Adaption
Jan
Glad to have found this group, it’s nice to finally get in touch with
“dbs for depression” patients. I am one of five patients (up to now)
in a study of the university hospital of Leuven, Belgium, where I was
implanted with two pairs of leads (of four electrodes each) on 29 June
2007. In spite of a number of technical problems (a.o. on 28 December
2007 one of the leads had to be replaced), a 5.5 V stimulation on one
pair of leads has had a spectacular effect on my depression since
around February 2008. Stimulation of the other pair of leads had no
effect, but it took the doctors about 4 months (and it cost me 4 more
months of depression) to find that out. In the winter of 2008-2009 I
was also subjected to a double blind study which took another 4
months, but on 24 March 2009 the successful pair of leads was
activated again and I have been well to very well since then. Not as
well as I used to be before I fell ill back in 1998, of course, but
acceptable. Since a few weeks however, the depression is gradually
coming back, together with the anxiety, the apathy, the anhedony, the
lack of energy etc. I try not to panic, but the memory of ten years of
severe depression is so terrifying... I lost almost everything I had
due to my depression: my wife left me, I lost my job, I lost most of
my friends, I couldn’t play music anymore, hardly left the house… You
all know what I’m talking about. Thanks to dbs I was able to work half-
time again; I found a wonderful new girlfriend; could go on journeys,
to festivals, etc. etc. Am I bound to lose all this again?
One of the possible causes of this relapse, I believe, is
“adaptation”: the brain “gets used” to the stimulation and the current
has to be stepped up to produce the same effect. My doctor has had to
do this once or twice in the course of the past two years. The problem
however is that brain stimulation also has side-effects, which get
worse the higher the voltage goes. In my case, the worst side-effect
is a constant feeling of agitation. And of course, there’s a limit to
how high the stimulators can go and that worries me too.
One of the possibilities I see to deal with this problem is to turn
the stimulators off for a while (a week, two weeks?) to give my brain
a chance to “normalize” and then turn them on again and see if this
creates the same effect as before. Does anyone out there have
experience with “adaptation” and turning the stimulators off to let
the brain “deadapt” for a while? I’d be glad to hear about your
experiences and suggestions. Thanks.
Jan
Rich Hayward
Nice to meet another DBS patient. I was implanted on June 12th, 2008 outside of Chicago, Illinois. I was depression free (or emotion free, I can't tell the difference) when I awoke from the surgery. I'm told that Parkinson's patients have the same experience, where just the placement of the wires into the target area of the brain resolves the issues. Unfortunately, they turned my device on and it's been a living hell ever since. At 6 months and each month thereafter they would reprogram the device and I would have an extreme emotional reaction. One month it was rage, another month mania etc. They tried drugs, but that never worked, so I would wind up going back in and have the device reprogrammed again.
Around month 14 (August), I started going through these intense emotional cycles where I would have a couple of good days (from a depressed person's viewpoint) then 4 or 5 days of worsening depression. It's impossible to explain what the last day of the cycle was like, but I've termed it "the day of insanity". On one of those days I was alone and tried to commit suicide. I went through a few more of these cycles before finally turning the thing off. The next morning all thoughts of harm or suicide were completely gone. Instead, I was extremely depressed, but that lightened over the next 2 weeks. I had 3 awesome days (by anyone's standard) and then returned to the same depression I experienced prior to the surgery. In total the device was off for 1 month.
I am currently in phase 2 of our study (4 years long supposedly), but I only go in every 6 months, so it's not like they are treating me or trying to figure out if there's a better setting for me. The device remains off, but I have been thinking about doing some experimenting on my own by turning it on for a set amount of time each day to see what happens. They had me on a 12 hour cycle at the end of the first year, so I know 12 hours is too much, but maybe 3 or 4 or 6 might produce a better result. I got the wink and a nod approval to do that when I was in for my 18 month appointment.
I found your comments on adaptation very interesting. I actually was thinking the exact opposite because it feels like the depression just rerouted itself around the wires. I was the second person in the states to get the implant and I've talked to a couple of others who were behind me and finally realized at month 12 that it wasn't going to work. I know of nobody who has had a good outcome. Maybe we're just not meant to be playing around with the emotional centers of peoples brains. I have a web site out there dedicated to depression, which keeps me busy (former programmer) if you want to check it out. www.sumthingtotalkabout.com
It was nice to hear from someone new. I know we are not the most social or communicative people around, but I know it helps to stay in touch with those who are going through the same thing, so feel free to keep in touch or if you having a bad day etc.
Rich Hayward
> Date: Mon, 11 Jan 2010 05:50:20 -0800
> Subject: Adaption
> From: jvan...@gmail.com
> To: dbs-for-d...@googlegroups.com
Hotmail: Trusted email with powerful SPAM protection. Sign up now.
Jan
Thanks for your reaction. I’m sorry to read that your depression
hasn’t lifted with dbs. The only people who fully understand what a
devastating impact TRD has on your life are TRD patients themselves,
so I think I can truthfully say that I know what you’re going through.
Thanks also for your link to Sum Thing To Talk About. I found the page
on stigma especially interesting and recognizable. Many people still
believe that the patient is responsible for his/her depression and, as
a consequence, also for his/her recovery. Even some psychologists and
the like do not always seem to realize that a major depression is a
genuine disease. A psychiatric nurse once beat the lot by suggesting
that I couldn’t be very depressed if I could be so angry. She had been
giving me the you-can-only-cure-yourself crap until I was so fed up
that I told her to cut it out (in less polite words, I must admit) and
that I would have made myself better a long time ago if that had been
in my power, “’cause I’m not the moron you seem to take me for”. She
was not amused. I got a reprimand in my weekly report and was labeled
an arrogant patient. Some psychiatric wards are worse than
kindergarten. I’ve gone through the table of contents of “Healing the
Stigma for Depression” and I will certainly read it. By the way, they
tried VNS on me back in 2004, but all it gave me was a left vocal cord
paralysis which left me with almost no voice for over a year. Now
luckily my right vocal cord compensates for the loss.
I too was depression free for about a week after my surgery due to
microscopic lesions in the target area, and my doctors assured me that
that could be a sign that electric stimulation of the same area would
have a similar effect. And it did. So I suppose I’m the first dbs for
depression patient you meet with a good outcome. Still, it’s a fragile
balance, especially with the “habituation” I wrote you about
yesterday. (I think “habituation” is a more suitable word than
“adaptation” – and “adaption” was just a typing error – but I’m not a
native speaker of English so correct me if I’m wrong.) I called my
doctor yesterday to ask her if it would be a good idea to turn the
stimulators off for a while and she thought it was definitely worth a
try. So around 4 p.m. Monday I switched off the current and within
minutes I was as depressed as I was before my surgery. It’s quite
amazing what a huge difference 2 x 5.5 V at the right spot in a
depressed person’s brain can make. This morning I switched the current
back on but at a much lower voltage, just to keep it bearable. Now I
hope that when I turn up the voltage again after a few days, the
antidepressant effect will be as great as before. I’m seeing my doctor
on Friday to discuss the result.
From what I’ve learned up to now, fine-tuning is extremely important
in the case of dbs. Some of the stimulation parameters my doctors
tried on me filled me with despair, triggered off panic attacks, gave
me nightmarish thoughts, etc. Other settings calmed me down, made me
sleepy or gave me a feeling of confidence. And all these effects
disappeared within seconds as soon as the current was lowered or
switched off. So personally, I’m pretty sure it is really possible to
influence the emotional centers of people’s brains. The problem is
that the effects are different from person to person. I only know one
other dbs patient, from the Toronto group, and her stimulator is on at
the same voltage day and night. She’s not entirely depression free,
but much better than before her surgery. So if I were you, Rich, I
would not give up and experiment with a 3, 4 or 6 hour cycle, like you
suggested yourself. I think it’s certainly worth a try and what have
you got to lose? I was a little amazed about the frequency of your
follow-up visits. For many months on end I had to go to the hospital
about every week to assess the previous week, fill out the depression
rating scales and try out new stimulation parameters. Since the final
phase of the study is over, I only have to go back for a routine
checkup every three months. But I can always see my doctor almost
immediately when things go wrong.
Take care,
Jan
On 12 jan, 00:36, Rich Hayward <rhaywar...@hotmail.com> wrote:
> Jan,
>
> Nice to meet another DBS patient. I was implanted on June 12th, 2008 outside of Chicago, Illinois. I was depression free (or emotion free, I can't tell the difference) when I awoke from the surgery. I'm told that Parkinson's patients have the same experience, where just the placement of the wires into the target area of the brain resolves the issues. Unfortunately, they turned my device on and it's been a living hell ever since. At 6 months and each month thereafter they would reprogram the device and I would have an extreme emotional reaction. One month it was rage, another month mania etc. They tried drugs, but that never worked, so I would wind up going back in and have the device reprogrammed again.
>
> Around month 14 (August), I started going through these intense emotional cycles where I would have a couple of good days (from a depressed person's viewpoint) then 4 or 5 days of worsening depression. It's impossible to explain what the last day of the cycle was like, but I've termed it "the day of insanity". On one of those days I was alone and tried to commit suicide. I went through a few more of these cycles before finally turning the thing off. The next morning all thoughts of harm or suicide were completely gone. Instead, I was extremely depressed, but that lightened over the next 2 weeks. I had 3 awesome days (by anyone's standard) and then returned to the same depression I experienced prior to the surgery. In total the device was off for 1 month.
>
> I am currently in phase 2 of our study (4 years long supposedly), but I only go in every 6 months, so it's not like they are treating me or trying to figure out if there's a better setting for me. The device remains off, but I have been thinking about doing some experimenting on my own by turning it on for a set amount of time each day to see what happens. They had me on a 12 hour cycle at the end of the first year, so I know 12 hours is too much, but maybe 3 or 4 or 6 might produce a better result. I got the wink and a nod approval to do that when I was in for my 18 month appointment.
>
> I found your comments on adaptation very interesting. I actually was thinking the exact opposite because it feels like the depression just rerouted itself around the wires. I was the second person in the states to get the implant and I've talked to a couple of others who were behind me and finally realized at month 12 that it wasn't going to work. I know of nobody who has had a good outcome. Maybe we're just not meant to be playing around with the emotional centers of peoples brains. I have a web site out there dedicated to depression, which keeps me busy (former programmer) if you want to check it out.www.sumthingtotalkabout.com
>
> It was nice to hear from someone new. I know we are not the most social or communicative people around, but I know it helps to stay in touch with those who are going through the same thing, so feel free to keep in touch or if you having a bad day etc.
>
> Rich Hayward
>
>
>
> > Date: Mon, 11 Jan 2010 05:50:20 -0800
> > Subject: Adaption
> > From: jvanma...@gmail.com
> _________________________________________________________________
> Hotmail: Trusted email with powerful SPAM protection.http://clk.atdmt.com/GBL/go/196390707/direct/01/
Jan
Thanks for your quick reaction. I’m sorry to read that your depression
hasn’t lifted with dbs. The only people who fully understand what a
devastating impact TRD has on your life are TRD patients themselves,
so I think I can truthfully say that I know what you’re going through.
Thanks also for your link to Sum Thing To Talk About. I found the page
on stigma especially interesting and recognizable. Many people still
believe that the patient is responsible for his/her depression and, as
a consequence, also for his/her recovery. Even some psychologists and
the like do not always seem to realize that depression is a genuine
disease. A psychiatric nurse once beat the lot by suggesting that I
couldn’t be very depressed if I could be so angry. She had been giving
me the you-can-only-cure-yourself crap until I was so fed up that I
told her to cut it out (in less polite words, I must admit) and that I
would have made myself better a long time ago if that had been in my
power “’cause I’m not the moron you take me for”. She was not amused,
and I got a reprimand in my weekly report and was labeled an arrogant
patient. I’ve gone through the table of contents of “Healing the
Stigma for Depression” and I will certainly read it. By the way, they
tried VNS on me back in 2004, but all it gave me was a left vocal cord
paralysis which left me with almost no voice for over a year. Now
luckily my right vocal cord compensates for the loss.
I too was depression free for about a week after my surgery due to
microscopic lesions in the target area, but my doctors told me that
that could be a sign that electric stimulation of the same area would
have a similar effect. And it did. So I suppose I’m the first dbs for
depression patient you meet with a good outcome. Still, it’s a fragile
balance, especially with the “habituation” I wrote you about
yesterday. (I think “habituation” is a more suitable word than
“adaptation”, but I’m not a native speaker of English so correct me if
I’m wrong.) I called my doctor yesterday to ask her if it would be a
good idea to turn the stimulators off for a while and she thought it
was definitely worth a try. So yesterday around 4 p.m. I switched off
the current and within minutes I was as depressed as I was before my
surgery. It’s quite amazing what a huge difference 2 x 5.5 V at the
right spot in your brain can make. This morning I switched the current
back on but at a much lower voltage, just to keep it bearable. Now I
hope that when I will turn up the voltage again after a few days, the
antidepressant effect will be as great as before. I’m seeing my doctor
on Friday to discuss the result.
From what I’ve learned up to now, the fine-tuning is extremely
important in the case of dbs. Some of the stimulation parameters my
doctors tried on me filled me with despair, triggered off panic
attacks, gave me nightmarish thoughts, etc. Other settings calmed me
down or made me sleepy. And all these effects disappeared within
seconds as soon as the current was lowered or switched off. But the
effects are probably different from person to person. I only know one
other dbs patient, from the Toronto group, and her stimulator is on at
the same voltage day and night. She’s not entirely depression free but
much better than before her surgery. So if I were you, Rich, I would
not give up and experiment with a 3, 4 or 6 hour cycle, like you wrote
yesterday. I was a little amazed about the frequency of your follow-up
visits. For many months on end I had to go to the hospital every week
to assess the previous week by means of several depression rating
scales and to try out new stimulation parameters. Since the final
phase of the study, I only have to go back for a routine checkup every
three months. But I can always see my doctor within days when things
go wrong.
Take care,
Jan
On 12 jan, 00:36, Rich Hayward <rhaywar...@hotmail.com> wrote:
> Jan,
>
> Nice to meet another DBS patient. I was implanted on June 12th, 2008 outside of Chicago, Illinois. I was depression free (or emotion free, I can't tell the difference) when I awoke from the surgery. I'm told that Parkinson's patients have the same experience, where just the placement of the wires into the target area of the brain resolves the issues. Unfortunately, they turned my device on and it's been a living hell ever since. At 6 months and each month thereafter they would reprogram the device and I would have an extreme emotional reaction. One month it was rage, another month mania etc. They tried drugs, but that never worked, so I would wind up going back in and have the device reprogrammed again.
>
> Around month 14 (August), I started going through these intense emotional cycles where I would have a couple of good days (from a depressed person's viewpoint) then 4 or 5 days of worsening depression. It's impossible to explain what the last day of the cycle was like, but I've termed it "the day of insanity". On one of those days I was alone and tried to commit suicide. I went through a few more of these cycles before finally turning the thing off. The next morning all thoughts of harm or suicide were completely gone. Instead, I was extremely depressed, but that lightened over the next 2 weeks. I had 3 awesome days (by anyone's standard) and then returned to the same depression I experienced prior to the surgery. In total the device was off for 1 month.
>
> I am currently in phase 2 of our study (4 years long supposedly), but I only go in every 6 months, so it's not like they are treating me or trying to figure out if there's a better setting for me. The device remains off, but I have been thinking about doing some experimenting on my own by turning it on for a set amount of time each day to see what happens. They had me on a 12 hour cycle at the end of the first year, so I know 12 hours is too much, but maybe 3 or 4 or 6 might produce a better result. I got the wink and a nod approval to do that when I was in for my 18 month appointment.
>
> I found your comments on adaptation very interesting. I actually was thinking the exact opposite because it feels like the depression just rerouted itself around the wires. I was the second person in the states to get the implant and I've talked to a couple of others who were behind me and finally realized at month 12 that it wasn't going to work. I know of nobody who has had a good outcome. Maybe we're just not meant to be playing around with the emotional centers of peoples brains. I have a web site out there dedicated to depression, which keeps me busy (former programmer) if you want to check it out.www.sumthingtotalkabout.com
>
> It was nice to hear from someone new. I know we are not the most social or communicative people around, but I know it helps to stay in touch with those who are going through the same thing, so feel free to keep in touch or if you having a bad day etc.
>
> Rich Hayward
>
>
>
> > Date: Mon, 11 Jan 2010 05:50:20 -0800
> > Subject: Adaption
> > From: jvanma...@gmail.com
> _________________________________________________________________
> Hotmail: Trusted email with powerful SPAM protection.http://clk.atdmt.com/GBL/go/196390707/direct/01/
Jan
Thanks for your reaction. I’m sorry to read that your depression
hasn’t lifted with dbs. The only people who fully understand what a
devastating impact TRD has on your life are TRD patients themselves,
so I think I can truthfully say that I know what you’re going through.
Thanks also for your link to Sum Thing To Talk About. I found the page
on stigma especially interesting and recognizable. Many people still
believe that the patient is responsible for his/her depression and, as
a consequence, also for his/her recovery. Even some psychologists and
the like do not always seem to realize that depression is a genuine
disease. A psychiatric nurse once beat the lot by suggesting that I
couldn’t be very depressed if I could be so angry. She had been giving
me the you-can-only-cure-yourself crap until I was so fed up that I
told her to cut it out (in less polite words, I must admit) and that I
would have made myself better a long time ago if that had been in my
power, “’cause I’m not the moron you seem to take me for”. She was not
amused. I got a reprimand in my weekly report and was labeled an
arrogant patient. I’ve gone through the table of contents of “Healing
the Stigma for Depression” and I will certainly read it. By the way,
they tried VNS on me back in 2004, but all it gave me was a left vocal
cord paralysis which left me with almost no voice for over a year. Now
luckily my right vocal cord compensates for the loss.
I too was depression free for about a week after my surgery due to
microscopic lesions in the target area, but my doctors told me that
that could be a sign that electric stimulation of the same area would
have a similar effect. And it did. So I suppose I’m the first dbs for
depression patient you meet with a good outcome. Still, it’s a fragile
balance, especially with the “habituation” I wrote you about
yesterday. (I think “habituation” is a more suitable word than
“adaptation”, but I’m not a native speaker of English so correct me if
I’m wrong.) I called my doctor yesterday to ask her if it would be a
good idea to turn the stimulators off for a while and she thought it
was definitely worth a try. So around 4 p.m. Monday I switched off the
current and within minutes I was as depressed as I was before my
surgery. It’s quite amazing what a huge difference 2 x 5.5 V at the
right spot in your brain can make. This morning I switched the current
back on but at a much lower voltage, just to keep it bearable. Now I
hope that when I turn up the voltage again after a few days, the
antidepressant effect will be as great as before. I’m seeing my doctor
on Friday to discuss the result.
From what I’ve learned up to now, fine-tuning is extremely important
in the case of dbs. Some of the stimulation parameters my doctors
tried on me filled me with despair, triggered off panic attacks, gave
me nightmarish thoughts, etc. Other settings calmed me down, made me
sleepy or gave me a feeling of confidence. And all these effects
disappeared within seconds as soon as the current was lowered or
switched off. So personally, I’m pretty sure it is possible to
influence the emotional centers of people’s brains. The problem is
that the effects are different from person to person. I only know one
other dbs patient, from the Toronto group, and her stimulator is on at
the same voltage day and night. She’s not entirely depression free,
but much better than before her surgery. So if I were you, Rich, I
would not give up and experiment with a 3, 4 or 6 hour cycle, like you
wrote yesterday. I think it’s certainly worth a try and what have you
got to lose? I was a little amazed about the frequency of your follow-
up visits. For many months on end I had to go to the hospital about
every week to assess the previous week, fill out the depression rating
scales and try out new stimulation parameters. Since the final phase
of the study is over, I only have to go back for a routine checkup
every three months. But I can always see my doctor within days when
things go wrong.
Take care,
Jan
On 12 jan, 00:36, Rich Hayward <rhaywar...@hotmail.com> wrote:
> Jan,
>
> Nice to meet another DBS patient. I was implanted on June 12th, 2008 outside of Chicago, Illinois. I was depression free (or emotion free, I can't tell the difference) when I awoke from the surgery. I'm told that Parkinson's patients have the same experience, where just the placement of the wires into the target area of the brain resolves the issues. Unfortunately, they turned my device on and it's been a living hell ever since. At 6 months and each month thereafter they would reprogram the device and I would have an extreme emotional reaction. One month it was rage, another month mania etc. They tried drugs, but that never worked, so I would wind up going back in and have the device reprogrammed again.
>
> Around month 14 (August), I started going through these intense emotional cycles where I would have a couple of good days (from a depressed person's viewpoint) then 4 or 5 days of worsening depression. It's impossible to explain what the last day of the cycle was like, but I've termed it "the day of insanity". On one of those days I was alone and tried to commit suicide. I went through a few more of these cycles before finally turning the thing off. The next morning all thoughts of harm or suicide were completely gone. Instead, I was extremely depressed, but that lightened over the next 2 weeks. I had 3 awesome days (by anyone's standard) and then returned to the same depression I experienced prior to the surgery. In total the device was off for 1 month.
>
> I am currently in phase 2 of our study (4 years long supposedly), but I only go in every 6 months, so it's not like they are treating me or trying to figure out if there's a better setting for me. The device remains off, but I have been thinking about doing some experimenting on my own by turning it on for a set amount of time each day to see what happens. They had me on a 12 hour cycle at the end of the first year, so I know 12 hours is too much, but maybe 3 or 4 or 6 might produce a better result. I got the wink and a nod approval to do that when I was in for my 18 month appointment.
>
> I found your comments on adaptation very interesting. I actually was thinking the exact opposite because it feels like the depression just rerouted itself around the wires. I was the second person in the states to get the implant and I've talked to a couple of others who were behind me and finally realized at month 12 that it wasn't going to work. I know of nobody who has had a good outcome. Maybe we're just not meant to be playing around with the emotional centers of peoples brains. I have a web site out there dedicated to depression, which keeps me busy (former programmer) if you want to check it out.www.sumthingtotalkabout.com
>
> It was nice to hear from someone new. I know we are not the most social or communicative people around, but I know it helps to stay in touch with those who are going through the same thing, so feel free to keep in touch or if you having a bad day etc.
>
> Rich Hayward
>
>
>
> > Date: Mon, 11 Jan 2010 05:50:20 -0800
> > Subject: Adaption
> > From: jvanma...@gmail.com
> _________________________________________________________________
> Hotmail: Trusted email with powerful SPAM protection.http://clk.atdmt.com/GBL/go/196390707/direct/01/
Jan
that it wasn’t published. Second try.
Hi Rich,
Take care,
Jan
> Jan,
>
> Nice to meet another DBS patient. I was implanted on June 12th, 2008 outside of Chicago, Illinois. I was depression free (or emotion free, I can't tell the difference) when I awoke from the surgery. I'm told that Parkinson's patients have the same experience, where just the placement of the wires into the target area of the brain resolves the issues. Unfortunately, they turned my device on and it's been a living hell ever since. At 6 months and each month thereafter they would reprogram the device and I would have an extreme emotional reaction. One month it was rage, another month mania etc. They tried drugs, but that never worked, so I would wind up going back in and have the device reprogrammed again.
>
> Around month 14 (August), I started going through these intense emotional cycles where I would have a couple of good days (from a depressed person's viewpoint) then 4 or 5 days of worsening depression. It's impossible to explain what the last day of the cycle was like, but I've termed it "the day of insanity". On one of those days I was alone and tried to commit suicide. I went through a few more of these cycles before finally turning the thing off. The next morning all thoughts of harm or suicide were completely gone. Instead, I was extremely depressed, but that lightened over the next 2 weeks. I had 3 awesome days (by anyone's standard) and then returned to the same depression I experienced prior to the surgery. In total the device was off for 1 month.
>
> I am currently in phase 2 of our study (4 years long supposedly), but I only go in every 6 months, so it's not like they are treating me or trying to figure out if there's a better setting for me. The device remains off, but I have been thinking about doing some experimenting on my own by turning it on for a set amount of time each day to see what happens. They had me on a 12 hour cycle at the end of the first year, so I know 12 hours is too much, but maybe 3 or 4 or 6 might produce a better result. I got the wink and a nod approval to do that when I was in for my 18 month appointment.
>
> I found your comments on adaptation very interesting. I actually was thinking the exact opposite because it feels like the depression just rerouted itself around the wires. I was the second person in the states to get the implant and I've talked to a couple of others who were behind me and finally realized at month 12 that it wasn't going to work. I know of nobody who has had a good outcome. Maybe we're just not meant to be playing around with the emotional centers of peoples brains. I have a web site out there dedicated to depression, which keeps me busy (former programmer) if you want to check it out.www.sumthingtotalkabout.com
>
> It was nice to hear from someone new. I know we are not the most social or communicative people around, but I know it helps to stay in touch with those who are going through the same thing, so feel free to keep in touch or if you having a bad day etc.
>
> Rich Hayward
>
>
>
> > Date: Mon, 11 Jan 2010 05:50:20 -0800
> > Subject: Adaption
> > From: jvanma...@gmail.com
> _________________________________________________________________
> Hotmail: Trusted email with powerful SPAM protection.http://clk.atdmt.com/GBL/go/196390707/direct/01/