This week’s choline diet highlights 05/20/2012
Posted by thetickthatbitme in Uncategorized.Tags: breakfast, choline, Coleslaw, Cooking, diet, eggs, health, recipe, Rye bread
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I tried to be good and cook simple, choline-rich meals at home this week. Here are some highlights:
McBreakfast Sandwich
I love making my own version of a fast food breakfast sandwich for several reasons. One, it’s healthier because I can use better ingredients. Two, it’s relatively inexpensive. Three, I don’t have to drive anywhere to get it.
Sometimes I use an English muffin or a bagel, but this week I didn’t have those, so I used sourdough, which I actually like better. I also subbed out boring old American cheese for some spicy pepperjack.
To drink, I had Treetop orange-pinapple juice, which I water down.
Choline count: fried egg (125 mg) + Canadian bacon (19 mg) + sourdough bread (15 mg) = 159 mg
Rainbow Coleslaw
I grew up on traditional southern-style coleslaw, and when the weather gets hot, I start craving it. I love putting it on pulled-pork BBQ sandwiches. Being that eating cabbage covered in mayonaise (or in my case, Miracle Whip) is not the healthiest way to get one’s veggies, when I make coleslaw at home, I try to make it a little healthier (and more rich in choline). One of the ways to do this is to use broccoli slaw. You can make it yourself in a food processor, or if you’re lazy like me, you can buy it already shredded up in a bag.
In a small bowl, I mix the dressing, which consists of Miracle Whip, sweet pickle juice (I didn’t have any, so I skimmed some out of the pickle relish jar), and horseradish sauce (for a kick). Some people also like to add vinegar (in place of pickle juice) and dijon mustard.
Then I dump the shredded veggies into a big bowl, add a diced tomato, and mix in the dressing. It’s best to refrigerate slaw for a few hours before eating, but I always sneak a few spoonfulls to make sure it tastes right.
Choline count: broccoli, cauliflower, carrot, cabbage, tomato
California Sandwich
I’ve been eating a lot of sandwiches lately. Boyfriend brought back several loaves of bread from Eric Schat’s Bakery, including some delicious rye bread, so I used some of it to make this sandwich.
I topped that slice of delicious rye bread with Miracle Whip, horseradish sauce, tomato slices, a fried egg, and half an avocado.
Choline count: fried egg (125 mg) + tomato (12 mg) + 1/2 avocado (9 mg) + rye bread (5 mg) + milk (39 mg) = 190 mg
Chorizo Scramble
Toward the end of the week, I started feeling guilty about eating so much bread, so I cooked up some Mexican chorizo with eggs and topped it with diced avocado and tomato. Cooking for two, I use five eggs and one package (a long link) of chorizo.
Choline count: 2 eggs (250 mg) + chorizo (58 mg) + tomato (12 mg) + 1/2 avocado (9 mg) = 329 mg
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Eating out {in the name of choline} 05/13/2012
Posted by thetickthatbitme in Choline Diet, Whole Person.Tags: chocolate soufflé, choline, diet, duck, filet mignon, health, hummus, restaurants, Yelp
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One of my dear friends is a new mommy who’s been going a little stir-crazy for the past two months waiting for her son to get his first shots and be allowed to leave the house more regularly. Yesterday, she got a few baby-free hours, which presented a perfect opportunity for some fine dining (or at least what we frugal ladies consider fine dining), and that’s how we found ourselves at a little place called Cafe Mundial in Monrovia.
Now, I must confess, I wasn’t thinking about my choline diet at all as I was scanning drooling over the menu, but it turned out that both my friend and I did fairly well on the choline count without really trying. Here’s what we had:
To Start
This restaurant serves their complimentary bread with a side of hummus (which is really not to be confused with humus). Much to my delight, when I looked up hummus today, I discovered it has 4 mg per tablespoon. (Side note: if you look up “humus,” which is how WordPress spellcheck thinks “hummus” should be spelled, you’ll find it has no choline. So if anyone ever commands you to “Eat dirt!” tell them, “I can’t. I’m on a choline diet.”) We also each ordered the soup du jour, which was tomato basil. (I have no picture of this, and couldn’t find one from Cafe Mundial.) Not much choline in the soup, but it was delicious!

Yummy hummus with bread for dipping. (Image via Yelp)
The Main Course
I had the duck conflit, which was accompanied by a small scoop of mashed potatoes and generous helpings of carrots and zucchini. You can see it pictured below with beans instead. Choline count for roast duck: 43 mg for half a pound. Cooked carrots and zucchini add 7 mg and 8.5 mg choline, respectively, for half a cup each.
The Finale
Though I admire the philosophy of “Life is short; eat dessert first,” this isn’t really possible with soufflé, owing to the long prep time. It was more like, “Life is short; order dessert first, or else it won’t be ready.” This one was accompanied by fresh strawberry slices and a vanilla bean sauce. We were a few bites into it when I said, “Hold on, I should take a picture of this.” It was just as delicious as it looks. I couldn’t find any nutritional data for chocolate soufflé, but boring old grocery-store-bakery chocolate cake has about 20 mg per slice. With all the eggs and chocolate in soufflé, I’m guessing this little treat comes it at around 30 mg.
So how well did I fare in the choline department? According to my (rough) estimate, I had about 100 mg of choline. My friend, who ordered the filet mignon (77 mg choline in 3 oz), out-cholined me by about 40 mg.
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Snacking in the name of choline 05/06/2012
Posted by thetickthatbitme in Choline Diet, Humor.Tags: Banana, carrot, choline, eclaire, health, humor, Peanut butter, recipe, Snack food, Sweet potato
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Since I spend a lot of time working from home, it’s difficult to resist a lot of snacking. Now I believe that eating small meals throughout the day is healthy; however, when you factor in my mighty sweet tooth and the fact that my better half keeps visiting the Entemann’s bakery outlet on his way home from work (he can’t resist the deals), well…you see the predicament. So I decided this week that if I’m going to be ‘bad’ and indulge in a few fattening or sugary or salty snacks, I had better make sure I was getting my choline. Here are some of the choline-rich snacks that my research turned up.
Savory Choline Snacks
Peanut Butter (21 mg in 2 tbsp) and Carrots (6 mg in 1 large carrot)
This is an established favorite for both me and my dad. I used to feel guilty about putting peanut butter on something that is otherwise pretty healthy, but with about 10 mg of choline per tablespoon, I don’t feel that bad. I do, by the way, buy the reduced fat peanut butter. If you prefer almond butter, it has about 8 mg of choline per tablespoon.
Pistachios (20 mg in 1 oz)
I’m a girl who likes to play with her food, so these are one of my favorite snacks. Sometimes I like to eat them with a few chocolate chips and some dried cranberries. If you’re wondering how many dry roasted pistachios are in an ounce, it’s about 49.
Edamame (56 mg in 100 g—about 2/3 cup)
I usually order edamame (boiled soybean pods) as an appetizer when I go out for sushi with friends. Some grocery stores also have it in the freezer section.
Sweet Choline Snacks
Peanut Butter (21 mg in 2 tbsp) and Banana (11 mg)
Yes, you can see I have a propensity to put peanut butter on a lot of things. This is a third-generation snack in my family that originated with my grandma. I find a glass of chocolate milk goes well with it. (One cup of chocolate milk also adds 42 mg of choline!)
Baked Sweet Potato (23 mg for a large one)
Sweet potatoes are so underrated. I try to substitute them for boring old russet potatoes whenever I can, including when I make home-made french fries. The easiest (and laziest) way to prepare a sweet potato, though, it to stab it with a fork a few times and then pop it in the microwave. I like mine with a little butter and brown sugar, but season salt or garlic powder is also good.
Ready for the finale? My most exciting discovery in my choline research is that chocolate is a great source of choline. (Which means, all those times when I was craving chocolate, it wasn’t just me, it was also my neurotransmitters.) I could list about 100 chocolatey snacks here, but I’m going to have some self-restraint and just do one.
Chocolate éclair (79 mg)
This one takes me way back to when I was too short to even see over a bakery counter. (Thanks, Mom, for getting me addicted to these at such a young age.) When I discovered this dessert, I considered changing my name to Claire, just so I could be “Chocolatey Claire.” Is an éclair the same as a doughnut? Of course not, silly! It’s far, far better. I recommend a tall glass of milk with this one.
If you want to try making some éclairs from scratch, here’s a yummy recipe over at Moo’s Pantry.
That’s all I’ve got for today. What high-choline treats would you add to this list?
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Ehrlichia: confusing cousins, the blood supply, and the new kid on the block 05/04/2012
Posted by thetickthatbitme in Diagnosis, TBI Facts.Tags: Blood donation, Blood transfusion, CDC, Ehrlichia, health, Lyme Disease, medicine, Minnesota, Rocky Mountain Spotted Fever, tick, Wisconsin
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Ehrlichia…I just met a girl named Ehrlichia…and suddenly the sound…
Nope. Doesn’t quite work.
Ehrlichia is actually named after German microbiologist Paul Ehrlich (1854-1915), who won the Nobel Prize in 1908. Here are some things you actually need to know about Ehrlichia:
1. Ehrlichia is transmitted through the bites of lonestar ticks and deer ticks. If you’ve had another infection carried by these ticks (like Lyme Disease), your doctor should have had you tested for Ehrlichia (or maybe you’ll be asking him/her to test you after reading this post?).
2. Symptoms of Ehrlichiosis include: fever, headache, chills, malaise, muscle pain, nausea / vomiting / diarrhea, confusion, conjunctival injection (red eyes), and rash (in up to 60% of children, less than 30% of adults). When it goes untreated (or improperly treated), complications can include breathing problems, bleeding disorders, and death (1.8% of cases).
3. Ehrlichia is effectively treated with doxycycline in both adults and children. The CDC recommends a 7-14 day course.
4. Your doctor shouldn’t wait for your test results to come back before prescribing you doxycycline. If your doctor thinks you might have Ehrlichiosis, he/she might order a PCR, a blood smear, or an IFA (antibody test). These tests can take a few weeks to come back, and in that time, you could get very, very sick. In addition, a negative result on any of these three tests does not rule out the possibility of infection. Often, in the first 7-10 days you are infected, you will test negative. For more information about these tests, take a look at the Ehrlichiosis fact sheet.
5. Ehrlichia can be easily misdiagnosed as one of two other infections. It’s a rickettisial disease, which means it’s in the same family with A. phagocytophilum and Rocky Mountain Spotted Fever (RMSF). Sometimes the rash patients get with Ehrlichia looks a lot like the rash patients get with RMSF.
6. It may be possible to contract an Ehrlichia infection through a blood transfusion. The CDC has not been very vocal about it, but it’s on their website. Fun fact: “Ehrlichia chaffeensis has been shown to survive for more than a week in refrigerated blood.” If you’ve had an Ehrlichia infection, it’s probably not a good idea for you to be a blood or organ donor.
7. There’s a newly identified species of Ehrlichia in Wisconsin and Minnesota. It doesn’t have a fancy species name yet, so scientists refer to it as Ehrlichia Wisconsin HM543746 or Ehrlichia muris-like (EML). This one is carried by deer ticks. If you live in one of these states and your doctor is not so hip to the new infectious disease research, he or she may have told you that you didn’t need to be tested for Ehrlichia because “we don’t have that here.” (I hate it when doctors say that!)Hopefully there will be a commercially-available, species-specific test for this soon. For now, my guess is that physicians in Wisconsin and Minnesota who suspect Ehrlichia infection are ordering tests for E. chaffeensis and E. ewingii.
Got an Ehrlichia story you’d like to share? Shoot me an e-mail.
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5 Things That Helped Me Heal 05/02/2012
Posted by thetickthatbitme in Humor, Whole Person.Tags: Arthritis Foundation, Craig Ferguson, exercise, Geoff Peterson, healing, health, Heating pad, humor, Memory foam, treatment
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1. Shower chair
We got this after I had my back surgery (to help me avoid bending, slipping, and falling), and I continued to use it after I was diagnosed with hermsii and Anaplasmosis. It really makes a difference being able to sit and relax while bathing. My boyfriend (who is healthy as a horse) also enjoys using it when he just wants to wash his feet!
2. Thermalon heating pads
These heating pads are my best friends. My mom, who has Arthritis, introduced me to them. I put mine in the microwave for about a minute, and it will stay warm for about 30, depending on how cold my house is. After the initial heating, you can reheat them for 30-40 seconds at a time. I prefer these to an electric heating pad because they provide moist heat, and I can fall asleep with one without burning myself. They helped me get off painkillers and sleep better on cold nights. They can also double as cold packs if you store them in the freezer inside a ziplock bag. I found them on sale at Walgreens for $15 each.
3. Low-impact exercise
Taking an Arthritis Foundation water aerobics class at a warm water therapy pool helped me stay active while I was getting treated. The warm water helped my joints feel better, and I think all the endorphins from exercising made me happier. I also made some great friends in the class who are just slightly older and much wiser than me. (Shout out to the pool ladies!) If you’re interested in this type of class, you can search for one in your area here.
4. Memory foam mattress pad
This was also a purchase made after my back surgery. My mattress is quite firm. (That’s how I used to like it when I was a young thing with no health problems.) I’ve always slept best on my side, but after surgery, and as I began developing more joint problems in my neck, hips, and knees, the mattress was too hard for me. Rather than shelling out $800 for a new mattress, I spent about $150 for this memory foam mattress topper from Costco. Now the bed is soft enough that I don’t feel like I’m sleeping on a plank, but not so soft that I sink in too far. I’m still able to roll over during the night so I don’t get too stiff.
5. Geoff Peterson
I can’t stress enough how much laughter helped me recover. My parents are a little obsessed with Craig Ferguson, and I started watching him, too, when I was staying with them and getting IV therapy. Craig’s exchanges with his robot sidekick Geoff Peterson make me laugh the hardest.
What are some things that have helped your healing process?
Well, Babs, you’re trickier than I thought 05/01/2012
Posted by thetickthatbitme in Diagnosis, Peer-Reviewed, TBI Facts, Tick-Lit.Tags: Babesia, Blood donation, Blood transfusion, health, IFA, labs, Lyme, medicine, PCR, smear, tick
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Welcome to the second installment of Tick-Lit Tuesday, where I comb through PubMed so you don’t have to. Today’s topic: Babesia and Blood Transfusions. Now, I know I posted about Babesia in the blood supply just a few days ago, but an interesting study has since come to my attention (thanks, Dr. W), and the implications are a bit scary. Okay, get your popcorn and let’s begin.
The Issue:
It has been well-documented that the tick-borne protozoan parasite Babesia can be contracted through blood transfusions. Blood centers aren’t required to test donated blood for Babesia, but this may change in the future, as Babesia infections contracted through transfusions are on the rise. So if we were to test all donors for Babesia prior to donation, which tests should we rely on to detect this pesky parasite? Let’s look at the candidates.
IFA: IFA is an abbreviation for indirect fluorescent antibody test. This type of test can also be referred to as serologic (as in blood serum) testing. If you’ve had one of these tests for Babesia, it’s probably titled something like “WA1 IGG ANTIBODY IFA” (for B. duncani) or “BABESIA MICROTI ABS IGG/IGM” on your lab results. If you’ve had Babesia in the past and been treated for it, your antibody test might still read positive because your body is still making antibodies to the parasite. This is one of the reasons why most insurance companies refuse to pay for treatment for Babesia if your only positive test is the IFA. They think maybe you had a past infection that you got over, so you don’t need treatment. (The other reason they refuse to pay is that they’re jerks, to put it nicely.) I’ll talk more about why this is such a problem later in this post.

A stained blood smear on which B. microti parasites are visible in red blood cells. (CDC Photo: DPDx). Via CDC.gov.
Smear: When we talk about a smear for Babesia, we mean a Giemsa-stained thin blood smear. This test involves looking at blood samples under a microscope to see if there are any parasites hanging around. The problem with this test is that Babesia can infect fewer than 1% of your circulating red blood cells, so it could take many, many smears before any Babesia show up under the microscope. For more information about that phenomenon, read this.
PCR: This stands for polymerase chain reaction. It’s basically a DNA test that tries to identify whether a gene associated with Babesia is present in the blood. PCR has been found to be “as sensitive and specific” as blood smears for Babesia (see this study), which is not saying much, considering the tendency of Babesia to go undetected with smears.
Hmmm, for whom shall I cast my ballot, the antibody test insurance companies don’t trust, the inaccurate smear, or the inaccurate PCR? Choices, choices…
Today’s question:
Can the donated blood of someone with a negative PCR and negative blood smear still be infected with Babesia and cause Babesia infection in transfusion recipients?
(Hint: This is a leading question.)
Let’s talk about a study published in the journal Transfusion in December of 2011 called “The third described case of transfusion-transmitted Babesia duncani.”
Here’s what happened:
In May 2008, a 59 year-old California resident (I’ll call him Cal) with sickle-cell disease had some red blood cell transfusions. Cal’s only risk factor for Babesia was the transfusions; he didn’t have any tick exposure. In September of 2008, Cal was diagnosed with a Babesia duncani (WA-1) infection. The parasites were visible on a blood smear, the indirect fluorescent antibody (IFA) test was positive, and the PCR was positive for the Babesia gene. This launched a transfusion investigation in which doctors tracked down 34 of the 38 blood donors whose blood could have infected Cal with Babesia. One donor, a 67-year-old California resident (who I’ll call Don) had a B. duncani titer of 1:4096 (on the IFA test). What does a titer of 1:4096 mean? Well, if the antibody test for B. duncani is negative, the titer will be < 1:256. That means that Don’s antibody test was positive.
What the article abstract doesn’t tell you, which the full article does, is that both Don’s PCR and blood smear were negative for Babesia. How did the researchers prove definitively that Don had Babesia in his blood? They injected the blood into Mongolian gerbils, and were later able to isolate the parasite from the gerbils. Conclusion: Even though Don showed no symptoms of Babesia and both his PCR and smear were negative, his donated blood caused Babesiosis in both Cal and the gerbils.
Here’s why the study’s findings are important:
1. Clearly, blood smears and PCRs are not good indicators of whether someone is infected with Babesia. Why insurance companies think these tests need to be positive before they’ll pay for treatment is a mystery to me. There are probably a lot of people out there who’ve had positive IFAs but negative smear and/or PCR who were then not treated for Babesia because either the doctor, the insurance company, or both said they didn’t have an infection.
2. As far as the blood donation goes, if we don’t start screening out donors with positive Babesia IFAs, we’re going to continue to contaminate the blood supply with Babesia. It should be as simple as that. Been bitten by a tick? No blood donation for you. Positive IFA? No blood donation for you.
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Four (surprising) places ticks hang out 04/30/2012
Posted by thetickthatbitme in Media, TBI Facts.Tags: Borrelia, Grizzly Peak, health, Lyme, mice, Permethrin, prevention, tick, Tilden Regional Park, yard
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Most people think you have to be hiking around in the woods to pick up a tick. In reality, ticks are a lot closer than you think. Here are four (possibly surprising) places where ticks hang out:
1. In your un-mown lawn. Ticks like to hide in vegetation to keep from drying out. Vegetation includes tall grasses, so don’t get lazy on the lawn upkeep!
2. In piles of fallen leaves. Yes, leaves are fun to jump in, and yes, the crunchy sound they make when you walk over them is lovely, but you (or your pet) could also be picking up ticks from leaf litter, so rake ’em up!
3. Anywhere mice or other rodents live. This includes wood piles, rock walls, crawl spaces, ground covers, abandoned vehicles, garbage, bushes, and palm trees. Mice also like to eat fallen fruit, so if you have fruit trees, be sure to dispose of any fruit that falls. If you have mice or rats in your home, chances are you have ticks, too. Here’s a more detailed list of mouse hiding places and what you can do to keep them away from your yard and house.
4. On and underneath wooden picnic tables and benches. To me, this is the creepiest one, because I’ve been to countless kids’ birthdays and neighborhood get-togethers in the park, and the last thing on my mind was tick exposure. If you don’t believe me when I say the risk is real, here’s an article abstract for a study conducted by Kerry Padgett and Denise Bonilla from the California Department of Public Health.
They collected ticks (some of which tested positive for Borrelia) from various areas in Berkeley’s Tilden Regional Park and found as many on wood surfaces as in leaf litter. If you’re planning on a day in the park, I recommend long pants and repellent with Permethrin.
If you’re spending time outdoors, it’s a good idea to check yourself for ticks as soon as you come inside. The University of Rhode Island’s Tick Encounter Resource Center has a great multimedia tool, the Tick Bite Locator, which suggests common places to check for ticks. They also have images of a variety of disease-carrying ticks (although the soft-bodied ones are missing) at different life stages.
Got a dog and not sure how to check him/her for ticks? WordPress blog After Gadget has a detailed explanation of how to do a thorough tick-check.
Be careful out there, everyone!
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Omelet you in on these yummy high-choline recipes 04/29/2012
Posted by thetickthatbitme in Choline Diet, Whole Person.Tags: breakfast, choline, diet, Food, leftovers, mushroom, omelet, recipe, Smoked salmon, Spinach
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In my family, omelets are somewhat of a sacred tradition. My dad was the omelet-master when I was growing up, and whenever we had weekend company, he’d make each guest and family member his or her own made-to-order omelet. By the time I was in high school, I’d picked up his technique and was making omelets for all my friends after school. Little did I know back then what a great source of the B vitamin choline omelets can be! (For more on choline, see the Choline Diet page.)The best thing about omelets besides the choline factor is the infinite possibilities–there are no rules about what cannot go in an omelet. Here are some of my favorites.
Smoked Salmon, Spinach, and Avocado Omelet
I love smoked salmon, and I’m always looking for new ways to cook with it (aside from just eating it on a bagel with cream cheese–yum). Check out this salmon omelet recipe from cuisineaustralia.com.
Choline Count: eggs (2) 200 mg + salmon (3 oz) 80 mg + spinach (2 oz) 11 mg + avocado (1) 19 mg = 300 mg of choline!
Mushroom, Spinach, and Feta Omelet
What do I like almost as much as smoked salmon? Crumbly cheeses! Feta and spinach are always delicious together, why not put them in an omelet? Add shiitake mushrooms for a bonus 66 mg of choline! Check out this recipe on closetcooking.com.
http://www.closetcooking.com/2008/03/mushroom-spinach-and-feta-omelet.html
Choline count: eggs (3) 300 mg + shiitake mushrooms (4 oz) 66 mg + spinach (2 oz) 11 mg + feta cheese (1 oz) 4 mg = 381 mg choline!
Leftover Stir-fry Omelet
This was my go-to omelet when I was a college student and rarely went grocery shopping or planned meals. I always seemed to have leftover Chinese food in my fridge, so I devised this omelet to make leftovers into breakfast. I usually use two eggs per person with a little milk. If you’ve got the jumbo eggs, you can get away with using one and use a little more milk (1 oz of skim milk has 5 mg of choline!). I whisk up the eggs and the milk in a bowl, then pour them into my omelet pan (yes, they make a size of frying pan that’s just for omelets). Meanwhile, I heat up the leftover stir-fry in a separate pan. Once that’s heated through and the egg mixture has set in the pan, I spoon some stir-fry onto one side. After a few minutes, the other side will be ready to fold over.
If you want to make a healthy stir-fry at home to use for your leftovers, you can try this recipe for Orange Ginger Beef Stir-fry from mccormick.com.
Choline count: eggs (2) 200 mg + beef sirloin (1/4 lb) 96 mg + broccoli (1/2 cup) 31 mg = 327 mg choline!
Hope you enjoyed this week’s high-choline recipes. Eggspect (sorry, I promise I’ll try to stop) to see more next Sunday!
Have a high-choline recipe (and mouth-watering photos) you’d like to showcase on this blog? E-mail thetickthatbitme AT gmail DOT com.






























