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4 week test?
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4 week test?

Everyone seems to have 4 week results.  My Doctor says that she will only do the 3 month test because results would not change the protocal and that a poor 4 week result could be demoralizing.  Is this legit? Does knowing your response earlier that 4 weeks help in any way?







































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Avatar_n_tn
Yes, it did for me.  I am a 2a genotype and had a pcr at 5 weeks.  It came back Non Detect.  The results helped me to realise that the meds may be working, I may be albe to end treatment early based on a few studies.  I am now waiting on my 14 week PCR.
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Avatar_n_tn
What your doc said about the 4 wk PCR is what mine said about the biopsy _"I recommend treating regardless of biopsy, so why get one?" (I did insist, and got a biopsy)

I asked for the 4 wk PCR and he was agreeable, as long as my insurance company would pay, and they will.  Sometimes, that is the deal breaker. I don't think it was depressing, I think it is encouraging, and like mistybean said, it can alter the course of some peoples' treatment.

friole
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Im thinking you said you were a stage 3 grade 4, if that is right then you would'nt be able for the shorter tx. anyway and would have to treat the full time. Maybe thats  your doc. reasoning. Good luck to you.....John
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92903_tn?1309908311
I'm on the opposite side of the street. I'm waiting for the results of the 4 wk (shuld have them today), but it's not clear to me why it was ordered. I'll ask the doc at some point, but my feeling was it's good information to have, say if I need to re-tx and some study comes out that says ppl with x results at 4 weeks who didn't acheive SVR....blah-blah-blah-.

It's info you can capture now, but never again. I even wondered if they couldn't preserve the blood without running the tests.
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Avatar_f_tn
My doctor doesn't normally do them either and made me promise that this wasn't a make it or break it deal..that is it wasn't undetect we would still go on.  I said of COURSE!

I am having mine done tomorrow.  I am a week behind GoofyballnutheadDad in this trek.

Goof - I wish you all of the GOOD FORTUNE (luck is too easy a word - you've worked too hard for this) in the entire world.

I will be looking eagerly to see GOOD NEWS!!!!!!!!!!!!!
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Avatar_m_tn
The fact that your doc ordered the 4-week without your prodding is a good sign. Adjustments can be made to dosage, etc., depending on results. Also, this can help determine tx length (and SVR odds) in a more precise way then without.

In another thread you asked about  ultrasound and grade?  Not really sure what they were talking about but there is a new machine in trial called Fibroscan that can help determine STAGE. Only three in the country so far until it gets FDA approval.

Good luck with your four-week results.

-- Jim
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I had my first test taken at 8 weeks.  I am upset that it wasn't done at 4 weeks just because of the data and that it could be helpful in the future for some reason we may not be thinking about now.

My 8 week was non-detect, but I have no idea how that compares to the 4 or 12 week.
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Avatar_n_tn
My doc wouldn't order an early pcr, I got my 1st one at 12 weeks.
I am undetectable, now it doesn't matter it would not have changed my tx protocol either way. Whether I had been undetectable earlier I would still go 48 weeks. I'm not sure how much dosage changes most doc's would make pre 12 weeks.
If there are reasons you have that you may change your tx protocol based on early pcr's, then I would push it. Otherwise I believe alot of people are obsessed with blood tests. CBC's every week when all counts are equalized and there's no real danger. Pcr's every month or more often; this obsession can sometimes become unhealthy. There is a point where you just have to settle in for the ride.    Good Luck
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Avatar_n_tn
I just had a four week PCR but actually because of the Dr's vacation I had the blood drawn after third shot so he could see me before he left. My viral count was over 3mil in 2003, which was my last PCR I can find. The viral load came back at 377000, to me that seems like quite a drop after really three weeks, would have liked it to be better, but it does show improvement. What are everyones thoughts on that drop?
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Avatar_f_tn
if you are a stage 3 or more there is no good reason to shorten the tx, so having a 4 wk test won't matter. I got one at 4 wk because that is when I moved on to the 3rd GI, the second while on tx. He ordered all tests again. He also only did cbc once a month and saw me after that result, also once a month. PCRs were at 12 mo, 24 wk, and 48wk. Then 4, 12, 24 and one yr post tx.
Even when I was anemic, they kept doing cbc once a month, it worked out fine.
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Dohhh. Did I say grade?

In considering whether to continue a tx that's not progressing ideally, I believe Susie2Q commented that an ultrasound indicates improvement to her grade 2 fibrosis. I hoped to get some discussion going for her benefit around that comment. Maybe she was talking about a fibroscan - that would be great!
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I WILL NOT GET A 4 WEEK AND HAVE MIXED FEELINGS. ALL I READ IS THAT A SVR AT 4 WEEKS MEANS AN ALMOST SURE CURE SO IT CAN MEAN A LOT TO SOMEONE. SVR AT 12 WEEKS IS GREAT BUT 4 IS FANTASTIC.
GOOD LUCK. I GUESS I AM JUST AFRAID TO FIND OUT.
BOBBY
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Avatar_m_tn
To the best of my knowledge my dr only does a 12wk pcr and just cbc etc monthly. I have mixed feelings also but I started with a high viral load over 18mil. and figure at the least I'm in for the long run.I had a 2 weel cbc and the only things out of range were my ast and alt levels. For these 5 weeks treatment has been outright good to me. This morning (our 14yr old shelty passed last night) I was able to dig a 4' deep grave in the back yard, buried her and then went to work changing an electrical service and running wires in a nasty attic crawl space. Now I'm off to one of my meetings. It kinda make me nervous -are the sides less because it's not working- but everything has so fallen into place for me on this journey that I'm learning to be patient and that my job is to just plod ahead and the results will be provided by a greater set director than me, when I'm ready for them.
Don
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Don I am truley sorry about your dog.......

Beth
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92903_tn?1309908311
Really sorry about your dog. I burried our 17 yr old cat in the yard about 4 years ago. It was difficult, and I don't mean digging the 4 foot hole in the rain. Sorry, guy.
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The quantitative portion of my 4 week test is in and below scale at < 615. Still waiting for the TMA, which will determine whether it's undetectable below 9 copies or so. Liver enzymes at 4 weeks were normalized too.  

Now if I could just get rid of that smell of rotting liver that seems to follow me about.....
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Avatar_m_tn
CONGRATULATIONS !!!!!!!!!!!!!!!!!!

Don't sweat the TMA. Regardless, I'm sure you're  still way under two logs for four weeks. My anemic mind has forgotten all your stats but this has only gotta be great news for SVR.

-- Jim
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goof - absolutely perfect on the PCR at 4 weeks.  Amazing.  I am confused - you had two quantitative tests run at the same time - one >615 and one >9?  Isn't that overkill?  Try some onions with that liver - that will mask the smell

strator -I have heard the greater the sx the greater the benefit, but do not believe it.  I have relatively no sides and went from 1.5 million to 2300 in 4 weeks.  You are doing all the good.  My regrets about your beloved dog.  That must have been difficult for you and your son.  All my 14 year old cat Spike does is sleep now adays and I think I will be facing the same thing soon.

kathy
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92903_tn?1309908311
Thanks for the kind words. I was holding out for good news when I saw the enzymes had dropped into normal range at week 3 (first in 25 years). When the enzymes went further at week 4 I thought, well they haven't bottomed out yet so I'm probably still killing bugs. And surely I am, it's just a question of whether the survivors are measureable. I actually had the draw done a couple days before week 4, so there's a little more wiggle room should they detect a few by TMA.

Remember t'was me spouting off a couple weeks ago that there wasn't a material diff between under 600 and under 10 at 4 weeks? Well strike that - now I want under 10 like I can taste it. It's this funny metallic taste that makes other stuff taste bad too. Maybe you've experienced it ;-)

Jim, the last measure I had was 1.3 mill about 8 months ago. So this is over 3 log drop :)

Friole, As I understand it Heptomax is a nice test because they do the quant first, then follow with the TMA if warranted (or the other way around, dunno). Here, my Doc ordered the 2 tests, which I think are run independently of one another. Don't know why the TMA is slower. The quant goes down to < 615 IU/ml. BTW, I've been rubbing sliced onion around my groin area lately for itching. It's something I read on an alternative/naturopathy site. No improvement on the liver smell (or the itching for that matter) - but I'll keep at it. Thanks for the tip :)

NYgrl, Thanks for your kind wishes. Between you and I, your careful choice of words didn't go unnoticed. Quite unneccessary, but thanks - it wasn't lost on me. :)

Please don't think I'm insensitive to those of you who haven't yet seen the PCRs you're hoping for. I'm not, and I wish you the very best. I'm just basking in a brief moment of success.


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Goof says:
"...commented that an ultrasound indicates improvement to her grade 2 fibrosis."

Holly mother of hemorhoids ..... I DID IT AGAIN! Make that *STAGE 2*. Oh, what I must be doing to your 02 deprived brain, Jim.

Say it after me, Goofy.... Eggs come in grades, fibrosis comes in stages. Eggs come in grades, fibrosis...
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Avatar_n_tn

Great news you got there, my theory is that them there critters you had just couldn't take the stand up comic routine. So they headed for the exit. Last one out turn off the lights.

John
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Thanks, John. Nice theory there bud, but trust me - if rotten humor would do them bugs in they never would have gotten a toe hold, let alone survived 25 years. Humor doesn't get this bad overnight, believe me.
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Avatar_m_tn
That's great news goofydude, keep it comin. I guess laughter does heal.

To all-thanks for your wishes on our dog. She had a good long life. Our 2 yr old shelty is taking it hardest. Hey, life is still life even on treatment. My Dad says ya just get up each day and keep shovelin' against the tide. On good days God gives you a bigger shovel. It feels easier to have people to shovel alongside. Now if I can just come up with an answer for my 13 yr old son suddenly wanting to have a girl over after school to 'help her with her homework.' This I'm too old for.
And my hands! They usually don'y chap open until December from outside work. Now they're cracking and chapping open all over. Is that from the Riba troll?
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Avatar_n_tn
when we're "in the moment" of hep c, it's like that's all there is. how right you are that life still goes on. i have a 90-lb very spoiled dog that i love dearly, will be devastated when something happens to him.  and your son.....lol.  our rule was that the door had to stay open. as days went on, door would be open an inch less..an inch less...an inch less...and you better believe Momma was on top of THAT situation!!!!!  kids think they're slick!!!  lol
goofydad...you never fail to make me laugh out loud. glad you had good results
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THANK YOU!!! You make me continually laugh and that is what we all really need fighting this disease. Everyday, you make me wish you were a friend locally. Thank you again!

Sincerely,
Dana
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85135_tn?1227293372
Great news on your PCR. May your sides be mild.

The other Dana
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Avatar_n_tn
Goofy- that's purely wonderful news on your tests! I think how you look at life has an awful lot to do with how you live it and how it lives you. And frankly, I think humor does kill bugs! I'm not sure about onions though - I suspect they just clear rooms and provide peace and quiet. As for that metallic taste - my doc suggests zinc lozenges (fight metal with metal, I guess) and it sort of works, kind of.

Strator- I'm so sorry about your dog. We have 2 at the moment and they are such a comfort. When we lost our last dog at 17 I thought we'd never have another, but here we are now with 2 more and loving every moment. As for the shovel, is there someplace I can trade in my teaspoon for a backhoe?
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Avatar_f_tn
strator; so sorry about your friend, she left a vacant space in everyone's heart, it seems. It is so sad to see children and other pets grieve, because you find yourself unable to comfort them.  Good luck on the other issue, the tutoring lessons, I guess as long is not in biology...
plenty of members have had mild sides and still got svr. I think that was ONE study I read, a long time ago, about bad sides=svr, not enough to believe the theory.

the goofball; I will join in the chant: "Eggs come in grades, fibrosis comes in stages, Eggs come in grades, fibrosis comes in stages, Eggs come in stages, fibrosis in grades...and congratulations!!"


maybe you should now move on to garlic vinagraitte, looks like the onions were sautee too long.
I hear it helps with facial hair...
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Avatar_f_tn
OK I just had to do a little dance in my cube.  Boy oh BOY I am SO ECSTATIC FOR YOUR AND YOUR TESTS!!!!!!!!!!!

Just did my 4wk.  will see results next week.  I just want to follow along nice and quietly in your shadow and repeat "Eggs come in grades, fibrosis comes in stages, Eggs come in grades, fibrosis comes in stages, Eggs come in stages, fibrosis in grades!"

YIPPEEE YIOW KAYAY!!!!!!!!!!!!!!!!!!!!!!!!!!!!

Not really sure how to spell that so I'll just say EGGS EGGS EGGS!

:)
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Avatar_n_tn
Goofball - That is great news...congratulations.  News like that gives the rest of us even more encouragement in the great journey we will be embarking on........hahahaha....I sound like I just walked out of a Star Wars movie or something.

Strater - I am really sorry to hear about your dog.  I have 3 dogs and know how bonded we get.  again I am sorry for you loss.

deb in az
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Avatar_n_tn
glad to hear about your test results...

*the dip*
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Avatar_n_tn
I messaged Doctor Ben Cecil and asked if fatty liver would speed up the progression of fibrosis and this was his reply:

It should not be a major problem. Stage one fibrosis is very mild. Try to get back to you weight at age 21. That is likely your ideal weight. Ben Cecil, MD

When I was 21 I weighed 103 pounds, YIKES!!!  I got some work to do for sure!!

*dip on the treadmill*





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Avatar_f_tn
OH my I missed that - I am so sorry.  I can't even imagine the pain you are going through.  I love my dog so much I can't even think about it.

My thoughts are with you during this time.  I know how you must feel and it breaks my heart.
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Avatar_m_tn
A laugh and comfort to start the day, life is good. My hands feel like they've been baked in sand and soon I'll be able to stand a dime up in the splits, (let's see 10 fingers x 10cents, maybe I can get a real small cup of coffee). But as long as my mind stays glued together....

Whenever parenting scares me I remember that despite all the cards stacked against her my 30yr old daughter has become a wonderful reponsible adult with very little quality guidance from myself or her mother. And now she has 10 and 4 year old girls to get through the teenage years. I may have it easy.
Have a fun day all. Enjoy every easy second or minute if you can. Good thoughts to all in need.
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Avatar_f_tn
argh! the skin! I forgot to talk about the skin!
I always had dry skin, and started using U-lactin for it, years ago. The lactic acid+urea+glycerin+Eucerin combo gives my skin life and keeps it from scaling and drying. Try to get similar ingredients in a cream form for the hands. During tx, my skin got worse, it was splitting like tissue paper, in places it never did before in addittion to the usual places, like the finger tips by the nail. It bled, which is scary to remember that, because I did not know I had hep c for many of those yrs. At the end of tx, it was the one side that would have done me in, the "paper cut-like" splits.  Someone here recommended skin repair and it worked wonders. It kept the skin from opening and bleeding. I use the one by Nexcare.  I also used vaseline on my hands and limited the water touching them by wearing latex gloves for water chores. Use a good cream with urea and lactic acid and cover the hands with cotton gloves at night for a while. Things, like Desitin, protect the skin very well, I wish they made it without the "baby" smell, though.

ok, good luck on finding a good one to control that annoying effect.
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Avatar_m_tn
In general, the 4-week PCR is a win-win situation with no downside.

If you have little or no fibrosis,  then the early PCR offers not only an indication of how rapidly you're responding but options to shorten treatment.  

If you have significant fibrosis, and your medical team believes in agressive, individualized treatment, then the week 4 PCR offers you doctors an opportunity to up the dosage.  

The hitch of course is that most doctors (mine does, Cecil does, many other well-known docs do) will not make tx altering decisions based on the 4-week.  

That said, it still makes sense to  me for your own tx database to help you make your own decisions. After all, many of us have changed doctors mid-stream or re-treated with another doc. The week 4 PCR is great info to bring across should you decide to switch to a doctor that will use the data.

The plan with my doc, probably at the extreme, was to double-dose the Peg until I cleared with weekly PCR's.  Therefore,  I had 6 PCR's until I cleared at week 6. After that, the group recommended montlly PCR's although I only take them every 2-3 months but do watch my ALT carefully between.  Enzymes and CBC's are done monthly except lately because of both falling hemoglobin and ANC. So until they stabalize, the CBC is being done weekly.

-- Jim
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Avatar_n_tn
does your insurance allow you to do PCR's that often, or are you picking up the tab?  If you don't mind me asking of course...
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Avatar_f_tn
there are a few websites dedicated or based on the Rainbow Bridge, if you visit them, have some tissues handy.  They also have the options of creating "memorials" to our loved ones with pictures capabilities. Again, be ready for a weep.
There are a couple variations to the poem in those sites also.
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Avatar_m_tn
As far as I know they pick up any blood test the doctors order. Of course, I'm kinda behind in all my paperwork (like months LOL) so I can't 100% confirm this. :)  But if I remember correctly, the PCR test is not all that expensive from the insurance companies point of view. They are not charged what we are -- in other words,  the test might be $400 but the insurance company only pays around $100 or so.

-- Jim
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Avatar_n_tn
that's great!  It took 2 months here, to get the results back and several hundred dollars to do a "specialized test" such as a PCR...I am sure when I go the tx route I will have to fight tooth and nail for frequent tests...God Bless America!
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Avatar_m_tn
Because of my psoriais, lately I've been soaking once or twice a day in the tub with Balnetar Oil. It's a therapeutic tar bath solution you put in the tub and requires no rx . You could get your druggist to order it or find it on the net. I find it helps my skin and the itching. Reading from the bottle:

"soothing relief from psoriasis and other scaly skin conditions".  It also contains alpha keri bath oil as a moisturizer.  I also add a little mineral oil to the mix.

Basically you soak for 10-20 minutes and then towel dry.  If you want to wash, do it before, not after.  

Not sure if this will be helpful for all skin conditions but might be worth a try although it's a little expensive. Also be sure to clean the tub throurougly after as the tar oil can cause staining on the porcelin.

Coal tar, tar oil, etc. has been around for many years as a tx for psoriaisis and other skin conditions, Nowadays, they just throw a lot of  topical steroids at you, which I also use but trying to cut down on.

--  Jim
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Strator, you sound like you are doing great still working.  Let me suggest since you are a WORKING MAN to try O'Keeffe's Working Hands.  It's overnight relief and has worked wonders on my cracking feet (heels).  I use is also on my hands because I wash them all the time.

Hope it works for you!  Good luck and sorry about your dog.  I got my Westie before treatment to be my treatment buddy.  She is eight months old today.  What a wild thing.  Glad I have her cause she makes me walk her everyday and does not let me get by w/o playing with her.  Very tunacious!  Tiki is her name and I am so happy I made the decision to get her just prior to treatment.

Off to the study clinic today.  They did a 4 week PCR 2weeks ago,  Going to bring the results home w/me today.  Friole I will email them to you because you and I both know.....I HAVE NO CLUE!

Take Care
Fisheress
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This is for your Shelty.

When an animal dies that has been especially close to someone here, that pet goes to Rainbow Bridge. There are meadows and hills for all of our special friends so they can run and play together. There is plenty of food and water and sunshine, and our friends are warm and comfortable. All the animals who had been ill and old are restored to health and vigor; those who were hurt or maimed are made whole and strong again, just as we remember them in our dreams of days and times gone by.
The animals are happy and content, except for one small thing: they miss someone very special to them; who had to be left behind.

They all run and play together, but the day comes when one suddenly stops and looks into the distance. The bright eyes are intent; the eager body quivers. Suddenly he begins to break away from the group, flying over the green grass, his legs carrying him faster and faster. YOU have been spotted, and when you and your special friend finally meet, you cling together in joyous reunion, never to be parted again. The happy kisses rain upon your face; your hands again caress the beloved head, and you look once more into the trusting eyes of your pet, so long gone from your life but never absent from your heart.

THEN YOU CROSS RAINBOW BRIDGE TOGETHER...
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Avatar_f_tn
Oh my GOD nothing on here has made me cry as hard as that.

I have to take a walk.  Oh my GOD I have to save that.  Thank you.  I can't even breathe now I am holding my breath so people dont hear me weeping.

That was so gorgeous.
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92903_tn?1309908311
Strator:
I uses <a href="http://www.porterslotion.com/shopmain2.html">Porters Original Lotion<a>when I'm outside in the winter. Some don't like it, but it works for me. I buy it at Restoration Hardware... a bottle lasts forever. I think it has alcohol in the formula, some would say that's not what you want.

AZ and Carpedi:
What does a fish spend on a business trip? His Carpe Diem. (Clearly this isn't my strong suit)
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Thanks again everyone, and painintheside, you made my day ;-)
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Avatar_n_tn
I join Debby with the tears...I am such an animal lover that reading your thread was a joy, tears of joy here :)

Thank you

Beth
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Avatar_n_tn
If a fish does go on a business trip I suppose that means he has to leave the office pool, and his per diem must be scale-based? By the way, what IS your strong suit???

ribbet.
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