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mb
medicine forum beginner
Joined: 10 Mar 2005
Posts: 22
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 Posted: Thu Jun 01, 2006 4:39 pm Post subject:
Re: will acuvvue oasys or advance 2 be okay for swimming?
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Dr. Leukoma wrote:
| Quote: | Anon E. Muss wrote:
On 18 May 2006 10:43:01 -0700, "Dr. Leukoma" <drg@leukoma.com> wrote:
Studies show that acanthamoeba has a prediliction for attachment to
silicone-hydrogel lenses.
In vitro or in vivo?
Most eye doctors will never see a case of acanthomeba keratitis in the
course of their entire career, so I think the risk is quite low.
True, but I saw four cases in a 6 month period two years ago.
Of course, not swimming in your contacts is safest, but does one want
to be a caricature of caution?
You should speak to the mother who emailed me today about her
daughter's experience with acanthamoeba keratitis and 3 subsequent
corneal transplants. I'm pretty sure how she would answer your
question.
DrG
|
I am the mother who Dr. G spoke to several weeks ago. I share the
following information with you. There is a risk with swimming in
contacts. The problem is consumers are not fully aware of this risk.
We should be fully informed and if you want to take that risk, go
ahead, but let us know ALL the risks.
There is an increasing trend of Acanthamoeba infections in the last
several years in certain areas in this country. Some of our
ophthalmologists are very concerned. This infection has been more
common abroad because of the older water systems. Acanthamoeba is
ubiquitous in nature. It is in our tap water, lakes, pools, hot tubs,
air, soil. Most contact lens solutions do not kill Acanthamoeba even in
the required disinfectant times. Prevention and education is critical
to keep our eyes safe. We need to question why it is on the FDA website
that you do not swim with contacts yet most consumers are clueless
about this risk as well as our eye health practitioners. We also need
to question why a non-prescription contact lens was deregulated and
sold in dolllar stores for four years. Our youth started getting this
infection. Prevent Blindness Amercia and other concerned eye health
organizations had to draft legislation, which was passed this year
after pending in Congress for two years, to make it illegal to
prescribe any contact lens without going through a licensed eye
practitioner.
I make these statements and have become involved in eye health advocacy
because my daugther who was fourteen at the time contracted
Acanthamoeba keratitis when she swam with her contacts. She battled
this infection for two years and received three corneal transplants.
The parasite simply would not die. Medical therapies were astronomical
not to mention her pain and suffering. She is now bug free, but her
vision in her left eye has been compromised the rest of her life. You
can read her story on the Prevent Blindness America website, "Eyes on
Capitol Hill" and her advocacy efforts when she told her story to
legislators and the importance of the Vision Preservation Act,
legislation that must be passed. Please write your Congressman
supporting this legislation. 15-20 years ago you just lost your eye as
we had no medical therapies to fight this parasite. At the time, I
sought out other people who also had this infection as I felt very
alone and needed support. We have formed a support group called MAAD
(Mothers Against Acanthamoeba Disease). I believe this is the only
support group of its kind in this country. Please read these stories of
our other MAAD group members who have suffered this tragedy. We want to
be involved to protect and support other people as we would not wish
this infection on our worst enemies.
Our eyesight is too precious not to be protected.
mary beth |
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William Stacy
medicine forum Guru
Joined: 01 May 2005
Posts: 1177
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| Posted: Thu Jun 01, 2006 7:42 pm Post subject:
Re: will acuvvue oasys or advance 2 be okay for swimming?
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mb wrote:
my daugther who was fourteen at the time contracted
| Quote: | Acanthamoeba keratitis when she swam with her contacts.
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Can you share with us where she was swimming? (pool, pond, ocean?)
thanks
w.stacy, o.d. |
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LarryDoc
medicine forum Guru Wannabe
Joined: 29 Apr 2005
Posts: 262
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| Posted: Thu Jun 01, 2006 8:14 pm Post subject:
Re: will acuvvue oasys or advance 2 be okay for swimming?
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In article <1149179960.312317.198850@g10g2000cwb.googlegroups.com>,
"mb" <marybethx@yahoo.com> wrote:
| Quote: | I am the mother who Dr. G spoke to several weeks ago. I share the
following information with you. There is a risk with swimming in
contacts. The problem is consumers are not fully aware of this risk.
We should be fully informed and if you want to take that risk, go
ahead, but let us know ALL the risks.
|
Dr. G and I agree with you, of course. We make every effort to
carefully educate our patients about the risks and ways to mitigate
them. The contact industry has responded by producing lenses that have
less impact on cornea physiology and disinfection products that do the
job. Our peer journals have articles addressing this issue, most
recently this month: the big cover story in one such journal. We hear
the warnings and advice at continuing education seminars. Most
professional and competent eye doctors do indeed tell their patients how
to manage their eye care. Helping to keep our patient's eyes healthy is
our job and ethical responsibility, not to mention it's good for
business.
But the wearer must take the ultimate responsibility to "do the right
thing" after they are fully informed and this, I think is where the
problem lies.
Save a buck, stretch out the longevity of the lens, re-use (or don't
use) appropriate lens care products, re-order lenses by mail without a
prescription and without routine eye doctor visits, dig in the garden
and forget about washing up before handling lenses, ignore symptoms of
things gone wrong until it's too late.
There's only so much education and hand-holding we can do.
The problem is not with the contact lenses but with how they are used
and handled. Look at the recent fungus scare. Less than a dozen people
with "severe" problems and a hundred or so affected people out of 30
million regular contact lens wearers is an issue blown way out of
proportion. The reality of thousands of people with completely avoidable
and preventable "minor "eye health issues that can escalate to "serious"
and resulting from poor lens fitting or lens care is a major concern.
I'm sorry to hear about your daughter. Your advocacy will help to
prevent these kinds of tragedies from affecting others. It's been
difficult to get the US federal and state governments to do their part.
We try. You are trying. Thanks for your efforts.
LB, O.D. |
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mb
medicine forum beginner
Joined: 10 Mar 2005
Posts: 22
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| Posted: Thu Jun 01, 2006 8:48 pm Post subject:
Re: will acuvvue oasys or advance 2 be okay for swimming?
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William Stacy wrote:
| Quote: | mb wrote:
my daugther who was fourteen at the time contracted
Acanthamoeba keratitis when she swam with her contacts.
Can you share with us where she was swimming? (pool, pond, ocean?)
thanks
w.stacy, o.d.
|
She swam in a self enclosed private lake which included a pond. When
she was finally diagnosed correctly, our doctor said it was a slow
growing infection to start and slow to leave. She first was diagnosed
with pink eye for two weeks. Did not get to the right doctor for about
5-6 weeks, by that time it was out of control and burrowed deeper into
her cornea. |
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mb
medicine forum beginner
Joined: 10 Mar 2005
Posts: 22
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| Posted: Thu Jun 01, 2006 8:58 pm Post subject:
Re: will acuvvue oasys or advance 2 be okay for swimming?
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LarryDoc wrote:
| Quote: | In article <1149179960.312317.198850@g10g2000cwb.googlegroups.com>,
"mb" <marybethx@yahoo.com> wrote:
I am the mother who Dr. G spoke to several weeks ago. I share the
following information with you. There is a risk with swimming in
contacts. The problem is consumers are not fully aware of this risk.
We should be fully informed and if you want to take that risk, go
ahead, but let us know ALL the risks.
Dr. G and I agree with you, of course. We make every effort to
carefully educate our patients about the risks and ways to mitigate
them. The contact industry has responded by producing lenses that have
less impact on cornea physiology and disinfection products that do the
job. Our peer journals have articles addressing this issue, most
recently this month: the big cover story in one such journal. We hear
the warnings and advice at continuing education seminars. Most
professional and competent eye doctors do indeed tell their patients how
to manage their eye care. Helping to keep our patient's eyes healthy is
our job and ethical responsibility, not to mention it's good for
business.
But the wearer must take the ultimate responsibility to "do the right
thing" after they are fully informed and this, I think is where the
problem lies.
Save a buck, stretch out the longevity of the lens, re-use (or don't
use) appropriate lens care products, re-order lenses by mail without a
prescription and without routine eye doctor visits, dig in the garden
and forget about washing up before handling lenses, ignore symptoms of
things gone wrong until it's too late.
There's only so much education and hand-holding we can do.
The problem is not with the contact lenses but with how they are used
and handled. Look at the recent fungus scare. Less than a dozen people
with "severe" problems and a hundred or so affected people out of 30
million regular contact lens wearers is an issue blown way out of
proportion. The reality of thousands of people with completely avoidable
and preventable "minor "eye health issues that can escalate to "serious"
and resulting from poor lens fitting or lens care is a major concern.
I'm sorry to hear about your daughter. Your advocacy will help to
prevent these kinds of tragedies from affecting others. It's been
difficult to get the US federal and state governments to do their part.
We try. You are trying. Thanks for your efforts.
LB, O.D.
|
I highly dispute your statement, this issue was "blown out of
proportion." First of all, you NEVER would have even heard about this
fusarium outbreak if the Singapore health ministry did not demand
answers and pull this product from the market. That is the only reason
why the CDC and FDA stepped in. These infections would have continued
to occur. This product was NEVER tested for its efficacy against
fusarium yet it was allowed to be purchased by consumers with the FDA's
stamp of approval. The company blatantly admitted this. If there was
one death with this product, it would have been pulled from the market,
yet 200 people going blind is nothing? If your own child was affected
with this infection or Acanthamoeba, I am sure your mindset would be
different.
mb |
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Anonymous
Guest
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| Posted: Thu Jun 01, 2006 11:14 pm Post subject:
Re: will acuvvue oasys or advance 2 be okay for swimming?
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On 1 Jun 2006 13:58:40 -0700, "mb" <marybethx@yahoo.com> wrote:
| Quote: | This product was NEVER tested for its efficacy against
fusarium yet it was allowed to be purchased by consumers with the
FDA's stamp of approval. The company blatantly admitted this.
|
I don't know if this was true, but it wouldn't be surprising.
Fusarium is/was an extremely rare cause of keratitis. Like
acanthamoeba, most eye doctors will never see even ONE case of these
in their entire career.
For a contact lens solution to be tested against every potential
pathogen was unrealistic. However, that may change now.
| Quote: | If there was one death with this product, it would have been pulled
from the market, yet 200 people going blind is nothing?
|
Where do you get this number? 200 people being affected is certainly
not necessarily the same as 200 people "going blind". The vast
majority of people with acanthamoeba or fungal keratitis certainly do
NOT go blind. |
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William Stacy
medicine forum Guru
Joined: 01 May 2005
Posts: 1177
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| Posted: Thu Jun 01, 2006 11:56 pm Post subject:
Re: will acuvvue oasys or advance 2 be okay for swimming?
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Based on my admittedly brief study of this subject, it seems that
acanthamoeba corneal infections are caused primarily by soft contact
lens wearers who come in contact with contaminated fresh water like
ponds and lakes, and even tap water (in areas where the public water
supply has been recently flooded). I concur with strongly cautioning cl
wearers about swimming, bathing, or otherwise contaminating their
contacts with such waters. However, as I posted earlier, I think
swimming in the 3.5% saline ocean waters, away from sewer and river
discharge areas is relatively safe for contact lens wearers, probably
safer than ordinary lens care (where sterile techniques are NEVER
observed).
I have not found a single case that can be definitively traced to clean
ocean swimming (if anyone can find me one, please post it and I will
modify my opinion appropriately). My interest in this is that I want our
recommendations to patients to be based on both scientific evidence and
its logical extensions.
w.stacy, o.d. |
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mb
medicine forum beginner
Joined: 10 Mar 2005
Posts: 22
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| Posted: Fri Jun 02, 2006 1:03 am Post subject:
Re: will acuvvue oasys or advance 2 be okay for swimming?
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Anonymous wrote:
| Quote: | On 1 Jun 2006 13:58:40 -0700, "mb" <marybethx@yahoo.com> wrote:
This product was NEVER tested for its efficacy against
fusarium yet it was allowed to be purchased by consumers with the
FDA's stamp of approval. The company blatantly admitted this.
I don't know if this was true, but it wouldn't be surprising.
Fusarium is/was an extremely rare cause of keratitis. Like
acanthamoeba, most eye doctors will never see even ONE case of these
in their entire career.
For a contact lens solution to be tested against every potential
pathogen was unrealistic. However, that may change now.
If there was one death with this product, it would have been pulled
from the market, yet 200 people going blind is nothing?
Where do you get this number? 200 people being affected is certainly
not necessarily the same as 200 people "going blind". The vast
majority of people with acanthamoeba or fungal keratitis certainly do
NOT go blind.
|
If one person goes blind because of a faulty product, that is very sad.
A corneal transplant will affect your vision the rest of your life.
Below is one man who trusted a product he was putting in his eye.
On May 15, 2006 the FDA issued a press release stating: "Based on this
scientific and epidemiological data suggesting that ReNu with
MoistureLoc may increase susceptibility to Fusarium, Bausch & Lomb has
decided to permanently remove the ReNu with MoistureLoc product
worldwide." The recall followed Bausch & Lomb's conclusion that the
product's formula may increase the risk of fungal eye infections in
certain situations. Bausch & Lomb, Inc. and the FDA both acknowledged
there is a problem in the chemical properties of ReNu with MoistureLoc
after testing confirmed that the solution allows a polymer film to form
around the Fusarium fungus, preventing the disinfectant in the product
from killing the fungus.
The injured party, who resides in upstate New York, was diagnosed with
a fungal infection in his left eye in October 2005, and was referred to
a cornea specialist at Columbia Presbyterian in New York City. The
specialist performed a corneal confocal microscope exam and several
biopsies, which confirmed the diagnosis of Fusarium keratitis. The
specialist notified the plaintiff that a cornea transplant would be
necessary. Because the transplant procedure could not be performed
until the infection was under control, the victim was prescribed
voriconazole, a potent anti-fungal medication, which had to be
administered approximately every 2 hours, 24 hours each day, over the
course of several months. After the infection appeared to be under
control, the cornea transplant procedure was performed. During the
cornea transplant surgery, additional signs of the fungal infection
were discovered. This later led to approximately 5 flush-out surgeries,
which involved accessing the back of the left eye through an incision
in order to remove additional evidence of the Fusarium fungal
infection. The infection returned following the flush-out surgeries,
requiring the victim to undergo a lengthy and invasive surgery with the
following procedures performed on his left eye: lensectomy,
capsulectomy, removal of the iris, removal of vitreous fluid, and
removal of the fungal infection. The victim is left with only 15%
vision in his left eye and is currently awaiting FDA approval for an
iris transplant. |
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Anon E. Muss
medicine forum Guru Wannabe
Joined: 22 May 2006
Posts: 136
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| Posted: Fri Jun 02, 2006 5:45 am Post subject:
Re: will acuvvue oasys or advance 2 be okay for swimming?
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On 1 Jun 2006 18:03:39 -0700, "mb" <marybethx@yahoo.com> wrote:
| Quote: | Anonymous wrote:
On 1 Jun 2006 13:58:40 -0700, "mb" <marybethx@yahoo.com> wrote:
This product was NEVER tested for its efficacy against
fusarium yet it was allowed to be purchased by consumers with the
FDA's stamp of approval. The company blatantly admitted this.
I don't know if this was true, but it wouldn't be surprising.
Fusarium is/was an extremely rare cause of keratitis. Like
acanthamoeba, most eye doctors will never see even ONE case of these
in their entire career.
For a contact lens solution to be tested against every potential
pathogen was unrealistic. However, that may change now.
If there was one death with this product, it would have been pulled
from the market, yet 200 people going blind is nothing?
Where do you get this number? 200 people being affected is certainly
not necessarily the same as 200 people "going blind". The vast
majority of people with acanthamoeba or fungal keratitis certainly do
NOT go blind.
If one person goes blind because of a faulty product, that is very sad.
|
Yes, but you are flat-out distorting the truth rather than engaging in
hyoerbole.
Also, we are talking semantics here, but I hardly think "Renu with
MoisturLoc" (RWM) was a "faulty product".
And there still is no determind direct cause/effect relationship with
fusarium keratitis and RWM -- i.e., there has still not been a "this
is what caused the problem" revealed cause. But initial and
subsequent reports DO suggest an extremely strong association.
FWIW, and this is just my opinion, I think that there is probably
something in the RWM formulation that either doesn't kill fusarium
well or something in it that works like culture medium for fusarium --
just like the below FDA press release states.
And once again, I do not fault B&L for producing a product that
perhaps was not tested (adequately) against fusarium. It was (and is)
a rare pathogen. But you can bet any FUTURE product better be tested
against it!
| Quote: | A corneal transplant will affect your vision the rest of your life.
|
This is true, but having (to have) a penetrating keratoplasty (PKP)
does not mean the same thing as having gone blind. And one person
going blind is not the same as "200 people going blind."
| Quote: | Below is one man who trusted a product he was putting in his eye.
|
One man going blind in ONE eye is unfortunate, but let's not make a
mountain out of a molehill here. From all initial reports, I think
B&L acted in good faith, did everything they should have, and there is
(from what I can tell) *no negligence* on their part. Just BAD LUCK.
However, with the limited brain power of the average juror (if brains
were dynamite, they couldn't blow their nose), I wouldn't be surprised
if they award this guy trillions of dollars. It happened to Mark
Speaker
(<http://www.crstoday.com/PDF%20Articles/1005/CRST1005_F4_Kopff.html>).
[Partial quote from <http://www.newsinferno.com/archives/1193> SNIPed] |
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mb
medicine forum beginner
Joined: 10 Mar 2005
Posts: 22
|
| Posted: Fri Jun 02, 2006 2:17 pm Post subject:
Re: will acuvvue oasys or advance 2 be okay for swimming?
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Anon E. Muss wrote:
| Quote: | On 1 Jun 2006 18:03:39 -0700, "mb" <marybethx@yahoo.com> wrote:
Anonymous wrote:
On 1 Jun 2006 13:58:40 -0700, "mb" <marybethx@yahoo.com> wrote:
This product was NEVER tested for its efficacy against
fusarium yet it was allowed to be purchased by consumers with the
FDA's stamp of approval. The company blatantly admitted this.
I don't know if this was true, but it wouldn't be surprising.
Fusarium is/was an extremely rare cause of keratitis. Like
acanthamoeba, most eye doctors will never see even ONE case of these
in their entire career.
For a contact lens solution to be tested against every potential
pathogen was unrealistic. However, that may change now.
If there was one death with this product, it would have been pulled
from the market, yet 200 people going blind is nothing?
Where do you get this number? 200 people being affected is certainly
not necessarily the same as 200 people "going blind". The vast
majority of people with acanthamoeba or fungal keratitis certainly do
NOT go blind.
If one person goes blind because of a faulty product, that is very sad.
Yes, but you are flat-out distorting the truth rather than engaging in
hyoerbole.
Also, we are talking semantics here, but I hardly think "Renu with
MoisturLoc" (RWM) was a "faulty product".
And there still is no determind direct cause/effect relationship with
fusarium keratitis and RWM -- i.e., there has still not been a "this
is what caused the problem" revealed cause. But initial and
subsequent reports DO suggest an extremely strong association.
FWIW, and this is just my opinion, I think that there is probably
something in the RWM formulation that either doesn't kill fusarium
well or something in it that works like culture medium for fusarium --
just like the below FDA press release states.
And once again, I do not fault B&L for producing a product that
perhaps was not tested (adequately) against fusarium. It was (and is)
a rare pathogen. But you can bet any FUTURE product better be tested
against it!
A corneal transplant will affect your vision the rest of your life.
This is true, but having (to have) a penetrating keratoplasty (PKP)
does not mean the same thing as having gone blind. And one person
going blind is not the same as "200 people going blind."
Below is one man who trusted a product he was putting in his eye.
One man going blind in ONE eye is unfortunate, but let's not make a
mountain out of a molehill here. From all initial reports, I think
B&L acted in good faith, did everything they should have, and there is
(from what I can tell) *no negligence* on their part. Just BAD LUCK.
However, with the limited brain power of the average juror (if brains
were dynamite, they couldn't blow their nose), I wouldn't be surprised
if they award this guy trillions of dollars. It happened to Mark
Speaker
(<http://www.crstoday.com/PDF%20Articles/1005/CRST1005_F4_Kopff.html>).
[Partial quote from <http://www.newsinferno.com/archives/1193> SNIPed]
|
Maybe they should have disclosed on their product, this solution may
cause a "rare" infection which could result in blindness. And we
haven't bothered to test this product against this fungus either.
However, the risk is less than .01%, but if you are a bad luck person,
this could happen to you. |
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Quick
medicine forum Guru
Joined: 19 Jun 2005
Posts: 343
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| Posted: Fri Jun 02, 2006 5:08 pm Post subject:
Re: will acuvvue oasys or advance 2 be okay for swimming?
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mb wrote:
| Quote: |
Maybe they should have disclosed on their product, this
solution may cause a "rare" infection which could result
in blindness. And we haven't bothered to test this
product against this fungus either. However, the risk is
less than .01%, but if you are a bad luck person, this
could happen to you.
|
So some people are using the term "cause". Is it that
the solution "may *cause* a 'rare' infection" or is it the
case that it may not prevent it. Is there a difference?
-Quick |
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LarryDoc
medicine forum Guru Wannabe
Joined: 29 Apr 2005
Posts: 262
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| Posted: Fri Jun 02, 2006 6:00 pm Post subject:
Re: will acuvvue oasys or advance 2 be okay for swimming?
|
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|
In article <%f_fg.37421$4L1.26577@newssvr11.news.prodigy.com>,
"Quick" <quick7135-news@NOSPAMyahoo.com> wrote:
| Quote: | mb wrote:
Maybe they should have disclosed on their product, this
solution may cause a "rare" infection which could result
in blindness. And we haven't bothered to test this
product against this fungus either. However, the risk is
less than .01%, but if you are a bad luck person, this
could happen to you.
So some people are using the term "cause". Is it that
the solution "may *cause* a 'rare' infection" or is it the
case that it may not prevent it. Is there a difference?
-Quick
|
You bet.
Or, more accurately:
In the incredibly unusual situation in which a contact lens wearer
handles fusarium fungus contaminated soil (which exists only in certain
specific climate zones) and fails to wash their hands prior to handling
their contact lenses, and then uses MoisturLoc solution (no longer
available) and subsequently develops symptoms of infection, and then
ignores those symptoms for a period of time prior to seeking medical
care from a doctor who misdiagnoses the causative organism for the
infection, then that person will be at risk for possibly permanent loss
of vision in the affected eye.
Still, the risk of death from being struck by lightening while holding a
golf club while standing on the green in a middle of thunderstorm is
possibly greater than that of blindness from fusarium.
Of course one has be rather strange to be playing golf standing in the
pouring rain with lightening all around. And pretty negligent digging in
the dirt and not washing up before sticking their fingers in the eye.
All of which is easily prevented by simple wearing plus lenses!
LB, O.D. |
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Quick
medicine forum Guru
Joined: 19 Jun 2005
Posts: 343
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| Posted: Fri Jun 02, 2006 6:34 pm Post subject:
Re: will acuvvue oasys or advance 2 be okay for swimming?
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LarryDoc wrote:
| Quote: |
Of course one has be rather strange to be playing golf
standing in the pouring rain with lightening all around.
And pretty negligent digging in the dirt and not washing
up before sticking their fingers in the eye.
|
Ummm, I'll agree with the dirt part. Pouring rain with a
bit of lightening has to be weighed against finishing this
round so you can make the tee time for your afternoon
round at the other course...
-Quick |
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Dr. Leukoma
medicine forum Guru
Joined: 30 Apr 2005
Posts: 1283
|
| Posted: Fri Jun 02, 2006 7:24 pm Post subject:
Re: will acuvvue oasys or advance 2 be okay for swimming?
|
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Quick wrote:
| Quote: | LarryDoc wrote:
Of course one has be rather strange to be playing golf
standing in the pouring rain with lightening all around.
And pretty negligent digging in the dirt and not washing
up before sticking their fingers in the eye.
Ummm, I'll agree with the dirt part. Pouring rain with a
bit of lightening has to be weighed against finishing this
round so you can make the tee time for your afternoon
round at the other course...
-Quick
|
....or, you could get struck by lightening and contract fusarium from
lying face down in a mud puddle afterwards.
DrG |
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mb
medicine forum beginner
Joined: 10 Mar 2005
Posts: 22
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| Posted: Fri Jun 02, 2006 7:53 pm Post subject:
Re: will acuvvue oasys or advance 2 be okay for swimming?
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Dr. Leukoma wrote:
| Quote: | Quick wrote:
LarryDoc wrote:
Of course one has be rather strange to be playing golf
standing in the pouring rain with lightening all around.
And pretty negligent digging in the dirt and not washing
up before sticking their fingers in the eye.
Ummm, I'll agree with the dirt part. Pouring rain with a
bit of lightening has to be weighed against finishing this
round so you can make the tee time for your afternoon
round at the other course...
-Quick
...or, you could get struck by lightening and contract fusarium from
lying face down in a mud puddle afterwards.
DrG
|
I needed a good laugh. You guys a tooooo funny. Go play some golf,
but before that...
explain to me how a 16 year old contracts this fusarium infection in
the dead of winter in North Dakota using this product when at the time
they claimed you could only get it in tropical climates? |
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