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Medical Forum / Diseases and Disorders / Sinusitis / January 2008

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Ear pain/fluid

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dolysods@yahoo.com - 14 Jan 2008 20:02 GMT
I had the awful sinus crud/infection that was going around for the
most of December.  After a zpak, nasonex (use every day), mucionex d
or entex pse, zyrtec( use every day), things got better, had the cough
keep tickling for a few weeks.  I've been trying to wean myself off of
the decongestants (family doc is all about rebound pain) and when i'm
off of them for 2-3 days my right ear is killing me.  Usually taking a
decongestant and tylenol is enough.  How long should this take to
clear up?  I remember growing up I always had fluid in my ear and
every time i went to the doc.. sure that i had a infection this
time ..he said it was fluid and keep taking the decongestants.  I
periodically have my chiropractor check the ear and there has never
been any puss or anything.  Once he said my ear drum seemed to be
bulging a bit because of the fluid.

Is there anything i can do? or do i just have to wait it out?

thanks

Tracey
truehawk - 15 Jan 2008 02:55 GMT
On Jan 14, 3:02 pm, dolys...@yahoo.com wrote:
> I had the awful sinus crud/infection that was going around for the
> most of December.  After a zpak, nasonex (use every day), mucionex d
[quoted text clipped - 15 lines]
>
> Tracey

Tracey
Otitis media is a classic biofilm disease.

Bacterial biofilms in otitis media: evidence and relevance.
http://www.ncbi.nlm.nih.gov/pubmed/18049376?ordinalpos=1&itool=EntrezSystem2.PEn
trez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVDocSum


Now, what you can do about it. If you don't mind I can offer a low
tech, Granny treatment.
Biofilms in general react with tannic acid, which might explain the
theraputic value of hot tea and honey, however for pulling the  goo
off you can not beat the tea made from the center membrane and shells
of papershell pecans.
Buy a couple of pounds, shell each pecan, extract the tannin-rich
membrane between the nutmeats. These can be held in your mouth until
they soften and chewed to release the tannins. Reserve the shells to
brew a pecan tannin tea, (strain using a wire mesh tea strainer, those
fine particals really help) for mouthwash and nasal lavage.
Try holding a couple of the center membranes in your mouth whenever
you can. Goo will fall out and you can spit it out.
When you feel the "pull" you will figure it out. It is likely that you
will spit out and see things that you have never seen before, and
pulling the biofilm out of the area adjacent to your eustachian tube
will take some days.
Drainage and goo may be heavy the first 5 or 6 days and gradually
subside over 2 or 3 weeks.

You might want to take some advil before starting, not because the
Pecan Shell tea damages tissue, but because the area that the goo is
pulled off of is often raw to start out. On the good side, if you use
it long enough, territory reclaimed seems to stay reclaimed.  On the
bad side you will need to brush the extra tannin off your teeth.
Hope this helps you do something for yourself to get some relief
without having to beg for it.
I had an ear blow out bloody pus when I sneezed, at the same time I
was being told that they could not culture anything.
I hated that. That is also when I figured out just how few of the
billions of bugs out there have had their culture conditions developed
and adequately characterized so that they show up on the medical
radar.
Michael - 15 Jan 2008 08:13 GMT
> On Jan 14, 3:02 pm, dolys...@yahoo.com wrote:
>
[quoted text clipped - 56 lines]
> and adequately characterized so that they show up on the medical
> radar.

Thanks for the practical hint.

Do you dilute the 'pecan tea' for nasal lavage or just use straight.
Have you tried using black tea, or is the concentration of tannins
insufficient?

My own thick crud has responded well initially to H2O2, Xylitol,
Alkalol, extra baking soda in the saline etc.  However after about two
to three weeks the additive gradually becomes less and less effective
and a 'tougher'/stickier film remains; I have assumed this is just the
residual bacteria adapting.  Presumably there is no universal panacea
otherwise the group would be extolling it from the rooftops.

Thanks for any additional suggestions,

Michael
truehawk - 16 Jan 2008 01:27 GMT
> > On Jan 14, 3:02 pm, dolys...@yahoo.com wrote:
>
[quoted text clipped - 73 lines]
>
> Michael

Michael:
Tell me how you do.
I think that you will find the undiluted tea much more tolerable than
H2O2.
Mostly I just hold the center membranes in my mouth, whenever I can.
The bacteria do not seem to adapt to it. Pecans and oak leaves remain
pretty slime free.
When I started to use it though, I spat for about 4 days straight as
layer after layer of crud pulled loose.
It is like removing the paint from an old bearue, except the paint
will not grow back in you stop stripping half way,
and this stuff will. But if you keep sniffing the crud out and
spitting it out, you will peal the film off deeper and deeper into
your sinuses. Which may start to drain green and smell terrible which
is a good sign, It means that I am actually getting the bottom
bacteria out.  The green is usually stuck to the surface and all that
comes down is the clear amyloid goo that is left after the bacteria
digests all the iron out of the blood seeping from the wound that it
has created.
If I  stop half way I am not any worse off than I  was, I just have to
start over again.
Steven L. - 16 Jan 2008 03:25 GMT
> I had the awful sinus crud/infection that was going around for the
> most of December.  After a zpak, nasonex (use every day), mucionex d
[quoted text clipped - 11 lines]
>
> Is there anything i can do? or do i just have to wait it out?

Very warm (not hot) compresses applied to the ear will help open the
Eustachian tube and ease drainage.

Watch your symptoms carefully.  If they appear to worsen, that means the
infection is flaring up again and you'll need another type of
antibiotic.  If not, then it will just take time to clear on its own.

This may sound facetious, but if you were thinking of taking a vacation
or a nice long getaway weekend, this is a good time to do it.  Fly down
to the Bahamas or the Virgin Islands, and relax in the sunshine and
warmth.  It may be just what your body needs to clear itself of the
infection.

Signature

Steven L.
Email:  sdlitvin@earthlinkNOSPAM.net
Remove the NOSPAM before replying to me.

Steven L. - 16 Jan 2008 03:26 GMT
> I had the awful sinus crud/infection that was going around for the
> most of December.  After a zpak, nasonex (use every day), mucionex d
[quoted text clipped - 11 lines]
>
> Is there anything i can do? or do i just have to wait it out?

Very warm (not hot) compresses applied to the ear will help open the
Eustachian tube and ease drainage.

Watch your symptoms carefully.  If they appear to worsen, that means the
infection is flaring up again and you'll need another type of
antibiotic.  If not, then it will just take time to clear on its own.

This may sound facetious, but if you were thinking of taking a vacation
or a nice long getaway weekend, this is a good time to do it.  Fly down
to the Bahamas or the Virgin Islands, and relax in the sunshine and
warmth.  It may be just what your body needs to clear itself of the
infection.

Signature

Steven L.
Email:  sdlitvin@earthlinkNOSPAM.net
Remove the NOSPAM before replying to me.

Michael - 19 Jan 2008 08:24 GMT
> dolys...@yahoo.com wrote:
> > I had the awful sinus crud/infection that was going around for the
[quoted text clipped - 30 lines]
> Email:  sdlit...@earthlinkNOSPAM.net
> Remove the NOSPAM before replying to me.

Truehawk

Very many thanks.

Have tried a black tea mixture (four bags of Liptons in 500 ml.
boiling water and left to steep)  and add salt to make a hypotonic
saline, without the salt its very unpleasant indeed.  Am using same 3x
per day. The first day was impressive large quantities of glutenous
glugg of various colors falling out throughout the day and today , the
fourth day, stuff still falls out for about 1  1/2 hour afterwards
but  clearly I am down to the thicker stuff now - which feels more
like tectonic plates shifting. Some of it now is a clear brown gue -
the brown is not the tea stain

Was surprised to see dark/black lumps of I assume blood in the center
of the large thick goo formations.  How did you know they would be
clear?  [That was what made the original physician insist it had to be
allergy, that much was not green] When I took antibiotics originally,
when amoxy, bactrim,  biaxin and Levaquin used to work, the clear
glutin would turn either green or brown and become much thicker,
almost granular small golbs, and begin to just detach and fall out
after the first day or so with the affected region gradually
decreasing in size. But at that stage I could also wash substantial
quantities of the stuff out. [The biaxin was not being tried long term
low dose but in 10 day courses only]

H2O2 even in very dilute concentrations, 1 teaspoon to 250 ml. saline
I find very painful -- the black tea is not at all uncomfortable.

Perhaps a dumb question: where do you find unshelled Pecans now, they
were in the supermarket in November and up to Christmas but seem to
have disappeared?

Oak Leaves -- these I can obtain in quantity at the appropriate times
of year, there are many Oaks on the Farm I happen to live upon -- and
I know that Oak galls have been used as a source for the tannic acid
for inks for thousands of years, and were used traditionally for hide
preparations because they do hydrolyze flesh proteins, but might there
be other compounds in an Oak gall or leaf tea that might produce an
'adverse event' if used for sinus lavage?

Might one be able to purchase tannins commercially?

Once again many thanks

Michael
judy.n - 19 Jan 2008 17:43 GMT
Michael,
 Are you irrigating with the tea? I sort of read Elizabeth's post to
say she holds the solutions in her mouth.
 My ENT once tried coffee, because a patient told him it worked: he
didn't find it helpful.
 If the tea works, it's another tool for us.
Judy

> > dolys...@yahoo.com wrote:
> > > I had the awful sinus crud/infection that was going around for the
[quoted text clipped - 77 lines]
>
> Michael
truehawk - 20 Jan 2008 05:13 GMT
> Michael,
>   Are you irrigating with the tea? I sort of read Elizabeth's post to
[quoted text clipped - 85 lines]
>
> > Michael

Judy:
My friend
I have irrigated with it in the past, it was not irritating and was
great for goo removal but every thing tried to come out at the same
time.
I don't irrigate with the tea because my infection is up in the
olfactory nitch and if I irrigate and stuff falls out in-mass it
blocks the exit to the sinuses and I can't even get enough air through
to swallow.  People who have a locus of infection somewhere else might
not have this problem. But they should be aware that this might
happen.
If it does happen the remedy is to use the tannin tea and such the
obstruction out the back.
If I kinda soak it out from the back then I don't get the ice dam
effect and I can make room to breath much  better rather than worse.
Without it so much goo comes accumulates during the night that I
strangle awake and can't breath well long enough to get any sleep.

Michael:
I think any good source of tannin should work.
The Black tea is brilliant.  I wonder if instant tea, without sugar
would not enable one to mix get a suitable concentration of tannin.
I have a stock of pecans, so I have not been aware that I may not be
able to find them later.
I stick with eatables. If it does not irritate my mouth then I figure
that it is safe to try in my sinuses. I have been afraid that
commercial tannins might have traces of something like  hexavalent
chrome of some other toxin.

I notice that a grey squirrels of my acquaintance will shell some
nuts, but pecans he eats shell and all.
The wisdom of squirrels.
Michael - 20 Jan 2008 09:04 GMT
> > Michael,
> >   Are you irrigating with the tea? I sort of read Elizabeth's post to
[quoted text clipped - 118 lines]
> nuts, but pecans he eats shell and all.
> The wisdom of squirrels.

Judy, perhaps I misread Truehawk / Elizabeth 's post but, yes, I am
irrigating with the tea. (If i had been told I two years ago someone
was contemplating such, let alone myself be doing  it, I would have
thought them well outside the fringe.)  However there does appear to
be some evidence in the literature - I have attached below two of the
408 abstracts which turned up when I put 'tannins bacteria' into
PubMed, I have not had time to review the lot.

A quick article on the chemistry of tea explained that the tannins
rapidly fall out of solution as the water cools but that a small
amount of acid makes them soluble at lower temperatures, apparently
this is the reason for putting a slice of lemon in tea  So, happy
hands at home,  I have added a small quantity, four or five drops of
vinegar to the mixture.  This is even more effective against the
mucus.

In my enthusiasm, if x is good 10 x is better, I added two teaspoon so
vinegar to the next wash.  This was unpleasant but highly effective in
freeing up clog.  However the thick mucous expands before dropping out
and I ended up clogging myself up completely for 6/8 hours so I will
stick to the smaller quantity of vinegar - my mucous is actually
inside the sinus cavities themselves, I am certain you don't need me
to describe the effect of rapidly swelling mucous.

One major change for me its that for the past three or four years all
has been post nasal drip and nothing has come out of the nostrils,
despite their being completely clear - now I have to blow my nose!

As I have said in prior posts any new innovation has stopped working
for me after about 3 weeks - but I am going to keep this up and see
what happens - I assume with black tea the range of effective
compounds is sufficiently broad that the bacteria will not be able to
adapt quickly.

One aside; the first time I used the tea there was a grey black stain
round near the whole of my white bathroom sink - I had thought it
clean but clearly there was a biofilm -  It took 20 minutes of work
with an abrasive chemical cleanser and plastic 'wool' pad to remove
same. If biofilms are that difficult to remove mechanically from a
glazed sink goodness knows if we are ever going to get our sinus
clear!

Michael

Antibacterial activity of polyphenol components in oolong tea extract
against Streptococcus mutans.
Sasaki H, Matsumoto M, Tanaka T, Maeda M, Nakai M, Hamada S, Ooshima
T.

Department of Pediatric Dentistry, Osaka University Graduate School of
Dentistry, Osaka, Japan.

The purpose of the present study was to determine the antibacterial
activity of oolong tea extract on oral streptococci, including
Streptococcus mutans and Streptococcus sobrinus, and to identify the
response to its components. Antibacterial activity was found when the
extract was added to S. mutans cells in chemically defined medium but
not in complex broth media. Further, pretreatment with bovine serum
albumin reduced the antibacterial activity. The extract showed
antibacterial activity against all of the oral streptococci examined,
with the highest activity against S. mutans MT8148R. This activity was
found to originate from a monomeric polyphenol-rich fraction, and it
was stronger than that of pure polyphenols. Moreover, some
combinations of monomeric polyphenols showed the highest level of
antibacterial activity. These results suggest that the antibacterial
activity of oolong tea extract is caused by a synergistic effect of
monomeric polyphenols, which can easily bind to proteins. Copyright
2004 S. Karger AG, Basel

PMID: 14684970 [PubMed - indexed for MEDLINE]

Large molecules as anti-adhesive compounds against pathogens.
Wittschier N, Lengsfeld C, Vorthems S, Stratmann U, Ernst JF, Verspohl
EJ, Hensel A.

University of Münster, Institute for Pharmaceutical Biology and
Phytochemistry, Hittorfstrasse 56, D-48149 Münster, Germany.

Anti-adhesive compounds are potential prophylactic tools in
alternative treatment regimes against bacterial infection, as
bacterial adhesion is commonly mediated by carbohydrate-protein
interactions between surface adhesions of microorganisms and the host
cell. The use of exogenous polyvalent, high-molecular carbohydrates
and tannin-like plant-derived compounds should antagonize the adhesive
interaction. A range of carbohydrates and carbohydrate- and
proanthocyanidin-enriched plant extracts were screened for potential
anti-adhesive effects against Helicobacter pylori, Campylobacter
jejuni, Porphyromonas gingivalis and Candida albicans in different in-
situ assays on primary tissue. The adhesion of H. pylori on human
stomach tissue was effectively blocked by glucuronic acid-enriched
polysaccharides from immature okra fruits (Abelmoschus esculentus).
These compounds also had strong in-vitro effects against C. jejuni
(inhibition up to 80%), but were ineffective in an in-vivo study in
infected chicken broilers due to metabolism in the gastrointestinal
system. Polysaccharides from Glycyrrhizia glabra, also enriched with
glucuronic acid, showed strong anti-adhesive properties against H.
pylori and P. gingivalis (inhibition 60-70%). Pelargonium sidoides
extract, containing mainly polymeric proanthocyanidins, was effective
against H. pylori in a dose-dependent manner. Due to the
multifunctional adhesive strategy of C. albicans, no effective
compounds were detected against this yeast. Structure-activity
relationships are presented and the potential in-vivo use of
carbohydrate-based anti-adhesives is discussed.

PMID: 17637170 [PubMed - indexed for MEDLINE]
Michael - 20 Jan 2008 10:39 GMT
> > > Michael,
> > >   Are you irrigating with the tea? I sort of read Elizabeth's post to
[quoted text clipped - 191 lines]
>
> read more »

Truehawk/ Elizabeth:

Take a look at the following:-

: J Antimicrob Chemother. 2001 Oct;48(4):487-91
Antibacterial action of several tannins against Staphylococcus aureus.
Akiyama H, Fujii K, Yamasaki O, Oono T, Iwatsuki K.
Department of Dermatology, Okayama University Graduate School of
Medicine and Dentistry, Shikata-cho 2-5-1, Okayama 700-8558, Japan.
akiyamah@cc.okayama-u.ac.jp
We examined the antibacterial action of several tannins on plasma
coagulation by Staphylococcus aureus and the effect of conventional
chemotherapy combined with tannic acid below the MIC. Coagulation was
inhibited in plasma containing tannic acid (100 mg/L), gallic acid
(5000 mg/L), ellagic acid (5000 mg/L), (-)-epicatechin (1500 mg/L),
(-)-epicatechin gallate (500 mg/L) or (-)-epigallocatechin gallate
(200 mg/L) after incubation for 24 h. All tannins inhibited
coagulation at a concentration below the MIC. The MICs of oxacillin
and cefdinir for S. aureus were reduced to < or = 0.06 mg/L in Mueller-
Hinton agar plates with tannic acid (100 mg/L) at a concentration
below the MIC. The antistaphylococcal activity of tannic acid was
reduced in plates with 10% rabbit blood, but not in those with 10%
rabbit plasma. Membranous structures formed in a culture medium
containing equal proportions of plasma and tryptic soy broth after
incubation for 24 h. The colony counts of S. aureus in membranous
structures in the medium containing oxacillin (40 mg/L) and tannic
acid (100 mg/L) were c. 10-fold lower than those in medium containing
oxacillin (40 mg/L) alone (P < 0.01). Tannic acid merits further
investigation as a possible adjuvant agent against S. aureus skin
infections treated with beta-lactam antibiotics.
PMID: 11581226 [PubMed - indexed for MEDLINE

You may find the last two paragraphs of the full article text of
particular interest, available at:-
http://jac.oxfordjournals.org/cgi/content/full/48/4/487
truehawk - 21 Jan 2008 05:38 GMT
> > > > Michael,
> > > >   Are you irrigating with the tea? I sort of read Elizabeth's post to
[quoted text clipped - 226 lines]
> You may find the last two paragraphs of the full article text of
> particular interest, available at:-http://jac.oxfordjournals.org/cgi/content/full/48/4/487

Michael
Thanks very much for the reference.
It will give comfort to my ENT the next time I see him.

About knowing the goo would be clear:
Staph for one, keeps all the iron from blood it snacks on for itself.
This is called beta hemolytic.
On blood agar staph itself is greenish gold, but surrounding the gold
is a halo is a wide clear halo of plasma. I think at least some
strains catalyze the remaining plasma albulium to an amyloid ogolimer
so it makes the goo at very low metabolic cost, which is why it can
afford to make so much of it.
Michael - 21 Jan 2008 21:05 GMT
Truehak & Judy;

I will post a progress update in mid February, unless an unexpected
problem occurs prior.

At present as Truehawk described clear goo and various forms of green,
grey  & yellow slime  still 'unstripping' and gradually washing and
sliding out.

Michael
truehawk - 23 Jan 2008 01:36 GMT
> Truehak & Judy;
>
[quoted text clipped - 6 lines]
>
> Michael

Instant tea works.
Michael - 26 Jan 2008 08:42 GMT
> > Truehak & Judy;
>
[quoted text clipped - 8 lines]
>
> Instant tea works.

Have now tried,  plus salt plus a few drops of vinegar, the following:
Black Tea Bags, Green Tea Bags and 'Instant' Black Tea. (All same
brand)

Black tea bags appears to be the most immediate in effect; green tea,
less immediately detaches but it carries on working with the crud
sliding out for much longer. Instant tea made to double concentration
works but is half as effective, or less, than either of the above.

[A brief article on instant tea manufacture describes the process as
'freeze drying,' with enough compounds left in the residual leaves for
them to be packaged and sold in black tea bags. Ugh, I  thought the
bags were just tea leaves too powdery to be sold as leaf, what we used
to call 'sweepings.' Apparently the other ingredient, at lest the
variety of 'instant tea' I purchased, is maltodextrin.  I assume
allowing the bags to steep for 30/45 minutes just extracts more
tannins than are in the instant tea, which is strong but not really
bitter]

Michael
truehawk - 27 Jan 2008 21:19 GMT
> > > Truehak & Judy;
>
[quoted text clipped - 29 lines]
>
> Michael

Michael:
Good investigation on the tea. I have tried spoonfuls of instant tea
and find that they tint the goo, and are somewhat effective. Certainly
better than nothing. The strongest tea made from bag tea does seem
more effective.
However, the red dust from the inner lining of the pecan nut does not
tint the goo, but it makes it contract and give up most of it's
water.
A big ball of albuminum-like hydrated amyloid goo becomes a small rope
of with fluffy edges, that occupies 1/10th or less of the former
space. The dust is there in partials, not in solution, but the effect
is not unpleasant the pull until the plaque detaches is intense.
The mechanism and stereochemistry would be of great interest.
sdworkin91@yahoo.com - 28 Jan 2008 04:04 GMT
> > > > Truehak & Judy;
>
[quoted text clipped - 43 lines]
> is not unpleasant the pull until the plaque detaches is intense.
> The mechanism and stereochemistry would be of great interest.

I'm new here but I figured it was time for me to come of the sinus
closet since I have actively have read many of the posts here daily
for many years.  Without going into my whole history (as it probably
would be a repeat of most of yours :) I suffer from many of the long
term "chronic" problems that have been described on the site and
pretty much am in the same boat as many of you regulars I have read on
this site.  I've had 4 surgeries, multiple antibiotics, steroids,
multiple ENTs, immunologists, trip to Mayo, blah blah blah over the
last 14 years.  As my "team" of doctors and medical professionals are
pretty sure I'm dealing a biofilm, I am pretty keen on trying this tea/
tannin thing.  I was wondering how many tea bags to steep in 500cc of
water.  I bought pure black tea at Whole Foods and have a Grossan
irrigator. (I actually see Dr. Grossan, he is my ENT)  i alos started
the Vit D3 suggestion I read on here as well to see if that helps.
Look forward to making progress,
Sergei91
truehawk - 28 Jan 2008 06:50 GMT
On Jan 27, 11:04 pm, sdworki...@yahoo.com wrote:

> > > > > Truehak & Judy;
>
[quoted text clipped - 60 lines]
> Look forward to making progress,
> Sergei91

I rarely irrigate because my infection is wayyyyyyy back. It lies in
the no-mans land between my sinuses and my esophagus and if the stuff
swells 4 or 5 times prior to coming off, as it is prone to do with
most irrigation solutions,  it will choke me down.
Michael is currently irrigating and reports using 4 bags of tea Lipton
to 500ml of water with about 1/8 teaspoon or so salt to make a
isotonic soulution
He acidifies the solution with 4 drops of vinegar. I think that lemon
would also work.
I once used 4 bags of Pickwick black tea to a cup of water to make my
garrgle, and the tea was as black as coffee with a reddish tint.
Since Michael's comment about tea bag tea being tea that has had some
of it's soluibles already boiled out, I am thinking of finding a new
source of Pickwicks, or getting some loose black tea.
But I hold the source of tannin in my mouth so that my airways will
not be blocked in the middle of the night, and for that I prefer the
center membrane from between pecan nutmeats.

I must caution you to take some Advil or other pain killer before you
start, as the sensation of the tannin pulling at the biofilm is
can be like having your hair pulled from underneath. The pull can be
eye-watering the first couple of times that you use it.   Then you
feel a snap or twang and eventually the thing falls out.

I would also suggest that  that you get Doc G to prescribe 21 days of
azythromycian or cylindamyician. I think the tannins will reduce the
biofilm load, and give the bacteria fewer places to hide from the
antibiotics.
I also look farward to trying the D3.
judy.n - 20 Jan 2008 13:42 GMT
Michael,
 I've added vinegar for years, starting when I had a pseudomonas
infection. I find I tolerate about a scant tsp per quart of hypertonic
saline solution.
 Interesting about the film on your sink.
 The dental literature has written for years about biofilms in their
tubing: an article my husband showed me years ago is what got me to
boil the irrigation water. It's also what makes me use the neti pot--
I'm leary of any dark, wet tubing--no matter how much vinegar/bleach
is used. I can throw the neti pot in the dishwasher on high heat...
 I hope the tannins work for longer than 3 weeks.
 It's also interestng how it works for Elizabeth, if held orally.
 Anything that works.
Judy

> > > Michael,
> > >   Are you irrigating with the tea? I sort of read Elizabeth's post to
[quoted text clipped - 191 lines]
>
> read more »

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