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*************************************************** From: Patti or Jeff or Cassidy <theaterhost@voyagerliveaction.com> Date: Wed May 2, 2007 10:11 pm Subject: The Ways of the Heart... Stoker coughed, becoming conscious on the examination table. "I'm still watching the sky, Johnny.." "It's not there anymore, Mike, that's the treatment room ceiling." Johnny replied, testing the engineer's orientation seriously. Dr. Brackett moved into his field of view and smiled. "Now that's a little better, lucid vocalization. How are you feeling, Mr. Stoker?" Mike focused inward, listening to himself and his heartbeat. "The tightness has gone away and I don't feel like I'm suffocating any more." he said, suddenly aware that he was wearing a nasal cannula. "That's the Verapamil finally doing its job." Gage said, setting a foot onto the runner of Mike's gurney at his feet. "What happened to me?" Chet, who was standing nearby, answered eagerly. "Asystole, Stoker. You were down for ...what? Six seconds with no pulse at all? Man, it really sucked. I nearly sh*t myself. But Johnny said that it was just a side affect of the Adenosine. And after that first dose you remember, he did it again with a double a few minutes later, because your heart began racing like it was doing before to beat the band, and it was beginning to seriously effect your ability to breathe." Gage lifted his head, looking tired. "After the third bolus, you still didn't return to sinus rhythm. So, Dr. Brackett finally let me call in a big guns calcium channel blocker to set you to rights once and for all. I'm glad it worked, because that means, you were never ever in any danger of having a heart attack." "What was wrong with me?" Dr. Brackett lifted his chin from where he was studying Mike's EKG monitor. "Something called paroxysmal supraventricular tachycardia. Specifically, in your case, you had a bout of AV nodal reentrant tachycardia most likely brought on by adverse environmental stimuli. The rapid beating of the heart during PSVT can make your heart a less effective pump so that your body organs don't receive enough blood to work normally. Your lab results are still being ordered to rule out certain other trickier causes, just to be on the safe side." Kel said. "But all in all, you're doing just fine." |
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Joe Early, who was studying Mike's running EKG and comparing it to the earlier one in crisis, said. "I think you're right, Kel. His P waves were located either within the QRS complex or shortly after it with a short RP interval. And I definitely don't hear an S3 or crackles so serious problems that way are out. All we have to do now is disprove symptomatic preexcitation syndrome, prescribe a course of post care treatment, then send him home. Mike's narrow complex AVNRT is pretty typical of the kind, extremely common, and of no danger to you, Mr. Stoker, whatsoever. You're healthy, strong, and with that negative cardiac history, I'd be surprised if you weren't up and about and doing a series of jumping jacks and other exercises by sundown." he grinned. "Need me for anything else, Kel?" "No, thanks, Joe. That second consultation was all I needed on this one." "Ok, see you later at break." Brackett nodded. Joe Early exited the room. Kel turned to Dixie, who was adjusting Mike's I.V. to a new rate to maintain his normal sinus activity following the abrupt termination of his SVT. "Dixie, I want a cardiac enzyme evaluation, a full electrolyte analysis and a complete blood cell count, also routine thyroid studies. Let's fit him for a take-home Holter. Oh, and please schedule him for an echocardiogram and a stress test." "Why those last things?" asked Mike, folding a hand under his head on his pillow. Dr. Brackett pursed his lips. "PSVT may start suddenly and last for seconds or days. Patients may or may not be symptomatic after a first attack. It all depends on their hemodynamic reserve, their heart rate, the duration of the PSVT, and the possibility of co-existing diseases. Incessant SVT, such as what you experienced today, can reoccur and eventually cause tachycardia-induced cardiomyopathy if it goes unconverted for too long and too often without prompt treatment. "The ECHO and a radiograph will or won't rule out a certain congenital heart defect known as an Ebstein anomaly of the tricuspid valve, the one physically invisible cause of this kind of PSVT. That stress test will give us another long ECG reading of how your heart's currently functioning. There's another structural abnormality know as Wolff Parkinson White syndrome, in which extra electrical tissue has grown inside of a heart's AV node setting up abnormal electrical circuits that may cause SVT. A person with WPW syndrome may be at risk for cardiac arrest if they develop atrial flutter in the presence of that new rapidly conducting accessory pathway. Extremely rapid ventricular rates during AF can cause deterioration to ventricular fibrillation. Sometimes, sudden death occuring with a bout of tachycardia may be the only initial presentation of WPW syndrome. I want to check you for that. Johnny thought he saw a Delta wave in V2 at the scene." "What are those?" "A Delta wave is a slurred upstroke to the QRS complex." Chet answered, being snidely bookworm. "It means your heart's cheating on refilling before squeezing out its blood again. Not a good thing." Mike actually smiled for the first time since falling sick. "Thanks for that answer, Dr. Chet." he teased, looking up. |
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"Anytime." smirked Kelly. Mike finally relaxed and he glanced at Dr. Brackett. "Okay, go ahead and run what you have to run. I don't want to die anytime soon. I've been doing this line of work too long to give it up now." Stoker tried to smile. "Say, doc, quite honestly, did I hurt my heart today?" Stoker asked. "AVNRT is diagnosed in 50-60% of patients who present with regular narrow QRS tachyarrhythmias like you did. Patients with PSVT in the setting of a structurally normal heart have an excellent prognosis and typically move on to live long, happy and normal lifestyles without restrictions." "And if my heart's found not to be normal?" Stoker said, picking at his bed sheets. "I'd like to evaluate you on a detailed individual basis, in order to tailor make the best therapy and cure possible for your specific tachyarrhythmia. In order to best accomplish that, an electrophysiology study that takes a set of intracardiac recordings will help me map your heart's current accessory pathways and reentry circuits and tell me how they're functioning, right now." Kel told him. "This test involves placement of several pacemaker electrodes into your heart chambers to record electrical activity. The electrodes are placed via a catheter that is threaded through the veins to the heart, under local anesthesia in the cardiac catheterization lab. Dr. Brackett took out his stethoscope and began a followup exam on Mike. "I'd also like to do a cardiac catheterization and coronary angiography, but only if your stress test result is abnormal. This would be done under local anesthesia using a dye in the arteries to highlight any blockages and any possible new damage. "Also, I've already ordered an ambulatory ECG for you. This is because you arrived here with your symptoms stopped and the ECG reading medicated normal. We'll be monitoring your heart over a period of 1-2 days. The Holter will document any abnormal heart rhythms that you experience. You'll wear the monitor device while you go about your daily activities. You'll also keep a diary. That way, if I find any abnormalities on your ECG recording, I can compared it with what you were doing and feeling at the time. If you'd like, I can monitor you for a few weeks or months to assess the frequency of the recurrence of these arrhythmias and heart rates." Mike sat up on the bed. "Oh, doc. That sounds like going through a whole heaping lot just to pinpoint out a few maybes." "True, but what you've suffered and what you're going to suffer symptom wise for the future, won't go away by itself. It's here to stay. We don't have to do heart surgery, you don't need it. We can easily prescribe medications to keep the PSVT at bay." Dr. Brackett turned to McCall. "Dix, would you get him on 240-480 mg Verapamil SR PO qd to prevent a recurrent PSVT incident today. Follow it up with Digoxin, 0.375 mg PO qd. And Mike, those are both by mouth." "Thank you." Stoker sighed. "I hate needles." "No problem. Now getting back to the Holter monitor. I can use it to adjust or change medications based on just on clinical findings,.. I can repeat an ECG at will or plan further therapy if your condition worsens in any way while working." "That's just it, doc. I'll be working. As a messy, sooty, actively overheating firefighter. Do you think a battery pack sensor will stand a rat's *ss chance of surviving through all of that in a live fire?" Stoker reasoned. Kel's face fell. "Well, no. Probably not." "And I really don't like the idea of popping pills daily before the first gray hairs set in, you know what I mean?" Stoker insisted, sitting up a little straighter. "I do. All right, here's an alternative. I have a cath lab procedure available. Radiofrequency catheter ablation. It's more than 90% effective in curing PSVT to the point that it'll never recur nor require any further medication." "What does that involve?" Mike asked, interested. |
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"During this procedure, special plastic tubes called catheters are inserted into a vein into the upper leg/groin area and are advanced to the heart using a fluoroscope. The catheters are used to record electrical signals from inside the heart. They can locate precisely the site from which the SVT originates. Radio waves are delivered at the tip of this catheter to the precise location of the SVT, creating a small coagulation of the tissue approximately 2 mm in diameter. We burn out that area, effectively turning it off. Then we withdraw all tubes and wires and we're done." "How long will I have to stay here?" "Catheter ablation procedures are generally performed in an outpatient setting or with an overnight stay for observation." "And the risks?" Gage asked still learning as Stoker was doing. "Sounds like a fairly new procedure." "Oh, it is. But it's been highly successful. Complications, which occur at a rate of 1-3%, include deep vein thrombosis, systemic embolism, infection, cardiac tamponade, and hemorrhage. The risk of death is approximately 0.1%. The lifetime risk of fatal malignancy as a result of radiation exposure is low to none." Brackett offered. "I'll do it." Mike decided even before the doctor got out his last sentence. "Ok," Kel smiled. "I'll go make a few phone calls." And Brackett left them for the black phone on the wall. Chet frowned, holding out a hand. "Mike, wasn't that a little fast?" "Not really." said Stoker. "It's either pills, a bionic Holter strapped to my belt like a twenty four hours a day, seven days a week scba bottle, or feeling like crap again later like I felt like earlier. Not much of a choice to consider, Chet, now is there?" "No, I guess not. Want me to tell Cap how you're doing?" Chet asked. "Sure, go ahead. And find out about Roy for me, will ya?" Mike whispered. "I will." Kelly promised solemnly. "I'll be right back. His replacement's not here yet and so we're still 10-7." And he left the room. Stoker took a deep breath and nodded at the news of their station's status. Gage fussed with Stoker's I.V. "They'll be transferring you to the cardiac wing upstairs now. If I know Dr. Brackett like I think I do, he'll have you trussed up like a chicken and undergoing that quick fix inside of ten minutes." he said. "That's a good thing. I don't really want to remember today for much longer." Johnny nodded, lowering his head miserably. But then Dixie came over with a blood drawing tray from the back cabinet and he put on a neutral expression quickly so she wouldn't notice his or Mike's emotional weakness. Dixie launched into her usual bedside manner with firefighters. Drawl and artificially sarcastic. "Policy, boys. I'll apologize in advance so here's this ailment's nurse to patient and paramedic speech. In most people, supraventricular arrhythmias are not dangerous. Mild arrhythmias, such as isolated premature beats, may require no treatment at all. Supraventricular tachycardia may also be a side effect of cold remedies." she leaned into both of them while she dug for an artery. "Most paramedics don't know that one." Then she straightened up to loosen the tourniquet that she had tied around Stoker's arm. "And this, is what you failed to do today, so remember it, Mr. Stoker. If the episode of rapid heartbeat or palpitations is your first, and the symptoms last longer than a few seconds to a minute or two, call a rescue squad." Gage rocked forward on his toes and stabbed an I told you so glare at Mike behind her lecturing back. McCall went on fully aware of what Johnny had done, but refusing to show it. "Or, if you have had previous episodes of supraventricular tachycardia, and the current episode does not go away with vagal maneuvers, the coughing, deep breathing, or muscle tensing, the following conditions warrant a visit to the nearest hospital emergency department. Do not drive yourself to the hospital." |
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Mike's attention was drifting while he flexed his muscles one by one to see how they effected his EKG readout's audible rate. Dixie poked him in the chest to get it back. "Ever.." she punctuated with a firm nail stab. "Ow.." Stoker complained. "Pay attention, Mr. Narc'd Up Boy. Call in paramedics if you have rapid heartbeat and feel dizzy or faint, if you have rapid heartbeat with chest pain or if you ever feel short of breath with rapid heartbeat. While you're waiting for help to arrive, you can try the following things to try and avert the attack. Hold your breath for a few seconds.." Johnny was mouthing snappy comebacks silently in the background. "That's if you're not already fainted." "Dip your face in cold water.." McCall droned. "Try not to drown when you faint." Gage added sotto voce'. "Or cough.." Gage mouthed, 'Bend over first and wait for the examiner's gloved finger to get inserted." Stoker was in hysterics about now, but the Verapamil kept his heart rate minimal. Dixie caught on, but she refused to let Gage distract her from her job. "Tense your stomach muscles as if you are bearing down to have a bowel movement." she finished her sampling and bent Mike's elbow up. "But don't fudge your shorts or you'll gross out all your rescuers." Johnny said out loud, making Dixie grin. She ignored him. "If these maneuvers don't work, lie down and relax. Take some slow, deep breaths. Often, your heart will slow by itself. If the symptoms continue, get immediate transportation to a hospital." Johnny fussed with Mike's pillows, fluffing them. "In other words, call me." he said, pointing to himself. "No, I think I'll call any other station BUT 51's." Stoker shot back. McCall pitched her voice even louder to be heard so she wouldn't start laughing, too. "The following lifestyle choices may help control your condition: Quit smoking, Reduce caffeine intake. Avoid illicit drug use.....Most stimulate your heart. Control your weight...... Obesity makes your heart work much harder. Work towards a diet low in fat, cholesterol, and salt..." she ticked off her fingers. "In a firehouse?" Gage and Stoker both exclaimed together, giggling. Dixie recited on.. "Cut back on excessive alcohol use...." The silence in the room that followed was staggering with its arrival. Stoker and Gage froze in place and both were biting their lips, fighting for control over... "Say, fellas. Did I say something to offend you? You both look like you just lost your best friend." Dixie said, her eyes growing big with concern. Mike Stoker's eyes filled then, and he took Dixie's hand. "You know Dix, in a way, we have." he said sadly. "And that's why Roy isn't here right now with me. You see, he lost his son in the river bed this afternoon. Umm, the car he was inside of, was full of drunk teenagers who were drag racing." "Oh, no.." Dixie said, her mouth flopping open. "Not Chris DeSoto." Gage swallowed quietly. "Yeah, he...he died because he got ejected, but uh, it was quick. From.... what we both saw.." "Now I understand why you're here, Mike. Your heart must be breaking." McCall whispered as she hugged them both. |
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************************************************** From: Pat or Cassidy or Jeff <voyagerliveaction@yahoo.com> Date: Thu May 3, 2007 8:36 am Subject: The Life You Save... Much later, Dixie visited Mike Stoker's room on the fifth floor. She found him sleeping, still with tears on his face and a notepad still resting on his lap. He had written something there, a single sentence. 'Students take a sip of grim reality.' She frowned, wondering why he had written it, when he awoke at her light, vitals taking touch. "What time is it?" Mike asked. "It's late. You should have been sleeping hours ago. I thought Dr. Brackett told you to catch up on some rest. The ablation was a complete success. You don't want to undo all that nice cautery work of theirs now do you?" Stoker just sighed, and picked up the notepad he had dropped. He slowly smoothed out its lined yellow pages. McCall, sensing that he had something deeply personal to unload, took a chair by his side and she just waited, until he was ready to speak. Stoker's eyes were red and the lines of fatigue around them made him seem far older than his thirty years. "It's not fair, Dixie." he finally said quietly. "I was there and yet, I still couldn't do anything to help them despite having everybody at the station with me, and all our fancy gear. Nobody's heard from Roy since it happened and I'm really, really afraid to even call his home. What do I do now? I feel so useless, so empty. Something needs to be done about things that happen like this so that they never ever happen to anyone else ever again." he cried. "Shhh.." Dixie soothed, giving him a tissue from his bedside box. "It's okay. You're hurting. For yourself, for Roy... for Chris..." Mike Stoker nodded, looking down as he squeezed tears out of his eyes. "I know that. I... I just want it to stop. And, I want to make a difference somehow for those students at the high school who're probably still doing, all those stupid crazy things." "You're only one person, Mike. What can you do by yourself?" McCall asked gently. |
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Turning to the window, Mike Stoker saw the moon rising over the hill and he heard the sounds of traffic on the freeway coming through his open window. "I think I've almost figured that out. Would you help me iron out the details?" Dixie smiled and moved her chair closer. "Sure. Show me what you have." ------------------------------------------------------------------------------------------- Four weeks later, Dr. Morton was watching a news broadcast on a network channel while eating an orange. He was surprised when he recognized a few names flashing across the screen. "Say, Dix. Have you seen this?" he asked. Dixie, recognizing the piece, nodded her head. "I sure have. Enjoy." she smirked. Then she left the room, leaving him to devour his bright tangy fruit, and the news story. |
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##Every 15 Minutes someone in the United states dies in an alcohol related car crash. ##This statistic is the basis of the "Every 15 Minutes" program. The program offers a real life experience without the real life risks. This emotionally charged program, entitled Every 15 Minutes, was an event designed to dramatically instill teenagers with the potentially dangerous consequences of drinking alcohol. This powerful program challenged students to think about drinking, personal safety, and the responsibility of making mature decisions when lives are involved.The program was proactive; it used very dramatic visual lessons in regard to death. It was staged last week at a time when it was known that teens were more apt to participate in the consumption of alcohol. Parent/child involvement was a large portion of this program, and all of it was designed by a local regular Firefighter Mike Stoker, an Engineer, at Station 51 in Carson. ##More than 950 students took their seats in bleachers as a grim reaper roamed slowly and silently around what would soon be revealed as the simulation of a grisly car accident....## The screen turned black and Mike Morton was captured completely by the video shown. A voice of a dispatcher blared over a loudspeaker, simulating radio response calls to an emergency as a tarp was removed, where he recognized as being at the local riverside high school, revealing the aftermath of a head-on collision. At first, Morton thought the footage was real, but then he saw the moulage look of cast blood and was reassured. |
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Empty beer bottles were strewn on the ground near the crumpled vehicles. The "dead" and "injured" lay in various positions in and around the wreckage. Only one person--the driver of one of the vehicles--was on his feet and stumbling around in a daze. He was eventually "arrested" for driving under the influence and taken to jail. ##This scene was only part of a two-day event. Close to forty volunteers from several local police and fire agencies volunteered their time and equipment to bring this innovative firefighter's new awareness program to life. ##Throughout the first day, the "Grim Reaper" removed a student from a classroom every 15 minutes. These students represented those who were dying as a result of an alcohol/drug related collision in the United States. Volunteers transformed these pre-selected students into the "walking dead" by painting their faces white and having them wear black robes. ##A uniformed officer then entered the classroom and read the student's obituary. The obituary was very realistic and included such details as the cause of death, past accomplishments, future plans and surviving family members. ##Meanwhile, a prearranged mock death notification was made by uniformed officers to each student's parent at their home or place of business. Each notification varied as to the cause of death and surrounding circumstances. Most parents were told they would need to identify the body at the morgue and were given information on organ donation. Even though all the parents were aware of the details of the program and previsously agreed to the prearranged death notification and knew that it was pretend, the resulting emotions witnessed were powerfully sad, and visceral as they were caught unprepared for the harsh realism of the notifications delivered. ##The "living dead" students, once made up, were returned to their classes to resume their day, with one exception,they couldn't speak or take part in any activities for the remainder of the day. ##Officer Vince Howard of the Los Angeles Highway Patrol... "The event was a real eye opener, because when a person who's killed actually is your own friend, it really hits home. It's was a great program for the teens because their lives are just beginning and so many doors are opening up for them." |
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##Howard was the cruiser cop first to arrive at the DUI scene, followed by more police officers, fire engines and ambulances. A sobriety test was given to the driver of one of the vehicles--the occupants of the other vehicle were pronounced dead at the scene after extensive resuscitation efforts by the paramedics of Station 51. The roof was cut off one of the cars to free an injured person trapped inside. The injured were strapped to gurneys and taken away in ambulances to Rampart Emergency-- and the dead were taken by a coroner to the county morgue. The one person who escaped the crash with only minor injuries was booked into the county jail for drunk driving. ##Because of the fatalities, a medical examiner soon arrived, as did the staff from a local mortuary. A male passenger ejected through the windshield was placed into a body bag and was transported to the morgue by the coroner. ##The injured passengers were transported to the hospital by ambulance and the worst of them by a paramedic flight helicopter. Hospital personnel at Rampart General worked on these victims until they were pronounced brain dead in front of their parents and family relatives to demonstrate what goes on in a trauma room following a drunk driving accident. The parents were then notified of their deaths officially and were asked about organ donation. ##The "drunk" driver was given field sobriety tests by officers, handcuffed and transported to the police department for a simulated booking. ##The teenager was found guilty of drunk driving and vehicular homicide at his sentencing hearing. His attorney from the public defender's office detailed his client's perfect student record and asked for a sentence of probation. In making her case against the defendant, a lawyer from the city attorney's office listed the crimes committed, the fatalities and injuries that resulted, and how the lives of families had been wrecked. She emphatically stated that probation wasn't enough, and that while the maximum 10-year sentence may serve justice, it would not heal the pain of survivors or bring back those who were killed. ##The firefighter father of a dead student then described how he had been deprived of his son, and made an emotional plea for the maximum sentence. He detailed how he and his wife wouldn't see his boy graduate from school or be able to share any more in his birthdays or holidays. He concluded by saying that his life had been devastated, and that it would never be the same. ##When the defendant was allowed to speak, he expressed his remorse and willingness to accept responsibility for his actions. He further stated his readiness to accept the judgment of the court. He received the maximum sentence for his crimes. |
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##The mock accident staged by the Los Angeles County Fire Department and the California Highway patrol was watched by all juniors and seniors from Riverside High School. ##The "dead" students, including the ones pulled from their classrooms, all spent the night at the Los Altos Jesuit Retreat. ##The students' absence from their homes that night was to further simulate that he/she was "gone" for the parents. Upon arrival at the retreat the students were treated to dinner and chaperoned activities, such as a game of baseball between students and chaperones, basketball or even swimming. Evening activities included interacting with police, State of California Alcoholic Beverage Control agents, emergency medical personnel, firefighters and members of the community. Guest speakers at that time included the Los Angeles County coroner, describing DUI accident cases, how he responded to the scene, contacting parents, and how that made him feel. Another speaker was a man who drove while intoxicated and was involved in an accident in which three of his best friends were killed. ##After listening to the speakers, students wrote letters to their parents. Some students were able to say things to their parents they were never able to say before. Students were asked if they would feel comfortable reading their letters to the student body and parents at the following day's funeral services for the dead. Each letter began 'Dear Mom and Dad, Every 15 Minutes someone in the United States dies in an alcohol-related traffic collision… and today I died…I never got a chance to tell you……..' ##Parents had the task of writing their own child's obituary. The real possibility of a child dying in this type of scenario created a tremendous impact on the teens, parents, friends, and the community. The range of emotions this invoked in participants and observers was vast. Each person reacted in his or her own unique way. The distinction in this program was that the community joined together as a whole to help teens find alternatives in their battle with casual involvement with alcohol. ##The assembly ended with the showing of a music video. The video was compiled from footage of participating students two to three weeks prior to the program as well as footage of the mock DUI accident. The video was followed by selected students reading their letters to Mom and Dad along with presentations by police, parents, medical personnel and school officials on the horrible consequences of poor decision making when alcohol was involved and how it impacted them personally. The intent of this part of the program was to show the students that their decisions didn't only affect themselves. F/F Stoker called forward actual survivors and victims of an alcohol tragedy to drive home the point. ##Students were then asked to rejoin their parents. ##Firefighter Engineer Mike Stoker comments.... "Letters were exchanged along with, hopefully, renewed commitments of love and respect. From what I saw on that final night, made all my hard work, planning and fundraising, well worth it." "It was extremely emotional," said Captain Stanley, who received much feedback from students at the high school, thanking his firefighter Mike Stoker for coming to stage the event. "It affected them in many ways, depending on past experiences." |
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##Rebecca Ellis, a senior who lives in Sunnyvale, said she can't drive yet, thought the program helped students to comprehend how scary and common alcohol-related accidents really were. "For something to happen like this every fifteen minutes is mind boggling," Nurse Dixie McCall of Rampart Hospital said. "I'm glad that we've put in the effort, because some people really need it." said Chet Kelly, another firefighter working at Station 51. |
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It was the second day of the Every 15 Minutes program event at Riverside High. Paramedic Firefighter Roy DeSoto slowly stepped up to the microphone.. "I hold in my hand, the high school ring, that Chris was wearing the day he ...died.. because of alcohol. Working in the fire department, I see a lot of accidents, and I always fear the worst, but pray for the best at each and every one of them. My dispatchers didn't have any information, but on that day, I know they said to hurry. I had no idea my life had been forever changed in a split second without my knowing. "Yesterday, hopefully, I was able to show you just how many people's lives one person's choice can affect. Like what you saw enacted today on the athletic field. All of the emergency personnel, the parents, the friends that knew people involved in the accident--my--- my son.. Those are all the people who are really going to be most affected by your absolutely last, can of cold beer. So as you enjoy it, think about the others around you first before you ever decide to get behind that wheel. "Chris. I will nev-- I will never get to see you smile, or hear your voice. I can only say, that I love you still. From the bottom of my broken heart." |
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