The Skinny on Diabetes

Type 1 diabetes is an autoimmune disorder, meaning that the body’s immune system attacks its own pancreas affecting its ability to produce insulin; this usually happens at a young age.  In this case scenario, insulin has to come into your body from outside a good example of which is an insulin pump.  FYI not all autoimmune disorders happen at a young age.

Type 2 diabetes is a different ball game.  Contrary to the popular belief, increased sugar consumption doesn’t cause type 2 diabetes.

Just because type 2 diabetes is linked to high levels of blood sugar, it may seem logical to assume that eating too much sugar is the cause of diabetes.  However, it’s not that simple.  High-sugar diet can increase the risk of developing diabetes but doesn’t directly cause it.  There is no proven link between the two.   By analogy, driving on the road can increase your risk for an accident but a mere fact of driving doesn’t cause it.

What happens with type 2 is that people develop insulin resistance.  Here’s how it works.  When you consume sugar, it attaches to hemoglobin that delivers it to your body cells to be used for energy.  Think about insulin as a key to open the door (of a cell) to let glucose in.  In case of insulin resistance the door won’t open and glucose can’t get in.  As a result, glucose builds up in the bloodstream instead of being absorbed by the cells.

It is believed that excess weight and physical inactivity largely contribute to the insulin resistance.  Genetics play a role, as well.

How type 2 diabetes is diagnosed:  A1C test   A1C test kit

A1C is a widely used test to diagnose type 2 diabetes. It is also called HbA1C or glycated hemoglobin test.  Hemoglobin is a substance found in the red blood cells which carry oxygen throughout your body.  When blood sugar level is elevated, sugar combines with hemoglobin making it “glycated” in which case scenario A1C test shows an elevated number.  This test is being used to show how well your diabetes is being controlled.  Since red blood cells live up to 3 months, this test should be at this interval.   This very test was used to diagnose my type 2 diabetes.

For people without diabetes, the normal range for the A1C test is between 4% and 5.6%.  A1C levels between 5.7% and 6.4% indicate increased risk of diabetes and levels of 6.5% or higher indicate diabetes.  The goal for people with diabetes is a A1C level less than 7%.  The higher the A1C number is, the higher the risks of developing diabetes-related complications.


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1.  DISCLAIMER

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Posted in A1C, About diabetes, blood sugar, diabetes, diet, Health, insulin resistance | Tagged , , , , , , , , , , , , , , | 23 Comments

Brown fat, cold weather and diabetes

About a week ago my morning fasting BG was a whopping 118; I couldn’t believe it. Thinking that it must have been a bad strip or a glitch of sorts, I rechecked and it was about the same. Ditto for the postprandial BG that I usually don’t check.

I was baffled. How come? C’mon now, I didn’t eat anything I wasn’t supposed to. I didn’t do absolutely anything to cause this. Where did this come from? In an instant I could foresee diabetes meds in my near future. Oh no, not me.

I turned to the internet and after a bit of googling found out that it could be the cold weather to blame. A number of websites including Healthline report a higher A1C as well as more people diagnosed with diabetes in the colder months.  What’s more, diabetes is more common in European countries that in say, Africa or South America, because it’s colder up north in Europe. And there is a reason for it. It all has to do with the brown fat and adaptation to cold.

Back in the prehistoric days, says Healthline, our ancestors lived in constant freezing temperatures. For that reason, they had lots of brown fat so they could have become insulin resistant to raise blood sugar as well as raise the freezing point of their bodies, while at the same time giving their brown fat plenty of fuel to keep them warm. As brown fat plays a role in glucose control, their BG levels never reached critical levels, so they were able to survive.

Now this starts making sense. I knew it wasn’t me, I just knew it. And now turns out that it was the cold weather to blame.

In the next day when the weather warmed up a bit, my fasting number was 105. And then a 100.

That’s more like it. I don’t check my fasting BG every day. I do it about once or twice a week. Looking back at my records, I noticed that the numbers in the winter time are around 100, while at summer they are typically in the mid 90s.

Oh well. You live and learn.

Posted in blood glucose, diabetes, diabetes management | Tagged , , , | 4 Comments

Blue Light Eye Opener

The reason I’m saying this is because I am the last person on earth to have learned about the mere existence of a blue light. My (now former) eye doctor didn’t utter a word about it, either for lack of knowledge or who knows why. Up until searching the net, I was clueless. And discovered the blue light while searching how to manage my CAT. For those unfamiliar, CAT is my own abbreviation for the cataract that I blogged about earlier.  I am far more comfortable with a short form rather than spelling it all out. Yikes.

Our eyes are vulnerable things, and usually we take the ability to see for granted. However, a matter as trivial as looking at a computer screen while blogging away can do much harm, and not only to the eye lenses but to the retina as well. The latter can result in macular degeneration, one of the leading causes of blindness. Contrary to the popular belief, not caused by diabetes but by exposure to the blue light. This is according to the All About Vision website but not an eye doctor?  Unbelievable.  Smh

To deal with the blue light, you need to find some ways to block it. Enter blue light blockers (eyeglasses), whether with magnification or not. Yes, they do exist. Not sure that my now former eye doctor was even aware about it. But now I know, bingo. Long lives internet.

Off I went to buy said glasses. This took some time and lots of googling. The choices are endless to send my head spinning. There are distance eyeglasses, readers, sunreaders, of course blue light blockers and countless combinations of all to boot. And if this wasn’t enough, there are literally tons of features to consider.

After you hopefully figured out what you want, you have to make sure that your new glasses are a good fit. Welcome to a virtual fitting room for lack of a better word. Roll up your sleeves and measure the following using your existing glasses as a template. I’m talking about things like lens height and width, ditto for the frame; add a bridge width and an arm length to the mix, and with a little bit of luck you will get the picture.

After looking high and low on the net, I came across this wonderful website that describes the eyeglass frames in great detail. Eye Heart, based in California.

1. eye heart

Image Source: EyeHeart.com

Found this one on the Amazon website:

2. measurements

Image Source: Amazon.com

I have ended up with a pair of Eyekepper reading glasses from Amazon that are only slightly amber tinted therefore provide only about 20% blue light protection. I really wanted more protection, something that Uvex glasses would provide, and I don’t really care if I see everything amber tinted.

As long as I know that my eyes are protected, this is all that matters. Uvex glasses unfortunately don’t come with magnification. Besides, turned out that most folks (buyers) don’t like too much of an amber tint therefore Eyekepper doesn’t make them this way, so I am currently putting up with the less protection. Still better than nothing.

The Eyekepper glasses came in a nice zipped hard case that did wonders to having things organized. Now I know exactly where my beautiful blue light blockers are instead of looking up all over the place, oh where did I put the darn glasses? No more.

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But you know what? Since wearing these glasses, I started sleeping at night. You hear this from a non-believer as I have always thought that the melatonin production in relation to the blue light blockers eyeglasses is nothing but a sales pitch. But have to admit, I was wrong. You know how easy it is to admit your wrong? Yea right. This is exactly where I am right now.

Zzzz

I have learned to sit about 20 inches away from the screen, use ambient light when the  room is dark and nothing but a TV or a computer is on, as well as take breaks from sitting by the screen. Perfect time to do some chores waiting on the back burner to eventually get done. Such as bringing my shower curtain liner back to life. Here’s to hoping that all this will help me to buy more time being able to see.

 

UPDATE: after all said and done, I went on browsing WordPress for the similar posts and found this gem. Here now, Helen Hayward is talking about a certain eye exam that her doctor was unaware of. No kidding! Perhaps we should set up a society of the eye doctors who lack in knowledge… something like that.

Read her post here:  blue light

Posted in Blue light, cataract, How to buy eyeglasses, Uncategorized | Tagged , , , , , , | 2 Comments

My CAT

No am I not talking about a kitty cat.  In this post I want to cover cataracts.  I really don’t like this word; sounds like something creepy straight out from Halloween walking around… can’t even describe. I would much rather use the first three letters and call it CAT (all caps on purpose).

In a nutshell, CAT is a cloudy area in the eye lens. The lens is located in the front part of the eye, right behind the iris.  Normally when the lens is clear, the light enters the eye through said lens and focuses a clear image on the retina, much like a camera does. When however lens is cloudy (or you jerk the camera), the image goes blur. Uh oh.

Here is what our eyes are made of.

See the lens?  There is a nucleus right smack in the middle of it.  Not seen in this picture but trust me, it is there.  Will come back to this later when I describe the types of a CAT.

I first learned about having a CAT about a year or two ago.  Based on the fact that I am still able to see, I assume that mine is a slowly developing kind.  Likely a result of a lifelong sun exposure.  Once I learned that, all my going to the beach flashed in front of me, and I wanted to beat myself up.  Not that it would help any.  But the good news is, this probably is not diabetes related.  Actually my diabetes is under control now.  This morning my fasting number was 94.

IMG_1015-001

As my eye doctor was silent about the details of my CAT, naturally I turned to the internet.  And came across this great website, VisionAware that describes the CAT types in great detail.

There are three types of a CAT.  And contrary to the popular belief, not all of them are caused by diabetes.  If you however do a google search for causes of a CAT, the first two that pop up are older age and, you guessed it, diabetes. This sounds almost politically correct, however is not always true.  There are other reasons including trauma, inflammation and certain meds; and CAT can also happen to babies or older kids with no diabetes in sight.

The first type is a Nuclear CAT.  Remember nucleus inside the lens?  This is it. Exactly the part that gets damaged.  Nucleus begins to harden, and when that happens, the trouble begins yet progresses slowly and silently (without symptoms) for many years before it begins to actually affect vision.

Traditionally and not surprisingly, Nuclear CAT is associated with aging.  However merely growing older does not cause CATs.  The damage begins when one is still fairly young but then the CAT is relatively small and doesn’t affect vision, hence is not detected.  Only later on when it does affect vision, you see your doctor and receive the breaking news.  Of course  the jury is out on this one and you can find plenty of different opinions on the net. But I believe this is exactly what happens and the developing of a CAT is not necessarily age-related.  YMMV.

Then there is a Cortical CAT.  It affects the cortex, or outside edge of the lens, where the white cloudy areas (opacities) develop.  Those of us with diabetes are at risk for this type of a CAT.

The third one affects the back part of the eye and is called Posterior CAT.  Posterior means the back of the eye which is where cloudy or opaque area form.  Those of us who are on steroids or having diabetes are at risk.

These three are basic types.  There is a small bunch of subtypes of each but I don’t want to go there.  Too complicated.

All said and done, you might start thinking that CATs happen to the older folks only. Oh well, this isn’t always true.  Sometimes babies are born with it, or the older kids develop it, for a number of reasons, including genetics.  It’s called congenital CAT, or childhood / juvenile CAT. If a surgery is needed which is not always the case, it can be done as early as at six weeks of age.

Done with the CAT, next thing I’ll be talking about some eye protection that deserves its own post.

Did you notice?  You type the word cataract with left hand only, let alone CAT.

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Disputing Medical Bill

This is a sequel to my previous post, Diabetic Eye Exam.  In summary, I was billed for an eye test that was never done, under the disguise of a Refraction Test.  And now I’m trying to dispute said bill.

I heard tons of success stories on the net about disputing medical bills, however mine is not one of them.  It seems crystal clear that I was billed for a procedure never done, acuity test was done against my wishes and in violation of Informed Consent…  but that’s about it.  I’m stuck with paying the bill regardless.

I tried going the complaint route anyway and filed an Appeal with my insurance company.  Turned out this isn’t an appeal but a grievance, hence off it goes to the next department over.   Am still waiting to hear from  them

Next was an appeal with the doctor’s office within 30 days; am still waiting for the response which is pretty much to be expected.

State Medical Board was my next step, with the same net results so far.  I have neatly summarized everything into about 3/4 of a Word page and submitted by email.  Much to my surprise, my complaint was accepted.  What happens here, remains to be seen but likely not much.

I have ended up paying the bill as to avoid problems with the credit and to keep my 800 score.  It took the Billing full two weeks to deposit the check so I had to start an inquiry with the bank in the meantime.  All said and done, it goes without saying that I will not set my foot in this doctor’s office for the rest of my natural life.

All in all, I was given a test that I did not need nor want but was billed regardless while not a word about managing a current condition, a cataract that I was diagnosed with in this very office a year or two prior.  None, zero, zilch, nada.

I turned to the internet, and found out about three types of a cataract as well a plethora of information that the doctor didn’t utter a single word about.  Will cover this in the next post.

While I still have no clue about the extent of a damage, turned out that I can do a few ounces of prevention.  Found out I have to wear sunglasses in any weather, even when the skies are overcast.  And blue light blocking glasses when I am surfing the net.  This was the first time I ever heard about blue light blocking. Done, bought a pair on Amazon.  The lens have yellow tint to them so some colors are off but I can live with that.  These provide great protection being practically wraparound and the frame is flexible so I can wear them on top of the readers.  Will write more about blue light blocking later on.    Here they are, my Uvex Blue Light Blockers. Great price to boot, under $10.

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This is a pair of sunreaders (a combination of sunglasses and readers) that I found on my last going to a local Dollar Tree.

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Here’s to hoping that all this will buy me more than “a couple of years” quoted.  Isn’t that something that I had to find all this on the Internet, Facebook, Amazon as well as a few other sites, and of course, the Dollar Tree.  But not from my eye doctor!  The latter is apparently too much surgery oriented, because this brings in the $$.

It goes without saying that I won’t set my foot in this doctor’s office for the rest of my natural life.  Will see someone else next year, and this time I will know better what is covered and what is not, what to ask about and what to watch for.

P.S.  I am the last person on earth to have learned that Diabetic Eye Exam is covered in full.  The same thing took place a year or two prior when I just paid what I thought was a Specialist Copay. Now I know better.  You live and learn.

On the other hand, had I just paid the $$ and moved on without doing anything else, I would have never learned what I know now.  Will cover this later on.  Stay tuned.

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Diabetic Eye Exam

This exam is all about testing the eye pressure, also known as a dilated eye exam.  A yellow potion is dropped into your eyes and the pressure is measured.  Then the eyes are rinsed and off you go on your merry way.  This is covered in full by Medicare.  So far so good.

I’ve been there, done that, came in for the Diabetic Eye Exam.  But first the doctor wants to do a Visual Acuity Test.  What in the world for?  The good doctor says, this is standard and yes, it is covered by your insurance.  Next I found myself looking at a chart from a distance, one eye at a time, and reading the letters.  My protests were ignored. C’mon now, I don’t need advices with the eyeglasses as I don’t wear them, and am buying my readers at the Dollar Tree. I told you all this the last time when I saw you a year or two ago, remember?  The doc ignored my pleas and handed a prescription for the eyeglasses anyway.  Tried refusing, to no avail.  He goes, just take it.

I am back in the chair, a yellow concoction goes into my eyes and the pressure is measured.  The verdict, no diabetes related problems.  How about my cataract, diagnosed on the previous visit?  I had to ask about that or else it won’t be addressed.  Doctor pretty much matter of factly states that I have a couple of years.  C’mon now.  A couple years before I go blind?  What’s the extent of a damage?  But no more comments and off I go home.

By the way, some doctors have a way of delivering the breaking news.  have a penchant for this as something strikingly similar happened when I was first diagnosed with diabetes.

Turned out my eyes were not rinsed enough and the driving proves a challenge.  So I pulled into the nearest parking lot, opened the trunk and retrieved a water spray bottle along with a spare box of Kleenex.  This helped although following the rinsing, the Kleenex came out all yellow.  This rinsing should have been done back at the doctor’s office, as far as I am concerned.  Oh well. Had to manage on my own.  It took a few hours for the yellow drops effect to completely wear off.

A week later – surprise, surprise – a bill for $50 comes my way.  Upon calling the Billing I am told this is for the Refraction Test.  But it wasn’t done?  My protests fall on deaf ears. Other than Acuity Test and Dilated Eye, none other tests were done. The Acuity Test by the way, is traditionally done at renewing the driver’s license.  And the real Refraction Test uses a computerized tool called Phoropter.  The latter was never done, and the former was called the wrong name as this brings in the $$.

This is how Phoropter looks like:

Phoropter

To be continued.  Stay tuned.

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I saw a hand surgeon today

10 Oct 1 PIC

First off, my hands are crooked, especially the right one, thanks to Rheumatoid Arthritis. So I secured a referral from my PCP doctor and went to see a Hand Surgeon today. I went in with the high hopes as I heard good things about this particular doctor, that he could do something close to a miracle.

Not so fast.

Xrays taken, I am being whisked to another room, am sitting tight and waiting.  An assistant peeks in and asks if I am in pain, and off on his merry way. He seems to be in a big hurry, didn’t take my vital signs or asked more questions that I thought was a given but not a problem.

In comes a lady wearing a white gown of sorts and asks how I am. I am like, I am here to see a doctor so-and-so, and who are you?  Then she confesses to being a resident, and proceeds asking questions.  Mind you, it’s one of the Health Centers of Cleveland Clinic, hence the red tape. I told her that I would much rather see a doctor sooner than later. Argh, this is exactly what I hate about big places with the big red tapes.

Finally the hand doctor comes in, takes a look at my hands and delivers the news. Not of a good variety. Basically he says that a surgery won’t help in that it’ll limit my range of motion.  This coupled with a fact that I am not in pain, played into him not recommending surgery.  End of story.

I was crushed. I was having high hopes and in a matter of minutes they were poof, gone. My whole world came crumbling down. Maybe he is right but I am at the receiving end. Oh well. I went home feeling pretty much hopeless and gloomy. Life however goes on, and so is the street traffic. I went out a different way than I went in, took chances with an unfamiliar exit from the parking lot and ended up going the right way after all.

On my way home stopped for a grocery shopping and splurged on a few things, which is something I usually don’t do. But now it didn’t matter. Nothing matters. My hands are doomed to be crooked for the rest of my life, so what’s the point in saving a few bucks?

Came home, googled a bit. Found out that the doctor was actually talking about a joint fusion. There is however an option of a joint replacement, but I likely won’t do it. Will sit tight and wait, maybe something else pops up. A new procedure, a new technology. C’mon now, this is the 21st century, after all.

There’s still a glimpse of a hope (I think).  Thanks for the ear, my dear readers.

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What happened to my morning fasting BG

Lately it’s been around 100, give or take. I however found out that the variations have to do with sleeping or not for the full 8 hours at night. Yesterday someone texted me at 4 am which woke me up, and I just couldn’t go back to sleep. So I slept a total of about 4 or 5 hours. I checked my fasting BG anyway and boom, 115. Oh no.

I know for a fact that I haven’t done anything to cause this disaster. Not that I had tons of sweets; I actually did everything by the book, so it must have been something else. Most likely lack of sleep.

In the day before, my morning fasting number was 101. And today, 97. My phone is set to silent from now on.

9 Sept 9. IMG_0331

If only someone invented self-cleaning shower liners, my life would be nearly perfect

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The Journey of a Test Strip — where to buy them.

Where do you buy your strips? This is the question of the day.  Actually not exactly a question but I was at a loss how else to word it. Am still recovering from a shock at hearing local drugstore prices.

Of course you can buy them anywhere and pay through the roof as I just discovered. I was quoted a price over $50 for a 50-count bottle at a local pharmacy. And that is my insurance co-pay. At first I thought I didn’t hear it right and asked again. The pharmacist wasn’t a bit surprised and repeated, $57.99 after some discount whatever that means.

I briefly stopped by at the Rite-Aid site that of course follows the suit in terms of prices.  Since my brand has no reviews and I am a review junkie, I tried to leave one. I said that these strips are grossly overpriced and that off I’m going to the greener pastures with reasonable prices. Predictably enough, this review was moderated for violation of some terms.

I still have one good bottle of 50-ct test strips to go; it expires in October. But now that I was done with all the local pharmacies, I turned to the online sources.

eBay was my first stop. There are some good prices, however few and far between, and then there are some sky high ones. An expiration date remains a gray area and more often than not is not stated. The excuse is that even though the strips did expire, they are still good. The others make a sweeping statement that the strips don’t expire because they are not medication. Really.

Here now, see for yourself:  8 Aug 27. not medication

You need to exercise quite a bit of a due diligence here. I blogged about this yesterday. The strips do expire because they contain enzymes (proteins).  The above strips turned out to have expired last year.

My next stop was Amazon. You can find reasonable prices here, expiration date isn’t posted but I hope it’ll be within the range. I would rather shop for the strips here as I’m buying a gift card at a local grocery store for which I get gas discounts and double points on my credit card that I redeem as a statement credit.

Here now, meet my shopping cart.  Isn’t it lovely?  No bidding and no hassle.

8 Aug 27. Amz shopping cart

Walmart is still on my list as they carry budget test strips. Such as Reli-On, OneTouch and FreeStyle, all are priced rather nicely. OneTouch strips however can get slightly complicated; will cover this later.

And then I came across this gem. Can you believe it? Accu Chek sells the strips on their site with or without a prescription. 8 Aug 27. PRICES on A site

Home delivery is available with the subscription, and naturally, the more you buy, the less you pay per unit. Delivery frequency is between one and six months and the limit is set to six 50-ct strip vials per home delivery order. Subscriptions are available in one-, two-, three- or six-month intervals, and can be canceled any time or so they say. The expiration dates are guaranteed for six months as per email. Wow.  This one definitely took my breath away.

I still don’t get it how come that the strips are available from the manufacturer at rock bottom prices while the drugstores charge through the roof. An unbelievable overhead.

To be continued. I am not quite done yet.

Posted in diabetes, diabetes management, Prices, test strips, Uncategorized | Tagged , , , , , , | 1 Comment

The Journey of a Test Strip

I am of course talking about diabetic test strips that I use on a daily basis.   First off, a bit of history.

Test strips and meters likewise are an important part of managing diabetes at home. Nowadays we take them for granted but it wasn’t always this way. Imagine having to do this in a lab and then wait for the results, reportedly ready in a few hours but I bet in my case it would be a few days easily. Then the first meters came into the play. They were bulky, required a few steps and were difficult to use.

The modern meters are easy to use but the strips come with a caveat. They have an expiration date, and I wouldn’t take chances using the ones that have said date in the past. Of course the jury is out as far as strips accuracy or effectiveness but I’m not into this right now. Anyway, the test strips appear to the be the most controversial of all. I am not on insulin or any diabetes medications so can’t comment about effectiveness of the strips related to this. In this post I will discuss the expiration date and the price.

Just how important the expiration date is, is described in detail on the Healthline site.  In regards to the test strips, it is compared to milk.  Apparently it’s not that simple and lots of other variables come into play. With milk, it depends on a brand name, how far it’s been transported and where from etc. Which reminds me of buying a Chobani Greek Yogurt that turned out all mushy and runny; possibly due to the storage problems. After having contacted the manufacturer, I received two coupons for this very product. But I digress.

Back to the test strips. Possibly the milk analogy applies to the test strips just as well, but I wouldn’t take chances with either one. And yes, contrary to some folks’ popular belief, test strips expiration dates do exist. Let’s take a closer look into it.

What makes the strips work?

The little strips despite looking pretty dry, in fact contain enzymes and chemicals. Enzymes being essentially proteins, do expire. So for example if you take nutritional supplement that has past due expiration date, it just won’t be as effective. However it is crucial with the BG test strips, especially for those on insulin.

Of course, the price comes into equation, especially for those whose insurance policy puts limits on the amount of strips per month.

Where oh where do you buy your strips? Will discuss this in the next post. Stay tuned.

And by the way, today my fasting number was 101

8 Aug 26. 101, part 1

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Diabetes is unforgiving

It won’t allow a single misstep. No simple carbs means just that which I found out the hard way when enjoying regular Mountain Dew last month. With it being a lemon-lime flavor, it didn’t even taste like an old Mountain Dew was but tasted like heaven regardless.

Eventually it went down to 114, but went up briefly once again when my computer crashed and had BSOD. My carbs schedule was disrupted for awhile but diabetes doesn’t care.

Now I’m back to watching my carbs, and this morning my fasting number was 106. Woo-hoo! This made my day.

8 Aug 18. 106

 

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