Sunday, July 31, 2005

The Best of 'Ten Foot Stop', Pulmonary Embolus, Diving and Anticoagulation

Fitness to dive post pulmonary embolus after an airplane flight? What pulmonary assessment would be necessary? History of two episodes of DCI in the past.

Answer[s]:
From Jim Caruso, MD:
This is a very timely question given the inter-relationship of long travel to dive sites and the occurrence of PEs [pulmonary emboli]. I do not believe there is any cookbook approach to these patients and important factors such as age, health status and meds must be considered.
Certainly the usual V/Q and PFT studies are important. If the patient is to be anti-coagulated, that could be very dangerous on dive station. I would try to keep the INR to a minimum but your first priority is to minimize the risk of a repeat PE.

Since air-trapping is a primary concern in diving (like asthma or emphysema) and PEs can cause infarcts but have no specific pathology that predisposes a person to a greater risk of an air-trapping problem, I do not have any other blanket recommendations for evaluating such patients that is diver specific. My big concern would be recurrent PEs, especially since diving often involves travel and dive sites are often remote where medical care is nil.


From Allen Dekelboum, MD:

Although this is not in my area of expertise, I am concerned about why the PE occurred following flying. Was it due to stasis in the lower extremities on long flights. I think this is a rhetorical question and not necessarily the questioners personal problem, although I could be mistaken. Also he himself has had two episodes of DCI in remote areas. What kind of diving is
he doing?
I would be interested in knowing his hematologic status, re., clotting, etc. Is there any permanent damage from the PE? Pulmonary studies including diffusion studies would be indicated.


From Dr. Ed Kay:
If still on Coumadin I would warn of increased risk should DCS occur. If the individual understands the theoretical increased risks, I would return to diving with "informed consent".
If not on Coumadin, or if individual elects to dive with risk factor of anticoagulant I would make sure lung parenchyma has returned to normal with PFTs and Spiral CT. I see no reason to limit diving if everything checks out OK.


From Martin Quigley, MD:
As I'm sure you are aware, there is little (or nothing) in the standard diving medicine texts (e.g. Bennett and Elliott) and the US Navy and NOAA Diving Manuals concerning diving after pulmonary embolism. I don't think any formalized testing is generally required before a return to diving. I'd wait 6-12 weeks after the acute PE, and obviously all anticoagulation would have had to have been completed before diving could be considered.
The only assessment I'd do would be to ensure that there was no limitation of exercise tolerance (have the prospective diver walk up a couple of flights of stairs - or even better have the diver wear scuba gear (no fins) while climbing stairs). If there was any limitation of exercise tolerance, then there might be a role for formalized pulmonary function testing. The answer doesn't seem very scientific, but my guess would be that diving after a PE doesn't present significant limitations.


From Dr. Richard Moon, Duke University and DAN: The main issues would be: (1) Residual cardiopulmonary effects, if any (e.g. pulmonary hypertension) and (2) Anticoagulation.
With regard to (1) pulmonary hypertension would be exacerbated by immersed exercise, particularly in cold water, and could conceivably lead to pulmonary edema. If symptoms/signs resolved satisfactorily with no evidence of pulmonary hypertension on chest radiograph, then this should not be an issue. Another possible residual effect could be an increase in respiratory dead space due to residual hypoperfusion of a lung segment/lobe. Diving itself is associated with increased dead space (see Salzano JV et al, Physiological responses to exercise at 47 and 66 ATA. J Appl Physiol 57:1055-1068, 1984, Mummery HJ et al. The effects of age and exercise on physiological dead space during simulated dives at 2.8 ATA. J Appl Physiol 2003, in press - the text can be downloaded in .PDF format from the American Physiological Society website). If the dead space were already high due to the residual PE effects, then the addition of diving could cause the person to require a significantly higher ventilation to maintain isocapnia.

If the person is still taking anticoagulants, then it goes without saying that the effects of otic/sinus barotrauma could be exacerbated. Also, local hemorrhage is a feature of both inner ear and spinal cord DCS. If the diver is unlucky enough to experience either of these, then a more severe result might ensue.


From scubadoc:
We periodically receive letters requesting information about diving and anti-coagulation. We present the following information to the diver (or the doctor) and expect them to make their own decisions about diving. Having had many very unpleasant encounters with coumadin in my past surgical life - I'm quite skittish of allowing a person to dive while on the drug.
Several things come to mind that should be addressed before allowing return to diving or certification to dive in candidates with PTE.
First, pulmonary testing should be done to rule out any air-trapping or reduction in lung function as pulmonary embolism is capable of causing lung damage with scarring and loss of pulmonary reserve. Normal PFTs [helium loop?] and spiral CT scan might allow diving if all is OK. Diving with 60% pulmonary function would be borderline should a stressful situation arise requiring increased cardiopulmonary reserve. Pulmonary hypertension that is not symptomatic on the surface might lead to right heart overload and failure when the effects of immersion are present.
Secondly, coumadin is an extremely dangerous drug in that it can allow relatively minor trauma to turn into disastrous situations from hemorrhage; namely the minor trauma of sinus, ear and lung barotrauma that can occur with every dive. This would be the main reason to disallow diving. An effort should be made to rule out causes of thrombosis, such as abnormal proteins.
Thirdly, there is some indication that anticoagulants may actually worsen neurologic outcome in decompression accidents by causing hemorrhagic lesions to worsen (Bove, 1997, p.198.). There are no studies on this subject - only isolated reports of the use of coumadin in PTE in a person after having had neurological DCS. (Spadaro, Moon, Fracica: Life threatening PTE in neurological decompression illness. Undersea Biomed Res 19 (Suppl): 41-42, 1992.)
For more information you may want to visit our web page at http://www.scuba-doc.com/antcoag.htm .

From Dr. CJ Edge, UKSDMC
It's interesting reading the replies re PE and diving. I've actually had an episode of multiple PEs post long haul flight in 1995 on coming back from a dive trip to the Maldives. I (being a physician) didn't recognise the symptoms for 2 days after getting the severe pleuritic pain on inspiration and put it down to a pneumonia.
The answer in terms of what should happen is, to my mind, fairly clear cut. V/Q scan or spiral CT will show the extent of the problem. Haematological studies should be carried out, looking principally for the common problems i.e. factor V Leiden, prothrombin gene mutation, factor S and/or C deficiency etc. Family history may be important. Anticoagulation should be undertaken, keeping the INR 2-2.5 for an initial period of 3 months, provided that there are no contributing haematological abnormalities, such as those mentioned above, that are found (if there are, the whole question is more complex). Diving can then be resumed after 3 months. I don't believe that increases in residual volume etc. are relevant; one generally doesn't know what these parameters were before the problem arose, which is the important issue. However, to "cover one's back" one could repeat the spirometry including helium dilution tests and CO diffusion if one was really concerned (I didn't have this).
In this particular case, the person had had two episodes of DCI beforehand. I believe that this is relevant only to indicate that probably the person is dehydrated, as many divers are in tropical situations, and that the PE is a manifestation of dehydration and immobility (part of Virchow's triad).
I advise all divers in such a situation to take a factor Xa inhibitor prior to travelling for > 4H flight, to drink plenty and especially not to let themselves get dehydrated when diving. I do this, I'm diving again and I've had no further problems.
Addendum: It may be worth pointing out that one can carry out an INR measurement at home now using the new kits. Therefore it may be safer for divers to be on warfarin than it was in the past. The INR should be kept between 2 and 2.5; any level greater than 3 can lead to an unacceptable risk of spontaneous haemorrhage.

Friday, July 29, 2005

Finding stuff on Scubadoc's Diving Medicine

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Thursday, July 28, 2005

Bookmarks Worth Keeping!

Doc Vikingo's Good Guy Resource for Divers
http://tinyurl.com/9usp6

DAN Report on DCI, 2004
http://tinyurl.com/arhqs

CDC Centers for Disease Control and Prevention, References and Resources
http://www.cdc.gov/travel/reference.htm

Emporiatrics: An Introduction to Travel Medicine
http://tinyurl.com/859ft

Travel Medicine, PJ Online
http://tinyurl.com/a2lo9

Travel Medicine: Helping Patients Prepare for Trips Abroad
http://tinyurl.com/9yxae

MedEd Online
http://www.mededonline.org/

Scuba Diving Accidents and Hyperbaric News from Google

PADI Gold Palm scuba instructor, tourist diver drown scuba diving ...
CDNN - New Zealand
Mayumi Fukuda, 25, a Japanese scuba diving instructor employed by PADI Gold Palm Pastime ... Volunteer rescue divers found Morita on the day of the accident. ...

Scuba Victim Flown To Marquette General
WLUC-TV - Negaunee,MI,USA
The victim of a scuba diving accident in St. Ignace was flown by Coast Guard helicopter to Marquette General Hospital Wednesday. ...

Bungling diver swims into mouth of shark
Xinhua - China
... Chinese man accidentally swam onto the tooth of a shark whilst scuba-diving in ... by the park, however, it was the first time that such an accident had happened. ...

FSU diving team joins search for missing girl
Tallahassee.com - Tallahassee,FL,USA
A team of scuba-diving scientists from FSU's pioneering Underwater Crime ... already have participated in numerous criminal and accident investigations, including ...

Man dies after dive at Trout Lake Park
London Free Press - London,Ontario,Canada
WOODSTOCK -- A Kitchener man hurt in a diving accident at Trout Lake Park has died, the park's second ... Two scuba divers died at the park during a winter dive. ...

Woman Survives Local Scuba Scare
WZZM - Grand Rapids,MI,USA
A West Michigan native, scuba diving in Lake Michigan over the weekend, had a close ... they were in the process of repairing the pipe when the accident occurred. ...

HBOT To Treat Chronic Conditions
Canada Free Press - Canada
What treatment would you choose, a leg amputation or increased amount of oxygen? ... amputation because of a failure to use hyperbaric oxygen therapy (HBOT). ...

North Las Vegas hospital entering phase two of $9.6 million ...
Las Vegas Sun - Las Vegas,NV,USA
... The hyperbaric chambers are pressurized, enclosed capsules that provide double the oxygen level than a ... an average of one to two hours of treatment in the ...

Cash crisis shuts MS centre
Norfolk Eastern Daily Press - Norfolk,England,UK
... The therapy centre provided hyperbaric oxygen treatment, physiotherapy, counselling, dietary advice and yoga, and was the only one of its type in a radius of ...

He got out just in time.
Times Herald-Record - Middletown,NY,USA
... Thursday night to Westchester, where he could get specialized treatment. ... Without oxygen, you stop breathing. In hyperbaric therapy, the patient is placed in a ...

Travis hospital's hyperbaric chamber helps to quickly cure wounds
Fairfield Daily Republic - Fairfield,CA,USA
... The patients inside are put in masks or hoods to breath 100 percent oxygen. The Air Force originally started using hyperbaric treatment to treat those who ...

Healing Under Pressure
TheHorse.com - Lexington,KY,USA
... wounds, can turn around quickly with oxygen treatment.". ... can get expensive with one treatment session running ... medical schools have hyperbaric facilities, however ...

Saipan lawmakers want scuba divers to pay for decompression ...
CDNN - New Zealand
... A decompression chamber is a machine used to treat a person suffering from what is called decompression sickness -- a disorder that affects deep-sea divers. ...

Diver, 24, identified
Exmouth Journal - UK
... Two other female divers, both from Torbay, were also treated for the effects of decompression sickness after being involved in the tragedy. ...

Diver who resurfaced too quickly at Sandsprit Park is flown to ...
Stuart News (subscription) - Stuart,FL,USA
... Authorities said the diver might have suffered from decompression sickness, also known as "the bends." It occurs when nitrogen bubbles build up in a diver's ...

Man airlifted following diving accident
RTE Interactive - Ireland
A diver has been airlifted from Dublin Bay to hospital in Galway this afternoon after becoming ill with the decompression sickness known as the bends. ...

(Really) Risky Business
Fast Company - USA
... Unless divers spend time in shallower water letting gas bleed out of their system, they will suffer decompression sickness, more commonly known as "the bends ...

Two rescue divers hospitalised in Galway
RTE Interactive - Ireland
... hospital in Galway. Rescue services say the men may be suffering from the decompression sickness known as the bends. They were taken ...

HBOT To Treat Chronic Conditions
Canada Free Press - Canada
... During that time it has saved the lives of many divers stricken by decompression sickness (the bends) when they've surfaced too quickly. ...

Minister warns divers of bends
Fiji Times - Fiji
... Mr Naivalu said decompression sickness was an emerging public health problem in the Northern Division especially in Bua province where many people dove for ...

Travis hospital's hyperbaric chamber helps to quickly cure wounds
Fairfield Daily Republic - Fairfield,CA,USA
... The Air Force originally started using hyperbaric treatment to treat those who suffered from altitude-induced decompression sickness. ...

Patent Foramen Ovale Closure Devices
Journal of American Medical Association (subscription) - Chicago,IL,USA
... 23 PFO closure devices have also been used to prevent decompression sickness in divers and to manage right-to-left shunting in patients with right-sided ...

Wednesday, July 27, 2005

Board certified hyperbaric and wound care specialist physician boarded in UHMS and CWS.

St. John's Pleasant Valley Hospital, Hyperbaric and Chronic Wound Care Center, 2309 Antonio Street, Camarillo, CA 93010 is currently seeking a board certified hyperbaric and wound care specialist physician boarded in UHMS and CWS.
We can offer 2-3 shifts per week and possibly more.
Our shifts are generally 8-10 hours per day.
We are a busy center with approx 20-25 wound care patients per day and approx 10 HBO patients per day.
We are single or double covered depending on the census.
Shifts will be available October 2005
Please contact John Tesman, MD @ 805.389.5800 ext 6712 or send CV to:

Monday, July 25, 2005

HYPERBARIC PROGRAM MANAGER-CHT’s

HYPERBARIC PROGRAM MANAGER-CHT’s

New, multiplace facility being added on to an existing monoplace facility in Marietta, Georgia

COBB HYPERBARIC MEDICINE at KENNESTONE

55 WHITCHER STREET, Suite 200

MARIETTA, GA 30060-1168

We are seeking experienced, well-qualified individuals to join an existing practice. The Program Manager must have experience as Safety Director and with management and marketing.

Competitive salary Excellent Benefit Package

Please call:
Helen B. Gelly, MD

770-422-4268 or email: hbowound@aol.com

UHMS News - Don Chandler Retiring at end of 2007.

Don Chandler, our Executive Director has announced his plans to retire at the end of 2007. A Search Committee has been formed that is chaired by our President-Elect, Dr. Bret Stolp. Based upon previous searches, it is anticipated that the search will b a lengthy one, thus we are now accepting applications.
One point needs to be clear to all applicants. The corporate office will not remain in Dunkirk, Maryland. The geographic location of the office at the time a successful applicant will assume the duties of Executive Director has not yet been decided. A Relocation Committee has been formed and a decision for relocating the corporate office is expected to be made no later than June, 2006. Applicants need not inquire about the geographic location of the corporate office until the committee has made its recommendation to the UHMS Board of Directors and the Board has approved a new location.
An undergraduate degree from an accredited institution is required. Graduate and post-graduate degree(s) is/are desired but not required. A successful candidate will possess a good working knowledge of diving medicine and hyperbaric medicine.
Experience managing a non-profit organization will be a plus. Please list in the cover letter, salary requirements and any particular terms of employment that are deemed essential. Group life insurance, 50% of health insurance, and a limited 403-B investment plan are provided.
Interested parties should send a resume and cover letter, in Word format and attached to an email, to: donchandler@uhms.org
If an applicant does not have access to email, he/she may mail the application to:
Undersea and Hyperbaric Medical Society
(Personal for Don Chandler)
P.O. Box 1020
Dunkirk, MD 20754

DAN Will Conduct A Diver Medical Technician Course in November

Through a joint effort of Divers Alert Network and the Duke University Medical Center, DAN will host its fifth Diver Medical Technician (DMT) course in November.

Eric Douglas, Director of Training at DAN, said he expected a full complement of 12 participants for the six-day event, which runs Nov. 6-11. Participants will spend four days at DAN Headquarters and two at the Duke hyperbaric chamber.

Douglas said diver medical technicians (DMTs) serve at the critical first step in the diving medicine chain, caring for injured divers on the scene and acting as tenders in the hyperbaric chamber. 'Many of the participants in these programs are diving safety officers with dive teams or tenders associated with hyperbaric chambers,' Douglas said. 'But a good number of them have also been dive professionals interested in advancing their knowledge of dive medicine so they can better tend to the divers in their care.'

Skill training includes all DAN's current training programs, with specialized training in use of the otoscope and field neurological surveys. Attendees who complete the course receive DMT certification through the National Board of Diving and Hyperbaric Medical Technology (NBDHMT). This course has a prerequisite of EMT-B or paramedic and diver certification.

The course offers lectures presented by internationally known faculty, hands-on practical skills, and the experience gained through 14 hours of clinical time in the Duke Center for Hyperbaric Medicine and Environmental Physiology. It gives participants an opportunity to learn both at DAN Headquarters and at the Duke Hyperbaric Center.

Capt. Brian T. Wilson, who attended a recent course, commended the program. 'I have been to many schools, since it is my job being as training officer for the county, and as a firefighter in the USAF Reserves,' said Wilson, an officer from Forsyth County, Ga. Fire Dept. 'This class was very well thought out, and the instructors were very knowledgeable in their respective fields.'


For further information about the November course, check the DAN website
www.DiversAlertNetwork.org <http://www.DiversAlertNetwork.org/> or
contact Douglas, at 1-800-446-2671 ext. 553 or via email at edouglas@dan.duke.edu
<mailto:edouglas@dan.duke.edu> . And for information about courses offered at DEMA, visit the Coming Events section of the website.


Dan Leigh, DAN

survey looks at scuba diving practices and any injuries that result from diving

July 25, 2005

Dear Scuba Diver:

I need your help. I am writing to ask you to participate in a anonymous research survey. This survey looks at scuba diving practices and any injuries that result from diving. I am an Emergency Medicine resident and an avid dive enthusiast, I am conducting research into dive related injuries and diver safety, and asking scuba divers from the United States to respond. This short survey is administered through the Internet and will take about 10 minutes of your time.

This project was approved by the Institutional Review Board (the committee that oversees research at this institution) at the Resurrection Medical Center in Chicago, Illinois. If you are willing to help with this study, please complete the questionnaire via the link below and return it as directed. One option (unlinked to responses) at the end of the survey provides space for an email address entry for notification of results if you would like a copy.

Thanks and safe diving! This survey automatically ends on 9/30/05

Adam Beckett, DO

docadzz312003@yahoo.com

Link to the survey:

https://fs6.formsite.com/RMCEMRP/form298218861/secure_index.html



Sunday, July 24, 2005

Blonde Humor from 'scubadoc'

A blonde lady motorist was about two hours from San Diego when she was flagged down by a man whose truck had broken down. The man walked up to the car and asked, "Are you going to San Diego?"
"Sure," answered the blonde, "do you need a lift?"
"Not for me. I'll be spending the next three hours fixing my truck. My problem is I've got two chimpanzees in the back which have to be taken to the San Diego Zoo. They're a bit stressed already so I don't want to keep them on the road all day. Could you possibly take them to the zoo for me? I'll give you $100 for your trouble."
"I'd be happy to," said the blonde. So the two chimpanzees were ushered into the back seat of the blonde's car and carefully strapped into their seat belts. Off they went. Five hours later, the truck driver was driving through the heart of San Diego when suddenly he was horrified!! There was the blonde walking down the street and holding hands with the two chimps, much to the amusement of a big crowd. With a screech of brakes he pulled off the road and ran over to the blonde.
"What the heck are you doing here?" he demanded, "I gave you $100 to take these chimpanzees to the zoo."
"Yes, I know you did," said the blonde, but we had money left over . . . . . . so now we're going to Sea World.

Question: Extreme problems equalizing. Dr. Dekelboum's Techniques

Hello:

I am a 21 year old college student new to the diving scene. My father and I became certified last summer, and we are currently planning another trip for next month. He has contacted you guys before and told me how quick and helpful you were answering his questions, so now I have a question of my own...
When I was younger I was very prone to ear infections, to the degree that almost every time I went into the water, if I wasn't extremely careful, I would get sick. When we went diving for the first time I had a really hard time with the pressure. My dad was able to equalize very quickly, and had to wait for about 5 minutes for me to reach the depth at which we were diving. It was so bad that I had to dive inch by inch in order to not be in excruciating pain. I want to go on this trip, but I don't think I should if it is going to be that painful, I also don't know if I am doing any permanent damage to my ears. I would just like to know if there is anything I should do or consider when diving in the future so as to not be in pain, or harm my ears... I would hate to have to stop diving...
Please let me know when you get a chance what you think I should do.
Thank you so much for your time, and I hope to hear from you soon.

Answer by Dr. Allen Dekelboum:

Hello Diver:

Your request was referred to me for comment.

Do you have difficulty when descending in airplanes? If so, your Eustachian tubes might have some residual narrowing from your ear infections as a child. It should not be painful for you to dive. If you do have pain, you might not be equalizing correctly. I am linking my tips for equalization that might offer you a way to avoid pain and to equalize without any middle ear damage. I would try the Lowry technique. It does take some practice and should always be done gently. All equalization techniques should be done gently.

If you are unable to dive without pain, then I would recommend that you not dive. Repeated barotrauma to the ears can produce some permanent problems.

Good Luck.

Allen Dekelboum, M.D.

Undercurrent Online Update

We thought that you might be interested in this online update from Undercurrent. If you are not a member of this no-profit organization - then you should certainly investigate joining.

scubadoc

**********************************

Undercurrent -- Consumer Reporting for the
Scuba Diving Community since 1975

July 07, 2005

**********************************************
DIVING NEWS

Deaths of three dive professionals shake the industry: Popular CocoView scuba guide, Tulio Gomez, died on June 22, while leading a dive trip at the Roatan, Honduras resort. A second diver, Texan Randy Gibbs, died during the same dive. There were no witnesses and the deaths are still being investigated. More information about the deaths and a fund established for Tulio's family can be found at http://www.websitetoolbox.com/tool/mb/ccv. . . . D.J. Pottorf, a 34-year-old crew member on the Nekton Rorquel in the Bahamas, died Monday June 21. He died while free diving off the boat at Orange Cay. . . . The body of a missing San Diego diver was found Monday afternoon, June 28. Steven Donathan, a 50-year-old San Diego scuba instructor, vanished on June 27 on a dive on the Yukon, a scuttled destroyer 100 feet below the surface. His body was discovered on the bottom level of the Yukon, the sixth level, a very difficult place to access.

Shadow Divers: Among the best of all diving nonfiction is Robert Kurson's Shadow Divers, a tale of two wreck divers who discover the hull of a German U-boat near New Jersey and trace the story behind it and those who died in it. Published last year, the book will be turned into a major film directed by Ridley Scott. If you haven't read this block buster, it's now available in paperback and can be purchased directly through Undercurrent, at Amazon's best prices. Click here and all of our profits on this and any other purchase you make will go directly to preserve coral reefs.

And Don't Forget No Safe Harbor: the tragic tale of the sinking of the Wave Dancer and 20 deaths in the 2001 Belize Hurricane. Also available at Undercurrent.

Fish Story: Bob Charles, a Florida Keys diver from Cudjoe Key, claims to have the bruises and four stitches in a lip following an attack by a 100-pound Goliath grouper last month. "It was just so fast," Charles told the Keynoter, a Florida Keys newspaper. "I didn't realize my head was in his mouth until I was on the way to the hospital, and I saw the blood." Charles, spearfishing for snapper in 30 feet of water, said the grouper had been following him. Charles' story reminded Bob Berger, owner of Bonefish Bob's tackle shop in Islamorada, of a true story 35 years ago, in the waters of Maine, when a monkfish killed a diver. "My son-in-law was giving diving lessons to four or five guys near the Nubble Light House off York," said Berger. "They were in 20 feet of water. All of a sudden a monkfish grabbed one diver by the throat and there was nothing the others could do. The fish killed the guy,"(Bill Sargent, June 26, Florida Today)

Less Fatigue With Nitrox? In the June issue of Undercurrent we report that researchers have found no measurable difference in fatigue, attention levels, or ability to concentrate in divers using either compressed air or Nitrox. They conducted a double blind, randomized controlled study using 11 divers who breathed either air or Nitrox 36% during an 18 m dry chamber dive for a bottom time of 40 minutes.

In the June issue of Undercurrent, subscribers read about:

Tobago, West Indies; Not Your Everyday Caribbean.
The Cypress Sea: Northern California Boat Diving
Aqua Lung's Mistral regulator; Our tests suggest a limited audience.
(Read the full report)
Nitrox Myths
Unfriendly Skies for Divers; Rules and restrictions for divers
No Safe Harbor: A new book on the Wave Dancer tragedy
Dive Computers: Part II; Five computers compared.
Scubapro MK20 Cracking Problem Reported.
Tougher to Get to Bonaire... Serious Injury at Sting Ray City (get the full story)... Diving Mimics Psychosis... Eating Napoleon wrasse in Australia... Divers underwater during earthquake... and much, much more.

Note: Our travel writers never announce their purpose, are unknown to the destination, and receive no complimentary services or compensation from the dive operators or resort.

Coming in the July issue: Land based diving on Yap... and a little-advertised liveaboard on Palau... first hand report of the grounding of the T&C Aggressor... Bret Gilliam and Chris Newbert ask: Is digital imaging photography?... Why your first stage regulator may not be up to the task, and much much more.

Ben Davison, editor/publisher
editor@undercurrent.org

Want to Try Undercurrent? For $9.95 we'll send you a four issue mail subscription to our newsletter. Not only that, we'll send you FREE the 460-page 2005 Travelin' Divers Chapbook, with more than 1600 reviews of worldwide resorts and liveaboards, covering water temp, visibility, fish and critters, accommodations, food, you name it. Offer applies to residents of U.S. and Canada ONLY.
Offer Ends August 1!
https://www.undercurrent.org/secure/UCnow/spec_offer.html

HELP A BUDDY OUT: forward this message to another diver, so they can get this special offer, too!
https://www.undercurrent.org/secure/UCnow/spec_offer.html

Residents of countries other than the US or Canada can sign up to receive the Undercurrent newsletter here:
https://www.undercurrent.org/secure/UCnow/nlsub_cc.html


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UHMS Urgent Message to Members from Tom Workman

Dear UHMS Member,
I am sure you will recall that several notices have been sent to you regarding the importance of participating in the HOTA/Lewin Group survey on hyperbaric costs. As of earlier this week, only approximately 130 surveys had been submitted. We need at least 250 to insure a rock-solid analysis. So, we are far short of the goal.
Why is this important? CMS just released payment rates for 2006 (two weeks early) and the newly proposed rate is $91.42 per 30-minute increment. It is certainly good news that the rate did not decrease but this represents less than a 1% increase. That said, the down side is that it did not go up higher. There are those within the Lewin Group that feel we can justify perhaps an increase in the $20 per increment range, bringing reimbursement to a more appropriate amount of approximately $110-112 range per 30-minute increment. However, in order to give us the data to support this level, WE NEED TO HAVE YOUR INPUT!
If yo have not yet submitted your report to the Lewin Group, please do so before 1 Aug, a week from this coming Monday. Please fax your report to Stephanie Cameron at (703-269-5501). Make sure that you include ALL OF YOUR COSTS, such as portions of staff costs, management fees, supplies, etc. It does not take many of these extra charges to drive the rate up. Be thorough.
As I have said before, you have an opportunity to have a significant input to our future. Please do not relinquish that opportunity. We need as much data as possible.
For those of you who have already submitted your information, thank you. For those of you who have not yet done so, please accept my thanks in advance.
Tom Workman
Dir, Quality Assurance & Regulatory Affairs
**********************************************
W.T. Workman, MS, CAsP, CHT
Director, Quality Assurance & Regulatory Affairs
Undersea and Hyperbaric Medical Society Satellite Office
18111 Copper Ridge Drive
San Antonio, Texas 78259-3612
Tel: +1(210) 404-1553
Fax: +1(210) 404-1535

Monday, July 18, 2005

Question: Find "Divers Complete Guide to the Ear"?

In reading about the Frenzel method of equalization, I came across this
reference

Frenzel equalization method
I am interested in learning the Frenzel method of equalizing, when one
forces the tongue toward the back of the throat while plugging the nose.
Please explain the technique to me in a manner that would be useful for
teaching.
via email
Miami, Fla.

You'll want to refer to "The Diver's Complete Guide to the Ear" in which we
describe all the methods for equalizing your ears. The Frenzel maneuver
described by DAN is: "Adding air to the middle ear by closing the nose,
mouth and glottis voluntarily, then driving the tongue backward, which acts
as a piston to compress air into the nasal cavities and through the
eustachian tubes." In other words: Close your nostrils and the back of your
throat, and thrust your tongue against the soft palate. This gently forces
air through the eustachian tubes.

Where is the Guide available?

Canadian Diver
*********************************

Answer:"Divers Complete Guide to the Ear" can be downloaded at this web site:
http://tinyurl.com/axqh7

The article, written by John Francis with DAN, is well written and has with excellent diagrams.

Best regards:
Ern Campbell, MD
Scubadoc's Diving Medicine
http://scuba-doc.com/

Scuba Clinic
http://scuba-doc.com/scubaclinic/

Saturday, July 16, 2005

Free Issue of Ocean Realm magazine - Letter from Editor, Richard Stewart

Hi Ernest, Some months ago I offered to send a free copy of Ocean Realm to your list members. We received many dozens of requests and collected them into an Outlook file folder. Then we had a major email application corruption and had to rewrite from the last back up. Well, unfortunately that last back up did not have that folder with everyone’s addresses! If there a way to send a second offer with an explanation for those who already requested but did not get a copy?
Thanks, Richard

Friday, July 15, 2005

Alerts from the FDA


DRUGS


Jul 8, 2005 Reports of Sudden Vision Loss Added
to Labeling for Erectile Dysfunction Drugs
(Viagra, Cialis, Levitra)


Jul 6, 2005 Lovastatin (Mevacor) May Cause
Liver Dysfunction


Jul 6, 2005 Nitroglycerin Patch (Nitro-Dur) Taken With
Sildenafil May Cause Severe Hypotension


Jul 5, 2005 Dietary Supplement (Liqiang 4) Contains Glyburide, FDA Warns

Jun 17, 2005 FDA Limits Use of Gefitinib (Iressa) for Non-Small-Cell Lung Cancer

Jun 16, 2005 Nationwide Recall of Repackaged Drugs (Able)

Jun 15, 2005 Lomefloxacin HCl (Maxaquin) Linked to Risk of Peripheral Neuropathy, Tendon Effects

Jun 15, 2005 Temozolomide (Temodar) Linked Rarely to Secondary Malignancies

Jun 14, 2005 Efavirenz (Sustiva) Use During Pregnancy May Cause Fetal Harm

Jun 13, 2005 Oxcarbazepine (Trileptal) May Cause Serious Hypersensitivity Reactions

Jun 6, 2005 Nationwide Recall of Pediatric 80- and 160-mg Acetaminophen Tablets (Tylenol)

DEVICES
Jun 29, 2005 Worldwide Recall of Vascular Grafts (Hemashield VANTAGE)

Jun 24, 2005 Enclosed Bed Systems (Vail) Withdrawn From Market

Jun 20, 2005 Certain Defibrillators (PRIZM and CONTAK) Recalled due to Potential Malfunction

Jun 16, 2005 Nationwide Recall of Insulin Syringe 1-cc, 28-Gauge 1/2-Inch 100s (AccuSure)

Rachael Steidley Joins DAN 'Road Warrior' Team

Divers Alert Network has named Rachael Steidley as the organization's newest Field Sales and Services Representative. She joins Julie Clarke and Brittny Davis as DAN 'Road Warriors.'

As a DAN Field Sales and Services Representative, Steidley will represent DAN at dive shows and industry functions in California and visit DAN Business Members and other dive operations there.

In making the announcement, Dave Lawler, DAN Director of Marketing, cited her dive industry experience and familiarity with DAN programs. 'She has extensive work experience in dive industry sales and marketing' Lawler said. 'Having Rachael in California affords DAN a more immediate presence to a significant number of dive operations on the West Coast.'

Steidley said she is very excited about joining the DAN family. "I feel DAN is an irreplaceable asset to the diving industry and look forward to increasing DAN's presence and support base among the Southern California dive community," she said.

She is assistant to her husband, Michael Steidley, Southern California regional sales manager of Aqua Lung America; as such she visits dive stores throughout Southern California. From 2002-2003 she was sales associate for Sport Chalet, Inc. in Point Loma, Calif. Through Sports Chalet, Inc., she managed the Sea World Snorkeling Program in the summer of 2004.

A diver for 13 years and PADI Instructor, Steidley is a PADI IDC Staff Instructor and an instructor for Emergency First Responders. Through DAN, she is an instructor for Oxygen First Aid for Diving Injuries, Advanced Oxygen, Hazardous Marine Life Injuries and AED use. She also teaches the BLSPro course and On-Site Neurological Assessment for Divers courses.

Email her at rachaelsteidley@hotmail.com

Thursday, July 14, 2005

Call for Papers, 25th Diving for Science Symposium

This is a call for Papers and Posters to be presented at the 25th Diving for Science Symposium of the American Academy of Underwater Sciences (AAUS). Scientists, Dive Safety Officers, Students and Technicians are invited to contribute and present papers or posters describing recent research, underwater research diving techniques and technological developments related to scientific diving. Presentations from all areas of underwater science are welcome. The meeting, hosted by University of Washington, will be held in Friday Harbor, Washington, March 2-4, 2006.

Abstracts should not exceed 250 words. Abstract must be submitted online, http://www.aaus.org/symposium1.cfm, by 09/15/2005. Notification of acceptance will be received on, or before, 10/15/2005.

Formatting Requirements for Full Submissions in Word (.doc) or text (.txt) format will be provided with acceptance notification. Full Submissions must be uploaded online on, or before, 12/15/2005.

Douglas E. Kesling, BSN, M.A., DMT-A Training and Safety Coordinator NOAA National Undersea Research Center University of North Carolina Wilmington 5600 Marvin K. Moss Lane Wilmington, NC 28409 910.962.2445 wk 910.962.2410 fax

Visit AAUS.org

Friday, July 08, 2005

From Don Chandler, UHMS 'Fitness to Dive' Course

To all--
This is to update you on the next Fitness to Dive course (33 CME credit hours) for physicians that will be held in Hyannis, Massachusetts on October 16-19, 2005 - immediately following the UHMS Northeast Chapter annual meeting that will be held on Saturday, 15 October. While this course is specifically designed for physicians, nurse practitioners and Physician Assistants who do, or potential will, conduct diving physical examinations are also encouraged to attend.
Both the Northeast Chapter meeting and the Fitness to Dive course will be held at the "Cape Codder Resort and Spa" located at Route 132 and Bearse's Way, 1225 Iyanough Road, Hyannis, MA 02601. Telephone numbers are (508) 771-3000 or (888) 297-2200. The fax is (508) 771-6564 and their website is www.CapeCodderResort.com
The Cape Codder has given us special room rates for the chapter meeting and for the course: $119 (single or double). You are requested to use the the 888-297-2200 number for making reservations and identify yourself as going to the "Fitness to Dive Course" as this will get you the reduced room rate.
Most of you who will attend the course will fly into Boston's Logan Airport. I recommend you rent a car and use the following directions to the Cape Codder:
From Boston: Approximately 75 miles (1 ½ hours). Take the Southeast expressway (Route 93 South) to Route 3 South. Follow to the Sagamore Bridge. Cross the Sagamore Bridge to Route 6 East. Follow Route 6 East for approximately 20 minutes to Exit 6 (Hyannis Route 132). Bear right as you come down the exit ramp and merge with Route 132 South. Continue on Route 132 South for about 1-½ miles. The Cape Codder Resort is located just before the second traffic light on the right.
We are planning for refreshment breaks morning and afternoon, but you will be on your own for breakfast. Our first class begins at 8:00 AM on Sunday the 16th and our last class is scheduled to end at 5:00 PM on Wednesday the 19th. Should you need to return to your medical practice on Wednesday and have booked a late flight from Boston, Dr. John Wassel, our Course Director will, I am sure, make special arrangements for you to make your flight.
hope to see lots of your there for this very popular course. A big plus is that you could arrive one day early and attend the Northeast Chapter meeting where you can listen to some excellent scientific presentations. I have attached an application that you can use to either fax to me (410) 257-6617 or send it in regular mail. You can also register on-line at www.uhms.org
If you have questions, please contact me at email: donchandler@uhms.org or telephone (410) 257-6606 x101
Don

Thursday, July 07, 2005

Questions and Answers

Age of air in my tank

This may be a stupid question, I have not used my equipment for almost 7 years. I only use it in my work which is residential swimming pools. My last VIP was 7/98. My tank is still full, is this air still good and/or should I have it VIP and refilled? Will the tank need to be Hydro’d since it has been so long?
Second question is the regulator, again not used for 7yrs. “Scuba Pro” Should this also be checked out may it need to be re-built. Again, This is for leak checks in pools of no more than 10ft. and I have not had to need to use this equipment for all these years.

Please advise.

Answer by Stephen Barsky

Hello:

Dr. Campbell asked me to respond to your questions. I would recommend that you have the tank drained, inspected internally, hydroed and refilled. There is probably nothing wrong with it, however, if there is active corrosion in the tank, this can deplete the oxygen inside the cylinder, which could be a problem.

Tanks must be hydrostatically tested every five years, so your cylinder is definitely out of hydro. Your regulator should also be serviced. Depending on how and where you stored your regulator, the o-rings may be very dry and/or cracked. This would cause the regulator to not perform properly. While you're at it, you should have your BC inspected as well.

You'll be a lot more comfortable using your gear if you know it has been serviced and everything is operating correctly.

-- Regards,
Steve Barsky
Marine Marketing & Consulting/Hammerhead Press

**************************************
Stingray Injury

I was stung by a stingray ten days ago in the gulf of mexico. I was treated with tetanus and medicine for shock and allergy. Since then it seemed to be fine. The puncture wound is in the bottom of my foot.

Yesterday I noticed some localized swelling. Almost like a hematoma or abcess? Like a grape size, harder. When I walk on it it feels like I'm walking on a grape or rock. At the time it was done the medical clinic was not sure if the barb had come out or not. What should I do now?

Answer:

It is entirely possible that you have a portion of the barb or some of the proteinaceous substance surrounding the barb still in your foot. Sometimes this will not show up on x-ray and other diagnostic procedures are required.

There might be the need for surgical debridement of the wound, if this has not been done before now.

See my web site information about this at http://scuba-doc.com//hzrdmrnlf.html and at this site http://www.emedicine.com/aaem/topic421.htm .

Hope this is helpful!

scubadoc
Diving Medicine Online
http://scuba-doc.com/

***********************************************
Pulmonary barotrauma, cerebral embolism in Marfan's patient

My son has recently had a gas embolism to the brain following a shallow (<15m dive). He is a master diver, and has dived over 50 dives. We were in Zanzibar - on his first dive he experienced visual disturbances which he thought was salt in his contact lenses. The second dive 45 minutes later he experienced severe weakness and surfaced early. The next day he had two wonderful perfect dives. Day 3 upon surfacing, he experienced pain in his thighs with pins and needles and tingling in his arms. Upon surfacing he appeared comatose although he says he could hear what people were saying. His pupils were pinprick and he was basically paralysed (flaccid). My other son who is a newly qualified doctor was his buddy and adminstered 100% oxygen with rebreather immediately. He had three tanks of oxygen all in all. We returned to South Africa three days later where he saw Dr. Frans Cronje an expert in South Africa, who realised that he must have had some pulmonary baratrauma. He found on ct scan that he had various bullae in his lungs due to the fact that he has marfans syndrome. We realise that he has had a close shave with death and that diving is now contra indicated. However, your articles suggest removal of the bullae. Is this the treatment of choice in your country. Many thanks.

Answer:

Hello:

The advice that you have received from Dr. Cronje is absolutely correct and further diving is contraindicated in your son. Inherited bullae or blebs [as is the case with Marfan's Syndrome] are located in both lungs and surgery would be difficult if not impossible to remove all of the enlarged and partially blocked air spaces.

Bullae can be removed and often are removed in countries all over the world - not just the USA. This is done to prevent pneumothorax [collapse] of the lung but not to allow resumption of diving. However, persons with a need to resume diving as a livelihood and who can be shown not to have air trapping have been able to resume diving after successful surgery.

Again, I completely agree with Dr. Cronje that your son would be at great risk for another episode of arterial gas embolism with any further diving. In addition, he may also be at risk for bleb rupture with coughing, sneezing, or any procedure that requires the closure of the glottis and straining. Even mountain climbing and air travel might be considered as offering an increased risk of bleb rupture.

One final caveat - his cerebral embolism has left scarring with loss of neurons. Further diving with the risk of decompression illness or emboli might add to this damage.There are numerous links to pulmonary barotrauma on our web site, including one on Marfan's Syndrome.
http://www.scuba-doc.com/mrfnsynd.html
http://www.scuba-doc.com/spntpnu.htm

I hope this has been helpful!

Ernie Campbell, MD
'Scubadoc's Diving Medicine'
http://scuba-doc.com/

**************************************************

Tuesday, July 05, 2005

'Long Term Effects' published in Italian

We have previously given permission to translate and publish into Italian several of our articles on our web site, including the Medscape article, Long Term Effects of Scuba Diving. Marco Daturi has now published in Italian our article which can be seen at the links below [in Italian]

Dear Dr Cambell,
A lot of people is appreciating your article, thank you again, in Italy we missed it.
It's published in the news in the home page of http://www.scubaportal.it
and inside the portal in the Medicine section:
http://www.scubaportal.it/ScubaPortal/Template/Articolo.asp?Menu1=Rubriche&MenuCliccato=Gli%20Articoli&NomeArticolo=Effetti%20a%20lungo%20termine&NomeArtLivSup=Medicina&iPosPrimoLivClic=1&Pag=1

thank you again!!
Best regards, Marco

Humor from scubadoc

Using math to get ahead!

This equation should be taught in all math classes!
From a strictly mathematical viewpoint it goes like this:
What Makes 100%? What does it mean to give MORE than 100%? Ever wonder about those people who say they are giving more than 100%? We have all been to those meetings where someone wants you to give over 100%. How about achieving 103%? What makes up 100% in life?
Here's a little mathematical formula that might help you answer these questions:
If:
A B C D E F G H I J K L M N O P Q R S T U V W X Y Z is represented as :
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26.
Then:
H-A-R-D-W-O-R-K
8+1+18+4+23+15+18+11 = 98%
and
K-N-O-W-L-E-D-G-E
11+14+15+23+12+5+4+7+5 = 96%
But,
A-T-T-I-T-U-D-E
1+20+20+9+20+21+4+5 = 100%
And,
B-U-L-L-S-H-I-T
2+21+12+12+19+8+9+20 = 103%
AND, look how far ass kissing will take you.
A-S-S-K-I-S-S-I-N-G
1+19+19+11+9+19+19+9+14+7 = 118%
So, one can conclude with mathematical certainty that While Hard work and Knowledge will get you close, and Attitude will get you there, it's the Bullshit and Ass kissing that will put you over the top.


******************************************************************


Unnerving but True


IDIOTS IN THE NEIGHBORHOOD: I live in a semi-rural area. We recently had a new neighbor call the local township administrative office to request the
removal of the Deer Crossing sign on our road. The reason: "too many deer
were being hit by cars" and he didn't want them to cross there anymore.
This one was from Kingman, KS.
______________________________________________________

IDIOTS IN FOOD SERVICE: My daughter went to a local Taco Bell and ordered a taco. She asked the person behind the counter for "minimal lettuce." He said he was sorry, but they only had iceberg. And he was a Kansas City chef!
______________________________________________

IDIOT SIGHTING: I was at the airport, checking in at the gate when an
airport employee >asked, "Has anyone put anything in your baggage without your knowledge? To which I replied, "If it was without my knowledge, how would I know? He smiled knowingly and nodded, "That's why we ask." Happened in Birmingham, Ala.
_______________________________________________________

IDIOT SIGHTING: The stoplight on the corner buzzes when it's safe to cross
the street. I was crossing with an intellectually challenged coworker of
mine when she asked if I knew what the buzzer was for. I explained that it
signals blind people when the light is red. Appalled, she responded, "What
on earth are blind people doing driving?!" She was a probation officer in
Wichita, KS
___________________________________________________

IDIOT SIGHTING: At a good-bye luncheon for an old and dear coworker who was leaving the company due to "downsizing," our manager commented cheerfully, "This is fun. We should do this more often." Not a word was spoken. We all just looked at each other with that deer-in-the-headlights stare. This was a bunch at Texas Instruments.
________________________________________

IDIOT SIGHTING: I work with an individual who plugged her power strip Back into itself and for the life of her couldn't understand why her system
would not turn on. A deputy with the Dallas County Sheriff's office no
less.
____________________________________________________

IDIOT SIGHTING: When my husband and I arrived at an automobile dealership to pick up our car, we were told the keys had been locked in it. We went to the service department and found a mechanic working feverishly to unlock the driver's side door. As I watched from the passenger side, I instinctively tried the door handle and discovered that it was unlocked. "Hey," I announced to the technician, "it's open!" To which he replied, "I know - I already got that side." This was at the Ford
dealership in Canton, Mississippi!
_______________________________________________________

* * * * They walk among us ... AND "REPRODUCE" ! * * * *


*******************************************************************

1. Andy Rooney on Monica.
Can you believe it? Monica turned 28 this week. It seems like only yesterday that she was crawling round the White House on her hands and knees.
2.
Andy Rooney on Vegetarians.
Vegetarian - that's an old Indian word meaning "lousy hunter."
3.
Andy Rooney on Prisoners.
Did you know that it costs forty-thousand dollars a year to house each prisoner? Jeez, for forty-thousand bucks apiece I'll take a few prisoners into my house. I live in Los Angeles. I already have bars on the windows. I don't think we should give free room and board to criminals. I think they should have to run twelve hours a day on a treadmill and generate electricity. And, if they don't want to run, they can rest in the chair that's hooked up to the generator.
4.
Andy Rooney on Fabric Softeners.
My wife uses fabric softener. I never knew what that stuff was for. Then I noticed women coming up to me, sniffing, then saying under their breath, "Married!" and walking away. Fabric softeners are how our wives mark their territory. We can take off the ring. But, it's hard to get that April Fresh scent out of your clothes.
5.
Andy Rooney on morning differences.
Men and women are different in the morning. We men wake up aroused in the morning. We can't help it. We just wake up and we want you. And the women are thinking, "How can he want me the way I look in the morning?" It's because we can't see you. We have no blood anywhere near our optic nerve.
6.Andy Rooney on cripes
My wife's from the Midwest. Very nice people there. Very wholesome. They use words like 'Cripes' 'For Cripes sake.' Who would that be; Jesus Cripes? The son of 'Gosh' of the church of 'Holy Moly'? I'm not making fun of it. You think I wanna burn in 'Heck'?

7.
Rooney on Grandma
My grandmother has a bumper sticker on her car that says, 'Sexy Senior Citizen.' You don't want to think of your grandmother that way, do you? Out entering wet shawl contests. Makes you wonder where she got that dollar she gave you for your birthday.

**********************************************************************************



ZEN AND WISDOM OF LIFE

Do not walk behind me, for I may not lead. Do not walk ahead of me, for I may not follow. Do not walk beside me either. Just pretty much leave me alone.

It's always darkest before dawn. So if you're going to steal your neighbor's newspaper, that's the time to do it.

Sex is like air -- it's not important unless you aren't getting any.

No one is listening until you fart.

If you think nobody cares if you're alive, try missing a couple of car payments.

Before you criticize someone, you should walk a mile in their shoes. That way, when you criticize them, you're a mile away, and you have their shoes.

If at first you don't succeed, skydiving is not for you.

Give a man a fish, and he will eat for a day. Teach him how to fish, and he will sit in a boat and drink beer all day.

If you lend someone $20 and never see that person again, it was worth it.

Don't worry--It only seems kinky the first time.

Good judgment comes from bad experience, and a lot of that comes from bad judgment.

There are two theories to arguing with women. Neither one works.

Experience is something you don't get until just after you need it.

Never, under any circumstances, take a sleeping pill and a laxative on the same night.
***********************************************
Why ARE Men Happier?



Men Are Just Happier People-- What do you expect from such simple creatures? Your last name stays put. The garage is all yours. Wedding plans take care of themselves. Chocolate is just another snack. You can be President. You can never be pregnant. You can wear a white T-shirt to a water park. You can wear NO shirt to a water park. Car mechanics tell you the truth.

The world is your urinal. You never have to drive to another gas station restroom because this one is just too icky. You don't have to stop and think of which way to turn a nut on a bolt. Same work, more pay. Wrinkles add character. Wedding dress $5000. Tux rental-$100.

People never stare at your chest when you're talking to them. The occasional well-rendered belch is practically expected. New shoes don't cut, blister, or mangle your feet. One mood all the time. Phone conversations are over in 30 seconds flat. You know stuff about tanks.

A five-day vacation requires only one suitcase. You can open all your own jars. You get extra credit for the slightest act of thoughtfulness. If someone forgets to invite you, he or she can still be your friend.

Your underwear is $8.95 for a three-pack. Three pairs of shoes are more than enough. You almost never have strap problems in public. You are unable to see wrinkles in your clothes. Everything on your face stays its original color. The same hairstyle lasts for years, maybe decades. You only have to shave your face and neck.

You can play with toys all your life. Your belly usually hides your big hips. One wallet and one pair of shoes one color for all seasons. You can wear shorts no matter how your legs look. You can "do" your nails with a pocket knife. You have freedom of choice concerning growing a mustache..

You can do Christmas shopping for 25 relatives on December 24 in 25 minutes.

No wonder men are happier!
******************************************
YOUR DRIVER'S LICENSE TELLS IT ALL



A mother is driving a little girl to her friend's
house for a play date.

"Mommy," the little girl asks, "how old are you?"

"Honey, you are not supposed to ask a lady her age,"
the mother replied. "It's not polite."

"OK", the little girl says, "How much do you weigh?"

"Now really," the mother says, "those are personal
questions and are really none of your business."

Undaunted, the little girl asks, "Why did you and
Daddy get a divorce?"

"That is enough questions, young lady, honestly!"

The exasperated mother walks away as the two friends
begin to play.

"My Mom won't tell me anything about her," the little
girl says to her friend.

"Well," says the friend, "all you need to do is look
at her driver's license. It is like a report card,
it has everything on it."

Later that night the little girl says to her mother,
"I know how old you are, you are 32."

The mother is surprised and asks, "How did you find !
that out?"

"I also know that you weigh 140 pounds."

The mother is past surprised and shocked now. "How in
heaven's name did you find that out?"

"And," the little girl says triumphantly, "I know why
you and daddy got a divorce."



"Oh really?" the mother asks. "Why?"

"Because you got an F in sex."
***************************************
THE WORST AGE
"Sixty is the worst age to be," said the 60 year old. "You always feel like you have to pee. But most of the time, you stand at the toilet and nothing comes out!"
"Ah, that's nothing", said the 70 year old. "When you're seventy, you don't have a bowel movement anymore. You take laxatives, eat bran, you sit on the toilet all day and nothing comes out!"
"Actually," said the 80 year old, "eighty is the worst age of all."
"Do you have trouble peeing, too?" asked the 60 year old.
"No, not really. I pee every morning at 6:00 -- like a race horse peeing on a flat rock, no problem at all."
"Do you have trouble having a bowel movement?"
"No, I have one every morning at 6:30."
With great exasperation, the 60 year old said, "Let me get this straight. You pee every morning at 6:00 and poop every morning at 6:30. So what's so tough about being 80?"
"I don't wake up until 7:00."

**************************************
The Obedient Wife

There was a man who had worked all of his life, had saved all of his
money, and was a real miser when it came to his money. Just before he died,
he said to his wife, "When I die, I want you to take all my money and put it
in the casket with me. I want to take my money to the afterlife with me."

And so he got his wife to promise him with all of her heart that when he
died, she would put all of the money in the casket with him.

Well, he died. He was stretched out in the casket, his wife was sitting
there in black, and her friend was sitting next to her. When they finished
the ceremony, just before the undertakers got ready to close the casket, the
wife said, "Wait just a minute! "She had a box with her; she came over with
the box and put it in the casket. Then the undertakers locked the casket
down, and they rolled it away.

So her friend said, "Girl, I know you weren't foolish enough to put all
that money in there with your husband." The loyal wife replied, "Listen, I'm
a Christian; I can't go back on my word. I promised him that I was going to
put that money in that casket with him."

"You mean to tell me you put that money in the casket with him!!!!?"

"I sure did," said the wife. "I got it all together, put it into my
account and wrote him a check. If he can cash it, he can spend it."
***************************************

THE MOST FUNCTIONAL ENGLISH WORD

Well, it's shit ... that's right, shit!
Shit may just be the most functional word in the English language.
You can smoke shit, buy shit, sell shit, lose shit, find shit, forget shit,
and tell others to eat shit.
You can throw shit, sling shit, catch shit, shoot the shit,
or duck when the shit hits the fan.
Some days are colder than shit, some days are hotter than shit,
and some days are just plain shitty.
Some music sounds like shit, things can look like shit, and there ar! e times when you feel like shit.
You can carry shit, have a mountain of shit, or find yourself up shit creek without a paddle.
Sometimes everything you touch turns to shit and other times you fall in a bucket of shit and come out smelling like a rose.
When you stop to consider all the facts, it's the basic building block of the English language.
And remember, once you know your shit, you don't need to know anything else!!
You could pass this along, if you give a shit; or not do so if you don't give a shit!
Well, Shit, it's time for me to go. Just wanted you to know that I do give a shit and hope you had a nice day, without a bunch of shit. But, if you happened to catch a load of shit from some shit-head..........
Well, Shit Happens!!!
*******************************************
THE PERKS OF BEING OVER 60 -


1. Kidnappers are not very interested in you.
2. In a hostage situation you are likely to be released first.
3. No one expects you to run into a burning building.
4. People call at 9 PM and ask, "Did I wake you?"
5. People no longer view you as a hypochondriac.
6. There is nothing left to learn the hard way.
7. Things you buy now won't wear out.
8. You can eat dinner at 4 P.M.
9. You can live without sex but not without glasses.
10. You enjoy hearing about other peoples operations.
11. You get into heated arguments about pension plans.
12. You have a party and the neighbors don't even realize it.
14. You quit trying to hold your stomach in, no matter who walks into the room.
15. You sing along with elevator music.
16. Your eyes won't get much worse.
17. Your health plan is beginning to pay off.
18. Your joints are more accurate meteorologists than the national weather service.
19. Your secrets are safe with your friends because they can't remember them either.
20. Your supply of brain cells is finally down to manageable size.
21. You can't remember who sent you this list.

SIGNS OF WEAR

'OLD' IS WHEN:

Your sweetie says, "Let's go upstairs and make love," and you answer, "Pick one, I can't do both!"
Your friends compliment You on your new alligator shoes....and you're barefoot.
A sexy babe catches your fancy and your pacemaker opens the garage door.
Going bra-less pulls all the wrinkles out of your face.
You don't care where your spouse goes, just as long as you don't have to go along.
You are cautioned to slow down by the doctor instead of by the police.
"Getting a little action" means I don't need to take any fiber today.
"Getting lucky" means you find your car in the parking lot.
An "all-nighter" means not getting up to pee.
***************************************
Sex With Ghosts ?

A professor at the University of South Carolina gave a lecture on the supernatural. To get a feel for his audience, he asks, "How many people here believe in ghosts?"

About 90 students raise their hands.

"Well, that's a good start. Out of those of you who believe in ghosts, do any of you think you've ever seen a ghost?"

About 40 students raised their hands.

"That's really good. I'm really glad you take this seriously. Has anyone here ever talked to a ghost?"

About 15 students raise their hands.

"Has anyone here ever touched a ghost?"

Three students raise their hands. "That's fantastic. Now let me ask you one question further...Have any of you ever made love to ghosts?"

Way in the back, Bubba raises his hand.

The professor takes off his glasses, and says, "Son, in all the years I've been giving this lecture; no one has ever claimed to have made love to a ghost. You've got to come up here and tell us about your experience."

The big redneck student replied with a nod and a grin, and began to make his way up to the podium. When he is at the front of the room, the professor asks, "So, Bubba, tell us what it's like to have sex with ghosts?"

Bubba replied, "Shiiiiit! From way back thar I thought you said, 'Goats!' "

*********************************************
A man took his wife to the rodeo and one of their first stops was the
breeding bulls exhibit. They went up to the first pen and there was a
sign attached
that said, "This bull mated 50 times last year."
The wife playfully nudged her husband in the ribs and said, "He
mated 50 times last year." They walked to the second pen which
had a sign attached that said, "This bull mated 120 times last
year." The wife gave her husband a healthy jab and said, "That's
more than twice a week! You could learn a lot from him."

They walked to the third pen and it had a sign attached that said,
in capital letters, "This bull mated 365 times last year." The
wife, so excited that her elbow nearly broke her husband's ribs,
said, "That's once a day. You could REALLY learn something from
this one."

The husband looked at her and said, "Go over and ask him if it was
with the same cow."

NOTE: The husband's condition has been upgraded from critical to
stable and he should eventually make a full recovery.
*******************************************
A punk rocker gets on the bus with green, yellow, purple and
orange hair. An old guy sitting on the bus stares at him, and
the punk says, "What's the matter, old man, didn't you ever
do anything wild in your life?" And the old man says, "Yeah,
one time I shagged a parrot. I thought maybe you were my kid."

*******************************************
A passenger in a taxi leaned over to ask the driver a question and tapped him on the shoulder.
The driver screamed, lost control of the cab, nearly hit a bus, drove up over the curb, and stopped just inches from a large plate glass window.
For a few moments everything was silent in the cab, and then the still shaking driver said, "I'm sorry but you scared the daylights out of me."
The frightened passenger, apologized to the driver, and said he didn't realize a mere tap on the shoulder could frighten him so much.
The driver replied, "No, no, I'm sorry, it's entirely my fault. Today is my first day driving a cab . I've been driving a hearse for the last 23 years.
*******************************************
One liners from the 'Big Guy'

1. Okay, okay! I take it back. Unf--k you.

2. You say I'm a bitch like it's a bad thing.

3. Well this day was a total waste of make-up.

4. Well, aren't we a damn ray of sunshine?

5. Don't bother me, I'm living happily ever after.

6. Do I look like a people person?

7. This isn't an office. It's hell with fluorescent lighting.

8. I started out with nothing and I still have most of it left.

9. Therapy is expensive. Popping bubble wrap is cheap. You choose.

10. Why don't you try practicing random acts of intelligence and senseless acts of self-control?

11. I'm not crazy. I've been in a very bad mood for 30 years.

12. Sarcasm is just one more service I offer.

13. Do they ever shut up on your planet?

14. I'm not your type. I'm not inflatable.

15. Stress is when you wake up screaming and you realize you haven't gone to sleep yet.

16. Back off!! You're standing in my aura.

17. Don't worry. I forgot your name too.

18. I work 45 hours a week to be this poor.

19. Not all men are annoying. Some are dead.

20. Wait...I'm trying to imagine you with a personality.

21. Chaos, panic and disorder ... my work here is done.

22. Ambivalent? Well, yes and no.

23. You look like shit. Is that the style now?

24. Earth is full. Go home.

25. Aw, did I step on your poor little itty bitty ego?

26. I'm not tense, just terribly, terribly alert.

27. A hard-on doesn't count as personal growth.

28. You are depriving some village of an idiot.

29. If assholes could fly, this place would be an airport.
**********************************************
Neighbor kid story
Little Nancy was in the garden filling in a hole when her neighbor peered over the fence.
Even though he didn't much like the kid, he was interested in what the cheeky-faced youngster was doing, so he asked, "What are you up to there, Nancy?"
"My goldfish died," replied Nancy tearfully without looking up, "and I've just buried him."
The neighbor laughed and said condescendingly, "That's a really big hole for a goldfish, isn't it?"
Nancy patted down the last heap of earth, and then replied, "That's because he's inside your damn cat."
************************************************************
Due to inherit a fortune when his sickly, widower father died, Robert decided he needed a woman to enjoy it with. So he went to a singles bar and he searched until he spotted a woman whose beauty took his breath away.

"Right now, I'm just an ordinary man," he said, walking up to her, "but within a month or two, my father will pass and I'll inherit over 20 million dollars." The woman went home with Robert, and four days later she became his stepmother.

Men will never learn.
***************************************************************
A man and a woman, who have never met before, but who are both married to other people, found themselves assigned to the same sleeping >room on a transcontinental train.

Though initially embarrassed and uneasy over sharing a room, they were both very tired and fell asleep quickly ... he in the upper bunk and she in the lower.

At 1:00 AM, the man leaned over and gently woke the woman saying, "Ma'am, I'm sorry to bother you, but would you be willing to reach into the closet to get me a second blanket? I'm awfully cold."

"I have a better idea," she replied. "Just for tonight, let's pretend that we're married.

"Wow! That's a great idea!" he exclaimed.

"Good," she replied. "Get your own damned blanket!"

After a moment of silence, he farted.
*************************************************************
A blonde and a lawyer sit next to each other on a plane. The lawyer asks herto play a game. If he asked her a question that she didn't know the answer to, she would have to pay him five dollars; And every time the blonde asked the lawyer a question that he didn't know the answer to, the lawyer had to pay the blonde 50 dollars.
So the lawyer asked the blonde his first question, "What is the distance between the Earth and the nearest star?"
Without a word the blonde pays the lawyer five dollars.
The blonde then asks him, "What goes up a hill with four legs and down a hill with three?" The lawyer thinks about it, but finally gives up and pays the blonde 50 dollars.
Then the lawyer asked her what the answer was and without a word the blonde gave the lawyer five dollars.
************************************************************
Who says working in a hospital can't be fun ... actual writings from hospital charts:
1. The patient refused autopsy.
2. The patient has no previous history of suicides.
3. Patient has left white blood cells at another hospital.
4. She has no rigors or shaking chills, but her husband states she was hot in bed last night.
5. Patient has chest pain if she lies on her left side for over a year.
6. On the second day the knee was better, and on the third day it disappeared.
7. The patient is tearful and crying constantly. She also appears to be depressed.
8. The patient has been depressed since she began seeing me in 1993.
9. Discharge status: Alive but without permission
10. Healthy appearing decrepit 69-year old male, mentally alert but forgetful.
11. Patient had waffles for breakfast and anorexia for lunch.
12. She is numb from her toes down.
13. While in ER, she was examined, X-rated and sent home.
14. The skin was moist and dry.
15. Occasional, constant infrequent headaches.
16. Patient was alert and unresponsive.
17. Rectal examination revealed a normal size thyroid
18. She stated that she had been constipated for most of her life, until she got a divorce.
19. I saw your patient today, who is still under our car for physical therapy.
20. Both breasts are equal and reactive to light and accommodation.
21. Examination of genitalia reveals that he is circus sized.
22. The lab test indicated abnormal lover function.
23. Skin: somewhat pale but present.
24. The pelvic exam will be done later on the floor.
25. Patient has two teenage children, but no other abnormalities.
******************************************************

Tourist
After a tourist had been served in the Las Vegas cocktail lounge, he beckoned the waitress back and said, "Miss, would y'all give me a piece of ass?"
She looked him over, smiled and said, "Sure, why not? It's pretty slow here right now, so let's go!"
When the pair returned half an hour later, the man sat down at the same table and the waitress asked, "Will there be anything else?"
"Yes," replied the tourist.
"Where ah come from in Mississipi, we lack our bourbon 'n watuh cold, so ah still need a piece uh ass for mah drink."
******************************************************************

Moishe

MOISHE A man walks into the street and manages to get a taxi just going by. He gets into the taxi, and the cabbie says, "Perfect timing. You're just like Moishe."

Passenger: "Who?"

Cabbie: "Moishe Glickman. There's a guy who did everything right. Like my coming along when you needed a cab. It would have happened like that to Moishe every single time."

Passenger: "There are always a few clouds over everybody."

Cabbie: "Not Moishe. He was a terrific athlete. He could have gone on the pro tour in tennis. He could golf with the pros. He sang like an opera baritone and danced like a Broadway star and you should have heard him play the piano."

Passenger: "Sounds like he was something, huh?"

Cabbie: "He had a memory like a computer. Could remember everybody's birthday. He knew all about wine, which foods to order and which fork to eat them with. He could fix anything. Not like me. I change a fuse, and the whole neighborhood blacks out."

Passenger. "Wow, some guy eh?

Cabbie: "He always knew the quickest way to go in traffic and avoid traffic jams, not like me, I always seem to get into them"

"Passenger" Mmm, not many like that around"

Cabbie: "And he knew how to treat a woman and make her feel good and never answer her back even if she was in the wrong; and his clothing was always immaculate, shoes highly polished too."

Passenger: "An amazing fellow. How did you meet him?"

Cabbie: "Well, I never actually met Moishe."

Passenger: "Then how do you know so much about him?"

Cabbie: "I married his widow."
******************************************************************
Understanding Engineers

Understanding Engineers - Take One
To the optimist, the glass is half full. To the pessimist, the glass is half empty. To the engineer, the glass is twice as big as it needs to be.

----------------------------------------
Understanding Engineers - Take Two
A pastor, a doctor and an engineer were waiting one morning for a particularly slow group of golfers. The engineer fumed, "What's with these guys? We must have been waiting for 15 minutes!" The doctor chimed in, "I don't know, but I've never seen such ineptitude!" The pastor said, "Hey, here comes the greens keeper. Let's have a word with him." "Hi George! Say, what's with that group ahead of us? They're rather slow, aren't they?" The greens keeper replied, "Oh, yes, that's a group of blind fire-fighters. They lost their sight saving our clubhouse from a fire last year, so we always let them play for free anytime." The group was silent for a moment. The pastor said, "That's so sad. I think I will say a special prayer for them tonight." The doctor said, "Good idea. And I'm going to contact my ophthalmologist buddy and see if there's anything he can do for them." The engineer said, "Why can't these guys play at night?"

------------------------------------------
Understanding Engineers - Take Three
What is the difference between Mechanical Engineers and Civil Engineers?

Mechanical Engineers build weapons and Civil Engineers build targets.

------------------------------------------
Understanding Engineers - Take Four
The graduate with a Science degree asks, "Why does it work?" The graduate with an Engineering degree asks, "How does it work?" The graduate with an Accounting degree asks, "How much will it cost?" The graduate with an Arts degree asks, "Do you want fries with that?"

--------------------------------------
Understanding Engineers - Take Five
Three engineering students were gathered together discussing the possible designers of the human body. One said, "It was a mechanical engineer. Just look at all the joints." Another said, "No, it was an electrical engineer. The nervous system has many thousands of electrical connections." The last one said, "Actually it was a civil engineer. Who else would run a toxic waste pipeline through a recreational area?"

--------------------------------------
Understanding Engineers - Take Six
"Normal people believe that if it ain't broke, don't fix it. Engineers believe that if it ain't broke, it doesn't have enough features yet"

---------------------------------------
Understanding Engineers - Take Seven
An architect, an artist and an engineer were discussing whether it was better to spend time with the wife or a mistress. The architect said he enjoyed time with his wife, building a solid foundation for an enduring relationship. The artist said he enjoyed time with his mistress, because the passion and mystery he found there. The engineer said, "I like both." "Both?" "Yeah. If you have a wife and a mistress, they will each assume you are spending time with the other woman, and you can go to the lab and get some work done."

--------------------------------------

Understanding Engineers - Take Eight
An engineer was crossing a road one-day when a frog called out to him and said, "If you kiss me, I'll turn into a beautiful princess." He bent over, picked up the frog and put it in his pocket. The frog spoke up again and said, "If you kiss me and turn me back into a beautiful princess, I will stay with you for one week." The engineer took the frog out of his pocket, smiled at it and returned it to the pocket. The frog then cried out, "If you kiss me and turn me back into a princess, I'll stay with you and do ANYTHING you want." Again the engineer took the frog out, smiled at it and put it back into his pocket. Finally, the frog asked, "What is the matter? I've told you I'm a beautiful princess, and that I'll stay with you for a week and do anything you want. Why won't you kiss me?" The engineer said, "Look, I'm an engineer. I don't have time for a girlfriend, but a talking frog, now that's cool."

*******************************************************************
IF YOU THINK YOU'RE DUMB ABOUT COMPUTERS, READ THIS, YOU'LL FEEL BETTER.
Take heart, anyone among you who believes he or she is technologically challenged, you "ain't seen nothing" yet. This is an excerpt from a Wall Street Journal article:
1. Compaq is considering changing the command "Press Any Key" to "Press Return Key" because of the flood of calls asking where the "Any" key is.
2. AST technical support had a caller complaining that her mouse was hard to control with the dust cover on. The cover turned out to be the plastic bag the mouse was packaged in.
3. Another Dell customer called to say he couldn't get his computer to fax anything. After 40 minutes of troubleshooting, the technician discovered the man was trying to fax a piece of paper by holding it in front of the monitor screen and hitting the "Send" key.
4. Yet another Dell customer called to complain that his keyboard no longer worked. He had cleaned it by filling up his bathtub with soap and water and soaking the keyboard for a day, then removing all the keys and washing them individually.
5. A Dell technician received a call from a customer who was enraged because his computer had told him he was "Bad and an invalid." The tech explained that the computer's "bad command" and "invalid" responses shouldn't be taken personally.
6. A confused caller to IBM was having trouble printing documents. He told the technician that the computer had said it "couldn't find printer." The user had also tried turning the computer screen to face the printer but that his computer still couldn't "see" the printer.
7. An exasperated caller to Dell Computer Tech Support couldn't get her new Dell Computer to turn on. After ensuring the computer was plugged in, the technician asked her what happened when she pushed the power button. Her response, "I pushed and pushed on this foot pedal and nothing happened." The "foot pedal" turned out to be the computer's mouse...
8. Another customer called Compaq tech support to say her brand new computer wouldn't work. She said she unpacked the unit, plugged it in and sat there for 20 minutes waiting for something to happen. When asked what happened when she pressed the power switch, she asked, "What power switch?"
9. Another IBM customer had trouble installing software and rang for support. "I put in the first disk, and that was OK. It said to put in the second disk, and had some problems with the disk. When it said to put in the third disk, I couldn't even fit it in." The user hadn't realized that "Insert Disk 2" implied removing Disk 1 first.
10. A story from a Novell NetWare SysOp:
CALLER: "Hello, is this Tech Support?"
TECH: "Yes, it is. How may I help you?"
CALLER: "The cup holder on my PC is broken -and I am within my warranty period. How do I go about getting that fixed?"
TECH: "I'm sorry, but did you say a cup holder?"
CALLER: "Yes, it's attached to the front of my computer."
TECH: "Please excuse me. If I seem a bit stumped, it's because I am. Did you receive this as part of a promotional at a trade show? How did you get this cup holder? Does it have any trademark on it?"
CALLER: "It came with my computer. I don't know anything about a promotional. It just has '4X' on it." At this point, the Tech Rep had to mute the caller because he couldn't stand it. He was laughing too hard. The caller had been using the load drawer of the CD-ROM drive as a cup holder and it had snapped it off the drive.
11. A woman called the Canon help desk with a problem with her printer. The tech asked her if she was "running it under windows." The woman responded, "No, my desk is next to the door. But that is a good point. The man sitting in the cubicle next to me is under a window and his printer is working fine."
12. And last but not least: TECH SUPPORT: "O.K. Bob, let's press the control and escape keys at the same time. That brings up a task list in the middle of the screen. Now type the letter "P" to bring up the Program Manager.
CUSTOMER: "I don't have a 'P'".
TECH SUPPORT: "On your keyboard, Bob."
CUSTOMER: "What do you mean?"
TECH SUPPORT: " 'P' on your keyboard, Bob."
CUSTOMER: "I'm not going to do that."
*********************************************************

How to handle your husband

A couple was celebrating their golden wedding anniversary on the beach
in Montego Bay, Jamaica. Their domestic tranquility had long been the
talk of the town. "What a peaceful & loving couple".

The local newspaper reporter was inquiring as to the secret of their
long and happy marriage.

"Well, it dates back to our honeymoon in America, " explained the man.
"We visited the Grand Canyon in Arizona and took a trip down to the
bottom of the canyon by horse. We hadn't gone too far when my wife's
horse stumbled and she almost fell off. My wife looked down at the horse
and quietly said, "That's once."

"We proceeded a little further and the horse stumbled again, this time
causing her to drop her water. Once more my wife quietly said, "That's
twice." We hadn't gone a half-mile when the horse stumbled for a third
time. My wife quietly removed a revolver from her purse and shot the
horse dead.

I shouted at her, "What's wrong with you, Woman! Why did you shoot the
poor animal like that? Are you crazy??"

She looked at me, and quietly said, "That's once."


"And from that moment... we have lived happily ever after."

******************************************************
How to face a problem...

Boudreaux's twenty-one-year-old daughter tells her parents she has missed her period for two months. Very worried, they go to the drugstore and to buy a pregnancy kit. The test result shows that the girl is pregnant.

Shouting, cursing, crying, Boudreaux says, "Who was the pig that did this to you? I want to know!"

The girl picks up the phone and makes a call.

Half an hour later, a Ferrari stops in front of the Boudreaux's house; a mature and distinguished man with gray hair, impeccably dressed in a very expensive suit, steps out of the car and enters the house.

He sits in the living room with Boudreaux, the mother and the girl, and tells them, "Good morning, your daughter has informed me of the problem. I can't marry her because of my personal family situation but I'll take financial charge of the situation.

If a girl is born, I will bequeath her two retail stores, a townhouse, a beach villa and a $1,000,000 bank account. If a boy is born, my legacy will be a couple of factories and a $2,000,000 bank account. If it is twins, a factory and $1,000,000 each.

However, if there is a miscarriage, what do you suggest I do?"

At this point, Boudreaux, who had remained silent, places a hand firmly on the man's shoulder and tells him, "Den' you try agin'!"
********************************************************************
Grandma's and children:

An elderly woman and her little grandson, whose face was sprinkled with bright freckles, spent the day at the zoo. Lots of children were waiting in line to get their cheeks painted by a local artist who was decorating them with tiger paws.

"You've got so many freckles, there's no place to paint!" a girl in the line said to the little fella. Embarrassed, the little boy dropped his head.

His grandmother knelt down next to him "I love your freckles. When I was a little girl I always wanted freckles, she said, while tracing her finger across the child's cheek. "Freckles are beautiful!"

The boy looked up, "Really?"

"Of course," said the grandmother. "Why, just name me one thing that's prettier than freckles."

The little boy thought for a moment, peered intensely into his grandma's face, and softly whispered, "Wrinkles."

~~~~~~~~~~~~~~~~~~~~~~~~~

A grandmother was telling her little granddaughter what her own childhood was like. "We used to skate outside on a pond. I had a swing made from a tire; it hung from a tree in our front yard. We rode our pony. We picked wild raspberries in the woods."

The little girl was wide-eyed, taking this in. At last she said, "I sure wish I'd gotten to know you sooner!"

~~~~~~~~~~~~~~~~~~~~~~~~~

My grandson was visiting one day when he asked, Grandma, do you know how you and God are alike?"

I mentally polished my halo while I asked, "No, how are we alike?"

"You're both old," he said.

~~~~~~~~~~~~~~~~~~~~~~~~

When my grandson asked me how old I was, I teasingly replied "I'm not sure."

"Look in your underwear, Grandma," he advised. "Mine says I'm four."

~~~~~~~~~~~~~~~~~~~~~~~~

A Sunday school class was studying the Ten Commandments. They were ready to discuss the last one. The teacher asked if anyone could tell her what it was. Susie raised her hand, stood tall, and quoted, "Thou shall not take the covers off thy neighbor's wife."

~~~~~~~~~~~~~~~~~~~~~~~~~

Our five-year-old son Mark couldn't wait to tell his friend about the movie we had watched on television, "20,000 Leagues Under the Sea." The scenes with the submarine and the giant octopus had kept him wide-eyed.

In the middle of the telling, my husband interrupted Mark, "What caused the submarine to sink?"

With a look of incredulity Mark replied, "Dad, it was the 20,000 leaks!!"

~~~~~~~~~~~~~~~~~~~~~~~~~

A second grader came home from school and said to her mother, "Mom, guess what? We learned how to make babies today."

The mother, more than a little surprised, tried to keep her cool. "That's interesting," she said. "How do you make babies?"

"It's simple," replied the girl. "You just change "y" to "i" and add "es."

(Why wouldn't an English teacher love this one?)

~~~~~~~~~~~~~~~~~~~~~~~~~

" Give me a sentence about a public servant," said a teacher.

The small boy wrote: "The fireman came down the ladder pregnant."

The teacher took the lad aside to correct him. "Don't you know what pregnant means?" she asked.

Sure," said the young boy confidently. "It means carrying a child."

~~~~~~~~~~~~~~~~~~~~~~~~

A grandmother was surprised by her 7 year old grandson one morning. He had made her coffee. She drank what was the worst cup of coffee in her life. When she got to the bottom, there were three of those little green Army men in the cup. She said "Honey, what are these army men doing in my coffee?"

Her grandson said, "Grandma, it says on TV, "The best part of waking up is soldiers in your cup!"

~~~~~~~~~~~~~~~~~~~~~~~~~

A nursery school teacher was delivering a station wagon full of kids home one day when a fire truck zoomed past. Sitting in the front seat of the fire truck was a Dalmatian dog. The children started discussing the dog's duties.

"They use him to keep crowds back," said one youngster.

"No," said another, "he's just for good luck"

A third child brought the argument to a close..."They use the dogs," she said firmly, "to find the fire hydrant."
*********************************************************************************

One Monday morning a mailman is walking the neighborhood on his usual
route.
As he approaches one of the homes he notices that both cars are in the
driveway.

His wonder is cut short by Bob, the homeowner, coming out with a load of
empty beer and liquor bottles.

"Wow Bob, looks like you guys had one hell of a party last night," the
mailman comments.
Bob in obvious pain replies, "Actually we had it Saturday night. This is
the first I have felt like moving since 4 a.m. Sunday morning.

We had about fifteen couples from around the neighborhood over for a
party and it got a bit wild. Hell, we got so drunk around midnight that
we started playing WHO, AM"

The mailman thinks a moment and says, "How do you play that?" "Well, all
the guys go in the bedroom and we come out one at a time with a sheet
covering us and only our "privates" showing through a hole in the sheet.
Then the women try to guess who it is, Bob explains.

The mailman laughs and says, "Damn, I'm sorry I missed that."

"Probably a good thing you did," Bob responds. "Your name came up four
or five times.
**********************************************************

EDNA AND JIM

Jim and Edna were both patients in a mental hospital. One day while they were walking past the hospital swimming pool, Jim suddenly jumped into the deep end. He sank to the bottom of the pool and stayed there. Edna promptly jumped in to save him. She swam to the bottom and pulled Jim out.

When the Director of Nursing became aware of Edna's heroic act, she immediately ordered her to be discharged from the hospital, as she now considered her to be mentally stable.

When she went to tell Edna the news she said, "Edna, I have good news and bad news. The good news is you're being discharged; since you were able to rationally respond to a crisis by jumping in and saving the life of another patient, I have concluded that your act displays sound mindedness.

The bad news is that Jim, the patient you saved, hung himself in his bathroom with the belt of his robe right after you saved him. I am so sorry, but he's dead."

Edna replied; "He didn't hang himself; I put him there to dry. How soon can I go home?"

******************************************************************************

This is the Captain speaking.

A jumbo jet is just coming into the Tampa Airport on its final approach. The pilot comes on the intercom, "This is your Captain. We're on our final descent into Tampa. I want to thank you for flying with us today and I hope you enjoy your stay in Tampa Bay". He forgets to switch off the intercom. Now the whole plane can hear his conversation from the cockpit.

The copilot says to the pilot, "Well, skipper, watcha gonna do in Tampa?"

"Well," says the skipper, "first I'm gonna check into the hotel and take a big crap.... then I'm gonna take that new stewardess with the huge tits out for dinner..... then I'm gonna wine and dine her, take her back to my room and put it to her big time all night."

Everyone on the plane hears this and immediately begins looking up and down the aisle trying to get a look at the new stewardess.

Meanwhile the new stewardess is at the very back of the plane. She's so embarrassed that she starts to run to try and get to the cockpit to turn the intercom off. Halfway down the aisle, she trips over an old lady's bag and down she goes.

The old lady leans over and says: "No need to hurry, dear. He's gotta take a crap first."
******************************************************************************

Burial

A young preacher was asked by the local funeral director to hold a grave-side burial service at a small local cemetery for someone with no family or friends. The preacher started early but quickly got himself lost, making several wrong turns.

Eventually, a half-hour late, he saw a backhoe and its crew, but the hearse was nowhere in sight, and the workmen were sitting to one side, eating lunch. The diligent young pastor went to the open grave and found the vault lid already in place.

Taking out his book, he read the service. Feeling guilty because of his tardiness, he preached an impassioned and lengthy service, sending the deceased to the great beyond in style.

As he was returning to his car, he overheard one of the workmen say: I've been putting in septic tanks for twenty years and I ain't never seen anything like that.
***********************************************************************
Asylum for the Verbally Insane

We'll begin with a box, and the plural is boxes,
but the plural of ox became oxen not oxes.
One fowl is a goose, but two are called geese,
yet the plural of moose should never be meese.
You may find a lone mouse or a nest full of mice,
yet the plural of house is houses, not hice.

If the plural of man is always called men,
why shouldn't the plural of pan be called pen?
If I spoke of my foot and show you my feet,
and I give you a boot, would a pair be called beet?
If one is a tooth and a whole set are teeth,
why shouldn't the plural of booth be called beeth?

Then one may be that, and three would be those,
yet hat in the plural would never be hose,
and the plural of cat is cats, not cose.
We speak of a brother and also of brethren,
but though we say mother, we never say methren.
Then the masculine pronouns are he, his and him,
but imagine the feminine, she, shis and shim.

Let's face it - English is a crazy language.
There is no egg in eggplant nor ham in hamburger;
neither apple nor pine in pineapple.
English muffins weren't invented in England.
We take English for granted.
But if we explore its paradoxes, we find that
quicksand can work slowly, boxing rings are square,
and a guinea pig is neither from Guinea nor is it a pig.

And why is it that writers write but fingers don't fing,
grocers don't groce and hammers don't ham?
Doesn't it seem crazy that you can make amends but not one amend?
If you have a bunch of odds and ends and get rid of all but one
of them, what do you call it?

If teachers taught, why didn't preachers praught?
If a vegetarian eats vegetables, what does a humanitarian eat?
Sometimes I think all the folks who grew up speaking English
should be committed to of an asylum for the verbally insane.

In what other language do people recite at a play and
play at a recital?

We ship by truck but send cargo by ship.
We have noses that run and feet that smell.
And how can a slim chance and a fat chance be the same,
while a wise man and a wise guy are opposites?

You have to marvel at the unique lunacy of a language
in which your house can burn up as it burns down,
in which you fill in a form by filling it out,
and in which an alarm goes off by going on.

So if Father is Pop, how come Mother isn't Mop

And that is just the beginning - even though this is the end.

Author unknown