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Thursday, December 26, 2002

RESEARCH

* Rare MMR Vaccine Reactions Often Due To Gelatin

COMMENTARY

* Vaccines Need a Closer Look

ADVOCACY

* New Senate Leader Sen. Frist Backs Drug Makers

MEDIA ALERT

* Kids and Chemicals on PBS – Friday Evening, December 27

TREATMENT

* Pittsburgh Institute Starts New Autism Program

* Hope - and a Voice - For Autistic Children in South Australia

CARE

* Love, the Greatest Gift

* Autistic Boy, 12, Found Dead In Lake

READERS' POSTS

RESEARCH

Rare MMR Vaccine Reactions Often Due To Gelatin

A 'Jello Theory of Autism', anyone?

Severe allergic reactions to the measles-mumps-rubella (MMR) vaccine are rare, but when they occur they may oftentimes be tied to the gelatin used in the vaccine, a US study confirms.

Researchers found that out of a small number of people believed to have suffered serious allergic reactions to the MMR vaccine, about one quarter showed hypersensitivity to gelatin. Gelatin is used as a heat stabilizer in the manufacture of a number of vaccines, the study authors note in the December online issue of the journal Pediatrics.

In most cases, reactions to MMR vaccination are fairly mild and include a rash or fever. Rarely, serious allergic reactions marked by symptoms such as breathing problems, hives and rapid heartbeat occur. Immediate, severe reactions have sometimes been attributed to egg allergy because the MMR vaccine is cultured (grown) in chick embryo cells and may contain bits of egg proteins. But research has indicated that most MMR reactions are not associated with egg allergies.

Gelatin, on the other hand, has been implicated in vaccine reactions in recent years. The US Centers for Disease Control and Prevention (CDC) advises that anyone who has ever had a life-threatening allergic reaction to gelatin not get the MMR.

In the new study, a team led by Dr. Vitali Pool of the CDC in Atlanta, Georgia looked at data from a national registry of adverse vaccine reactions. Between 1991 and 1997, there were 168 "probable" or "possible" serious allergic reactions to MMR vaccination. The investigators were able to get blood samples from 22 of these people, who ranged in age from 15 months to 33 years. They then compared the samples with blood taken from 27 individuals with no history of serious MMR reaction.

They found that 27% of those with MMR reactions had antibodies to gelatin in their blood, indicating they were allergic. No one in the other group had these antibodies, according to the report.

"Results from this study support the hypothesis that (allergic

reactions) after MMR vaccines can in some cases be attributable to hypersensitivity to gelatin," Pool's team writes.

They advise that anyone with a history of severe reaction to a gelatin-containing vaccine be tested for antibodies to gelatin and other potential allergens before getting another dose of any gelatin-containing vaccine.

As for the roughly three quarters of MMR-reaction patients who did not show sensitivity to gelatin, the cause of their reactions remains unclear, according to the researchers. They call for more research to unearth other causes of allergic reactions to vaccination.

SOURCE: Pediatrics 2002;110:e71.

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COMMENTARY

Vaccines Need a Closer Look

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[Introduction by the Santa Fe New Mexican: This article is an attempt to express a minority view and position that is contrary to current government, public and majority medical opinion on the subject. However, whatever position on the vaccination decision one chooses to adopt, we feel the most important point is parental choice. Therefore, we ardently believe the best approach to this very controversial subject is to present both the pro and con, good and bad, known and unknown about immunizations and then help guide the patient or parents to choose what is best for them or their children.]

This is termed "informed consent" and should be the basis of every medical test or treatment; vaccinations being no exception.

Any medical therapy must balance the "effectiveness" versus the "safety" of its actions on the human body. For instance, aspirin therapy is effective in preventing a second heart attack after having a first heart attack and it is quite safe, only having a very small incidence of stomach or intestinal bleeding as a potential long-term side effect. As you read the following, please keep these key points in mind in terms of "effectiveness" versus the "safety" of vaccinations: Scientific evidence does support the effectiveness of immunizations. They do prevent infectious diseases; some better than others, but this point is not disputed. Scientific evidence does not support the safety of immunizations. Safety studies on vaccinations are limited to short time periods only: several days to several weeks. There are no long-term (months to years) safety studies on any vaccination or immunization. There is small but increasing scientific evidence of long-term side effects from immunizations that need much more study.

Inadequate Proof of Benefit of Vaccines It is true that there may be situations where extreme measures may be justified to preserve life and health. The basic question, therefore, is whether the benefits of current childhood vaccines outweigh the harm, or whether the reverse is true. As to the benefits of vaccines, polio has been eliminated from the Western Hemisphere, and smallpox may have been eliminated worldwide. [For information on history of smallpox eradication, the nature of the disease, and the side-effects of the vaccine, see the article "Don't Fear a Smallpox Outbreak" by Dr. Sherri Tenpenny.] Vaccine proponents would have us believe that vaccines have been largely responsible for controlling virtually all of the former epidemics of killer diseases in the U.S.. With the exceptions cited above, the facts do not bear this out. According to the records of the Metropolitan Life Insurance Company, from 1911 to l935 the four leading causes of childhood deaths from infectious diseases in the U.S.. were diphtheria, pertussis (whooping cough), scarlet fever, and measles. However, by l945 the combined death rates from these causes had declined by 95 percent, before the implementation of mass immunization programs. By far the greatest factors in this decline were sanitation through public health measures, improved nutrition, better housing with less crowded conditions and the introduction of antibiotics. Also, the virulence of microorganisms tends to become weakened or attenuated with the passage of time and serial passages through human hosts, one example of which is whooping cough

(pertussis) which is clearly a much milder disease today in Western nations than it was l00 or so years ago.

Safety Not Proven It should be pointed out that today's children receive 22 or more vaccines before school age, whereas today's senior citizens received only one, the smallpox vaccine. Some of these vaccines contain potentially toxic mercury (though mercury-free types have recently been produced in response to safety concerns). With growing public concerns about potential adverse reactions on the immature immune systems of children, it is reasonable to ask ourselves what is already known about such reactions.

There is a school of thought that the so-called "minor childhood illnesses" of former times, including measles, mumps, rubella (German

measles) and chicken pox, which entered the body through the mucous membranes, served a necessary and positive purpose in challenging and strengthening the immune system of these membranes. In contrast, so the theory goes, the respective vaccines of these diseases are injected by needle directly into the system of the child, thereby bypassing the mucosal immune system. As a result, mucosal immunity remains relatively weak and stunted in many children, complications of which may be the rapid increase in asthma and eczema now being seen, both in terms of frequency and severity.

This concept tends to be confirmed by four controlled studies, widely separated geographically, in which vaccinated children were found to have significantly more atopic disorders than controls. In commenting on the increased incidence of asthma and other atopic disorders in the United Kingdom in the article, "Measles and atopy in Guinea-Bissau," the authors made the following comment: "The rise of allergic disease among children in the UK over the past 30 years remains unexplained. One hypothesis is that infections in early childhood prevent allergic sensitization, and that successive generations of children have lost this protection as their exposure to infectious disease in early life has declined. Consequently the prevalence of atopy and concomitant allergic disease has risen."

It is true that in former times there were occasional serious complications from these childhood diseases, but this is an area in which nutritional approaches and homeopathy traditionally have been at their best. If these approaches were made widely available, it is probable that most of these complications could be eliminated. No one wants to see serious complications in our children, but the vaccine route may in time prove to be the worst possible choice that could have been made, as concerns the minor childhood diseases.

Threat of Brain Damage Perhaps the greatest concern with vaccines today rests with their possible causal relation to the growing epidemic of childhood autism, developmental delay and attention deficit hyperactivity disorder (ADHD). Regarding the latter, a recent news item stated that ADHD has increased from 900,000 in l99l to nearly 5 million today. Statistics may be open to question, but one cannot question the observations of veteran elementary school teachers who, in our experience, unanimously and emphatically report a marked increase in this disorder in recent years. Regarding autism, a recent survey mandated by the California state legislature found an increase of 273 percent in California in the past 11 years.

At present primary suspicion for this epidemic of neurobehavioral disorders rests with the MMR (measles-mumps-rubella) vaccine. Although scientific evidence has not yet reached the standards of scientific proof, one pioneer researcher in this area, Dr. Vijendra Singh with the Department of Pharmacology, University of Michigan, has published the report of a study in which he found that a large majority of autistic children tested had antibodies to brain tissue in the form of antibodies to myelin basic protein, a protein strongly correlated to measles antibodies (almost all of the children had been immunized with the MMR vaccine, and none had had these diseases).

This study tends to confirm the results of a similar study published in The Lancet in l998 by Dr. Andrew Wakefield and coworkers of the Royal Free Hospital in London, indicating a possible link between MMR vaccination, Crohn's disease of the bowel, and autism.

If the MMR vaccine were causing an autoimmune reaction involving the brains of autistic children, what would be the mechanism? Although research in this area is in its infancy, we do know some things. Both the measles and mumps fractions of the MMR vaccine are cultured in chick embryo tissue. As purely genetic material, viruses are highly susceptible to the process of "jumping genes," in which they may incorporate genetic material from tissue in which they are cultured. Furthermore, protein sequences in the measles virus have been found to have similarities to those found in brain tissues. As a result, once this foreign genetic material is introduced into the child by a vaccine, it may set in motion an immunologic attack on brain tissues, a process which the work of Dr. Singh would tend to confirm.

Stealth Virus A similar process may have taken place with the oral

(Sabin) polio vaccine, which is cultured in monkey kidney tissue. Years ago Dr. John Martin, then serving as director of the viral oncology branch within the U.S. Food and Drug Administration, found foreign DNA in contemporary polio vaccines. He later learned that a simian (monkey) cytomegalic virus had been found in all of the 11 African green monkeys imported for production of the polio vaccine.

After leaving the FDA Dr. Martin took a position as professor of pathology with the University of Southern California. There he tested blood samples from patients with chronic fatigue syndrome, autism, and other nervous system disorders. This work led to his discovery of unique cell-destroying viruses that were not recognized by the immune system. Termed "stealth viruses," some of which he thought had clearly originated from the simian cytomegalic virus, these viruses were missing specific genes which ordinarily would induce immune responses from the host. It should be admitted that this work is preliminary. No definitive conclusions can be drawn from it, but the need for further intensive investigation should be apparent.

Overdue in the opinion of many, on June l7, l999, U.S. government officials voted to withdraw their recommendation for the use of the live oral polio vaccine and to recommend exclusive use of the inactive (Salk) polio vaccine, because the former vaccine has been the only remaining source of polio cases in the U.S.A since l979.

Damage May Yet Escalate As another concept, it is highly pertinent that many of today's children are second-generation vaccinees; that is, they are born to mothers previously vaccinated with the measles, mumps, and/or rubella vaccines. It is possible that the reaction rates in the second-generation vaccines may be happening on a much large scale due to previous sensitization of mothers from their vaccines, this sensitization being transmitted in turn to the fetus during pregnancy. If this process is taking place, something we cannot know until appropriate research is done, there predictably will be additional increases in autism beyond that already taking place, should the process be continued into a third generation.

Time may prove that vaccine programs went awry when they deviated from the most basic of all medical ethics, the right of parents to accept or reject vaccines for their children. Freedom of choice provides a system of checks and balances now lacking. At the very least, this would provide the parents the power to compel better safety screening of vaccines.

Today we have a system in which vaccine production by the pharmaceutical companies is largely self-regulated. Naturally these companies are interested in profits from their products which, in itself, is not wrong. However, when arbitrary decisions in the mandating of vaccines are made by government bureaucracies, who are highly partisan to the pharmaceutical companies, with no recourse open to parents, we have all the potential ingredients for a tragedy of historical proportions.

In closing, it may be appropriate to cite an item which, though seemingly small in itself, may be indicative of the problems with which we are faced. In January l993 a scientific journal published the results of a study of 89 children with adverse clinical reactions following administrations of various combinations of vaccines. Detailed case histories were taken and blood tests were done to examine various parameters of cellular and humoral immunity. It was found that children with adverse reactions had marked increases in abnormal blood parameters as compared with children who had had no reactions.

The first study of its kind as far as we are aware, perhaps the most striking and significant feature of the report is not the results of the tests, which might have been anticipated, so much as the fact that it was published in a foreign publication, Czechoslovakia Pediatrics. American science has been foremost in the development and promotion of vaccines. That it should be laggard in basic safety testing, of which this study may represent one of the modest beginnings, is a sad reflection on the American scientific community. Do we not have a right to expect better?

[Harold Buttram is an author and physician at the Woodlands Healing Research Center in Quakertown, Penn.]

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ADVOCACY

New Senate Leader Sen. Frist Backs Drug Makers

Colleagues expect Frist to alter measure protecting vaccine producers from lawsuits

Tennessee Sen. Bill Frist's ascension Monday to Senate majority leader could end up helping drug companies.

Frist is author of a bill to protect vaccine makers from lawsuits over vaccine preservatives.

Frist maintains he is not the lawmaker who slipped that provision in a homeland security bill that passed in November.

But as the new Senate leader he will be responsible for renegotiating it as several Republican lawmakers unhappy with its inclusion in the bill have requested.

Two senators who objected to the provision said Monday that they expect Frist to honor the promise of outgoing Majority Leader Trent Lott, R-Miss., to modify the liability protection as soon as Congress returns.

"I don't expect any change with respect to this commitment, and I will be working to ensure it is carried out when Congress reconvenes in January," said Sen. Olympia Snowe, R-Maine.

A spokeswoman for Sen. Susan Collins, R-Maine, said Frist "has not given us any indication to think otherwise."

Frist's spokesman said the senator has already begun talking with Snowe, Collins and others about changes.

But Frist still is hoping to pass separately his original bill, which included the liability protection and other measures aimed at securing a sufficient supply of vaccines.

The provision would stop pending and future lawsuits against vaccine makers from families who believe their children were harmed by the mercury-based preservative thimerosal.

Some people believe thimerosal can cause the debilitating neurological condition of autism.

To be on the safe side, the Food and Drug Administration asked manufacturers in 1999 to take thimerosal out of their vaccines. Research has not proven thimerosal causes autism.

Eli Lilly and Co., the Indianapolis-based pharmaceutical giant, created thimerosal and is viewed as the primary beneficiary of the legislation.

Although Frist consulted Lilly and other interested parties when writing his bill, his spokesman said the provisions came from an advisory commission that makes recommendations on federal vaccine policy.

Besides the vaccine legislation, Lilly has other ties to Frist, the Senate's only physician.

Lilly boosted the sales of Frist's book on bioterrorism published after Sept. 11, 2001, by buying 5,000 copies and distributing them to doctors around the country.

Frist's spokesman said Lilly's promotion of the book did not affect the company's relationship with the senator.

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MEDIA ALERT

Kids and Chemicals on PBS – Friday Evening, December 27

This Friday evening, December 27, 2002 PBS stations across the nation will broadcast "Kids and Chemicals," a special one hour edition of NOW with Bill Moyers. This documentary features medical investigators and health officials engaged in the latest research on links between childhood illness and environmental contamination. Check local listing for the exact time.

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TREATMENT

Pittsburgh Institute Starts New Autism Program

The Watson Institute, 301 Camp Meeting Road, is offering therapy to children and adolescents with autism or an autism-related disorder through a new program called SCAFFOLD, which stands for Services for Children with Autism and Families Facilitating Outpatient Learning and Development. The program also provides diagnostic and wraparound evaluations and medication management.

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Hope - and a Voice - For Autistic Children in South Australia Flinders University will open the unit in February.

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Autistic children will no longer struggle to have a voice, with the first Early Intervention Unit specialising in autism being launched next year.

Flinders University will open the unit in February.

The program aims to work with parents and their autistic children on a one-to-one basis.

Autism is a lifelong developmental disability.

It is a dysfunction of some parts of the central nervous system that affects the way an individual processes information.

More than 400 South Australian children have been diagnosed with autism in the past 18 months.

Under the program, children will be individually assessed and tailored programs will be designed for each.

The university has developed a screening tool that detects autism in children under two years of age.

"Previously, these children were not being detected until they were around four years of age," unit director Dr Robyn Young said.

"But until now the difficulty is that once identified there has been limited opportunity available for intervention in South Australia."

One Adelaide mother – Litsa Fragos – left her job to travel to the US for 12 months to study a course in autism so she would be able to help her son Basil, 6, who developed autism four years ago.

"When Basil was just two he was always chattering away, he even sang songs," she said.

But all that disappeared in a matter of months as Basil developed autism. He is no longer able to speak.

"That has been the hardest part of all," Ms Fragos said. "Now, I cannot even remember his beautiful voice."

The single mother of two hopes that one day her son will be able to communicate and grow up to have some sort of normal, functioning, independent life.

People with autism have repetitive and restricted behaviour and interests, as well as impaired communication and social interaction skills.

There is no single, known cause of autism. It can vary in its impact on children, with some able to function normally, but others losing their speech, becoming obsessive, and losing their ability to communicate.

The unit will be a non-profit organisation dedicated to providing children with developmental disorders the opportunity to gain access to intensive services previously unavailable in SA.

Dr Young appealed for financial investors to help fund the unit's operations.

"Without community support these children will not receive the help they need and deserve," she said.

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CARE

Love, the Greatest Gift

Oak Harbor - When she kneels to thank God for his blessings this Christmas Day, Mary Geist may get red knees from the carpet. It takes time to ask the Lord to bless Josh and Alexis, Michaela and Micah, Dusty and Kiara, Delaney, Isaiah, Seth and Caleb.

Those are her 10 children, all born showing the effects of parental alcohol and drug abuse. Several have continuing mental and medical conditions, said Geist, who is raising the adopted children alone.

The children, whose ages range from 10 months to 9 years, aren't covered by medical or dental insurance. They do have Geist's wealth of love, faith and hope for fulfilled lives.

Inside their midsized rambler on Oak Harbor, nine children sit in little yellow chairs or on red plastic benches, finishing a morning snack of Cheerios. Baby Caleb, 10 months old, is steadying himself by clinging to the leg of Geist's sweat pants.

Petite and pretty, Geist looks younger than her 55 years.

Geist said she had a gruesome childhood in Minnesota, too awful to discuss, but nothing could diminish her love of children.

That morning, everyone was dressed in clean clothing, shoes were tied and every hairdo was just so. They said "hello" like a well-behaved Sunday school class.

After snacks, the youngsters scattered to a playroom with little fanfare. After an hour of fun, sounds of roughhousing came from the playroom -- the normal sounds of active kids.

Alexis, the apparent culprit, was asked to go to the kitchen and do homework at the center island. She stood, opened a book and worked independently for more than 30 minutes.

Michaela, 5, was asked to hold Caleb, almost walking at 10 months, after he tried to climb his mother like a tree.

Geist adopted siblings Josh and Alexis, both 9, on Whidbey Island in the mid-1990s when her husband worked for a Boeing support company.

Josh and Alexis both have Asperger's syndrome, a form of autism. They experienced two failed adoptions before Geist took them in.

"They had been sent to a day care for the retarded," Geist said. "They were put on a bus at 6 a.m. seven days a week."

All but two of her children are open adoptions, in which biological parents may remain in touch with the children. Some see their birth parents, some do not. Josh was never expected to walk or talk normally. Alexis had been kept mostly in a car seat during her first seven months of life.

Michaela, 5, who is a top student in her kindergarten class, was born with a partial cleft palate. Micah, 5, has asthma and extreme hearing problems. Dusty, 4, has a rare genetic disorder, Bannayan-Riley-Ruvalcaba syndrome, that carries a high risk of developing cancer.

Delaney, 3, cried for her first 17 days of life due to drug and alcohol withdrawal, Geist said. A former potential adoptive family gave her back. She has clubbed fingers and toes and a severe skin condition.

Isaiah, 3, from Lubbock, Texas, was not expected to live when he was born with a lung infection. He has residual lung problems and a speech impairment. Seth, 1 1/2, a half-sibling to Isaiah, was born with a neurological difficulty and heart murmur. He suffered extreme neglect during his early months but is healthy and happy now.

Kiara, 4, drifted from situation to situation her first three years. She didn't talk and appeared delayed. She has caught up in size and academics. Baby Caleb is a head-to-toe delight.

"He was a gift of love from God," Geist said. "Caleb is an affirmation of all that is good in life. He is a joy in every way."

Except when he is teething.

The children all go to bed around 8:30 p.m.

"That doesn't mean they stay in bed," Geist said, laughing. "Last night, Caleb was up teething. Dusty gets headaches and can't sleep."

The Geist gang goes grocery shopping together, thanks to a 12-passenger van that holds 10 child seats, blankets and toys. At the store, Geist pushes a cart with Caleb and Seth while Josh drives another cart with Dusty, Isaiah and Delaney. Alexis puts food in her cart.

Grocery shopping is a great chance for home-school lessons integrating math, courtesy and cooperation themes. The store director at Albertsons in Oak Harbor, Steve Banta, said the family is always well-behaved.

Courtesy clerk Laura Gregory helps load groceries, which are stacked around safety seats in the van.

"Every child knows where to sit with no bickering," Gregory said. "The older ones all help the younger ones. It's amazing. I am so impressed."

Most of the children were adopted in Yancey, Texas, where Geist and her husband owned a manufacturing plant.

The couple, now estranged, lived on a 400-acre ranch and spent as much as $25,000 for each private adoption.

"I learned about the children through social services, private agencies or word of mouth," Geist said. "I'm not on a crusade. I have a belief that children, babies, are the only thing in this world that are real and perfect, at least until adults may damage them."

There were horses and cattle and acres for the children to romp.

When things turned for the family, they turned quickly, with a tornado that wiped out all but the main ranch house, a botched sale of the business and a divorce.

The twister ripped air-conditioning units off the side of the house, but the structure, filled with the children, was spared. The single mother returned to Whidbey Island with the last of the property insurance money.

At their home, Geist takes all 10 children out for walks. She said neighbors, especially Clarence Pease, whom Geist calls her mentor, support her planned nonprofit venture, which she calls Wisteria House.

Located in her home, Wisteria House will offer a supportive, loving atmosphere for women and children in distress, Geist said. "It will be a hand up, not a handout."

She has another dream, too: to open a rodeo ranch on Whidbey Island to take in any special needs youngsters who would benefit from living in a country setting.

"Folks can come and camp with kids who may be adopted," she said. "There won't be picnics for potential parents with kids wearing name tags. ... The ranch would be the kids' home, forever if need be."

How far are hearts able to stretch? How can one person have so much to share?

"Children don't need the best toys or clothes, they need care and love," Geist said. "Love doesn't run out."

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Autistic Boy, 12, Found Dead In Lake

62908.story?coll=sfla%2Dhome%2Dheadlines <- - address ends here.

Miami - A 12-year-old autistic boy was found dead in a lake following an intense search of his neighborhood, police said Wednesday.

Linval Blair, of Miami, was reported missing around 6 a.m. Tuesday by his mother, who told officers she was worried about her son because he was severely autistic, said Miami-Dade police Detective Robert Williams.

Police found Linval's body floating in a lake next to his home in northwest Miami around 11:45 p.m. Tuesday after an extensive search by helicopters and authorities on the ground, Williams said.

"The boy's mother said he had a fascination with water," Williams said.

Medical examiners were performing an autopsy to determine the cause of death, Williams said. Police had no other information, but were still investigating.

Copyright (c) 2002, South Florida Sun-Sentinel

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READERS' POSTS

I have found that peanut butter has calmed my daughter down alot, it may not be a cure but I can tell a difference in her when she does not eat any for a day or two, reese cups or plain peanut butter is what I give her three times a day and its amazing how she behaves. Although due to being forced at school and with going for visitations with father she has become agressive, she is now back on her way with the peanut butter and love I donot believe in force with an autistic child, and that is how the specialist that I have come across is trained. Pam R Church ariellc@inet99.net

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To President Bush: I pray to God that no one in your group of family and close friends ever know the heartbreak of autism and related problems. Furthermore, I pray God will forgive you and your group of family and close friends for the Homeland Security Act Rider blocking the rightful lawsuits we families needed so desperately. Thank you for giving the chemical companies the legal right to damage us all. May God have mercy on your souls. Margueritte L. Dyhouse

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Aetna has denied doctor's letter of medical necessity for allergy and other testing, stating peer-reviewed literature doesn't support it. We are appealing, but need more documentation supporting our position. If you can help, please email bbrazy@mindspring.com

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Would like information on school age Autism programs in Lousiana (New Orleans), through the school system or private. Are there many resources and services there? Also I am looking for a Tech/Speak 32-6 that is not too terably expensive. Mayer-Johnson has it for about $545. Kathy Hudson (Abby's mom) jhud2@earthlink.net

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One of my tutors will be moving to Provo, UT, over the holidays. Her name is Annie Weir. She has worked for me for the past year. She is Lovaas/ABA trained, and has received extensive training from myself (a 7-yr. veteran) and from Central Valley Autism Project (a Lovaas replication site). She is an excellent tutor: dependable, hard-working, creative, very reinforcing, efficient, and speedy. She is looking to work 15-30 hrs./wk. on M-W-F and Saturdays. Until Jan. 4th, she can be reached at 916-791-0214. After Jan. 6th, she can be reached at 801-374-6939. She has her own transportation. Laura

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