I was diagnosed abut 6 years ago and have been on Methotrexate, ciclo sporin and arava with lots of cortisone injections into various joints. I am currently on nothing because my liver keeps bombing out!
I would really like to know what symptoms other people have because mine don't really fit in to the vague lists you find in the web.
My rheumatologist wants me to go on to Enbrel and i am not keen because i do not think my symptoms are that servere - i know its for prevention etc, but really (and i accept i am in denial) for me to go onto that hectic a medication I would have thought my symptoms needed to be more severe!
You were asking about symptoms. I have a slowly progressing version. I was diagnosed 5+ years ago. I started off with pain and inflammation in my hands and feet, along with fatigue. Over the years, it has progressed, so that I now have pain and inflammation through much of my body, and much of that is tendon related. And don't forget fatigue. That's a major issue when the disease is more active. I have had problems with my eyes, nerve issues, etc, and have begun to develop some osteoarthritis in relation to the PsA. I have been on one or two DMARDs for about 5 years. I've only needed one cortisone injection so far. Oh, and every spring brings a new and exciting flare, that sets me back by a few months and makes my life miserable.
I have found that most rheumatologists aren't super-quick to recommend Enbrel or other biologics. Based on what you are describing, this sounds like a perfectly logical move. It's not that your symptoms need to be more severe per se, rather that you are not controlled. If you need bunches of cortisone shots, you don't sound well controlled.
I would echo what Stoney mentioned. My symptoms are similar, joint pain, fatigue and occasionally problems with skin or eyes.
I found mtx to be brutal and could not tolerate it. And, I have never had a cortisone injection, only in the pill form. So, I agree that a biologic seems to be the logical next step. It won’t resolve everything, but you will likely feel much better using a biologic. There have been times that I was pale and barely able to get to the doctors office for treatment but left feeling great! Though it normally takes 3-4 days for me to see the full effect. So go for it! You can be in denial about PsA but go get your Embrel first!
There are many of us, including me, who think that the biologics are a significant positive change - with less risk. Its up to you to assess it appropriately.
I’ve spent a lot of time on the very detailed studies in NIH - for me, the risk / return profile of anti tnf’s is excellent (actually, its better than excellent, the reduction in mortality is significant and fun is increased to a level I wouldn’t have believed before…
I felt this way too. I dont think my symptoms are severe enough and I know enbrel like any biologic is a last resort medication. However, Ive come to my senses, my specialist wants to treat it aggressively because prevention is the key. While I dont have severe symptoms and most days I am not bothered by my disease, it is there and when I notice it, it is shocking to me. I was only diagnosed about 1 yr ago..it may be my 1 yr anniversary..but anyways since diagnosis in just one yr Ive seen many bad changes in my joints and this is while on medication too (mtx, plaquenel). Now Im going to take Biologic drug Enbrel. Dr says it is a better drug. I still have mobility issues in my foot, inflammation, swelling...and it affects my hips. Dr isnt sure if I have it in my hip or if the disease in my foot is affecting my hips. I had to accept that I need and should go on enbrel but everyone is different. Perhaps because of your liver issues... he wants to try enbrel. When you are on mtx you have to have monthly blood tests. it can really affect your liver. For me going on enbrel was also a concern because of my history of leg infections...but i was reassure by members on here as well as my dr when i told him of my concern, that the risk of serious infections is not a very common side effect. More common is colds etc.
Corisone injections did nothing for me, in fact they created worse symptoms. My dr was going to do cortisone injections frm time to time while on mtx but like i said they were not for me. I did take mtx and it helped with my symptoms and i tolerated it very well..no problems, no complaints, but it did not work for my disease totally...well not to my satisfaction or my drs. I guess at the time I was fine on mtx but have realized since all of my symptoms were not being controlled on mtx. I dont have it in severe form. Most days it is mild and my flares do not last long. I still dont understand what a flare is. I can cope with the pain as it is short lived altho it does cripple me but luckily they are like shooting pains and I know what i can and can't do or shouldnt do. But you cant really live like this. Im hoping enbrel will help me even more like the dr said it should. I like to be active, I have young kids and I am 34. I dont want to go downhill. Already im shocked my some of my limitations that have developed over just 1 yr.
Meppert said:
I would echo what Stoney mentioned. My symptoms are similar, joint pain, fatigue and occasionally problems with skin or eyes. I found mtx to be brutal and could not tolerate it. And, I have never had a cortisone injection, only in the pill form. So, I agree that a biologic seems to be the logical next step. It won't resolve everything, but you will likely feel much better using a biologic. There have been times that I was pale and barely able to get to the doctors office for treatment but left feeling great! Though it normally takes 3-4 days for me to see the full effect. So go for it! You can be in denial about PsA but go get your Embrel first! :)
Thank you all. feeling better again. My GP tells me the only reason I am not depressed is because I am in denial!
The process has begun for me to go on enbrel - it has to go before an arthritis panel and then onto my medical aid so will take a month to get approval.
I am just frustrated that there isnt a specific test for PSA and all you are getting is a qualitative measure from the doctor - and whilst she is very nice! I would like to see some proof but as she keeps saying, by then it will be too late!
I feel the same way...frustrated that there isnt a specific test either and sometimes I am in denial. Spometimes I just like to use the word arthritis because it makes me feel better ..it doesnt seem so bad just using the word arthritis lol. I dont know why. Anyways I just dont want to believe it at times. But the changes in me have made it possible for me to believe. I find them shocking. I must admit its less scary now knowing what i have, even though on days I like to question it. The specialist in the beginning didnt know whether it was RA or PSA ...he said they mimic eachother and it is only at the 1 yr mark that he is leaning towards PSA. It doesnt make me feel good that he didnt know frm the start but sometimes getting a diagnosis for autoimmune diseases isnt easy. My diagnosis was confirmed by an MRI. He had an idea but was doubting himself...then the MRI results came back and there was no doubt left in his mind...he turned into a different dr. I am thankful I got the MRI. The dr didnt take me seriously before this. I see only a specialist for my PSA. A rheumatologist. I do trust him a lot. I wouldnt trust just a regular GP. You must have been diagnosed by a rheumatologist , no? Just curious. If not, nothing wrong with asking for a referal. The right dr to see would be a rheumatologist for this. Anyways I have also started the process to go on enbrel. It's very slow esp on my end. My dr has been very slow in filling out my insurance form. Been 2 weeks now. Im not kidding. And Im on no meds right now because he said to stop mtx and go on enbrel. He actually thought Id be able to go enbrel the day after..he didnt realize either there is a process lol. He is not a new dr so I dont know what his problem is. Anyways after he fills out the form and I sign it then it goes to my insurance company for approval. Ive talked to them already and if i get approved my coverage is 100%. I just hope it helps the enbrel and controls all of my symptoms and I wouldnt mind if I was able to do even more than i do now while on it. That's if my dr will speed things up on his end and if the insurance provider approves it. The not knowing is hard. I trust my dr but at the same time he is forgetful. After stopping a past medication on his advice (plaquel), for months he thought i was still taking it. I kept on having to remind him i am only take mtx. He's interesting! I just hope he hasnt forgotten about the insurance form for enbrel. I have called the secretary about it but she doesnt say much. She's no help. Gives me the run around as if I asked for enbrel, as if she's doing me a favour! It's such bad service! lol And if this was just a sweater & their was a delay in getting it I would certainly just tell them to cancel the order but i cant cuz this is for my health.
If you can even say Haggis let alone use it for a screen name, your symptoms may be more severe than you think. It takes a very "strong person" to deal with haggis in any matter. Not so many years ago (well maybe more than few they were still using bladders to make them then) Canadian Customs a had a load come through. It was illegal then to ship food stuffs across the border (might still be considering the hissy fit they had at my pre-made frozen solid stuffed green peppers last summer they still do) In any event the custom agent who encountered them had no problem as they couldn't possibly be food and had his supervisor had no clue what they could be. The passed them through.
Someone had the NERVE to bring one to our Keats Society a couple years back. He's been banned. We tried to banish him to the microbrewery down the street, but his brother is the judge (and president of the society) They decided he could come back IF he brought a 20 years old single barrel (single malt of course) bottle for sampling.
In any event early and aggresive is the new norm. I'm trying to scare you but it is effective. Poke around this board a while and you will find way too many folk who started a flare, only to discover it WAS NOT a flare but rather a new normal..... Good luck with the Arthritis board. You are fortunate than you know to have a Dx, some folk suffer for years waiting.
My first Rheumy just had me take Naproxen. He did not feel my symptoms were that bad. I knew I had PSA....I had suffered from Psoriasis for years and even my dermatologist felt I had PSA, but I always got the feeling from the Rheumy that he didn't really believe me when I was describing my pain -- like it was all in my head. Unlike a lot of people I do NOT get the large swollen joints. I've had that occur only twice since I was diagnosed in 2005.
After some begging the Rheumy put me on Enbrel......Well, over time the Enbrel stopped working and I was in AGONY all the time. He told me to take an additional Naproxen each day and continue with the Enbrel. I was getting NO relief - I was exhausted, depressed and just could not focus because the pain was always there. I started doing my own research and found another Rheumy. This Rheumy asked a bunch of questions - the first being had I ever had any x-rays or MRIs done? What?!? My other Rheumy NEVER did this. Well, after a series of MRI's on my hands and feet the only way I can describe what the bones look like is "swiss cheese". The damage is horrible and I blame my first Rheumy for not taking my feelings and descriptions of my symptoms seriously.
Slowing down the disease is essential because once the damage is done it cannot be reversed. My disease took a very aggressive turn for the worse. I am now on MTX every week and I go in for Remicade infusions every 6 weeks. (I've tried all the other biologics - Humira, Simponi with and without MTX with no relief). I am exhausted ALL of the time, but I have to work. I have terrible flare-ups that occasionally need a kick in the ass with a dose of Prednisone. My doctor regulary does blood work on me and I've never had a test come back bad.
What if that first Rheumy cared more?? A lot of the preventative measure the medications were made for might have helped me.
According to a huge peer reviewed Nursing CEU I completed last year on liver disease , MILK TtHISTLE has been proven to reverse and or clear cirrhosis ,either from chemical or alcoholic toxins. Fatty cirrhosis is another story..
Have been on vicodin one or two tabs daily for pain ,plus milk thistle. I cannot say the disease and or cartilage damage progression has lessened , but i am more afraid of the biologic and heavy duty chemo side effects at this point. Of course the US government is now doing all it can to restrict vicodin because of the addicts and profiteers. Once my GP retires who knows my pain and the disease progression for over thirty years , I will be screwed and perhaps bedridden.
Our government is doing everything to limit and eliminate the disabled and elderly thanks to the global economy and the banking disasters .I am truly frightened for all the clients I once cared for who were quads and paras and for elderly friends. Yesterday I received a call from one 75 yr old who is full of arthritis and needs a knee replacement.. She was hit head on by an uninsured motorer ,is now in worse pain. Few Drs will take her because they ,"Have to wait to long to be reembursed by accident insurance." Also as a diabetic obama care which has kicked in for Medicare , will only pay for the largest needle diabetic testing equipment from the prehistoric age.
Guys, if we do not seek and find natural solutions ie diet ,herbs and other , we will have no alternatives other than being gunea pigs for big pharma for new drugs or nothing else. Even my low gymn payments for the community church pool has been going up ! Trying to keep it open for all the arthritic elderly , they have had to let go many employees.
Sadly, we will be ever incresingly on our own with these chronic diseases.I see it with the elderly and ill. I was a fecility hospice nurse after being a rehab nurse. Visited every Rehab and Assisted living in three counties. I watched the quality of care , Dr and Nsg staff deteriorate over the past decade. It has been all about money.! The alleged Nsg Shortage was a scam .Allnurses.com knows this . Pumping out the nurses from the schools , flooding the job seeking market and putting pressure on the more experienced higher salkaried nurses to leave for the cheaper inexperienced ones of whom many are just there for the money. Low staffing is still a huge problem as the hospitals want to keep it as low as possible to keep the profit margin up. The public blames the nurses but has no clue that they are doing the work of three now when only two or three decades ago they had manageable case loads. Again, it is all about money and not real concern for the sick and elderly anymore. Alternatives other than the Hemlock Society must be found and it is the people and not the system who have to find them..
Tntlamb that’s very funny! But I can assure you I have never seen a real haggis let alone tried to deal with one but have had many a fun evening sampling some delicious single malts!
I presume you let the man back into your society?
We are all fortunate for many things and my rheumy is very good and enbrel is the last option because. "it " is not being controlled and I am quite fond of my liver. And yes aggressive before too much damage is excellent but requires the end of the denial phase.
According to a huge peer reviewed Nursing CEU I completed last year on liver disease , MILK TtHISTLE has been proven to reverse and or clear cirrhosis ,either from chemical or alcoholic toxins. Fatty cirrhosis is another story..
Have been on vicodin one or two tabs daily for pain ,plus milk thistle. I cannot say the disease and or cartilage damage progression has lessened , but i am more afraid of the biologic and heavy duty chemo side effects at this point. Of course the US government is now doing all it can to restrict vicodin because of the addicts and profiteers. Once my GP retires who knows my pain and the disease progression for over thirty years , I will be screwed and perhaps bedridden.
Our government is doing everything to limit and eliminate the disabled and elderly thanks to the global economy and the banking disasters .I am truly frightened for all the clients I once cared for who were quads and paras and for elderly friends. Yesterday I received a call from one 75 yr old who is full of arthritis and needs a knee replacement.. She was hit head on by an uninsured motorer ,is now in worse pain. Few Drs will take her because they ,"Have to wait to long to be reembursed by accident insurance." Also as a diabetic obama care which has kicked in for Medicare , will only pay for the largest needle diabetic testing equipment from the prehistoric age.
Guys, if we do not seek and find natural solutions ie diet ,herbs and other , we will have no alternatives other than being gunea pigs for big pharma for new drugs or nothing else. Even my low gymn payments for the community church pool has been going up ! Trying to keep it open for all the arthritic elderly , they have had to let go many employees.
Sadly, we will be ever incresingly on our own with these chronic diseases.I see it with the elderly and ill. I was a fecility hospice nurse after being a rehab nurse. Visited every Rehab and Assisted living in three counties. I watched the quality of care , Dr and Nsg staff deteriorate over the past decade. It has been all about money.! The alleged Nsg Shortage was a scam .Allnurses.com knows this . Pumping out the nurses from the schools , flooding the job seeking market and putting pressure on the more experienced higher salkaried nurses to leave for the cheaper inexperienced ones of whom many are just there for the money. Low staffing is still a huge problem as the hospitals want to keep it as low as possible to keep the profit margin up. The public blames the nurses but has no clue that they are doing the work of three now when only two or three decades ago they had manageable case loads. Again, it is all about money and not real concern for the sick and elderly anymore. Alternatives other than the Hemlock Society must be found and it is the people and not the system who have to find them..
According to a huge peer reviewed Nursing CEU I completed last year on liver disease , MILK TtHISTLE has been proven to reverse and or clear cirrhosis ,either from chemical or alcoholic toxins. Fatty cirrhosis is another story..
Have been on vicodin one or two tabs daily for pain ,plus milk thistle. I cannot say the disease and or cartilage damage progression has lessened , but i am more afraid of the biologic and heavy duty chemo side effects at this point. Of course the US government is now doing all it can to restrict vicodin because of the addicts and profiteers. Once my GP retires who knows my pain and the disease progression for over thirty years , I will be screwed and perhaps bedridden.
Our government is doing everything to limit and eliminate the disabled and elderly thanks to the global economy and the banking disasters .I am truly frightened for all the clients I once cared for who were quads and paras and for elderly friends. Yesterday I received a call from one 75 yr old who is full of arthritis and needs a knee replacement.. She was hit head on by an uninsured motorer ,is now in worse pain. Few Drs will take her because they ,"Have to wait to long to be reembursed by accident insurance." Also as a diabetic obama care which has kicked in for Medicare , will only pay for the largest needle diabetic testing equipment from the prehistoric age.
Guys, if we do not seek and find natural solutions ie diet ,herbs and other , we will have no alternatives other than being gunea pigs for big pharma for new drugs or nothing else. Even my low gymn payments for the community church pool has been going up ! Trying to keep it open for all the arthritic elderly , they have had to let go many employees.
Sadly, we will be ever incresingly on our own with these chronic diseases.I see it with the elderly and ill. I was a fecility hospice nurse after being a rehab nurse. Visited every Rehab and Assisted living in three counties. I watched the quality of care , Dr and Nsg staff deteriorate over the past decade. It has been all about money.! The alleged Nsg Shortage was a scam .Allnurses.com knows this . Pumping out the nurses from the schools , flooding the job seeking market and putting pressure on the more experienced higher salkaried nurses to leave for the cheaper inexperienced ones of whom many are just there for the money. Low staffing is still a huge problem as the hospitals want to keep it as low as possible to keep the profit margin up. The public blames the nurses but has no clue that they are doing the work of three now when only two or three decades ago they had manageable case loads. Again, it is all about money and not real concern for the sick and elderly anymore. Alternatives other than the Hemlock Society must be found and it is the people and not the system who have to find them..
I was dx April 2011. It started in my rt hand at the pointer finger knuckle, well actually the back of my hand between the wrist and that knuckle. Guess the tendon there. Slowly moved to painful inflammation at the knuckle. That has never gone away. I was 1st put on steroid pills and plaquenil (sp), then off prednisone, but kept plaquenil. Then plaq. and sulfasalzine. Got a red flushing thing going on at my right arm and hand... stopped the sulfa. Started on Mtx 15 once a week plus the plaquenil. No change in pain or swelling at all yet. Been on the Mtx/plaq for 11 weeks. I've had pains in other places, like my hips for 3 weeks only, then gone (b4 the mtx trtmnts), heels off and on, rt. elbow for 2 solid weeks of pain..off and on now. Main pain is now from tendons that go from elbow to wrist. Can't turn my wrist or use any force, like pick the grandkids up. I have to put my rt.forearm instead of my hand, under their armpit to pick em up. you know what I mean. Anyways, my next appt is 2/15. Will see what she wants to do then. My point here is, I don't have nearly as much of the issues many of you have, but it seems that it doesn't matter... need to go on biologics at some point to keep it from getting worse according to so many comments here. Oh, I also do not have the fatigue issues. Never have. Well, I get a bit tired after the grandkids leave... I am their sitter.. 3 wonderful boys... 6 months, 4 and 4 - not twins, cousins :) . Wouldn't stop for nothing.. they keep me happy. Oh, the only thing that has helped me with tame the inflammation is consistent use of ibuprophen 400 mg. - once in morn and again b4 go to bed. I found that if I miss even 1 time, I swell and have lots of pain in my hand and wrist/arm. I experimented with levels... started with 800 each time and then down to the 400. the lower dose was no diff from the 800... so stayed low at 400mg. Get my blood tests every 8 wks. good so far. Thanks for listening. Take care all.
Man shows up with a 20 year single barrel, of course we let him back. But as a serious lush, (I bush the allowable limits for homebrew beer and wine in addition to the keats society) I'm very careful with my liver. That seriously was one of the reasons I moved quickly to a Biologic. The fewer DMARD's and NSAIDS that go through our bodies the better. The saftey of the biologics as opposed to others (especially predi) is a huge plus. Better disease control comes. to better than 90% within three. Over 60% get control with their first... I am convinced that the more we help out our liver, the better. that includes carbs, glutens, and most pain meds.
OBTW there isn't anything much more natural than the Biologics......
Haggis said:
Tntlamb that's very funny! But I can assure you I have never seen a real haggis let alone tried to deal with one but have had many a fun evening sampling some delicious single malts! I presume you let the man back into your society? We are all fortunate for many things and my rheumy is very good and enbrel is the last option because. "it " is not being controlled and I am quite fond of my liver. And yes aggressive before too much damage is excellent but requires the end of the denial phase.
Man shows up with a 20 year single barrel, of course we let him back. But as a serious lush, (I bush the allowable limits for homebrew beer and wine in addition to the keats society) I'm very careful with my liver. That seriously was one of the reasons I moved quickly to a Biologic. The fewer DMARD's and NSAIDS that go through our bodies the better. The saftey of the biologics as opposed to others (especially predi) is a huge plus. Better disease control comes. to better than 90% within three. Over 60% get control with their first... I am convinced that the more we help out our liver, the better. that includes carbs, glutens, and most pain meds.
OBTW there isn't anything much more natural than the Biologics......
Haggis said:
Tntlamb that's very funny! But I can assure you I have never seen a real haggis let alone tried to deal with one but have had many a fun evening sampling some delicious single malts! I presume you let the man back into your society? We are all fortunate for many things and my rheumy is very good and enbrel is the last option because. "it " is not being controlled and I am quite fond of my liver. And yes aggressive before too much damage is excellent but requires the end of the denial phase.
Have decided to stick with the natural attempts to control everything.......at least for the present. Watching the reality of what has gone on with the emergent side effects of the newer ssri's for depression and the conclusion of the WHI long term studies on the erroneous touted benefits of HRT therapy have made me err on the side of caution towards anything new coming out of Big Pharma Inc.
tntlamb said:
Man shows up with a 20 year single barrel, of course we let him back. But as a serious lush, (I bush the allowable limits for homebrew beer and wine in addition to the keats society) I'm very careful with my liver. That seriously was one of the reasons I moved quickly to a Biologic. The fewer DMARD's and NSAIDS that go through our bodies the better. The saftey of the biologics as opposed to others (especially predi) is a huge plus. Better disease control comes. to better than 90% within three. Over 60% get control with their first... I am convinced that the more we help out our liver, the better. that includes carbs, glutens, and most pain meds.
OBTW there isn't anything much more natural than the Biologics......
Haggis said:
Tntlamb that's very funny! But I can assure you I have never seen a real haggis let alone tried to deal with one but have had many a fun evening sampling some delicious single malts! I presume you let the man back into your society? We are all fortunate for many things and my rheumy is very good and enbrel is the last option because. "it " is not being controlled and I am quite fond of my liver. And yes aggressive before too much damage is excellent but requires the end of the denial phase.
Oh dear. My dr was lousy too in the beginnning. If it wasnt for my MRI , I wouldnt have been diagnosed. He didnt know what was going on with me pre-MRI, and was ready to give up...the only thing we were waiting on was the MRI. He even said to me, we still have the MRI but i doubt it will show anything. so I asked him but what about my symptoms and how the foots looks....he had no idea..didnt say anything except to exercise when I was already a busy mum of 2 and volunteer dog walker, had my own dogs, walked, bike ride, and swam..so my problems were not due to lack of exercise. I was shocked he dismissed me like this..but the MRI was very helpful. And when i got called back he apologized actually and diagnosed me. Since he has been very good. Is serious about it. But unlike you, my dr did order me an MRI and I am glad he did! My MRI didnt show damage in the joints (yet but he said yes i have arthritis) and he was very concerned. My xray prior to the MRI showed only extra fluid and swelling in the ankle and it was dismissed. Suzanne Hall said:
My first Rheumy just had me take Naproxen. He did not feel my symptoms were that bad. I knew I had PSA....I had suffered from Psoriasis for years and even my dermatologist felt I had PSA, but I always got the feeling from the Rheumy that he didn't really believe me when I was describing my pain -- like it was all in my head. Unlike a lot of people I do NOT get the large swollen joints. I've had that occur only twice since I was diagnosed in 2005.
After some begging the Rheumy put me on Enbrel......Well, over time the Enbrel stopped working and I was in AGONY all the time. He told me to take an additional Naproxen each day and continue with the Enbrel. I was getting NO relief - I was exhausted, depressed and just could not focus because the pain was always there. I started doing my own research and found another Rheumy. This Rheumy asked a bunch of questions - the first being had I ever had any x-rays or MRIs done? What?!? My other Rheumy NEVER did this. Well, after a series of MRI's on my hands and feet the only way I can describe what the bones look like is "swiss cheese". The damage is horrible and I blame my first Rheumy for not taking my feelings and descriptions of my symptoms seriously.
Slowing down the disease is essential because once the damage is done it cannot be reversed. My disease took a very aggressive turn for the worse. I am now on MTX every week and I go in for Remicade infusions every 6 weeks. (I've tried all the other biologics - Humira, Simponi with and without MTX with no relief). I am exhausted ALL of the time, but I have to work. I have terrible flare-ups that occasionally need a kick in the ass with a dose of Prednisone. My doctor regulary does blood work on me and I've never had a test come back bad.
What if that first Rheumy cared more?? A lot of the preventative measure the medications were made for might have helped me.
I think an article on PsA that shares a page on how to safely trim pubic hair is an incredible resource on how to best manage a disease that goes way beyond sore joints and some erosions but attacks also every major organ in your body without your knowledege is a wonderful resource......
Why bother with years of research, schooling, studies when all you need to do is grab bits and piece off the interrnt and make a cool slide show.
Diet is a part everything but as far as natural cure? There is NOTHING that has been cured naturally, but the we have been able to succesfully eradicate one disease in the history of the world (are close on a second) We were pretty close with pertussis and measles in this country until a rival manufacturesadmitted plot spread through the internet like wildfire and convinced folks to stop immunizing their children and go natural.....
