PAC2 Report on the Pediatric Cancer Caucus
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PAC2 Report on the Pediatric Cancer Caucus – September 16, 2010



PAC2 was honored to be invited and attend the briefing to Congress presented by the Pediatric Cancer Caucus.   The event was held in the Rayburn House Office Building, directly across from the Capitol. It started early and finished late.



The briefing was presented by an incredible mix of men and women with the knowledge, ideas, dedication and passion to cure childhood cancer.  So excuse the lengthy nature of this report, which will include both facts and my thoughts, but I'm compelled to convey as much as possible.  I wish I could take shorthand because so much was said.  Please excuse any errors and note that most are not direct quotes (unless noted with quotations), but my recollection and scribbling and are only intended to convey the message - which was one of hope....



As I made my way home, I just wished that each and every member of the childhood cancer community could have been there.  



The briefing was hosted by Congressmen
Joe Sestak (PA) and Michael McCaul (TX) and intended to demonstrate to Congress the urgent need for increased federal support to cure kids cancer.  CureSearch and Children’s Cause for Cancer Advocacy also hosted a pre-briefing breakfast.  The panelists included: 
The room was full to capacity, with many standing in the back.  ABC News was there, and further info will follow.  A partial list of other attendees includes:
I think it is important to note that while pharmaceutical companies were invited to attend unfortunately there were no representatives from the folks that bring you viagra cialis online pharmacy pharmacy for that issue, Nexium so we can all eat at McDonald's forever and of course, the cure for restless leg syndrome.  I've always wanted to ask if they had suggested language to relate to kids why profitability concerns preclude drug research for kids cancer; but maybe I'm just ODD?  [that's it on cynicism (for this post); I'm feeling too good] 



The opening remarks by Rep. McCaul were brief but important.  Today represented the largest collection of childhood cancer experts ever assembled before Congress. McCaul related the story of his introduction to childhood cancer through meeting with Tim and Donna Culliver of Adam's Angel's Ministry.  And hailed The Carolyn Pryce Conquer Childhood Cancer Act as the most non-partisan effort ever.



Dr. William Evans
of St. Jude then spoke. Like each speaker, his remarks were hopeful and forceful.  Some key points from his presentation:
  • WE, the entire community, are pleased the cure rate is 75%, but we must do better

  • New drugs for adults do not cure childhood cancer

  • Genomics and targeted therapies are the wave of the future, which we MUST make NOW

  • The $60 million St. Jude/Washington University Genomics Project will last at least 3 years and decode more than 600 kids genes

  • This project will provide a platform for new discoveries leading to better treatments

  • The missing link is resources; the Caroline Pryce Walker Conquer Childhood Cancer Act and the Creating Hope Act of 2010 are essential to moving forward

Dr. Evans concluded:
"This is the most exciting time in my 30 year career!"




Congressman Jim Moran was up next.  Sixteen years ago his daughter Dorthy felt like she had the flu.  After 7 trips to the doctor and hospital, he finally enlisted the aid of a friend at NIH.  Finally, she was diagnosed with a brain tumor, with a 10% chance of survival.  But finally, after "cutting, poisoning and burning", she survived.  Today, she is alive, with long-term complications, but alive.  He was very moving.  Anyone in VA needs to fully support Mr. Moran.



Former Congresswoman Deborah Pryce then encouraged the community to "keep telling your stories", and keep the pressure on!  That's what we do, right?  She called for more innovative thinking to solve this problem without simply throwing money at it.  That serves as the lead-in to later discussions for incentivizing big drug companies to participate. She encouraged Sestak and McCaul to make this an annual event before giving way to the doctors.  And to ensure that drug company reps are included next year.



Peter Adamson is, of course, the Chair of the Children's Oncology Group (COG).  And a wonderful speaker.  COG is the collection of 230 hospitals in the US and internationally that collaborate on childhood cancer research.  He has worked for 25 years in experimental treatments.  Many times, as the options grow short, he is asked "If it were your child, what would you do?"  As Joe and I sat there, nodding our heads, Adamson continued "What I say is that I can't tell you, even after 25 years of doing this, because I just can't even imagine sitting on that side, or what you're feeling, it is unimaginable.  But I can help guide you."  He so wants that to change.  Adamson spoke of Jordon, a patient with ALL.  She was treated with 11 drugs.  About 1/2 of them were developed in the 1950's, another 1/2 in the 1960's, and one was developed in the 1970's.  Cure rates may have climbed, but only because doses have increased.  But that in turn results in the majority of survivors battling long-term health consequences.  Jordan is now 16 years old and has a hip replacement.  If I heard correctly, he said that 4 of 5 kids experience severe, life-threatening, or fatal side effects - during treatment



He described COG as the "largest medical/scientific collaboration in history".  But what can Congress do to bring pharmaceutical expertise and talent to the table?  One example is the
Better Pharmaceuticals for Children Act, which is up for renewal.  And he expressed his whole-hearted support for the "Creating Hope Act of 2010".  Dr. Adamson concluded:
"We are entering an unprecedented time in history.  We will soon understand the fundamental drivers of childhood cancer.  We will have failed a generation of children unless we do something with it. The most optimistic group out there is pediatric oncology doctors.  Let today be the tipping point so that in 5 to 10 years, there are no more unimaginable stories."
Tough act to follow, but Dr. Susan Blaney from TCH is no rookie!  She spoke about barriers to drug development.  There are two basic impediments: 1) practical and 2) scientific.  Barriers include:
  • The marketplace for development of new drugs is small.  Only 1% of cancer cases involve children, it's an orphan disease.  That means it's not profitable for the drug companies to develop new treatments.

  • Drug companies also have concerns that if 'negative impacts' are observed early in the FDA approval process, it will delay roll-out, and thus profits

  • Investigators simply spend too much time completing grant applications instead of doing actual research

  • Because pills can't generally be swallowed by young kids, this delays the use of formulations

  • Now the are finding that tumors are not really just one type, but can contain 2 or 3 or 4 different types

Dr. Blaney concluded:
"Once the genomic work is completed, we will be able to develop new drugs.  We have the tools and technologies; but need funding.  Time is of the essence."
Dr. Kleinerman from MD Anderson is no holds barred. A 30-year veteran, she opened with the usual, most drugs were developed 30-40 years ago and the molecular abnormalities in kids are different than adults; different cancers.  She talked openly and frankly about her frustrations in obtaining funding.  She is recognized as a worldwide expert and sits on some of the grant review bodies. She says that excellent pediatric grant applications are losing out to mediocre adult grants because the review body only has one pediatric perspective and the others deem the adult drug to be more important to the cancer mission generally. Even though the science behind her application is better than the competing proposal.  So, what's the fix? 



She introduced the concept of a Childhood Cancer Study Section within NCI for pediatric cancer research study evaluation!  This will incentivize researchers to apply because they will know that the application will be judged by someone in-tune with ped-onc research.  This is truly a huge and important idea that can help level the playing field for us!   Dr. Kleinerman concluded:
"Curing childhood cancer is the equivalent of curing breast cancer in terms of productive life years saved"
Heard that somewhere!!



Drs. Hudson and Oeffinger then spoke about survivorship and
long-term effects of treatment.  One in 570 adults is a childhood cancer survivor - there are currently over 300,000 survivors.  They presented further information from the Childhood Cancer Survivor Study conducted by 30 participating institutions that looked at 14,000 kids and siblings.  One eye-catching chart shows the excess mortality.  This essentially tracks the number of kids that have survived 5-years, yet still experience an early death resulting from issues associated with either recurrence or complications from treatment.  So this is what happens with the 78% of survivors, excess mortality.  Ugh.  The charts starts at the time when a kid has survived 5-years, and then tracks the outcome as compared to the general populations.  The difference is the excess mortality.  (Note: graph created by PAC2 and is only intended to demonstrate the concept, excess mortality. Just like the 22% of kids diagnosed that die, this must also be reduced to 0%.  I will track the actual data down and provide asap)
http://api.ning.com/files/G*PC6hRe7V4X0WMRF4zu7oZIHfZWbVDrofUdXfn3vrP8TdOrsNIV8*0jZs6xl1bgzxahuNAerKj*SicWhul3vfDqavEus0W7/ExcessMortality.jpg?width=721


The doctors stated that 73% of survivors had at least one chronic health effect, 42% had very severe or fatal effect, with 10% developing a secondary cancer.



But aren't we doing better now, with 'new' treatments?  A case study of a mom and daughter both diagnosed with childhood cancer was presented to take a look at that question.  Talk about unimaginable huh?  The mom was diagnosed in 1975 with leukemia. My notes on her effects from treatment read 'the list goes on and on'. The daughter was diagnosed in 2002 at the age of 14.  Her list of secondary effects may have been a bit shorter, 'only' including: secondary cancer, a bone marrow transplant, infertility, hip replacement, thyroid problems, diabetes, and iron overload.  So, while we are able to save more kids; the long-term effects of the cure/"cutting, poisoning and burning" continue to result in terrible complications, and excess mortality. 



So what can be done?  They both STRESSED the importance of LONG-TERM FOLLOW UP. If these effects are detected early enough, by a physician who knows what to look for, we CAN improve these results.  But while 90% of adults follow-up, only 20% of kids are followed up.  As they become young adults they stray from the mix in an attempt to escape the hell they've been through (my thought).


But there are excellent programs and guidelines in place to help.  The
Long-Term Follow-Up Guidelines for Survivors of Childhood, Adolescent, and Young Adult Cancers from COG/CureSearch was referenced, as well as the Passport for A Cure program in place at TCH/Baylor.



Congresswoman Speier stressed the importance of
H.R. 2109:Childhood Cancer Survivorship Research and Quality of Life Act of 2009 she introduced on April 27, 2009 with Mary Bono Mack (CA).  HR 2109 is important bipartisan legislation that will improve and expand the delivery of medical and psychosocial care to survivors of childhood cancer.  Both doctors agreed that to minimize these late effects, follow-up and the use of the Guidelines are key.



Congressman Sestak
then spoke of his personal story with his daughter, the "only perfect child in the world", yep, him too.  I won't relate his personal story and thoughts; I don't want to not get it right, and like Tom Hanks said in Saving Private Ryan when asked about his wife and those rosebushes: "No, no that one I save just for me."  But Mr. Sestak is the highest ranking military officer ever voted into Congress, and both commands respect and comes across as a dad at once.  He said that he is here today as part of his "payback tour".  I hope the tour lasts a long time Mr. Sestak. It was an honor to meet you.



Nancy Goodman of
Kid v Cancer followed.  Her son Jacob was diagnosed at 8-years old.  He was a brother, an athlete, and a rock-and-roll keyboardist amongst so many other things. He was lost at age 10.  Nancy recounted the following sobering statistics:
  • The FDA has had an initial approval of only one pediatric cancer drug in the past 20 years

  • The NCI spends less than 4% of its budget on research for pediatric cancers

  • And the incidence of invasive pediatric cancers has increased by 29% over the past 20 years.

"If you look at these statistics, you can see there is clearly a crisis in the system that your Caucus should be commended for highlighting today"
She has been the driving force behind the Creating Hope Act of 2010 to encourage new drug development, expand the availability of tissue to cutting edge research.  Kids v Cancer is also working to increase access to funding to ensure that every worthy idea in pediatric cancer research is fully explored. 



Her talk stressed the cost of childhood cancer, in terms of pain to the surviving family members and also the "loss of an entire lifetime's hopes, dreams, and experiences."  She referenced an "image of a bald, frail child in a hospital gown on a fundraising brochure" yet "what people don't know is how few of dollars that are donated go to fight pediatric cancers".  I
agree





Nancy applauded Senators Sam Brownback (KS) and Sherrod Brown (OH) who introduced the Creating Hope Act of 2010 to provide incentives for biotech and pharmaceutical companies to invest in the development of new drugs for pediatric cancer and other pediatric rare diseases through a priority review voucher program.  When a company develops a drug for pediatric cancer and recieves FDA approval they would get a voucher.  The voucher provides rights to expedited FDA approval for any other drug which would get that drug to market faster.  Vouchers could be worth hundreds of millions of dollars!



Nancy doesn't stop there. When Jacob died, the family arranged for his tissue to be sent to four researchers for study.  Two of them achieved significant breakthroughs!  One determined that metastases are fundamentally different from the primary tumor, and a second developed the first ever model for diagnosis of brain cancer; pediatric or adult.  Toward this end, Kids v Cancer is launching a parent-led pediatric postmortem brain tumor tissue donation program.  Lots more to come from Nancy and Kids v Cancer on that!



Well, Nancy doesn't stop there either!  Saying that NCI funding levels are particularly important for kids, because unlike adult cancers, where 60% of research funding comes from private industry, private research into kids cancers is negligible.  The NCI funding levels are not proportionate to the age of diagnosis of kids, the years lost, the decreased quality of life of survivors, the 30-year survival rates.....or the "overall value society places on healthy kids".  Again, I
agree



Nancy concluded:
"We appreciate the interest, commitment and support of the Pediatric Cancer Caucus and look forward to working with you toward these objectives so that one day, children like Jacob will be able to live out full, healthy and productive lives"


Nancy's presentation can be downloaded
here. Nancy is 8 months pregnant and we all wish her and her family all the best!



Susan Weiner of Children's Cause for Cancer Advocacy then spoke.  I was very excited to hear of another IOM study coming later this month, similar to the
report discussed here.  In addition, and just as exciting, was her thoughts on development of a public-private partnership to encourage more participation in pediatric cancer research while absorbing some of the risk.  Although in its early stages of development, and still needing seed money, the concept was also discussed in the report referenced above.
Congressmen McCaul and Sestak wrapped up this incredibly moving day by saying that we need to keep moving forward to "solve this crisis."  The legislative agenda discussed today, including:
  1. The Childhood Cancer Survivorship Research and Quality of Life Act;

  2. The Creating Hope Act of 2010;

  3. Re-authorization of the Best Pharmaceuticals for Children Act; and,

  4. Creation of a Childhood Cancer Study Section at the National Cancer Institute

will be a huge stop in the path to curing childhood cancer.



Simply put; it was incredible.  For once, I saw a comprehensive plan of action within the government, with participation from public groups, to address the thing we fight for every day; kids.  I came away full of hope, and so inspired by the amazing people that are working to make this happen.  They will not be able to implement this in a vacuum, or just because it's right.  They will need the help of educated and articulate childhood cancer advocates to support and fight for the steps outlined above with other Senators and Representatives.  That's where you come in PAC2. 



In the coming weeks and months, they will be seeking your support.  PAC2 hopes to continue to serve as a conduit for who, where and when we should, as Deborah Pryce put it: "apply the pressure".   We will continue to coordinate with these wonderful people that have put forth this plan; share with you what we learn and hopefully advocate together as "one voice united against childhood cancer".   I can't think of a more rewarding day.



My thanks to Cynthia Duncan, Lori Salley and Andy Mikulak of
Max's Ring of Fire.  A special thanks to Joe and Jane, for your support and friendship. And my many thanks to you PAC2, for all you do and for allowing me to represent you, and them. 



AJs Dad



Regenerative Medicine is Coming
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My father recently died of stomach cancer. I feel so much pain inside after losing him. There is a medical revolution in personal genomics and regenerative online pharmacy coming that may make such problems a thing of the past, but unfortunately for my father it's now too late. Nevertheless, these new breakthroughs will mean less pain and heartache for the future.

Here is a CBS News story from 2008:



Here is the latest update on that story:



the other 2 parts to the video:
http://www.youtube.com/watch?v=OMWa6VQnugw
http://www.youtube.com/watch?v=vGEwss3T854

Why "anxious, overachieving, white upper middle class" women won't put out..."Bourgeois Propriety".
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Now, to save the modern world, these sorts of women need a Viagra-like pill ? New York Times' Camille (I'm a Feminazi!) Paglia...

The implication is that a new pill, despite its unforeseen side effects, is necessary to cure the sexual malaise that appears to have sunk over the country. But to what extent do these complaints about sexual apathy reflect a medical reality, and how much do they actually emanate from the anxious, overachieving, white upper middle class?



In the 1950s, female “frigidity” was attributed to social conformism and religious puritanism. But since the sexual revolution of the 1960s, American society has become increasingly secular, with a media environment drenched in sex.



The real culprit, originating in the 19th century, is bourgeois propriety. [emphasis mine -.ed]
OK, so if the problems with Al Gore's and Bill Clinton's wives not giving them any more 'happy moments' (directly leading to embarrassing incidents such as Monica playing the skin flute under Bill's desk at the Oral Office, and Al Gore mad in lust after a frightened masseur...see video below) is 'burgeois propriety', what exactly is it, and will the proposed female online pharmacy pill cure it?



Googling of  'burgeois propriety' gets me lots of links to scholarly journals that aren't so much available without subscription, and this gem...

In sociology and political science, bourgeoisie (adjective: bourgeois) describes a range of groups across history. In the Western world, between the late eighteenth century to now, the bourgeoisie is a social class characterized by their ownership of capital and their related culture. A member of the bourgeoisie is a bourgeois or capitalist (plural: bourgeois; capitalists).



They are a part of the middle or merchant classes, and derived social and economic power from employment, education, and wealth, as distinguished from social classes whose power came from being born into an aristocratic family of titled land owners granted feudal privileges by the monarch. The bourgeoisie emerged from late feudal and early modern towns, through the control of long distance trade and petty manufacture. Bourgeois and bourgeoisie originate in the French language, meaning "city-dweller" (from bourg, cf. German Burg).
Addition of 'propriety' gives more than just a faint sheen of Marxist putdownism. Of which I think Camille approves, she being a dirty socialist leftist feminazi and all. Digress I will no further. More Camille...

In the discreet white-collar realm, men and women are interchangeable, doing the same, mind-based work. Physicality is suppressed; voices are lowered and gestures curtailed in sanitized office space. Men must neuter themselves, while ambitious women postpone procreation. Androgyny is bewitching in art, but in real life it can lead to stagnation and boredom, which no pill can cure.
And we have who to blame for this 'male neutering' of which you speak, Camille? Got a damned mirror?

Nor are husbands offering much stimulation in the male display department: visually, American men remain perpetual boys, as shown by the bulky T-shirts, loose shorts and sneakers they wear from preschool through midlife. The sexes, which used to occupy intriguingly separate worlds, are suffering from over-familiarity, a curse of the mundane. There’s no mystery left.



The elemental power of sexuality has also waned in American popular culture. Under the much-maligned studio production code, Hollywood made movies sizzling with flirtation and romance. But from the early ’70s on, nudity was in, and steamy build-up was out. A generation of filmmakers lost the skill of sophisticated innuendo. The situation worsened in the ’90s, when Hollywood pirated video games to turn women into cartoonishly pneumatic superheroines and sci-fi androids, fantasy figures without psychological complexity or the erotic needs of real women.
It's beginning to sound as if Camille is ready to return to the heady days of Gone With the Wind, with Rhett Butler exclaiming "No, I don't think I will kiss you. Although you need kissing badly. That's what's wrong with you. You should be kissed, and often, and by someone who knows how." Well, maybe, but seeing Camille Paglia's mugshot, I volunteer someone else. Elfie, you still lurking around somewhere ?



Camille Brillo...Frank Zappa would've hit it.



More Camille...

Furthermore, thanks to a bourgeois white culture that values efficient bodies over voluptuous ones, American actresses have desexualized themselves, confusing sterile athleticism with female power. Their current Pilates-honed look is taut and tense — a boy’s thin limbs and narrow hips combined with amplified breasts. Contrast that with Latino and African-American taste, which runs toward the healthy silhouette of the bootylicious Beyoncé.
Like this, then, Camille? Thin and amplified? Androgynous?







Hmmmmm...no foolin'.



Camille, the reason men won't hit on feminist women (read: you) so much anymore is that you've screwed the pooch (maybe literally, maybe not). You feminists have made it so freakin' hard (well, not literally) to successfully pick one of you up without worrying about the consequences; lawsuits, sexual harassment complaints &c. Men are neutered. Well, many of the big-city-dwelling New York upper east side sorts of metrosexual men (you know if it's you of whom I speak, you out there serenading your cat) are useless twibbons. And Camille knows who are the exceptions...

A class issue in sexual energy may be suggested by the apparent striking popularity of Victoria’s Secret and its racy lingerie among multiracial lower-middle-class and working-class patrons, even in suburban shopping malls, which otherwise trend toward the white middle class. Country music, with its history in the rural South and Southwest, is still filled with blazingly raunchy scenarios, where the sexes remain dynamically polarized in the old-fashioned way.
There you go. Country music gives us hope that our 'real men' traditions will live on, feminism be damned. Camille, you should put on a wet t-shirt and visit a NASCAR venue somewhere; maybe your luck will change.



Oh, and here's the result of anxious, overachieving, white upper middle class women who won't put out: Al Gore, manbearpriggish~!















Chemo Treatment #4
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This past Tuesday, January 26th, was Ed's 4th chemo treatment and it was all "normal". Nothing unusual, nothing different, . . . We are getting used to this routine. We arrive at Cooley around 8:30 for blood work, then meet with Dr. Bowers, then into the infusion suite for the chemo. The staff to Hampshire Hemotology are great--all very nice and helpful. We still think highly of Dr. Bowers and love his oncology nurses as well, in particular "the wonderful" Shayne. Augie was there to greet us again, I just haven't been able to get a picture of him yet.

Thankfully, I'm still able to join cheap viagra for his treatments (because my supportive and understanding supervisor and employer!). cialis doesn't really need me there for the treatment. He reads the paper while I work on my laptop and afterwards he could definitely drive himself home. However, I like to be there when Ed meets with Dr. Bowers to be sure Ed shares all pertinent information and also to hear what Dr. Bowers has to say. This week there wasn't any new news. The chemo seems to be shrinking the tumors on the liver and Ed seems to be responding well (no signs of the cancer getting worse). So we'll continue with the treatment and probably have a CT scan done sometime in the next month (probably around the 6th treatment).

We are very thankful that Ed is having no serious side effects and is beginning to get his energy back. There are no further signs of hair loss. Ed still has occasional swelling in his feet/ankles. Dr. Bowers told him he should elevate his feet during the day (hmmm...where has he heard this before!?) (Grover feel free to yell at him if he doesn't do this while at work!)

Although Dan hasn't updated his blog, he did send me a quick email earlier this week and he seems to be doing well and keeping quite busy. Last weekend he went to Rome for an arch workshop. This weekend I think he's headed to Siena. He's also sharing a TA position with another student. Ed would still like to try to fit in a trip to Italy. Since he's responding so well to the chemo, we might actually entertain this now. We'll see.

I have to say it is a little weird to say Ed has cancer when he has been doing so well. I remember how awful it was when he got the initial diagnosis and now here we are not even 2 months later and he's doing so well that you wouldn't even know he has cancer by looking at him. That is a good thing--don't get me wrong! And it's easy to forget that cancer has entered our lives and so there are times when I'm waiting for the other shoe to drop. But for now, we'll live in the moment, and relish the fact that he is responding so well to the treatment and life can continue on fairly normal, at least for the time being.

So thanks for the continual good thoughts and prayers. We appreciate them all.

Waiting in the exam room for Dr. Bowers. Can you believe he actually smiled for me?

This yellow X appears on the back of the exam room doors. What do you think they are for? Note that these are the only doors in the room, so to indicate "exit" doesn't make sense. Any guesses?

On the back of the bathroom door as well. Post your guess and we'll ask Dr. Bowers at one of our upcoming appointments.

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Diposkan oleh
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di
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VMM (Available in Singapore)
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2) if swelling of the legs,
3) if pains occur in the region of the heart, spreading out to the arms, upper abdomen or the area around the neck,
4) or in cases of respiratory distress (dyspnea). (1)

VMM (Available in Singapore)
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VMM (Available in Singapore)


VMM®, a high-potency blend of herbs, is a potential immune system builder that helps nourish and fortify the body against attacks of illness and fatigue. When taken regularly, VMM® is a highly effective formula for building internal body resistance.

Long before Louis Pasteur discovered penicillin, nature offered remedies to help boost the body's immune system and maintain good health. Many herbs from throughout the world help support a healthy immune system when the body is attacked by viruses and bacteria.

Herbal nutrition bolsters the body's immunity by nourishing other systems, in particular the digestive, respiratory, circulatory and nervous systems. The health of these systems, in turn, helps that of the immune system.

VMM®--with eight powerful natural herbal ingredients--nourishes your body's immune system to support it before and during times of illness.

1) Echinacea: A bitter herb that supports the body's immune system and helps the body maintain respiratory health.

2) Thyme Leaf: An aromatic botanical that acts as a potential herbal digestive aid, helping support body health through appropriate nutrition and enhanced digestion.

3) Hyssop: A pungent herb that helps soothe feelings of stress and anxiety that might inhibit optimum immune system health.

4) Hawthorn Berry: An astringing berry that supports circulatory and digestive systems for enhanced health.

5) Irish Moss: An herb that helps ease the discomfort of digestive disorders.

6) Rosemary Leaf: A tonic herb with antioxidant capacity that supports circulatory health and the nervous system.

7) Mullein Leaf: An astringing plant that nourishes mucous membranes to help the body maintain respiratory health.

8) Ginseng: An energizing herb that boosts vitality by supporting respiratory and circulatory health while helping ease the negative effects of stress.

So how does it work? Simply put, the immune system is the body's defense system. It protects the body from foreign particles. There are three types of defenses:

1) the anatomic defense system,
2) the inflammatory defense system,
3) and the immune defense system.

The anatomic response is the first line of defense. Some examples of anatomic responses are skin and stomach acid. Anatomic barriers prevent foreign substances from entering the body.

If foreign particles pass through the first line of defense they are greeted by the second line of defense called the inflammatory response.

The immune response is the central part of the immune system. It is the key fighter of foreign particles that have made their way into the body.

VMM® is a powerful herbal formula that assists the immune system in defending everyday attacks. It is used to assist the body in its natural defense against infections, mostly colds and flu. VMM® exerts its primary effects on the internal immune system and associated organs.

USAGE :

VMM® is most effective if taken at the onset of signs of symptoms of colds and flu.

Take 3 cheap cialis in the morning and 3 cheap cialis at night. Stop using for 3-5 days in a row each month to maintain optimal benefits.

During periods of fatigue and body aches, take 6 tablets in the morning and 6 tablets at night. Stop using for 3-5 days in a row each month to maintain optimal benefits.

For acute conditions, it is best to use VMM® for a 2-week period at the onset of symptoms followed by a 1-week break.

Preventative use of VMM® is best used during the cold and flu season. Take for a 3-week period to build up the immune system and then take a 1-week lapse of intake. Repeat as necessary, but do not continue taking VMM® for more than 8-weeks total.

Children (e.g. 4-8 years of age): Take 2 tablets per day with food (e.g. 1 tablet with breakfast, 1 tablet with dinner). Take for 2 weeks, then quit taking VMM® for 2 weeks, then start again for 2 weeks, and stop for 2 weeks, etc.

The term "immunostimulant" should not be referred to conditions of impaired immune function.

Echinacea, which is one of the active ingredients in VMM®, is contraindicated in conditions such as leukosis, collagenosis, multiple sclerosis, tuberculosis, diabetes mellitus, and AIDS.

As with any nutritional supplement, consult a health care provider prior to use if you are pregnant or nursing, have a medical condition, or are taking any medication. Also, please store out of reach of children.

During use of Hawthorn Berry, seek a health care provider:

1) if symptoms continue unchanged for longer than 6-weeks,
2) if swelling of the legs,
3) if pains occur in the region of the heart, spreading out to the arms, upper abdomen or the area around the neck,
4) or in cases of respiratory distress (dyspnea). (1)

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