Vitamin D3 and ALS (Lou Gehrig’s Disease)

Vitamin D3 Supplements May Help Slow ALS (Lou Gehrig’s Disease)

According to one of several studies unveiled at the Annual Meeting of the American Academy of Neurology, mixed in between a pair of studies further confirming how Vitamin D helps delay the process of neurological decline associated with Alzheimer’s Disease was a potentially groundbreaking bit of research, the cognitive treasure of Chafic Karam, a fellow at the Mayo Clinic in Rochester, Minnesota.

Vitamin D3 and ALSKaram and associates authored a study entitled “Can Vitamin D Delay the Progression of ALS?” The study was conducted throughout the 2011 calendar year.

The study involved 37 patients, all of whom suffer from ALS (Lou Gehrig’s Disease). All 37 were examined for a nine month period leading up to the point at which the testing of the hypothesis began. Twenty of the ALS patients were administered 2,000 IU of Vitamin D3 per day, while the other 17 were administered no vitamin D.

The patients were reexamined every three months. During the nine months leading up to the administration of what I can only presume were relatively well-made, top-shelf vitamin D3 (cholecalciferol) supplements, both groups showed similar progression in the ALS Functional Rating Scale (ALSFRS-R). However, upon the administration of the vitamin D supplements that began to change.ALS

At the three, six and nine month reexamination intervals, the group being administered the supplements showed slower rate of decline than the test group, which was being given no supplementation.

This suggests a possible relationship between down-the-road ALS treatment regimens and a possible role for vitamin D supplementation therein.

With the seemingly endless list of diseases and conditions which can be prevented or the symptoms of which lessened with regular sun exposure and/or vitamin D supplementation, it wouldn’t come as a major surprise if ALS is just the latest debilitating condition the name of which can be added to the aforementioned list. Or so we hope…

Source:  Karam C, Scelsa SN. Can Vitamin D Delay the Progression of ALS? Med Hypothesis. 2011;76(5):643-645

EGAN Wellness Center Supplements Now Available Online

Supplements Now Available Online

All of the high-quality dietary and nutritional supplements available at the EGAN Wellness Center and Med Spa can now be purchased conveniently online and delivered right to your home no matter where in the world that may be!

For years Nurse Practitioner Egan has identified the very best nutritional supplement manufacturers across the globe and offered a superior collection of the very best of the best at her clinic in Covington. Now, customers and patients no longer need to visit the clinic in person or even place an order by phone in order to purchase these supplements, many of which are available only through a physician.

Customers and patients can browse from the full catalog of health-enhancing supplements from the world’s premiere supplement manufacturers directly from Mrs. Egan’s website. Just visit PamelaEgan.com and click on the link entitled “Supplements” from the main navigation menu (see below).

EGAN Wellness Supplements

Pamela Egan Supplements

From the Supplements menu, simply choose your manufacturer from one of the world’s premiere supplement manufacturers. Just click the link for your preferred manufacturer, select your supplement(s), complete the simple and convenient online checkout and within 2-3 days your supplements will arrive right at your door.

Due to the large selection of products available, Designs for Health and Metagenics each have their own supplement shopping portal specific to their brand of supplements. All other supplement manufacturers’ products will be available through the EGAN Wellness Center & Med Spa’s Bonanza shopping booth. This includes but is not necessarily limited to Douglas Laboratories, Xymogen, Ortho Molecular Products, Newtropin, GHW Supplements, NuLiv Lifestyle and any others not listed here.

If you have a particular request or if the supplement you wish to purchase isn’t yet available through the EGAN Wellness shopping portal, please let us know and we’ll add it to the booth just for you.

Schizophrenia Linked to Vitamin D Insufficiency

Schizophrenia Linked to Vitamin D Insufficiency

By: Pamela Egan

A new study out of Iran has determined that individuals suffering from inadequate serum levels of vitamin D have more than double the chances of becoming schizophrenic than do people who obtain healthy amounts of the letter vitamin/hormone.

Low Vitamin D Serum Levels Doubles Chances of Becoming Schizophrenic

Vitamin D-3 Drops (Supplement)Unlike a traditional study, the research published July 22 in the Journal of Clinical Endocrinology and Metabolism constitutes what is known as a “meta analysis”. In a meta analysis, unlike a traditional experiment, study or clinical trial, instead of conducting original research using volunteers (test subjects), a control group and different variables to determine how the different variables react (or don’t react) to the volunteers under various circumstances; the researchers instead review previously conducted research. The objective is to review numerous studies which are similar in nature in an attempt to discern any patterns or other data that may surface in the presence of macro-data that may not be as obvious within the context of a single study.

In this particular instance, the researchers reviewed 19 different studies encompassing a combined total of over 2,800 people studied. The purpose of the research was to determine if any discernible link could be established between vitamin D deficiency and schizophrenia.

The scientists were surprised to discover that not only does vitamin D deficiency predispose an individual to developing schizophrenia, a grouping of psychiatric disorders characterized by among other things hallucinations, difficulty speaking, delusions and disoriented thoughts, but did so by a substantial margin. As it turns out, those who suffer from insufficient levels of vitamin D (which is actually a hormone – not a vitamin), a condition known as “vitamin D deficiency” or “vitamin D deficiency syndrome”, are more than two times as likely to become schizophrenic than are people who maintain normal/healthy levels of the hormone/nutrient. The exact figure is 2.16 times more likely for those whose levels are inadequate relative to those whose are.

While co-author Dr. Ahmad Esmaillzadeh expressed hope that his team’s findings “might help psychiatrists in the healing process of patients with schizophrenia,” he cautioned against jumping to any conclusions with regard to the role (if any) vitamin D supplements will play in the prevention and treatment of this mentally trying condition.

“Controlled clinical trials are needed to confirm the effects of vitamin D supplementation,” Esmaillzadeh added.

 

Vitamin D Deficiency Linked to Schizophrenia – Video

Symphysis Pubis Dysfunction

Symphysis Pubis Dysfunction

Symphysis Pubis Dysfunction, also known as SPD, is a common health condition that causes extreme pain in the hips, back, groin and legs of pregnant women. This painful pregnancy symptom is a result of the aptly named hormone Relaxin. Relaxin helps to naturally make ligaments relaxed and stretchy in order for the baby to ease its way into the world. Many times, relaxin does its job too well, causing the pelvic ligaments to become too loose too soon. As a result,the pelvic joint becomes unstable, causing moderate to severe pain and instability.

Symphysis Pubis DysfunctionAs many as 1 in 3 pregnant women may have this condition to some degree, and may not even recognize it as a condition all its own. More often than not, it is overlooked, as women do their best to endure it as another major discomfort of pregnancy.

Pelvic girdle pain can be anything from a minor ache to a searing sensation that wraps around the back and travels down below the belly. Most women will experience this at some point or another during their pregnancy. As the ever-expanding tummy puts ever-increasing stress on the  bones, joints, and muscles in the pelvis-the pain can hit at almost any point in the pregnancy, and the impact can range from minor aches and pains to debilitating and unbearable misery.

Apart from the lower abdomen and pubic pain and discomfort, SPD may also appear in the following symptoms:

  • Severe pain that tends to get worse when you lift your legs for getting into bed or car.
  • Difficulty to move the lower part of your body when you wake up in the morning.
  • Pain that gets worse when you lie on your back.
  • Reduced range of movement of the hip bones, causing difficulty walking.
  • Pain shooting down your buttocks and legs (sciatica).
  • A clicking sound near the pelvic area while in motion.
  • Urinary incontinence (rare cases).

If you think you may be suffering from this condition, do some research and talk to your Symphysis Pubis Dysfunction 2doctor. Never just endure the pain. Many things can be done to help lessen the symptoms of SPD. Acupuncture is an increasingly  popular way to alleviate all kinds of pregnancy ills, including pelvic girdle pain. Your doctor will almost always instruct you to purchase (and wear) a pelvic support girdle, aka a maternity belt with a special pelvic support built into it.

V2 Supporter

While there are alternatives (albeit none that really measure up in terms of effectiveness, appearance or even cost), the increasingly popular choice for dealing with moderate-to-severe pain of this nature is a product known as a V2 Supporter, or a variation thereof. The V2 Supporter is sold as a standalone compressive therapeutic undergarment, and can also be purchased as a 2-in-1 combo support undergarment such as the Prenatal Cradle Plus V2 Support and the Hip Brace Plus V2 Supporter.

V2 SupporterThis undergarment will  provide much needed support for your belly (and relief for your pelvis). These same products are also used to treat a very common condition during pregnancy called vulvar varicosities, which is effectively vulvar or vaginal varicose veins. While more common among women who are pregnant, many women who are not pregnant and some who’ve never even been pregnant occasionally come down with this most unfortunate condition characterized by painful swelling of the vulvar region.

Back to Symphysis Pubis Dysfunction, heating pads and ice have been known to offer significant relief. Choose the right sleeping  position — lie on your side with a pillow between your knees to keep hips aligned. Do what works  best for you and your body. Try doing KEGEL Exercises. Yes, our old friend can do wonders in this  situation. These handy little workouts strengthen the entire pelvic floor, the muscle that stretches  like a hammock across our abdomens and essentially holds all our organs up. The stronger it is, the  better it holds up the growing baby and uterus and the less everything presses on those already  weakened bones. If the pain is severe, ask your practitioner about pregnancy-safe pain relievers (never take any medications unless specifically okayed by your practitioner). Remember, do what  makes you comfortable and what makes you feel better. Work together along with your doctor and  family to make this special experience as comfortable and enjoyable as possible. More tactics to try: Sit  down to get dressed, and avoid heavy lifting and pushing (which you should be doing anyway). Do your best to stay off your feet and try to be patient until the baby comes. For most moms, once the baby is born and relaxin production ceases, your ligaments (and your dance moves) will return to normal in no time.

 

Video: Symphysis Pubis Dysfunction

 

TTC Questions

What To Know Before You Get Pregnant

The more you know about your body and how it works, the better you will understand what to expect when you become pregnant. Planning before you get pregnant is very important. Simply put, the healthier you are as you are planning your pregnancy, the more likely you are to have a healthy baby. It is advisable to start planning for pregnancy as soon as you begin to have thoughts about having a baby.By: Katie Henderson

TTC Questions

A baby’s organs begin to form in the first few weeks of pregnancy, before you may know that you are pregnant. As this is a critical phase of development, the more planning you do, the greater the pay off can be in terms of the health of your baby. Unfortunately, there are no foolproof methods for having a healthy baby, but there are many things you can do that may improve your chances of a good outcome.

Planning your pregnancy may help you to:

  • conceive more easily.
  • have a healthier pregnancy.
  • avoid or minimize pregnancy complications.
  • give birth to a healthier baby.
  • recover more quickly and easily after giving birth.
  • have a more pleasant postpartum (post birthing) experience.
  • minimize your child’s risk of future adult health problems.

By planning your pregnancy, you will know that during this important early stage you were taking the best possible care of yourself and your baby.

Before becoming pregnant, you need to know the following:

  • If you have any existing medical conditions that might affect your ability to conceive, have a healthy pregnancy, and/or give birth to a healthy baby.
  • The health of your reproductive organs and breasts.
  • Your fertility status.
  • Your genetic history/heritage.
  • Your metabolism rate.
  • The condition of your heart, blood, lungs, urine, and hormones.
  • If you need any adult immunizations/vaccinations.
  • How current lifestyle choices could affect your pregnancy or your baby.

TTC Difficulties: Trouble Becoming Pregnant?

If a man & woman are having regular sexual intercourse, most women will conceive within 6 months. Almost all women will become pregnant in one year. If you do not become pregnant after a year, it may be time to consider consulting your doctor. Only after a year of trying to conceive would a medical doctor consider your situation as having trouble getting pregnant. All women are different however, so don’t panic – at least not yet.

Having trouble getting pregnant may be due to many factors. These include but are not limited to: timing, stress, age, premature withdrawal or pulling out by the partner, reduced vaginal lubrication, or more complicated medical factors, such as male and/or female infertility issues.

A pre-pregnancy checkup can help you identify which, if any, of these factors could be influencing your ability to conceive. This could save you and your partner a great deal of unnecessary stress. Knowing your body, particularly when you ovulate, helps you plan conception. Immediately before, during, or immediately after ovulation are the best times to conceive. Once you know you’re ovulating, you have a 24-48 hour window of opportunity to become pregnant. Remember, sperm can live 24-72 hours in the woman’s reproductive system, so conception can happen if you make love a day or two before or after ovulation.

How Will I Know When I’m Pregnant?

The most common is a missed or late period. Although, this is not a sure way to tell. About three weeks after conceiving, you will begin to notice these other signs:

  • Tender, swollen breasts.
  • Fatigue.
  • Urge to urinate more often than usual.
  • Nausea, sometimes made worse by certain smells and tastes.
  • Becoming emotional, even teary.
  • Increased vaginal discharge.

What is the soonest I can know for sure?

A blood test at a doctor’s office, 5-7 days after conception is the fastest fool-proof method of getting that definitive answer.

For those willing to wait a couple of extra days, a home pregnancy test can determine if you are pregnant in as little as 10 days after the date on which you suspect conception occurred.

Once you think you’re pregnant, it is very important to schedule an appointment with your health care provider as soon as possible.

How to successfully develop new, healthy lifestyle habits before becoming pregnant

It can take time to establish new healthy behavior patterns and break harmful habits, especially those bad habits that have been repeated for years! The best way is to be motivated by why you are doing it. Sometimes it is easier to make changes for someone you love than for yourself. Think about the baby you are planning for. Don’t indulge in any habits you wouldn’t want your child to have.

What to eat while eating for two

As part of the revised FDA national dietary guidelines for healthy eating, there are two specific recommendations for pre-pregnant women that relate to iron and folate (folic acid):

  • Consume adequate synthetic folic acid daily (from fortified foods or supplements) AND food forms of folic acid from a varied diet.
  • Whether you are planning to get pregnant or not, you must be sure to get enough folic acid.

Folic Acid, also known as folate, is a B vitamin that helps a baby’s neural tube — the part of the embryo that becomes the brain and spinal cord — develop properly. It is critical to start taking it before conception and to continue taking it through the third month of pregnancy, when the baby’s neural tube is developing, to prevent birth defects in the spine and skull.

You can get Folic Acid by taking a high-quality multivitamin daily. You will also find it in fortified breakfast cereals; citrus fruits and juices; dried peas and beans; and green, leafy vegetables.

Eat foods high in heme-iron, iron-rich plant foods, iron-fortified foods, or foods that facilitate iron absorption, such as vitamin C-rich foods.

Iron is important during pregnancy as it prevents anemia, a condition in which the body isn’t able to produce enough healthy red blood cells. Developing infants need a high level of red blood cells in order to receive enough oxygen. And, anemia in the mother can be passed on to her baby.

You can get heme-iron by eating food such as red meats, fish, and poultry (basically, food from animal sources).  Iron-rich plant foods include cooked beans, lentils, and enriched pasta.  Many breakfast cereals are also iron-fortified.

Foods that help iron absorption consist of fruits (oranges, orange juice, cantaloupe, strawberries, grapefruit) and vegetables (broccoli, brussels sprouts, tomato, tomato juice, potatoes, and green and red peppers). These are especially effective when eaten with iron-rich foods like meat, fish, and poultry.

Is my weight a consideration for getting pregnant?

A healthy body weight promotes general health and reduces the likelihood of developing heart disease, some cancers, and diabetes. Achieving and maintaining a healthy weight is making an investment in your health, your prenatal health, the health of your future baby, and the well-being of your growing family.

Weight can and will affect a woman’s fertility. Studies have shown that a woman’s ability to become pregnant may be severely compromised by two weight-related extremes:

  • excessive thinness
  • excessive obesity

Once you do get pregnant, your weight affects the baby. Underweight women often have smaller babies. Infants with low birthweight (5-1/2 pounds or less) are at a greater risk of death within the first month of life, as well as increased risk for developmental disabilities and illness throughout their life.

Overweight women may suffer from medical problems, such as high blood pressure and diabetes, that can seriously complicate a pregnancy.  If you are overweight, you have a higher risk of having a baby with certain birth defects (like neural tube defects), experiencing more difficulty during labor and delivery, delivering via cesarean section, and hemorrhaging.

While you are planning your pregnancy is the best time to try to reduce your risks through good nutrition and exercise.  We strongly recommend that you take the time now, before you become pregnant, to assess your diet and eating patterns and begin to make changes that will help you achieve a healthy weight before you conceive.  Once you become pregnant, you should not try to lose weight as it could harm your baby.

Should I have a pre-pregnancy checkup before I try to become pregnant?

A pre-pregnancy checkup is a smart idea. Even if you think you are healthy and ready to get pregnant, a pre-pregnancy checkup is a good opportunity to start asking questions. Make a list of issues before your appointment and ask your caregiver for information.  Your health care provider can help you minimize risks associated with pregnancy and any existing medical conditions that could affect pregnancy. The more you can inform your caregiver before you conceive, the better advice they can give you to help you have a healthy pregnancy.

If you are taking any prescription medications, over-the-counter medicines, or alternative or herbal remedies, your caregiver can advise you about how and why you may need to change your practices.  Some drugs, and even seemingly harmless ones like some acne medicines or certain vitamins, can actually have the opposite affect on you once you become pregnant and/or could affect your baby.

How do my partner and I know if we’re emotionally ready to have a baby?

You’re emotionally ready to have a baby if you’re having it for the right reasons, with the right person, at the right time, and go into it with realistic expectations of yourself, each other, and your relationship.

Empathy in Medicine

Empathy Arguably Single-Most Important Trait for Healthcare, Medical Professionals

One of the most common complaints from patients about the healthcare professionals they look to for help, guidance and sometimes emergency care when sick, injured or otherwise in a state of less-than-ideal health is that too many doctors and medical professionals in general have grown desensitized to the humanity of the patients they treat.

While this may or may not be accurate in any given individual circumstance, the impression – for better or worse – stems from the seemingly robotic approach many people within the healthcare and medical professions be they doctors, nurses, home health aides or even salesmen at the local medical supply store, there appears to the patient to be a desensitized attitude among these professionals regarding issues that to them are extremely important – sometimes even life-or-death.

In order for a medical professional to excel at the highest levels of patient care, that individual need not only make the correct diagnosis, treatment plan, product, etc. By understanding the problems faced by the very people we care for medical professionals can see the issue as though through the eyes of the patient, which can be quite an eye-opening experience for a tenured healthcare pro who has become somewhat numb to the health problems faced by the people for whom we care.

Empathy is arguably among the most important characteristics which in many ways defines great healthcare and medical professionals, separating them from their peers.

The following is a video assembled by the Cleveland Clinic intended to drive home this very point. The video has been described as inspirational and has drawn very positive reviews from those within its intended audience who have had the opportunity to view it.

Empathy: The Human Connection to Patient Care

The Probiotic Prescription

The Probiotic Prescription

Probiotics: Listen To Your Gut

November 08, 2013

Let’s start with the facts behind what probiotics are. The root of the word probiotic comes from the Greek word pro, meaning “promoting” and biotic, meaning “life.” The Food and Agriculture Organization of the United Nations (FAO) defines probiotics as “live microorganisms, which, when administered in adequate amounts, confer a health benefit on the host.” Yes, they are actually alive, and most of these microorganisms are bacteria. Most people think of antibiotics and antibacterial products when you mention bacteria. Both of those kill bacteria so why would you want to consume anything that has live bacteria in it? It’s all about balance.

Increasing the number of good bacteria in the GI tract by taking probiotics supplements Probiotics Supplementsand eating foods that contain the “good bacteria” may help combat a number of health problems, a growing number of scientists say. New research indicates that specialized strains of these good bacteria could also help alleviate some mood and anxiety disorders.

When University of Toronto researchers gave chronic fatigue syndrome sufferers three daily doses of a Lactobacillus strain for two months, it boosted their levels of good bacteria. “At the same time, we reduced their anxiety,” says lead researcher A. Venket Rao, PhD. When the patients stopped taking the probiotic, their symptoms reverted as well, he says.

Probiotics from YogurtOur stressed-out lifestyle may be our stomach’s biggest enemy. According to María Gloria Domínguez Bello, PhD, a professor of microbiology at the University of Puerto Rico, society’s hectic pace, which leads to our reliance on junk food and overuse of anti­biotics, is throwing our internal ecosystem out of whack; she believes that there’s a link between our gut bacteria and the rise of food allergies and autoimmune diseasesCrohn’s Disease and Rheumatoid Arthritis among many others — in the industrialized world. “When there is a loss of balance in the different types of intestinal bacteria, they send signals to our immune system to overreact and become inflamed, leading to disease,” Domínguez Bello says.

See, when it comes to mood, it’s not all in your head — it’s in your gut, too. “The brain influences the digestive tract and vice versa,” says Rebekah Gross, MD, a clinical gastroenterologist at NYU Langone Medical Center. In fact, new research has found that our esophagus, stomach, small intestine, and colon have a big say in how our minds and bodies function and how happy we feel. “The gut is a critical group of organs that we need to start paying more attention to,” says Steven Lamm, MD, the author of No Guts, No Glory. “Doing so may be the secret to improving our overall wellness.”

ProbioticsIf it seems as if your stomach sometimes has a mind of its own, that’s because it does. The gut’s lining houses an independent network of hundreds of millions of neurons — more than the spinal cord has — called the enteric nervous system. It’s so complex and influential that scientists refer to it as “the second brain.” In addition to being in charge of the digestive process, your gut lining is the core of your body’s immune system and defends you against such foreign invaders as viruses and bacteria.

Cells in the gut lining also produce 95 percent of the serotonin in our bodies. (The rest occurs in the brain, where the hormone regulates happiness and mood.) In the gut, serotonin has a range of functions, including stimulating nerve-cell growth and alerting the immune system to germs.

Thanks to serotonin, the gut and the brain are in constant contact with each other. Chemical messages race back and forth between the brain’s central nervous system and the gut’s enteric nervous system. When we’re stressed, scared, or nervous, our brain notifies our gut, and our stomach starts to churn in response. When our digestive system is upset, our gut alerts our brain that there’s a problem even before we begin to feel the symptoms. Scientists suspect that our moods are negatively affected as a result. “The gut is sending messages that can make the brain anxious,” Dr. Gershon explains.

When the digestive tract is healthy, it filters out and eliminates things that can damage it, such as harmful bacteria, toxins, chemicals, and other waste products.

Although more research is needed, there’s encouraging evidence that probiotics may help:

  • Treat diarrhea, especially following treatment with certain antibiotics
  • Prevent and treat vaginal yeast infections and urinary tract infections
  • Treat irritable bowel syndrome
  • Reduce bladder cancer recurrence
  • Speed treatment of certain intestinal infections
  • Prevent and treat eczema in children
  • Prevent or reduce the severity of colds and flu

Side effects are rare, and most healthy adults can safely add foods that contain probiotics to their diet.

Nutrition and Disease Prevention: Poor Nutrition linked to Chronic Disease

Nutrition and Disease Prevention

By: Pamela Egan, NP-C, CDE, ABAAHP, MN

Prioritizing life and health maintenance is essential to achieving health and longevity. Diet, exercise, stress reduction and the avoidance of toxins are all key elements of health.

To operate optimally, the body needs a number of different vitamins, minerals and nutrients. The 13 essential vitamins are divided into two groups, fat soluble and water soluble. Vitamins A, D, E and K are fat soluble and can be stored by the body. B vitamins and vitamin C are water soluble – with the exception of vitamin B12 and they cannot be stored.

Medical foods represent an entirely different scientific and medical approach to managing health conditions. They are formulated with macro-and micro-nutrients that are recognized by scientific principles to support the dietary management of a disease or condition, and are to be administered under the supervision of a physician or license healthcare practitioner. Furthermore, they must be specially formulated and processed to provide nutritional support as part of an ongoing doctor-supervised dietary management program to treat a specific therapeutic or nutritional need. Medical foods contain nutrients in therapeutic amounts that typically cannot be acquired through normal dietary measures.

High quality nutrients are different that low quality nutrients such as those that you find inHigh-Quality Multivitamin, Mineral Supplement the drug store or over the counter.

Many of the negative vitamin studies reported throughout the course of the past decade were conducted using extremely low quality, drugstore and supermarket brand vitamins and nutritional supplements. Medical foods that are manufactured and packaged under GMP-certified conditions assure the highest quality and clinical reliability. Nutrisearch by Lyle MacWilliams is a good comparative guide to nutritional supplements or the lack thereof. The effectiveness of medical food programs have been evaluated in numerous clinical intervention and observational studies and published in well-known healthcare journals.

Medical whole food nutrients have been designed to support the management of a variety of chronic conditions including those associated with:

  • Cardiovascular disease
  • Metabolic syndrome
  • Type 2 diabetes
  • Inflammatory bowel disease
  • Chronic fatigue syndrome
  • Fibromyalgia
  • Premenstrual syndrome
  • Leaky gut syndrome
  • Atopic disorders

For questions or more information relating to this article, Ms. Egan can be reached at 985-892-3031 or www.pamelaegan.com.