AAPSG July 2005 newsletter

NOTICE NOTICE NOTICE

Young-On-Set Meeting Location Change

The meeting location for the Young-On-Set group, which meets on the 2^nd Sat of every month, is being changed. An e-mail will be sent out when location is determined. Also call Cayce Kovacs at 1-830-634-7332 for the new location.

Symposium

The symposium was a great success. A special thank you goes to all the vendors who gave us there support. Also, thank you to Dr Pappert, Dr Silvers, Dr Yankov, Susan Imke, RN and Christine Hunter, RN. Their lectures were very informative and hopefully everyone took home a message to "keep positive, eat properly and exercise!" Thank you to Cacye Kovacs for pinch hitting for Fred Dyas. Also, Cayce, Joan Duval and Kim Johnson-Vineyard who took care of the registration table, thank you all. Please let us know how well we did with the symposium and what changes need to be made for next year. Have a great summer!

POP Center

The Parkinson’s Outreach Program offers many FREE opportunities for the PD Patient, such as Yoga-Tai Chi classes, voice screenings, and driving evaluations to name a few. Give them a call to see what they can do for you. 210-349-0096 or call toll free 1-877-362-0126.

PLEASE NOTIFY US IF YOUR LOCAL ADDRESS OR E-MAIL ADDRESS CHANGES

Doak Walker shalom6@peoplepc.com , 210-674-3013, 7650 Hwy 90W #40, San Antonio, TX 78227-4059.

Our Web Site www.aapsg.org

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This newsletter is provided for informational purposes only. The material should not be used for treatment purposes without discussing it with your Doctor. Products, businesses, services, or websites are not endorsed by APDA, or AAPSG.

AAPSG Quarterly Newsletter, July 2005

Parkinson’s Prayer of Promise

Life used to be easy... ahhh what we used

to take for granted!

How could we ever know the struggles we

would be handed?

Simple efforts... threading needles, walking,

tying shoelaces;

To steadying balance, tremors, staring of

our own faces?

With each rise and fall, never-ending fears,

We learn to conquer burdens with

determination and tears!

This prayer is for our heroes who have tried

their best to see

That God has his reasons, we unselfishly

don't ask "why ME"?

And know there WILL come a joyous day in

our lifetime for all to see,

A magical moment, a MIRACLE! CURE!

for the heroes you and me!

What to Tell Your Children

Rasheda Ali watched PD hit a mountain of a man she calls Dad. A nation watched, too, as Muhammad Ali's shaking and slurred speech became more noticeable. He was in his 40s; she wasn't yet a teenager. At first Dad just seemed a little older and a little slower. Rasheda read voraciously, and quizzed neurologists for years. But it wasn't until her own sons began asking questions about their grandfather that Rasheda sought a way to explain PD so children could understand. "I read about neurons and how they weren't producing the dopamine that's needed to send signals to the brain," she said. "You're studying a really complicated illness and an illness that there is no cure for, so what do you tell a 4-year-old?"

When searches at libraries and bookstores netted nothing, she decided to write her own book. I'll Hold Your Hand So You Won't Fall: A Child's Guide to Parkinson's Disease, is written for adults to read to children. "I knew I wasn't the only person who was stumped when their children started asking questions, like "Why is Poppy shaking," said the young mother. The Merit-published short story has multicultural

illustrations and kid-friendly chapters titled "Tremors," "Genetics," "Shuffle Walk," "Slurred Speech," "Depression," "How You Can Make a

Difference" and the like. It identifies 14 PD symptoms and offers questions and ways to discuss the topics with children who might be fearful. Cerise A. Valenzuela, Daily Breeze

Patients' Stories Needed for PD Research

Researchers hoping to compile information about PD say patients' own stories could hold

the key to a cure. "Don't Be Silent: Tell Us Your Story" is the first nationwide effort to learn more about PD directly from people who have the disorder. The first-person accounts are being compiled by the Muhammad Ali Parkinson Research Center. Some doctors believe PD is caused by a genetic predisposition, coupled with environmental factors that have not yet been identified.

Survey participants will be asked to complete a confidential, online survey that takes less than an hour to complete. Results will be entered

in the PD Registry, a project under the direction of the Barrow Neurological Institute at St. Joseph's Hospital and Med Center in Phoenix, AZ. Responses will be kept private. The data will be used in summary form only when it appears in scientific publications. Eventually, the survey data will be made available to doctors and researchers who are looking for a cure or developing techniques to better manage the disease.

To achieve its goals, the center hopes to have 20,000 PD patients fill out the survey. It is available online at www.parkinsonregistry.com. Patients without access to a computer can request a printed copy of the survey, along with a postage-paid envelope to return the results, by calling 877-287-7122. The Tribune-Review

DBS – Are You a Candidate

Deep Brain Stimulation (DBS) is one of the most significant advances in the treatment for PD. The ideal candidate for DBS surgery is a levodopa responsive patient who has motor fluctuations with disabling PD symptoms of slowness and/or tremor when medication has ceased to work and

has disabling dyskinesias when on medication. Patients should have received maximal

AAPSG Quarterly Newsletter, July 2005

medication therapy including multiple medication trials.

The effect of the surgery is predicted by the peak effect of levodopa. Levodopa refractory problems such as speech problems or balance problems are not improved with surgery. This surgery is not appropriate for someone who has been recently diagnosed with PD or for someone who continues to have symptoms adequately control- led with medications.

Prior to deciding whether a person is appropriate for DBS, the individual must complete neuro- psychological testing. If there are cognitive difficulties or any signs of dementia, the person would most likely not be appropriate for surgery.

Rajeev Kumar, MD CNI - Parkinsonian People 2004

Although DBS seems to unscramble the brain’s movement signals to the rest of the body relieving the shaking, weakness and sometimes partial paralysis caused by PD, some people get relief even before the actual stimulation occurs. In experiments with baboons, researchers have found that using mild electricity to stimulate the surface of the brain also appears to improve symptoms without causing side effects. HAPS Happenings

Reasons for Unsatisfactory Outcomes for DBS Surgery

A study of follow-up care for patients with unsatisfactory outcomes from DBS surgery offers insights into the reasons for problems. The study will appear in the Archives of Neurology, August 05, JAMA/Archives.

Since the FDA approved DBS for the treatment of PD there has been a surge in the number of centers offering this procedure. There is no consensus regarding appropriate screening procedures, necessary training, or guidelines for the management of complications. Dr. Michael Okun, Univ of FL and colleagues evaluated 41 patients over a 2 year period who complained of unsatisfactory results from DBS surgery performed elsewhere. Each patient was evaluated by a movement disorders neurologist; medical records were reviewed; and the DBS devices were examined and properly

programmed. The researchers found problems with screening for surgery. Five patients (12 percent) had disorders that would not be expected to respond to DBS surgery. Nineteen patients (46%) had unsatisfactory placements of electrodes and 3 patients' devices had failed due to end of battery life. There were also problems with programming the DBS device and with medication adjustment. Thirty (73 %) of the patients required medication changes. Three patients improved markedly from medications alone, one from programming alone, and 17 after a combination of programming and medication changes. As evidenced, surgery does not replace appropriate medical management.

Twenty-one (51 %) of the 41 DBS failures in the study were successfully salvaged. Many, however, had persistently poor outcomes despite the interventions. This study provides insight into the common reasons for 'DBS failures'. As the prevalence of DBS therapy increases, implanting centers are becoming more experienced. It is hoped that this experience, along with ongoing efforts to educate DBS practitioners regarding effective practices, will result in improvement in the outcomes of DBS surgery."

John Pastor, JAMA, 352-392-3845

Do Not Be Fooled by “Cures”

There are people out there that will take advantage of our desire to be cured. The blood brain barrier (BBB) is a physical structure that filters the flow of fluid/chemicals from the 'outside world' to the brain. It is one of the body's protections against toxic substances, infections that want to enter the brain. Only some medications can get through the BBB to act on

the brain. For example, most, if not all, of the nerve growth factors and stem cells do not cross the BBB and therefore will have to be implanted directly into the brain to work. Thus, be very careful about “cures” such as growth factors, or stem cells in the injectable form or other items

being sold on the internet from other countries. Don’t try any “cure” on your own without checking with your doctor first.

Hubert H. Fernandez, NPF.

AAPSG Quarterly Newsletter, July 2005

Before the Hospital

Post operative confusion and slower recovery of PD motor symptoms are not uncommon in PD patients. Drs and nurses are not used to taking

care of the special needs of the PD patient. They do not intentionally want to provide poor care; we just don’t fit into their normal routine of care. I recommend you get several copies of "Hospitalization of the PD Patient” by Joseph Friedman, MD, a leaflet produced by the American Parkinson Disease Association. Give a copy to the surgeon, the admitting physician and all the nurses so that they are aware of the potential changes that may occur during and after surgery. Request copies on

www.apdaparkinson.org or call 1-800-223-2732

Being an Effective Advocate

Dr Byock at Dartmouth Hitchcock Med Ctr says “You have to be prepared, polite, and persistent.” His advice to those who are dealing with a chronic illness or disability is “Do research about the condition with which you are dealing. Use the resources that are available to you. Be smart shoppers in the healthcare marketplace. “

Being a smart shopper means knowing when to keep looking for help. Whenever there is a doubt, get a second opinion. This includes everything from medical advice to researching hospitals, home health agencies and hospice organizations. Don’t be afraid to ask questions.

- Find the primary doctor to go to for questions or problems whenever there are several specialists treating a person. Talk about what to do after hours or on weekends if a serious problem develops.

- Bring written questions to the doctor’s visit. If the doctor leaves the room before all of your questions are answered, stay put and politely let someone know you still need more information.

Families need to advocate for their loved ones.

Important innovations can be found at medical centers, but you must be really effective as a

consumer to get access to these innovations. Whether dealing with pain or any other aspect of a loved one’s chronic illness or disability when the person’s basic needs aren’t being met, demand to talk to those who are in a position to help. Take Care, 2005

Hospital Compare - A quality tool for adults that provides information on how well the hospitals in your area care for their adult patients with certain medical conditions. This information will help you compare the quality of care hospitals provide. Hospital Compare was created through the efforts of the Dept of Health and Human Services, Centers for Medicare and Medicaid Services (CMS) and organizations that represent hospitals, doctors, employers, accrediting organizations, other Federal agencies and the public. Go to www.hospitalcompare.hhs.gov

PD Resources

Murray Charters has painstakingly compiled a listing of PD resources that are available on the Internet. He has 35 categories in all, covering every imaginable aspect of PD concerns. This is a quick-find reference tool when you need PD

info. Those of you who have slower downloading can choose the text-only version:

http://www.geocities.com/murraycharters/txt_only/index_jp

The spiffier version is at:

http://www.geocities.com/murraycharters/index_mc.html

American Academy of Home Care Physicians Find a healthcare professional in this area who makes house calls or access a variety of educational articles and links.

Web site: www.aahcp.org , Phone:410-676-7966 PO Box 1037, Edgewood, MD 21040-0337

American Academy of Family Physicians -

This patient-friendly Web site contains valuable information on health topics from A to Z, as well as health tools and tips for healthy living.

Web site: www.familydoctor.org

11400 Tomahawk Creek Pkwy, Leawood,

KS 66211-2672

APDA Worldwide Web Site -

www.apdaparkinson.org

National Parkinson Foundation –

www.parkinson.org

World Parkinson Disease Association Web Site – www.wpda.org

AAPSG Quarterly Newsletter, July 2005

Falling

1. Most PD patients who fall do not wear helmets even though they should. Why risk hurting yourself for vanity. If you are one of the smart ones who will wear a helmet, the best place to ask about one is a center for Epilepsy (Epilepsy Foundation of Central & South Texas 210-653-5353). They are the ones who routinely use

helmets as patients can drop unexpectedly, but a bicycle or climbing helmet will also work.

2. PD medications do little to help with the problem of instability that often leads to falls and even to a fear of walking. German researchers found they could help by showing patients the

actual position of their center of gravity on a computer screen. First, they analyzed the person’s posture and gait and showed how adjusting their steps could compensate for their unsteadiness. Then, the physiotherapist pushed or pulled the person to the back or side, to which he or she responded by taking a counter- balancing step. Insufficient steps were corrected.

The overall goal was for the patient to maintain stability after the pushes by taking large compensatory steps. The study found step length increased, walking speed improved and self-rated mobility scores increased. The improvements lasted 2 months. HAPS Happenings

Service Dogs

Several people have asked about PD service/ helping dogs. One of the providers of dogs is The Gift of Sunshine, 1940 Stonesthrow Rd, Bethlehem, PA 18015. Call 610-554-8725 or

e-mail thegiftofsunshine@earthlink.net

Stem Cell Information

1. The official National Institutes of Health resource for stem cell research is

http://stemcells.nih.gov/info/faqs.asp

2. The prospect of using stem cells to treat PD is one step closer after Israeli scientists announced implanting human stem cells into the brains of rats which reduced the diseases’ debilitating symptoms. According to Dr. Binyamin Reubinoff of the Hadassah Embryonic Stem Cell Research Center at Jerusalem’s Hadassah Med Ctr, the research represents the first demonstration that human stem cells can replace damaged neurons

in an animal model. The study also showed that the neural cells did not multiply out of control. This was important because in a former clinical trial there was uncontrolled growth resulting in uncontrollable involuntary movements.

HAPS NL, Feb 2005

3. Brain Cells. Regenerative medicine scientists at the University of Florida's McKnight Brain Institute have created a system in rodent models that for the first time duplicates neurogenesis -- the process of generating new brain cells -- in a dish.

In the Proceedings of the National Academy of Sciences, researchers describe a cell culture method that holds the promise of producing a limitless supply of a person's own brain cells to potentially heal disorders such as PD.

If the discovery can translate to human applications, it will enhance efforts aimed at finding ways to use large numbers of a person's own cells to restore damaged brain function, partially because the technique produces cells in far greater amounts than the body can on its own. In addition, the discovery pinpoints the cell that is truly what people refer to when they say "stem cell." Although the term is used frequently to describe immature cells that are the building blocks of bones, skin, flesh and organs, the actual stem cell, as it exists in the brain, has been enigmatic, according to Dennis Steindler, Ph.D., executive director of the McKnight Brain Institute.

"We've isolated for the first time what appears to be the true candidate stem cell," said Steindler. "There have been other candidates, but in this case we used a special microscope that allows us to watch living cells over long periods of time through a method called live-cell microscopy, so we've actually witnessed the stem cell give rise to new neurons. A little more than a decade ago, scientists came to realize the brain continues to produce small amounts of new cells even in adulthood, overturning the belief that people are born with a fixed amount of brain cells that must last them throughout their lives.

"As far as regenerating parts of the brain that have degenerated, such as in PD, the ability to regenerate the needed cell type and placing it in the correct spot would have major impact," said

AAPSG Quarterly Newsletter, July 2005

Dr. Eric Holland, a neurosurgeon at Memorial Sloan-Kettering Cancer Center in New York.

John Pastor, jpastor@vpha.health.ufl.edu, 1-352-392-3845

Univ of Florida

FREEDOM

Held captive as a butterfly,

wings torn and tattered as I try

To beat my wings and fly once more

strong and beautiful, as before.

Free from bondage, at last to soar,

to do with ease the daily task,

to join the world with a joy for life,

to grow old with grace

with a smile on

Sandra Farris, October 2001

Selegiline

At doses of selegeline over 10 mg per day (and generally, it's thought to be 20 mg/day) one must avoid high-tyramine foods such as aged cheeses

and meats, and red wine, because there is a risk for hypertensive crisis. For PD, however, the dose is usually 5-10 mg daily, and this is not thought to cause a problem. However, if you have high blood pressure and use 5-10 mg selegeline daily, you should discuss use of high-tyramine foods with a registered dietitian.

Kathrynne Holden, MS, RD, NPF

Do NOT take iron or vitamins containing iron within 2 hours of taking Sinemet. NPF

Internet Diet Information

Diet & Recipe Analysis - Can compare intake

over time. Also has alternative nutrition, diet news, and message boards. Free trial

www.dietsite.com

Nutrient Search Tool - Finds foods with the highest or lowest concentrations of specific nutrients. For example, you can use this tool to

generate a list of low-carbohydrate foods, or to identify foods from a particular category that are high in protein and low in fat. Free http://www.nutritiondata.com/nutrient-search.html

Food Count - Large database; user's dietary intake can be saved for 90 days, track nutrient intake over time - Fee-based, free trial

www.foodcount.com

My Nutrition Analysis Tool - Can save foods frequently consumed for quick recall and reentry into the system - Free

www.nat.uiuc.edu/mynat

Information on Nutrition Facts of 10 popular fast-food restaurant chains

www.fatcalories.com

Diet Analysis - Fee-based

www.dietwatch.com

Diet & Physical Activity tracking - Free

www.fitday.com

Detailed Information on Nutrients - Your favorite foods, including brand names - Free

http://www.NutritionData.com

Nutrient Data Laboratory - USDA Food database - Free

http://www.nal.usda.gov/fnic/foodcomp/

PD Progression

PD affects people differently. Some will be incapacitated by tremors, others by their balance problems. Others will die not knowing they have PD because it is so mild, most will die WITH PD and not BECAUSE OF PD. The chances of dying from a heart attack or cancer is MUCH higher than dying from PD complications. Yet, there will be some, who will be devastated by the illness and will succumb to complications. As a very, very rough guide, the first 5 years is almost always good. The next 5 years will depend on how good you are as a patient and how good your doctor is as well. The next 5 years, can be challenging for some. Hubert H. Fernandez, NPF

Fish – Health & Depression

Depression occurs frequently among people with PD. Researchers have found that the omega- three fatty acids found in fish oil appear to be linked to better mental health.

- Why would fish oil make a difference? Our brains contain a large amount of fatty acids, including omega-three. However, western diets have changed dramatically in the last century -- we eat much more meat and far less fish -- and depression and other mental disorders have risen a hundred-fold. It's possible that we're not getting enough of the essential fatty acids we need for brain health. Researchers have found that some people who begin eating fish, or even

AAPSG Quarterly Newsletter, July 2005

consuming fish oil capsules, have seen an improvement in feelings of depression.

- Eating fish may also lower risk for heart disease, and help offset some of the pain of rheumatoid arthritis. It's a good idea to eat fish two or three times a week.

- What about mercury levels in fish?

Long-lived and "predator" fish may contain methylmercury, which can harm the developing nervous system of an unborn child, if eaten regularly. Women of childbearing age and children under age six are advised to avoid shark, swordfish, tilefish, king mackerel and fresh caught or frozen tuna steaks.

-Regarding canned tuna, women of childbearing age can eat about one can per week (six ounces.) A woman who weighs less than 135 pounds should eat less than one can of tuna per week. Mercury may also harm the nervous systems in adults, although a connection between mercury and PD has not been proven. For more information and updates, see the

Environmental Protection Agency site: http://www.epa.gov/waterscience/fish/advisory.html Kathrynne Holden, MS, RD, NPF

Drug Assistance

Are you looking for a way to lower the cost of medications? Pharmaceutical Research and Manufacturers of America (PhRMA) has collaborated with a variety of organizations to provide a wonderful and interactive Web site that acts as a gateway to patient assistance programs nationwide. The National Foundation

Caregivers Association (NFCA) is a member of this partnership, called the Partnership for Prescription Assistance. The Web site is designed to help low-income, uninsured patients get free or nearly free brand-name medicines. Its mission is “to increase awareness of and enrollment in existing patient assistance programs for those who may be eligible,” and to “offer a single point of access to more than 275 public and private patient assistance programs including more than 150 programs offered by pharmaceutical companies.” You can obtain information about specific medications or look for particular programs in your state. This site is an invaluable resource for family care-givers and healthcare

providers who are looking to find ways to afford prescription medications. You can get info on the Web at www.pparx.org or by phone at 888/4PP-ANOW. Real people answer the phone and have the knowledge and training to help you identify programs and fill out forms. If your income is low and you are uninsured, this is a resource you should check out. NFCA Newsletter, Take Care, 2005

Drugs

1. The FDA recently approved Apokyn^TM(an apomorphine hydrochloride injection given under the skin) as an effective rescue treatment to use during “off’ episodes.

2. According to a clinical study published in the Jan 2005 issue of Clinical Therapeutics, more than twice as many PD patients prefer

Parcopa^TM(carbidopa-levodopa orally disintegrating tablets) to conventional carbidopa-

levodopa tablets. The reason primarily influencing their preference was more rapid access to medication to treat “off” times, less interference with daily activities, convenience for nighttime dosing and the feeling of being less conspicuous about using medication. Parcopa is a Schwarz Pharma, Inc. formulation of carbidopa-levodopa that dissolves on the tongue without water. APDA NL Winter 05.

A $20 coupon is available for Parcopa at www.parcopa.com or call 1-877-727-2672.

3.Though there is no medication currently approved for the treatment of dementia in people with PD, a study of more than 500 PD patients, found that a drug currently being used to treat

Alzheimer’s (Exelon) was well tolerated and Parkinsonians and caregivers reported a modest improvement in cognition. HAPS Happenings, 2005

Comparison Shop

“Simply calling around, comparing prices between pharmacies, could save an average of 60%,” says Salvatore Cullari, Ph.D., an emeritus professor of psychology at Lebanon Valley College. The survey which compared medication costs from several different outlets found that “the lowest prices typically were at Costco and at online pharmacies,” said Dr. Cullari. “For the lowest price, check costs at a warehouse club’s pharmacy, a drugstore chain’s web site and your

AAPSG Quarterly Newsletter, July 2005

local pharmacy. For 100 - 25-mg tablets of Zoloft there was a wide range of prices:

LOCATION PRICE

A local CVS drugstore $298

www.cvs.com $264

www.costco.com $244

Canadian pharmacy endorsed on the Wisconsin governor’s web site $90

Woman’s Day Magazine Sept 2004

PD- Red Meat & Vitamin B2

In Oct 2003, Brazilian researchers published a study entitled: “High doses of riboflavin and the elimination of dietary red meat promote the recovery of some motor functions in PD patients.” It’s important to bear in mind that this information is based on one small study, and more studies are needed. Thirty-one subjects were enrolled, and only 19 remained for the

entire 6 months of the study. Although the results are encouraging, it cannot be stated that this plan will be helpful for everyone with PD.

Here are some reasons why the study is important:

1. All of the people originally enrolled in the study were found to be deficient in riboflavin (vitamin B2), despite the fact that their usual diets contained plenty of riboflavin for normal needs.

2. All of the patients who completed 6 months of treatment showed improvement in standing, walking and balance during the first 3 months following treatment.

3. After 2 weeks patients reported better sleep, better reasoning ability, and less depression.

- How was the study conducted? Thirty-one people, in all stages of PD, and taking various PD medications were initially enrolled in the study. Researchers questioned the patients about their dietary habits, and determined that their diets provided adequate riboflavin; also, that those with PD ate more red meat than subjects in a control group. Upon testing, however, they learned that all subjects had some degree of riboflavin deficiency. Because those with PD reported a higher intake of red meat, this was eliminated from their diet. The researchers then gave the subjects 30 mg of riboflavin, three times daily at 8-hour intervals, a total of 90 mg

per day. The dosages were spaced throughout the day because a high dose of riboflavin given

all at once is mostly excreted; whereas if given in smaller amounts throughout the day, absorption is increased.

Twelve people dropped out of the study; 19 remained for the full six months. Of those remaining in the study, most reported feeling better after about two to three weeks. Researchers measured their motor capacity each month and found that they showed significant improvement after three months; some continued to improve throughout the length of the study. Riboflavin status also rose to normal levels.

Will this diet cure Parkinson’s disease? No, this is not a cure for PD, and in fact, it isn’t known yet who, or how many, might benefit from this diet.

Ask your doctor if this diet could be right for you.

Foot Exercises

1. Toe raise, toe point, toe curl. Hold each position for five seconds and repeat 10 times. This helps cramps and hammertoes as well.

2. Toe squeeze. Place small corks between your toes and squeeze for five seconds. Repeat 10 times. This one is also good for hammertoes or toe cramps.

3. Marble pickup. Place 20 marbles on the floor. Pick up one at a time with your toes and put each marble in a small bowl. This is recommended for people who have pain in the ball of the foot, toe cramps or hammertoes.

4. The golf ball roll. Roll a golf ball under the ball of your foot for two minutes. This is a great massage for the bottom of the foot and arch strain as well as cramps.

5. Big toe pulls. Place a thick rubber band around both big toes and pull them away from each other, toward the small toes. Hold for five seconds and repeat 10 times.

6. Toe pulls. Put a thick rubber band around all of your toes and spread them. Hold for five seconds and repeat 10 times.

HAPS Happenings 2004

Memorials

In Memory of Thad Brannon, Jr

John & Judy Reeves, James Shea Jr,

Glen & Alfrieda Anderson

In Memory of James T Crow

Martha West Drake, Diana Braly,

Don & Sarah Norton, Tom E Nelson Jr,

Jefferson Bank Employees

In Memory of Rosa Lee Doerfler

Mary & David Riley, Mr & Mrs Bill Meier,

Ben & Krista Moreno, Diamond Air

In Memory of Peter Donato

Mr & Mrs Joseph J Ange,

Elena & Joseph Lombardo, Pamela Behrends, Richard & Judy Hoopman,

Ronald & Jeannette Donato,

Mr & Mrs William Richard, Alan & Karen Frisa

In Memory of Ron Duval

Renee Thompson, Erma Lee Walker,

Darlene Spencer, Ike & Mercedes Eisenhauer, James & Joy Eberwine, Greg Bucklin,

Dawn & Tommie Thompson, Cliff Hall,

Bill & Shirley Knothe, Glyn & Patsy Stewart, Fred & Ruby Aldrich, Doug Purcell,

Ruben Martinez, Bob & Terri Purcell,

Robert & MaryAnn Hermanson,

Dick & Judy Hoopman, Johanna Reynolds,

Beth A. Walls, Dr & Mrs Dick Stribley,

Carol Bertsch, Oliver & Becky Rickert,

Cathy Heffernan, Bertie Jones MD,

David & Dareen Widmann, Colleen Edwards,

Mrs George Wenglein, Cassidy Bucklin,

Carla & Doak Walker, Daphine Palmer,

Lou & Kaye Kennedy, C F "Skip" Harrington

Howard & Madeline Hyman,

In Memory of Dick Fuller

Fannie Mae Foundation

In Memory of George Gardner

Anne Beere, Earl R Ballinger & Family,

Prichard Hawkins McFarland & Young LLP, Cindy Salter, Kathryn Althaber

In Memory of Ted Greene

Theodore & Margaret Meyers

In Memory of Enrique Guillen

Braun Station Elementary Faculty & Staff.

In Memory of Linda Hall

Robert & Therese Sentell

In Memory of Irma Johnson

Sheryl Stauffer

In Memory of Ophelia Lambrect

Gerad & Betty Jo Blietz

In Memory of Dorothy Lehr Legan

Greater San Antonio Chamber of Commerce

In Memory of Mike Lerma

Aurelia Lerma, Javier & Julia Padilla

In Memory of Max Lipscomb

Helen E Myers

In Memory of Eris Mangrem

Pat Henderson, Annie Mae Taylor, Sherry Ely, Joseph & Wynon Clark, Barbara Agostinelli, Billie Hudson, Yarborough Management LLC,

Joel, Josh Smart and Donna Abbott,

Wallace & Sandra Cox

In Memory of Stephen Marquette

Sheryl Stauffer

In Memory of Joe Rodriguez

Ruth Moorman and Bob McVey

In Memory of Mary Rogers

Barbara & Ricks Wilson

In Memory of Ernst Schaefer

Mr & Mrs John Sobieski, Eunice Healton,

Dennis R. Hamlin, Joe & Jackie Herring, Pam Rogers, Claude & Margie Smith, Ervin & Velma Real, Mary Jo & Leonard Dylla, Raymond & Malgorzata LeBlanc, Southwest Research Institute, Dept. of Sensor Systems & NDE Technology, IHI Southwest Technologies,

Norma Reininger, Mrs Jessie Baker,

Enomie Real, Betty J. Melton, Joey McDonald

In Memory of Earline Shaffer

R.E. & Dorothy Gault, Mrs Pat Shannon,

VC & Ruth Russell, Dorothy Killough,

Joey & Adele Peters

In Memory of Gail Hall Swearingen

Barbara & Ricks Wilson

In Memory of Patsy Tate

Barbara & Ricks Wilson

In Memory of George Wenglein

Jean & Bernard Harris, Linda & Lee Padove, Helen Himstreet, Maxine & Bernie Rose,

Mr & Mrs Walter Redding, Sue Fuller,

Margie & Sam O'Krent, Nell Kothmann,

Mr & Mrs Tommy Griggs, Margaret Russell,

Mr & Mrs Tom Woliver, Robin B Carter,

Edith Montgomery, Harold & Ana Faye Bausch, Rod & Ilse Schall, Pat Dalton, Margaret Williams,

Ron & Joan Duval, Betty Kinsel,

Dr & Mrs John Knox, Dorothy & Alfred Adair, Paul Spitalink Consulting, Inc,

Mr & Mrs Daniel Howell, Ann Kuykendall,

Russ & Kathi Vander Zee, Dr Milton & Anita Lindner, Dr & Mrs Frank Sheperd,

Mr & Mrs Humphrey Price

In Memory of Bill Wise

Barbara & Ricks Wilson