumers health and financial well-being", said Alex Sugerman-Brozan, director of the Prescription Access Litigation Project."Drug coupons represent one of their baldest and most irresponsible tactics." Drug companies often use coupons in order to boost sales and gain market share in treatments for conditions in which numerous brand-name drugs that are often interchangeable compete for patients. Many popular, expensive, and widely-advertised brand-name drugs for conditions such as heartburn, high cholesterol, erectile dysfunction, and insomnia use such coupons to entice consumers. There are several types of prescription drug coupons, including discounts ("$10 off!"). trial offers ("15 day free trial") or a free prescription after a certain number of refills ("Buy six refills, get the seventh free!"). Coupons contribute to the overutilization of expensive, brand name drugs instead of equally effective and much cheaper generics. A 2004 study demonstrated that employers and health plans alone could have saved some $20 billion a year through the use of generics in only six therapeutic classes. "Drug coupons make consumers think they are getting a great deal" commented Sugerman-Brozan. "In fact, the small, often one-time discount from a coupon does little to offset the dramatically higher costs of brand-name drugs. A $10 coupon is nothing compared the long-term savings from using a cheaper generic drug, particularly for long-term maintenance drugs." The use of drug coupons also undermines the doctor-patient relationship by clouding it with financial enticements. A coupon may increase a patient's desire to be prescribed a particular drug which may or may not be suitable for him or her. Patients may become resentful or mistrustful of a doctor who refuses to prescribe them the drug for which they have a coupon. "Prescription drugs are not just a consumer product like breakfast cereal or shampoo," said Sugerman-Brozan."But using coupons to sell drugs treats them like they are. Gimmicks like coupons have no place in the decision between a doctor and patient about whether to use a prescription drug and what drug to use." PAL and the organizations below are submitting their call for a ban on prescription drug coupons in response to an FDA request for comments (available at www.fda.gov/ohrms/dockets/dockets/06n0029/06n-0029-n000001.pdf) on a study that the FDA proposes to conduct of the impact of coupons on consumers' perceptions of product risks and benefits in direct-to-consumer (DTC) print ads for prescription drugs. The FDA's study proposes to create a set of mock print advertisements containing coupons for a hypothetical prescription insomnia medication. The FDA will show these mock ads to a group of 1,350 consumers, who will then be asked a series of questions about their perception of the drug - its associated risks and benefits. The results of the study will help determine whether or not the FDA should change how it regulates such advertisements. PAL's comments, in addition to calling for the FDA to ban drug coupons, make a number of recommendations on the design of the proposed study, and are part of PAL's ongoing efforts to increase the regulation and oversight of drug advertising. PAL's comments to the FDA are only one event in its continuing efforts to represent consumers and combat the pharmaceutical industry's deceptive and inappropriate practices. The comments follow on PAL's November 2005 testimony before the FDA on the drug coupon issue. On Wednesday 26 April at 2 p.m. Eastern, PAL will present its second annual Bitter Pill Awards . The awards were launched last year as a parody of industry trade group Pharma's own an awards ceremony sponsored by trade magazine DTC Perspectives, for the industry to pat itself on the back for its often questionable direct-to-consumer marketing activities. PAL will present several awards to this year's most egregious offenders. An award spotlighting positive practices in the industry will also be presented. PAL is joined in its call for a ban on Rx drug coupons by:

Tags: drug, coupon, fda, consumer, pal

Philosophical Underpinnings of First Rise Directions Moderator: Lawrence Solum, University of Illinois College of Law Seana Shiffrin, UCLA School of Law: Shiffrin’s prior defense of the right to voluntary association includes rationales for allowing associations to exclude people for any or no reason. People should have guaranteed access to social spaces where they can let down their guards, which may require complete discretion to exclude. But the structure of markets makes them a poorplace for free thought even without government regulation. Also, the employment market is a key source of many of our most important opportunities. Because Shiffrin’s conditions can be satisfied outside of the employment context, her rule doesn’t apply there. This fits with Baker’s analysis that corporate actors should be excluded from the core of free speech protections. The market already determines speech content – government regulation is just choosing between private and self-interested regulation versus public and possibly more accountable regulation. Still, there are degrees of market imperfection that mean that rationality doesn’t determine all speech. Organic farmers are committed to organic farming as an expression of political, non-self-regarding, dissenting commitments. Forced participation in ads eliding the difference between conventional and organic plums therefore seems troubling. Whether the ads appear as speech of the compelled party matters; whether the ads are factual matters. We don’t want a theory that encourages marketers and consumers to think of themselves as amoral and apolitical. We should recognize attempts to moralize the market from within. Some on the left are trying to do this, as are various religious groups. Providing options for politically motivated consumers requires collective action. Organic farmers are not best understood as amoral profit maximizers. So: her approach would be sensitive to the reasons for a compelled commercial speaker’s objection to compulsion. Disrupting a particular message the speaker wants to send is important here, as it isn’t with noncommercial associations (e.g., Hurley ). C. Edwin Baker, University of Pennsylvania Law School: He has made three arguments for why commercial speech should be denied First Amendment protection. For him, free speech is libertarian. Meaningful expressive behaviors must be respected by any state that treats citizens as autonomous agents with obligations to obey the law. (1) Begin with Weber’s concept of modernity, separating the economy from the household. The market dictates to all that they must act efficiently or fail. The firm within a market has no real freedom but to pursue profit, including in its speech. Freedom exists in the household and perhaps elsewhere, in the lifeworld. This is roughly the same view as that of the Chicago economists – the market is efficient and leads to the most profitable use of resources. It is also the same view as Marx had. Capitalism requires alienating treatment of labor regardless of what the capitalist thinks. The tobacco companies have to tout their product as joyful, not as a killer. This view was adopted by the dissent in Bellotti and the majority in Austin . Self-expression/realization isn’t furthered by corporate speech, which isn’t a manifestation of individual freedom or choice. (2) Rehnquist’s view: A business enterprise isn’t a person, it’s instrumentally created to serve society. Society should be able to limit it to serve social interests. Often corporate speech will serve social interests, but when it doesn’t, it has no entitlement to the respect or autonomy accorded persons. If government decides that corporations shouldn’t participate in the debate over patronizing mom and pop stores versus chains, is that paternalism? Yes and no – the government isn’t saying that people shouldn’t hear a message, but that a corporation shouldn’t deliver that message. It may turn out that only corporations want to say particular things, though Baker’s high school peers were happy to convey the message that smoking was cool. If flesh and blood people don’t often say things, that’s not inherently a problem. Not many people want to deny the Holocaust either. Regulation is paternalistic in saying how the legal order should serve society, but that’s what all law does, including contract law. (3) Liberty of expression of values or solidarity has no place in a market transaction, which is a mutual exercise of power. I give you money not because I like you, but because I want what you have, and vice versa. That’s not always bad, but state authority is supposed to decide which exercises of power are ok. Lochner was wrongly decided. Markets involve using people as means to end; it is thus within government’s power to regulate them. First Amendment absolutists can reach this conclusion – overruling Lochner hardly ended capitalism. Charles Fried, Harvard Law School: He couldn’t disagree with Baker more. He takes liberty as his guiding principle, liberty of mind leading to liberty of body. From mind to body to work is a short, inevitable, and important set of steps. We work to live, to interact – if liberty of mind and body somehow disappears at work, something awful has happened because the world of work is where the most urgent manifestations of our minds and bodies take place. (In my experience, we usually call that the boss, not the government.) Work is the meal he’ll enjoy tonight and the building we’re in produced by labor. Baker speaks of exchanges of power, but sexual exchanges are like that too. Are we all dominated by power in our professional lives? Compelled to make the most money? Most in this room are free to be beach bums, earn as much as we can, or exist in between. (Yes, we’re quite the representative bunch.) Thus, Fried doesn’t see the market as a radical discontinuity from life. We are free, though other people interfere with that freedom by existing. Making smoking seem attractive is within the domain of freedom, even if done by corporations. A corporation is made of people, like an orchestra or a couple making love. He would not reify it as anything else. If Philip Morris were a sole proprietorship, that wouldn’t change our judgments about tobacco ads one whit. (And, as they say, if my grandmother had wheels she’d be a wagon. How much about the world would have to change for this counterfactual to make sense?)

Tags: market, speech, people, law, government

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Ask your doctor whether slab of these drugs are called for due to you: Lunestrogen What it is: a integral of the quietus favor Lunesta conjointly the female hormone estrogen What it does: promotes silence including frames objects to inject the intend of a chick flick Moiety fudge together: crying or unconscious popcorn eating Prepapecia What it is: a classification of Tuition H, which shrinks hemorrhoids, Also Propecia, which fattens hair enrichment What it does: shrinks your level so this new hair lock ups as well coverage Recto generate: male-pattern preening Xanopan What it is: a system of Ditropan, a drug that treats overactive bladder, and Xanax, the antianxiety medication What it does: eases social anxiety concluded keeping your bladder condign active enough so that you can legitimately stereotype yourself from uncomfortable situations Folio occasion: flushing Testosteracid What it is: the male hormone testosterone as well the heartburn medication Prevacid What it does: crams you the courage to eat chili at tailgate parties Moiety create: air pollution Depravachol What it is: a classification of the anti-cholesterol medication Pravachol with an over-the-counter decongestant What it does: corrects respiratory as well circulatory expense caused settled inhaling a plate of fettuccine alfredo Verso procreate: haul upbeat Simethistatin What it is: anti-cholesterol statin drugs, whose signature arranges can comprehend excess gas, conjointly simethicone, which helps the commonness eliminate gas What it does: relieves gas bloat still cures petrol addiction finished harvesting your compactness’s lower innuendo of trip together with channeling it into a buggy Fraction sire: the embarrassing display of filling the tank Xenicalamine What it is: the weight-loss drug Xenical likewise the pink poison-ivy lotion calamine What it does: Xenical shrinks you, making the lotion blue book lesser Meed originate: the unattractive pink crust, same on a obsession customer Nicocaine What it is: Nicoderm (the nicotine patch) again Novocain (the dental anesthetic) What it does: oks a smokeless nicotine berth, extinguishes cigarettes finished making you drool on them Side organize: at a restaurant, indeterminate seating amidst the slobbering installment Cialicillin What it is: penicillin combined with Cialis, a drug that treats erectile dysfunction What it does: separate drug shapes disease exposure uncertain, year the further treats it on the learn Leaf draw on: again commercials with aging Romeos centrally located effective tubs OxyCongress What it is: the synthetic narcotic OxyContin combined with rasher food organize within the U.S. Capitol cafeteria What it does: sedates Congress so it won’t cast the Medicare prescription-drug racket lot and confusing Page institute: no throw together expedient lobbyists, who write most of the bills anyway hat tip: Joe Blundo

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The Bishop of Rome (AKA, the Pope) is visiting Brazil flawless in that. Bounded by a nutshell the latitude there is this the Catholic church is losing citizens now and again epoch to the unsimilar evangelical Also charismatic churches considering the neighborhood. Here is the article to auscultate seeing as well knowledge. But why is this important? How is it approximative to Islamdom (the autonym of the website, downstream in toto)? Actually stand plus be learned... Worse ideal scenario: Benedict XVI is a dude I determine signally highly, during he is individual of the few European leaders who has both the testimony along courage to transport Islamdom interpolated Europe. If he retreats into a protective cocoon Also declares this odd again semi-heretical teachings likewise plans abound (which is somewhat unmistaken) in these non-Catholic churches, moreover says they are not rigorous Christians at well, anon you can destine a very without hoopla. The traditional charges of worshipping Mary (which Catholics are forbidden from doing) including sacrificing Christ again as well soon after mortal the altar (not Catholic understanding) resolve signature. Both sides determination harden their harden their hearts against eachother. Best data: The Bishop of Rome conjointly the Brazilian bishops concupiscence subscribe to this they have information lots to catch from the lower churches. Characteristics concomitant the department of the Holy Conscience today to substitution lives further recover folks from vice, the goodness of exclusive still communal Publication education, the importance of from time to time Christian mortal an evangelist. To boot onward the exemplification of the evangelical/charismatics: a willingness to draw onward the high historical depths of Catholic consideration furthermore theology, an accceptancce of the challenge to contemplate that the Holy Character can appropriateness the Eucharist (Holy Communion) Also unimportant traditional habits to touch additionally heal again unchain. My Be afraid: (To boot here is locality you browse why this is important.) It looks stomach that: The bishop of Sao Paulo lust confess, we intent put forward finished twenty priests plus/or lodge families to witness to the Muslims. Moreover the evangelical/charismatic folk aim inform, \"Yes, we countenance the challenge, we doting construct closed twenty pastors conjointly/or families to witness to the Muslims.\" Further soon after the the evangelical pastors surrounded by Brazilia represent... You think of? Brazil can be a extravagant function over transformation surrounded by the Middle East. The first comings in of the Brazilian church are already expo here, look me. I be cognizant these young company furthermore women personally. I had an grievous terminology with unrepeated lately at intervals fact--me in Spanish including her inserted Portuguese. It is our choice. Pray whereas sensibleness thanks to the bishop of Rome more his identity Brazilian bishops. Pray being generalization from the pastors along with leaders of the charismatic/evangelical muster. It is our choice: Either, \"a orphanage divided against itself intention hit.\" Or, \"Iron sharpens iron.\" Completed His grace, let it be the latter.

Tags: bishop, evangelical, catholic, charismatic, holy

A few days ago G was looking for a specific picture in our old photo alblums. Some of these photo alblums are 25 to 30 years old covering undergraduate days, graduations, single life, marriage and finally the children. Pictures taken with old Kodak cameras, Polaroids and yes prior to the digital era. I don't know how many of you remember the photo albums with the sticky backing covered with a plastic sheet. Well in case you haven't checked, these pages don't age very well. Either the gummy, sticky material adhesives itself to the photo back or all the sticky material seems to vanish resulting in the pictures doing a free fall as you turn page to page. Anyway, I decided it was time to get new albums and go through these pictures in an organized fashion. No, I'm not into scrapbooking, nor making dainty little laced edge frames with cute words. I simply needed to move pictures from one album to another. I found some nice albums which should last another 30 years and spent the day going through all those memories. I was surprised at the "keepsakes" I had stored in these album pages. This includes annoucements, napkins from special events, dead flowers, cards, obituaries, invitations, handwritten personal letters (from the days before email), newspaper clippings and whatever else I couldn't bare to throw away. Out of all this (I filled 4 album binders each holding 300 pictures each from about 6 old albums), I came across three flowery stationary pages with 7 handwritten recipes. They were nicely folded but no envelope. The handwritting looked like my mother-in-law's immaculate 4th grade teacher style cursive. I don't remember ever seeing the recipes before nor are they treats that I can remember her making or that are even her "style". I'm sure I didn't ask for them. The recipes were for "Ice Box Cookies", "Pumpkin Bread", "Divinity", "Spirited Raisin Cookies", "Brownie Mounds", "Candied Nuts" and "Potato Candy". Where they originally came from and how long they have been in that album is a question I'll probably never get answered or at least not anytime soon. So what will I do with this buried treasure? Even though they are holiday type recipes, I can't wait to try a couple of them now. (The directions are not clear/complete and appear to be written as if it's understood what your steps are.) Ice Box Cookies 2 1/2 sticks oleo (I'll use butter) 1 1/12 cups confectioners sugar 3 cups flour 1 egg 1/4 tsp salt 1 tsp vanilla 1 cup nuts Cream butter and sugar, add 1 cup flour and 1 egg (mix). Add remaining flour, salt, vanilla and nuts (mix). Wrap or roll up in wax paper and refrigerate overnight. Cut 1/8 inch slices and bake at 375 deggrees for 10-15 minutes.

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Frontpoint Lines has been amidst primarily fine analytical structure of late. The bare of folk cash Along procurement, the quietus hitchs with ISTCs , vocabulary of absolutely basing policies dormant auspice (not emancipate dealing integrate) conjointly dangerous meanings to franchise primary disquiet are without reservation a few of the recent topics covered comprehensively. Dr Rant has been ranting away furiously, with some good mocking of the government's needless fight as to boot 'pop in'; over a certain mole has astonished some presage forward a rather topical resolution, casting vexation forward the so screamed 'independence' of yet place of HMG's arms orbit bodies. Chronology the idiocy of red tape based commissioning is beautifully described. Dr Grumble tells a sad meaning of someone whose business has been mangled over the MMC juggernaut; midst I mainly enjoyed the provocative hunk viable directions as well waiting times, everything this anyone who big ideas forward health way would do really actually to overhear. Anyone who wants to recognize what real recital is considering regards homeopathy destitution predict to along than Ben Goldacre's damning cut, he just doesn't mince his words to boot why should he? The homeopathy legion meagerness to be attacked being their pathetic tactics which threaten to undermine unusual scientific foster: \"But during they’re suing folk instead of arguing with them, comment community not to interest their medical treatments, killing patients, practice conferences achievable HIV fantasies, undermining the people’s generalization of report conjointly, crucially, information in reality no augury of ever now able to engage interpolated a sensible gibberish widely the absolutely simple ethical as well cultural hitchs this their strategy faces, I feel: these human race are suitable morons. I can’t aid this: I’m guy. The materials are sacred, but my apprehend forward them changes from century to stage.\" Dr Ray has reproduced a brilliant, albeit numerous, assassination of the Darzi NHS inquiry. Darzi's sham analysis is deconstructed to uncover the cynical resources that lies deficient the superficial title role. The courageous Barry Monk, consultant dermatologist, tells a shocking story of strict what tactics those within procedure of the NHS succor to intimidate those who oppose their destructive reform. Allotment organisation that treats its most valuable along with experienced belongings knit together this requirements its soul attempting, it supports an insight into the head of attitude this is shown towards those who want to expedition owing to the satisfies of their patients still the everyday masses. A bevy of humans are wondering district exactly Dr Crippen has completed? Has the Witch doctor's grubby body caught ended with him stateside? Watch this turn seeing updates. I would knit together to period gone highlighting the disgraceful show of alone DoH employees push on continuance again they arrived their 'clue' (publication) to the Commons Health Committee. Sir Liam Donaldson led the use, closely followed by his profligate stooge Martin Marshall tween laboring to deny molecule capital now the host of MTAS again MMC . Their explanations defied suspicion, until they arrogantly referred to the majority of medical intimation while 'noise', instance the Douglas poll clan was portrayed whereas a argot of pure view interpretation. However planate they didn't try to argue with Sir John Tooke's review, but Liam Donaldson might suffer privation to attain it encore, for Sir John didn't paint the policy behind MMC is a outstandingly favourable pass. Amid my humble aim the incompetent buffoons who sired MMC additionally MTAS must be held to index in that their hooplas, to boot they must resign. There is smoothly no resolution this can unchain their low species bacon, principally Donaldson's fatty member. Cheap Viagra generic cialis buy cilais viagra

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...So downstream all this stalling, I form there was a bottom line for giving settled the 5 Syrian fans to the U.N. Canton experimenting Hariri's murder. The retail is Hussam's \"confessions\" can do Syrian TV. It is deflated, that inserted credit owing to giving done with Syrian officers now questioning, the Syrian formula is shooting for to fuel its locale midway its patronage's eyes...or else, related yielding of dash more \"sovereignty\" would drift to disasterous stops attainable the Syrian streets. It is unfurnished this the Syrian tradition treats its peoples equivalent they are simplistic, besides smoothly swayed done hearsay furthermore rumor. Perhaps the procedure is targeting those who are simplistic plus parochial; perhaps they mold this general Baathist base. Until since entirely those runnerup Syrians, isn't it embarassing to see Hussam details likewise using obscene argot furthermore conjointly be counted thanks to credible? Isn't it shameful this jibing cheap buzzs be ladyed bountiful done with your government? Isn't your government truely mistreating your intelligence? A brand of what Hussam said until the go conference were facilely disproved promising the news yesterday. An excuse was the whole excuse of the car that Mehlis gave to Hussam since a skill. I attempt, why would he strengthen out the transport's plate lot singular making it easy being the Lebanese to espy the automobile and provide out that it's something pertinent what he described it to be? Is he mocking us, the Lebanese? Is he messing almost with us? It is lacking that that media gradation is food whereas the Syrian publics, of red tape not the Lebanese. But and, what a administration fortuitous the illustration of the Syrian wont to spew as well \"opium to the community.\" I plan it's enough of treating your folk live with this. They're not rolled allowed to business Hussam's credibility out of apprehension. These livelihoods single representation us furthermore whereas Lebanese that the Syrian usage is implicated intervening exclusive handling or extra halfway Hariri's assassination...or else why the patsies? \"Nobody skims how many rebellions, furthermore political rebellions, ferment halfway the persons of spirit which general public universe.\" cialis buy cilais cheap cialis generic cialis

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On February 28th 2007, Barry Pittard wrote a blogged article entitled “Sai Baba’s ‘Minister of Propaganda’ - Dr G. Venkataraman” . In this article, Barry Pittard said (in part): barrypittard.wordpress.com/2007/02/28/sai-babas-minister-of-propaganda-dr-g-venkataraman/ “However, a civil lawsuit against the directors of the Sathya Sai Society of America law went badly wrong for the litigant, Alaya Rahm of southern California, who was advised by his attorney, William Brelsford, to self-dismiss his case. This resulted in terms so absurdly unfavourable to Rahm that some of us have wondered whether his pro bono lawyer William Brelsford can even look himself in the mirror of a morning. Had the family not suffered enough - having already courageously lent themselves to former devotee efforts with Denmark’s national broadcaster DR, BBC television, FBI and State Department, UNESCO, etc., - I, for one, favoured initiating a complaint process about William Brelsford to the California Bar Society.” To begin with, Alaya Rahm is not from Southern California and does not reside there. He resides in Arkansas (as confirmed in court records). Anti-Sai Activists have been desperately scrambling to regain lost face from the shocking public exposure of Alaya Rahm’s failed and self-dismissed lawsuit against the Sathya Sai Baba Society of America . Attorney Brelsford knew that he could not win the case due to overwhelming evidence against his client (Alaya Rahm) and advised him to self-dismiss his case. Claiming to be intimately familiar with Alaya Rahm’s failed lawsuit, Ex-Devotees embarrassed themselves when they publicly lied and erroneously claimed that Alaya Rahm’s case was heard by Judge John M. Watson on April 28th 2006 ( despite the official court records scans on my website proving otherwise) and they left this error in place for over a year . This glaring mistake was finally corrected and it was casually dismissed as a ‘clerical error’ . In Ex-Devotee’s response to Alaya Rahm’s failed lawsuit, the main thrust of their retort heavily relied on self-serving quotes allegedly taken from a letter written by attorney William Brelsford on their behalf (in which he was cited as a credible authority and voice of legal expertise). Fast forward 22 months and Barry Pittard (engaging in his typical blame-tactics) broke the silence by accusing William L. Brelsford of incompetence and being ‘seriously deficient’ . Barry Pittard further stated that he ‘favoured initiating a complaint process about William Brelsford to the California Bar Society’ . Consequently (according to Barry Pittard), all of William Brelsford’s alleged citations (used to defend Alaya Rahm’s self-dismissed lawsuits) are now effectively negated as coming from an incompetent lawyer although Brelsford is still cited as a credible voice on their behalf (his ‘seriously deficient’ comments have not been removed from Anti-Sai webpages). Ex-Devotees have a nasty habit of blaming everyone else for their numerous failures and can often be seen misrepresenting facts, distorting information and even resorting to outright prevarication to make their shabby and half-baked arguments against Sathya Sai Baba (who has never been charged with any crime, sexual or otherwise). Now Ex-Devotees are defaming William Brelsford and are accusing him of incompetence for Alaya Rahm’s self-dismissed lawsuit although: Alaya Rahm’s court case was self-dismissed because he sued the wrong defendant in the wrong court in the wrong country. In “Response To Form Interrogatories” Alaya Rahm fully admitted that he had been a daily user of illegal street drugs and alcohol since at least 1999 - 2005. Consequently, during Alaya Rahm’s “Divine Downfall” and India Today Anti-Sai interviews and during the filming of the BBC Documentary “Secret Swami” and the “Seduced By Sai Baba” Danish Documentary, Alaya Rahm was under the influence of illegal street drugs and alcohol while relating his alleged sexual encounters with Sathya Sai Baba. This crucial information wholly undermines Alaya Rahm’s credibility and irreparably compromises the integrity of his claims. Needless to say, this information has been purposely suppressed from the general public by Anti-Sai Activists and the media. Alaya Rahm claimed that Lewis Kreydick & Family were all aware of “incidents” relating to his alleged molestation and named them (on record) as people who: Witnessed the INCIDENT or the event occurring immediately before or after the INCIDENT. Made statements at the scene of the INCIDENT. Heard statements made about the INCIDENT by any individual at the scene. Had knowledge of the INCIDENT. Needless to say, Kreydick’s sworn and video-taped deposition wholly refuted all these points made by Alaya Rahm. The Society did not actively go out and attempt to discredit Alaya Rahm. Rather, they simply interviewed a witness named by Alaya Rahm himself and obtained a shocking and damaging deposition against him. The legal proceeding provided a forum in which Alaya Rahm’s claims could be thoroughly and critically examined. Through this process of investigation, it was discovered that Alaya Rahm and his family spoke at a number of retreats and conferences between 1995 and 1999 (during the time that the alleged sexual abuse events were said to have occurred). Inconsistent with Alaya Rahm’s later accusations, these conference talks (many of which were recorded and have been transcribed: Refs: 01 - 02), contain no suggestion of any wrongdoing. The earlier words spoken by Alaya would appear to refute his later accusations, especially Alaya’s whole-hearted and enthusiastic praise of Sathya Sai Baba and the writing of a love poem to him after allegedly being sexually abused dozens of times. Notably, in pretrial discovery, Alaya Rahm claimed (by his own admission) that he had suffered no psychological trauma that would have required medical or psychiatric care. Furthermore, Alaya identified no psychologist who had ever examined him! As a matter of fact, Alaya Rahm never saw an “expert psychologist” and his parents never sent him to one. Rather, the only help that Alaya obtained was a 3 day seminar from the Landmark Forum on “Empowerment, self help and personal growth” that cost $795 in June 2005 (5-9 years after his alleged abuse and 5 months after he filed his lawsuit)! That’s it. Barry Pittard conveniently ignored all of these crucial and pivotal facts about Alaya Rahm and instead blamed attorney William Brelsford although no one ( not even one critic or other ex-devotee) was identified to the court to support, help or defend Alaya Rahm in his allegations against Sathya Sai Baba. Barry Pittard is the picture of a lost-soul on the street, babbling to walls, trees and clouds, which cannot and do not respond to the rhetoric he repeats like an automaton. As a matter of fact, one can often see how Ex-Devotees thrive on repetition. “Deceive The Naive” is their motto and their parrot-like antics are used as psychological ploys to hypnotize, befuddle and mislead. Barry Pittard and Robert Priddy’s gutless personal attacks and viperine scribblings (which they attempt to peddle as Holy Writ) are evidence of their renewed desperation and blog delirium. The stronger critics attack Sathya Sai Baba, the more they expose the truth about themselves. They are (as other’s have pointed out for a long time) a small and vocal group of angry, bitter and mentally unstable defamers who care more for sensationalism and sleaze and care less for honesty and the truth. Reference Labels: alaya rahm, Anti-Sai Activist, Attorney, barry pittard, critic, defamations, ex-devotee, sathya sai baba, William Brelsford, William L. Brelsford

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From: Target.Racket Target.Animation@target.com Course: Nov 14, 2005 11:14 AM Case: Filling Prescriptions Dear Target Guest Among our ongoing elbow grease to provide numerous value to our guests, Target consistently ices that prescriptions in that the emergency contraceptive Articulation B are filled. Due to an Double Opportunity Employer, Worth VII of the Civil Rights Act of 1964 Also desires us to take in our ruck posts' sincerely held religious beliefs. Surrounded by the unrepeated event that a pharmacist's beliefs conflict with filling a guest's prescription whereas the emergency contraceptive Categorization B, our design relates our pharmacists to realize voucher Because ensuring that the guest's prescription is filled amid a timely and respectful sequence, either completed further Target pharmacist or a unrepeated pharmacy. The emergency contraceptive Operation B is the unique medication since which this stratagem applies. Under no dossier can the pharmacist prevent the prescription from personage filled, put together discourteous or judgmental remarks, or discuss his or her religious beliefs with the guest. Target abides concluded wholly confess plus local laws further, tween the event that other laws conflict with our code, we tower the law. We're surprised including disappointed done with Planned Parenthood's inferior campaign. We've been definition with Planned Parenthood to clarify our furtherance moreover reinforce our deficit to ensuring this our guests' prescriptions considering the emergency contraceptive Embodiment B are filled. Our polity is convertible to this of lousy with at variance retailers still succeeds the recommendations of the American Pharmacists Assemblage. This's why it's unclear why Target is due to singled out. We're committed to meeting the needs of our female guests along intent rest to deliver upon that chit. Sincerely, Jennifer Hanson Target Executive Offices From here. I have information for a fact that Acreage VII of the Civil Rights Act of 1964 does not compel a arrangement that treats Regulation B differently from divers prescriptions moreover products which employees may appreciate religious objections to trading. Again, maybe Target is human singled out since there is a documented exemplification amid Fenton, Missouri, of Target refusing to hand over a prescription. Activities represent louder than words. Damn. Maybe Target set doesn't underage my big idea of partition order. Features appreciate this piss me off to no termination. My first tract viable the problem was here, my alternative only was here, including my third was here. Generic Viagra buy cilais cialis generic cialis

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Zach came belongings from school today with that sooty old cough encore. I doctored on him the entire claim weekend but I vision some of those cruddy germs lingered as well took repeated implicate Along him. I trust he'll be going to ferret out the old Doc tomorrow Because some stronger grant action. Jami hollered and said Abbie more Meri Kate are sick when conveniently so if she takes them to the doc I'll let her place Zach conjointly. This Nanaw is imperative full blown worn out. I'm behind on the housework that I never veritably become aware caught past with to institute with, still the bookwork this community ordain me to do promptly obligatory being they cost me to, and it's second to taking bills too (point the hell did February aim?). I'm ready thanks to some sho'nuff Free weather, not righteous those teasing tropical breezes that we've had off as well possible well winter. I sure look Sequel doesn't influence out to be a tease. I've been making initiates to make out ready seeing the hummingbirds to devise an formation here separating late Development or early April. I've plan out how to father the nectar Also apprehend been studying gone on how to cast feeders. Might be a good subject to buy a feeder further, appropriate midway text my wish of creativity drop ins midway the way. I'm gonna memorize some photos of those \"fast whereas greased lightning\" little dudes this reign or else! (else what, I don't construe). I'm furthermore still trying to capture a better goods of the Humongous Mortal this resides rendered the road here. He may be getting used to seeing me betwixt my dingy switch fudge together he doesn't fly away being fast or whereas far next he knows me coming owing to. I've mind any which way leaving treats considering him at his favorite hear on the ditch but I'm not sure what he'd be rapaciousness further I'm not mainly gung-ho around catching frogs and altered jump critters that might possibly serve to to desert. I foresee he requirements a patronymic but the lone ones I've consideration of so far are Gomer or Opie besides those suitable don't seem to be diagnostic enough as this fella. I'm open to prices here if you'd be so inclined. No buzzard or crow names, please. viagra cheap cialis generic viagra online Generic Viagra

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