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"The bulk of the world is using wheat and, for the bulk of people, wheat is absolutely fine. People make exaggerated claims one way and another. But of the percentage of people eating wheat, a certain number don't do well."
— Dr. Peter H.R. Green, director of the Celiac Disease Centre at Columbia University
Whether you make this brittle with your Halloween-carving leftovers, or just because you really like the taste of pumpkin seeds, this gluten-free crunchy brittle is the perfect confection for an autumn afternoon. After making it, you can enjoy it on its own, break it in fine pieces and sprinkle it over ice cream, garnish a cake with it or serve it accompanying your dessert of choice.
Toast the seeds
Preheat the oven to 200 degrees C (400 degrees F). Place the seeds in a medium saucepan and add 250 ml (2 cups) of water. Put it on the stove and bring it to a boil. Lower the heat and let it simmer for 10 minutes. Strain the seeds and lay them on the baking tray. Put the tray into the oven and bake the seeds until they begin to brown. Take them out and put them in a bowl.
Making the brittle
Spread butter on the baking tray and set aside. In a saucepan over medium-high heat, mix the sugar, corn syrup, salt and the pumpkin seeds you just toasted. Stir to dissolve the sugar and mix ingredients. Let the mixture cook for six to eight minutes or until the fluid turns amber and starts bubbling. Stir the butter and vanilla extract into the mixture, while cooking, and leave it on the stove for another 2 minutes. Add the baking soda, stir until the mixture is foamy and pour into the baking tray you set aside earlier. Let the mixture cool until set, it should not take longer than 20 minutes. Break into pieces and store in an airtight container.


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Back to the hustle and bustle
Trip Start
Sep 08, 2009
Trip End
Jun 07, 2010
Where I stayed
Megan's apartment downtown
My time in Toronto started with a mini-adventure: manoeuvring the subway with 2 oversized suitcases. I would have been fine had it not been for the elevator being out of service... You know when you wheel a suitcase onto an escalator and it's not quite balanced on the step? Try that with two 23kg bags. I didn't know quite what to do as I saw them start to fall into oncoming people-traffic, but I know anything would have been better than what transpired. I held on. Yes, I kept a tight grip of the handles in a vain attempt to stop them from falling over, which resulted in me following closely behind them. Time seemed to move in slow motion as arms flailing, I stumbled backwards, grasping wildly at the sides (and getting friction burn in the process). People on the opposite escalator reached out to me, trying to give me a hand- but by the time I'd reached out too, they had been propelled in the opposite direction. Once my bags and I had finally stopped bumping down the steps head first, I had to get myself the right way up, pick up the bags, pick up all the things that had fallen out of the bag and get back in front of said items before I reached the top of the short escalator. Needless to say, I did not manage it, but some kindly commuters helped me out. Note to self: avoid taking two suitcases on escalators AT ALL COSTS.
My stay improved rapidly after that. I was couchsurfing again with some people I met on the internet- a lovely Taiwanese girl Peggy, her husband Mark and her sweet sister Megan. As soon as they saw how tall I was, they insisted Megan sleep on the couch instead of me. So I had my own room, in a lovely apartment right in the heart of the city. We had breakfasts and dinners together and they treated me like a guest at all times, not even allowing me to do the washing up. Incredible!
I spent my first afternoon just wandering around the city, getting my bearings. It was about a 30 minute walk down to the lake-front, and the roads were fairly busy with rush hour. I definitely had a reverse-culture shock after Blackfalds! So many people! So busy! Everyone so stylish and smart! So much going on it was overwhelming. And that's just after 3 weeks of living in the country. No wonder most people raised on the prairies stay put. I walked and walked and walked and walked- when I got home, I calculated I'd walked 7.5 miles in all. My only respite was going up the CN Tower. Instead of paying $22 just to go up to the lookout, I went to the revolving restaurant at the top for dinner (which included free entry to the lookout). The food wasn't bad- I just ordered a glass of water and a main course- but the views were spectacular. It was a great introduction to the city, and I didn't feel conspicuous going alone- even couples were just sitting there, watching the view go by out the window. I timed it so I hit the observation deck in time for sunset, and sat watching the colours intensify as time ticked by. Unfortunately in the process of taking a self-timed photo, my camera fell off and landed on the lens. There goes camera number two. But other than that, it was a great evening.
The next morning I was musing about what to do with my camera- repairs take at least a week, I couldn't afford to buy another new one, but how could I not take photos in Niagara Falls?! To my disbelief, Peggy insisted I had her old camera. So now I have three cameras! I spent the morning with Megan, getting a guided tour of the city. St Lawrence market was a highlight (take me to a food market anywhere, and I 'm happy). Next stop was the Rogers Centre- I'd scored tickets to the Toronto Blue Jays v Minnesota Twins baseball game, and so spent a very pleasant few hours sitting in the sun, reading my book- and occasionally cheering and clapping whenever anyone got a home run. I'd never watched a baseball game in my life, so while I didn't really know all the rules, it was a great experience. It was also school day, so the stands were packed with school kids, all cheering and waving banners from their schools. I walked back up through Kensington Market- a hippy Camden-esque area before collapsing back in the apartment.
Summer appears to have arrived in Toronto (at least for the time being). With temperatures hitting 28C, I decided a trip to Toronto Island was in order. I had no idea it would be so beautiful! Megan and I caught the 10-minute ferry ride over to the island, which was originally a spit coming off the mainland, and now houses an airport, several yacht clubs and summer homes. We wandered the length of the island over the next few hours, along beautiful beaches (including one 'clothing optional' beach) and along a boardwalk that made the most of the arresting views of Lake Niagara. Finally we stopped for a picnic before catching the ferry back to the city.
Since this was my last big stop before I left Canada, I spent the next 2 hours trying to find souvenirs. There was not a single gift store on the whole of Yonge Street, the main shopping street! Maybe that's testament to how Toronto handles tourism, I don't know. I caught the metro up to The Royal Ontario Museum, which offers free entry for an hour on Wednesdays. It was very similar to the Natural History Museum (on a smaller scale) and since I was pretty exhausted from all my slow walking (Megan has little legs!) I glanced at a few of the exhibitions. My favourite was the dinosaurs- they had a special exhibition of the largest and best-preserved fossilised dinosaurs nest and eggs, and you could see the little baby dinosaur embryos which was pretty cool! I decided to give the art gallery a miss (also free on Wed evenings) and went back to the apartments to pack.
The next morning I bid my farewells and eventually made it to the station, for my train/bus to Niagara Falls. Four stops left!

subset: commoncrawl


text:
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Nashville, TN – The Tennessee Titans reached terms on Tuesday with top draft pick, Baylor wide receiver Kendall Wright on a four-year contract.
Wright is expected to be in Nashville tomorrow and will will be available to the media on Thursday.
The 20th overall pick in the 2012 NFL Draft, Wright begins his pro career with the expectation of adding speed and explosive plays to the Titans offense, much like he did during his career at Baylor, where he served as the primary target for Heisman Trophy winner Robert Griffin III.
Possessing sudden burst and strong hands, Wright figures to make an early impact on offense and could factor into the return game as well.
Wright concluded his Baylor career as the most decorated and accomplished receiver in school history. He owns virtually every significant receiving record for the program, totaling 302 receptions for 4,004 yards and 30 touchdowns. He never missed a game in his four years with the Bears and recorded at least one reception in every contest.
As a senior in 2011, Wright set Baylor single-season records in receptions (108), receiving yards (1,663), receiving touchdowns (14), 100-yard games (nine), all-purpose yards (1,772) and consecutive games with a reception (tied own record with 13). He landed on numerous All-American lists and was a Biletnikoff Award semi-finalist.
In addition to tallying 30 receiving touchdowns, Wright scored two rushing touchdowns and passed for a pair of touchdowns during his career at Baylor.
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Search Forums scope search Title, Post, and Replies Title Only Title and Post filter search All Forums Welcome to Saxophone.org! Saxophone.org Announcements Member's Announcements General Discussions Vintage Saxophones Jazz Saxophone Legit Saxophone High School Saxophone Sax Repair Sax Equipment Tips for better searching
by dread.pirate.veritas (2 posts) 7 years ago
I found an old Conn Eb at an antique store... I was curious about how old it is and if it is rare or not. The serial is 725941, it is gold with silver keys and pearl inlay. The design around the logo is fireworks and stars, it says Conn USA on it. Any ideas???
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Missed the live Ask the Expert event?
Catch up on the conversation about enhanced efficiency fertilizers with the experts at Koch Turf & Ornamental in the Fertilizer Application forum .
How much coffee grounds in a compost pile??
Discussion in 'Organic Lawn Care' started by CorkscrewWillow, Jun 6, 2011.
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Bill Joy On Sun, Microsoft, Open Source, and Creativity 173
maitas writes "In this interview, Bill Joy talks about green energy and technology. His main point is: 'I'm all for sharing, but I recognize the truly great things may not come from that environment.'" The interview really runs the spectrum from the iPad to Microsoft, and from green tech to nanotech.


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Sunday, February 27, 2011
Revok Is Dead
Revok is Dead, but he is still killin it. Click the jump for more
This sticker saying 'Revok is Dead' is right in front of a mural with a sick piece from Revok.
Up with a hand drawn slap from ? from the At Large crew.
And MCHN underneath.
1 comment:
February 27, 2011 at 7:01 PM
the slap above revok is Bonks
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Dear Madame Psychosis,
The night is not the same without your voice on the airwaves. Your disquisitions on the esoteric and the intangibles of life were the shimmering payoff for a day cluttered with radio spots selling unflinching car financing and cheap, mismatched mattresses. Your slot has fallen on hard times since you left, but you probably knew that already. A friend of mine taped your hour most nights, luckily. On weekends we put them on and listen. We listen and we listen until the moon is low again and meaning's been smashed out of us. When I wake up on the couch with my shoes still on and the sunlight creeping into the room, your voice is still in my head, lulling me to a place that's fleeting, thin as air. Some things are better the second time around.
A fan,
Dylan Brown


text:
Globe Clipart
On this page you can download free globe clipart. The clip art is classified as geography clip art. Globe clipart added 30 January 2013. This clipart viewed 234 times and downloaded 2 times. Also you can find similar clipart images via tags: Globe, Geography, Education, Earth, Planet. If you like this clip art, share them with you friends!
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It only takes a minute to get started. Fill out our simple sign up form and login to the site.
This step is voluntary but will drastically boost your chances of receiving views from other daters on the site. Introduce yourself, your hobbies and upload your nicest photo of yourself.
Utilise our website's advanced search to find members who match your desired criteria. Or just browse through listings and find members that interest you.
Located someone who appeals to you? Send an email to them or just a wink and wait for their response. With a little luck you'll be on your way to a lifetime of happiness.
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Gila Woodpecker
Melanerpes Uropygialis
Gila woodpeckers excavate cavities in cacti and trees as nesting sites.
Gila Woodpecker
Ranging in length from 8 to 10 inches and with an average wingspan of 16 inches, the Gila woodpecker can be found in deserts, brushy woodlands and urban parks from the American southwest to west-central Mexico. It feeds primarily on insects, cactus fruit and berries. Although they do not use them immediately, waiting first for the sap to harden, Gila woodpeckers excavate cavities in cacti and trees as nesting sites. Females typically lay two broods a year of 3 to 5 eggs, which incubate for 14 days. Once abandoned, the cavities are occupied by reptiles, rodents and small birds like kestrels, elf owls, flycatchers and wrens.
In the desert, the woodpeckers perform the important ecological function of removing unhealthy flesh from the saguaro cactus. Some insects on which it feeds carry diseases, harmless to the bird, which damage the cactus and leave discolorations. The marks signal "Here be larvae" to the bird, and as it excavates the insects, it also cuts away the diseased tissue. As the sap hardens, the cactus is healed, and the excavation becomes a convenient nesting site.
Populations may be in slight decline because of human development of the Sonoran Desert and competition for nest sites with European starlings. A decrease in the Gila woodpecker population would damage the entire ecosystem, since its nest sites are widely utilized by other species, and it may be an important pollinator of the saguaro cactus.
Support our work and research to conserve the lands and waters on which all life depends — including the gila woodpecker!


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A grocery worker's strike could happen by the end of the weekend, if union leaders don't reach a deal with their employers by Sunday.
62,000 employees have been working without a contract since March.
For weeks, the union representing them has been in negotiations with the top three grocery store chains over worker's wages and health care benefits.
Workers from Vons, Albertsons and Ralphs recently rejected the most current offer.
A 72-hour notice of intent to strike was given at 7 p.m. Thursday if no deal is reached by Sunday, workers could walk
Published at 9:47 AM PDT on Sep 16, 2011 | Updated at 3:50 PM PDT on Sep 16, 2011


text:
29 June 2010
The Avs waited until the very last minute, but finally made qualifying offers for their corps of talented restricted Free Agents Yesterday (Stewart, Mueller, Stewart, err Quincey, and Yip), according to Jori over at Avs prospects (and I am digging the new design over there. Welcome to, well past 2005) . Thankfully they did not pull a Dave Tallon and miss the deadline (as far as we know. But with the Avs, they probably did it 4 weeks ago and didn't bother to tell anyone.)
I think some folks are a little worried about the possibility of other teams tendering offers to these players, and potentially losing them, but I'm not really all that worried about it. And the reason behind it is the compensation that comes back if someone does sign any of the Avs to offer sheets.
Here's the compensation chart, courtesy of NHLSCAP.com:
Amount |
Compensation Due |
$863,156 or less |
None |
$863,156 - $1,307,811 |
3rd round pick |
$1,307,811 - $2,615,623 |
2nd round pick |
$2,615,623 - $3,923,434 |
1st and 3rd round pick |
$3,923,434 - $5,231,246 |
1st, 2nd, and 3rd round pick |
$5,231,246 - $6,539,061 |
Two 1st's, one 2nd, one 3rd round pick |
$6,539,061 or more |
Four 1st round picks |
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March 22, 2017
Disclaimer: Please read.
Statements and opinions expressed in articles are those of the authors, not Truthdig. Truthdig takes no responsibility for such statements or opinions.
Does the Cold War Have Lessons for Today?Posted on Sep 19, 2008Until Russian troops rolled into Georgia in August, the Cold War was beginning to recede in memory, with an oddly sentimental glow. Here was a clear-cut American victory, in which not a single shot had been fired, at least not between the main antagonists. Considering the apocalyptic potential of the 40-year rivalry, the architects of U.S. policy appeared a wee bit wiser than they had looked during the gloomy days of Vietnam. And by comparison to the floundering "war on terror" and the breathtaking incompetence and ignorance of the Bush administration, the predecessors look like wizards. From Malenkov, Leffler moves to Nikita Khrushchev and the aftermath of the Cuban missile crisis. The world had come perilously close to nuclear destruction, saved only by John Kennedy's cautious diplomacy and the Russian leader's willingness to back down. Yet the first party secretary knew only too well how close they had come, and how a different American leader might have precipitated disaster. Chastened by the experience and driven by the need for domestic reform, Khrushchev beseeched the Americans to reverse the Cold War. As one poignant illustration, he sent no fewer than seven messages to Lyndon Johnson in the first months of his presidency, pointing out areas of possible agreement. Johnson was mildly interested, but preoccupied by Vietnam. By the time Leffler arrives at the Brezhnev years, 1975-1980, the story has taken on a certain mournful predictability. However, during the years following the demise of Khrushchev, much had changed. The United States had fought and finally lost its first major war, in Indochina. Richard Nixon had shocked the world by visiting China, which had become a mortal enemy of the Soviet Union. And most pertinently, Nixon and Leonid Brezhnev had met several times and initiated the era known as détente with a host of new agreements and dramatic changes in rhetoric. Leffler is surprisingly terse in his treatment of this subject, given his interest in lost opportunities. It is surely significant that no less a zealot than Nixon was temporarily able to disrupt the pattern. New and Improved CommentsIf you have trouble leaving a comment, review this help page. Still having problems? Let us know. If you find yourself moderated, take a moment to review our comment policy. Join the conversation
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By correction, September 24, 2008 at 6:42 pm Link to this comment CORRECTION to my just-posted response to diamond. My second to last paragraph suggests I am placing submarines in space. Not really. But I would like to place my head on Governor Palin's lovely shoulder while we cuddle on the bearskin rug and watch "The Caine Mutiny," the life-story of John McCain.
By libertarian, September 24, 2008 at 6:25 pm Link to this comment diamond- You make a good point about the illusion of invulnerability. But I doubt it's the "Cold War leftover hawks" who suffer this delusion…more likely younger and more careless analysts, such as C.Rice. I even agree with you about Putin's abilities. But your conception of the anti-missile system is mystefying to me. The aggressive use you envision is not possible for many reasons: ABM's don't work in realistic scenarios. The Russian mobile ICBM counterforce is modern and active. The Russians hold thousands of tactical field nukes with which to hammer European sites. Both we and the Russians are able to park missile submarines on top of seamounts in the Atlantic for months at a time or, for that matter, in earth orbit. There would be no usefulness to the US attack you describe. How about a nice game of chess?
By Lewis Bernstein, September 20, 2008 at 6:06 pm Link to this comment So much to say—where does one begin?
By Lana K, September 19, 2008 at 4:22 pm Link to this comment I enjoyed reading the article. Even though the book has flaws, it is the most objective book I have heard of in years. I am really shocked with the hatred toward RUssia that showed up in AUgust. If anything, please, remember RUssia was just one of the 15 republics in the USSR. WHile other republics had their own head of state, RUssia was "fortunate" to have the head of the whole USSR sit in MOscow. The USSR was run by Georgian (Stalin), Ukranian (Khrushev), Kazakh (Brezhnev) and for the first time in its history in 1980s by RUssian (Gorbachev).
By Per Fagereng, September 19, 2008 at 10:00 am Link to this comment Carolyn Eisenberg states that the Soviet invasion of Afghanistan "froze (President) Carter's heart and seemed to kill any prospect of reviving detente." Yet we have Zbigniew Brzezinski's boast that he goaded the Soviets to invade in order to get them bogged down in their own Vietnam. Did he do this without Carter's knowledge and approval? Highly unlikely. It's more likely that Carter's heart was already frozen.
By norman birnbaum, September 19, 2008 at 3:03 am Link to this comment A review that makes one wish to read the book. I'm curious as to how the author deals with three matters. (1) There was an opposition to the Cold War in the US, with the most varied elements, often totally without communication with one another (Kennan had nothing to do with the pacificists and did not like the student movement of the sixties, Mills had no contact with the bureaucratic and political insiders who opposed not only Vietnam but the entire complex of Cold War projects—many scientists amongst them.) In Europe, movements like the British protest against nuclear weaponry and its later but very vocal and visible German counterpart |
Right 3, Site wide - Exposure Dynamics
Right Skyscraper, Site Wide Right Internal Skyscraper, Site wide |


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Register | FAQ | Blowout Cards Shop | My iTrader | Forum Rules | Members List | Search | Today's Posts | Mark Forums Read |
Ebay/COMC/Online Selling/Shows/Paypal/Shipping Share online or show selling experiences. Ask questions about eBay, Paypal, COMC, shipping, etc... |
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04-18-2011, 12:34 AM | #1 (permalink) |
Join Date: Mar 2010
Location: Long Island, NY
Posts: 4,565
WTF PAYPAL (Possible warning, language)
I get this email from our good friends at PayPal a little over an hour ago.
Dear Andrew! Your payments will be held in a pending balance We're writing to let you know about a change to your PayPal account. Starting 5/16/2011, money from payments you receive will be placed in a pending balance for up to 21 days. By doing this, we're making sure that there's enough money in your account to cover potential refunds or claims. Even though you can't access the money right away, please ship orders quickly and communicate with your customers. After 21 days, you can withdraw money from each payment as long as the customer hasn't filed a dispute, chargeback, claim, return, or reversal. The money may be available sooner if: 1. We can confirm that the item was delivered. 2. Your buyer leaves positive feedback. (Applies only to eBay items) This change isn't necessarily permanent. We'll review your account every 35 days and re-evaluate if we should continue to hold your payments. If we decide to stop holding payments, we'll email you to let you know. Why are my payments being held? We reviewed your account and determined that there's a relatively higher than average risk of future transaction issues (such as claims, or chargebacks, or payment reversals). We understand that it may be inconvenient to have your payments temporarily held but please know that we didn't make this decision lightly. Before deciding to hold payments, we consider many factors. These factors include account and transaction activity, the rate of customer disputes, the type of business a seller runs, average delivery timeframes, customer satisfaction, performance and history. Questions? Let us know We understand youd like to have immediate access to the money you receive and were here to answer your questions about this change to your account. For more information and tips on what you can do to avoid having your future payments held, please see our Frequently Asked Questions. To speak to a Customer Service representative, log in to your PayPal account and click Contact Us at the bottom of any page. Thanks, PayPal 1) I have never had a claim held against me 2) I always ship my items out in a timely manner 3) Why am I being singled out??!! 4) They will be getting a nasty phone call in the morning 5) F&^k YOU PAYPAL
04-18-2011, 12:56 AM | #3 (permalink) |
Join Date: Mar 2010
Location: Long Island, NY
Posts: 4,565
It was definitely from PayPal, I have no doubt. There was no link provided or anything of that nature to indicate it was a spoof email.
04-18-2011, 05:10 AM | #4 (permalink) |
They did this to me a few months ago also. I never had any issues either. I called them and they said they were randomly checking accounts making sure people were sending out the correct items and in a timely manner. They also said once you receive positive feedback they release the payment. They did this to me for about a month and once they see you are doing everything the right way the let your account go back to normal.
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Nick Howell was a strong candidate to be one of the disappointments of training camp, especially after he did not make the depth chart.
But Howell said his recently discovered hernia prevented him from making proper blocks and limited his range of mobility during training camp. Howell and USC thought he merely had a sore groin until the hernia was discovered. And this is not just a "sports" hernia, which is near the abdomen. Howell's is lower and more serious and one reason why he probably will not return this season.


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Experience - Willow Weaving Course: Christmas Obelisks and Reindeer |
A woven obelisk provides a neat and elegant alternative to a traditional tree, with the added bonus of not dropping needles. Come along and spend half a day constructing your ″tree″ and then spend the other half making a reindeer sculpture, a reindeer who is likely to have a very individual character. Participants on the day course will need to provide a packed lunch. Alternatively, single activity sessions run 10am - 12.30pm or 1.30pm - 4pm.
Date |
Time |
Tutor |
Sunday 26th Nov |
10:00am - 4:00pm |
Jam Mian |
Clothing advice |
Wear comfortable clothing that allows for free movement. |
What′s provided |
All tuition, materials, use of tools and homemade tea/coffee and biscuits/cake |
Accessibility |
Adult course. For any other enquiries, please ring to discuss. |
Cost |
Full day £60 |
How to book |
Telephone: (01332) 694500 |


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SOMAVERT- pegvisomant
Pharmacia and Upjohn Company LLC
HIGHLIGHTS OF PRESCRIBING INFORMATIONThese highlights do not include all the information needed to use SOMAVERT safely and effectively. See full prescribing information for SOMAVERT. SOMAVERT (pegvisomant) for injection, for subcutaneous use Initial U.S. Approval: 2003 INDICATIONS AND USAGESOMAVERT is a growth hormone receptor antagonist indicated for the treatment of acromegaly in patients who have had an inadequate response to surgery or radiation therapy, or for whom these therapies are not appropriate. The goal of treatment is to normalize serum insulin-like growth factor-I (IGF-I) levels.(1) DOSAGE AND ADMINISTRATION
DOSAGE FORMS AND STRENGTHSFor injection: 10, 15, 20, 25 or 30 mg (as protein) lyophilized powder in single-use vial for reconstitution (3) CONTRAINDICATIONSNone (4) WARNINGS AND PRECAUTIONS
ADVERSE REACTIONSMost common reported adverse reactions (> 6%) are infection, pain, nausea, diarrhea, abnormal liver tests, flu syndrome, injection site reaction (6) DRUG INTERACTIONS
See 17 for PATIENT COUNSELING INFORMATION and FDA-approved patient labeling. Revised: 4/2016 |
SOMAVERT is indicated for the treatment of acromegaly in patients who have had an inadequate response to surgery or radiation therapy, or for whom these therapies are not appropriate. The goal of treatment is to normalize serum insulin-like growth factor-I (IGF-I) levels.
The recommended loading dose of SOMAVERT is 40 mg given subcutaneously, under healthcare provider supervision. Provide proper training in subcutaneous injection technique to patients or their caregivers so they can receive once daily subcutaneous injections. On the next day following the loading dose, instruct patients or their caregivers to begin daily subcutaneous injections of 10 mg of SOMAVERT.
Titrate the dosage to normalize serum IGF-I concentrations (serum IGF-I concentrations should be measured every four to six weeks). The dosage should not be based on growth hormone (GH) concentrations or signs and symptoms of acromegaly. It is unknown whether patients who remain symptomatic while achieving normalized IGF-I concentrations would benefit from increased SOMAVERT dosage.
The recommended dosage range is between 10 to 30 mg given subcutaneously once daily and the maximum daily dosage is 30 mg given subcutaneously once daily.
Prior to the start of SOMAVERT, patients should have an assessment of baseline levels of liver tests [serum alanine aminotransferase (ALT), aspartate aminotransferase (AST), serum total bilirubin (TBIL), and alkaline phosphatase (ALP)]. For recommendations regarding initiation of SOMAVERT based on baseline liver tests and recommendations for monitoring of liver tests while on SOMAVERT, refer to Table 1 in Warning and Precautions (5.2).
The following instructions are for the healthcare provider to reconstitute and prepare the 40 mg loading dose. The healthcare provider will need to reconstitute 1 vial of lyophilized powder of SOMAVERT containing 20 mg of pegvisomant with supplied diluent (two vials of lyophilized powder and two vials of diluent will be needed for the 40 mg loading dose). The healthcare provider will also need to inject the reconstituted SOMAVERT solution twice into the patient's upper arm, upper thigh, abdomen, or buttocks (each injection in a different area).
For patient or caregiver instructions for reconstitution and administration of daily doses (10 to 30 mg), see the Patient's Instructions for Use.
For injection: 10 mg, 15 mg, 20 mg, 25 mg, and 30 mg lyophilized powder in a single-use vial for reconstitution with supplied Sterile Water for Injection, in a separate glass vial.
GH opposes the effects of insulin on carbohydrate metabolism by decreasing insulin sensitivity; thus, glucose tolerance may improve in some patients treated with SOMAVERT. Patients should be carefully monitored and doses of anti-diabetic drugs reduced as necessary to avoid hypoglycemia in patients with diabetes mellitus.
Baseline serum alanine aminotransferase (ALT), aspartate aminotransferase (AST), serum total bilirubin (TBIL), and alkaline phosphatase (ALP) levels should be obtained prior to initiating therapy with SOMAVERT. Table 1 lists recommendations regarding initiation of treatment with SOMAVERT, based on the results of these liver tests (LTs).
Asymptomatic, transient elevations in transaminases up to 15 times ULN have been observed in < 2% of subjects among two open-label trials (with a total of 147 patients). These reports were not associated with an increase in bilirubin. Transaminase elevations normalized with time, most often after suspending treatment (SOMAVERT should be used in accordance with the information presented in Table 2 with respect to liver test abnormalities while on Somavert treatment).
Baseline LT Levels | Recommendations |
Normal |
Elevated, but less than or equal to 3 times ULN | May treat with SOMAVERT; however, monitor LTs monthly for at least one year after initiation of therapy and then bi-annually for the next year. |
Greater than 3 times ULN |
If a patient develops LT elevations, or any other signs or symptoms of liver dysfunction while receiving SOMAVERT, the following patient management is recommended (Table 2).
LT Levels and Clinical Signs/Symptoms | Recommendations |
Greater than or equal to 3 but less than 5 times ULN (without signs/symptoms of hepatitis or other liver injury, or increase in serum TBIL) |
At least 5 times ULN, or transaminase elevations at least 3 times ULN associated with any increase in serum TBIL (with or without signs/symptoms of hepatitis or other liver injury) |
Signs or symptoms suggestive of hepatitis or other liver injury (e.g., jaundice, bilirubinuria, fatigue, nausea, vomiting, right upper quadrant pain, ascites, unexplained edema, easy bruisability) |
SOMAVERT has significant structural similarity to growth hormone (GH) which causes it to cross-react in commercially available GH assays. Since serum concentrations of therapeutically effective doses of SOMAVERT are generally 100 to 1000 times higher than the actual serum GH concentrations seen in patients with acromegaly, measurements of serum GH concentrations will appear falsely elevated.
There have been cases of lipohypertrophy in patients treated with SOMAVERT. In a double-blind, 12-week, placebo-controlled study, there was one case (1.3%) of injection site lipohypertrophy reported in a subject receiving 10 mg/day. The subject recovered while on treatment. Among two open-label trials (with a total of 147 patients), there were two subjects, both receiving 10 mg/day, who developed lipohypertrophy. One case recovered while on treatment, and one case resulted in a discontinuation of treatment. Injection sites should be rotated daily to help prevent lipohypertrophy (different area than the last injection).
In subjects with systemic hypersensitivity reactions, caution and close monitoring should be exercised when re-initiating Somavert therapy [see Adverse Reactions (6.3)].
Clinically significant adverse reactions that appear in other section of the labeling include:
Elevations of serum concentrations of ALT and AST greater than ten times the ULN were reported in two patients (0.8%) exposed to SOMAVERT in pre-approval clinical studies. One patient was rechallenged with SOMAVERT, and the recurrence of elevated transaminase levels suggested a probable causal relationship between administration of the drug and the elevation in liver enzymes. A liver biopsy performed on the second patient was consistent with chronic hepatitis of unknown etiology. In both patients, the transaminase elevations normalized after discontinuation of the drug.
Elevations in ALT and AST levels were not associated with increased levels of TBIL and ALP, with the exception of two patients with minimal associated increases in ALP levels (i.e., less than 3 times ULN). The transaminase elevations did not appear to be related to the dose of SOMAVERT administered, generally occurred within 4 to 12 weeks of initiation of therapy, and were not associated with any identifiable biochemical, phenotypic, or genetic predictors.
Because clinical trials are conducted under widely varying conditions, adverse reactions rates observed in clinical trials of a drug cannot be directly compared to rates in clinical trials of another drug and may not reflect the rates observed in practice.
In a 12-week randomized, placebo-controlled, double-blind, fixed-dose study of SOMAVERT in subjects with acromegaly, 32 subjects received placebo and 80 subjects received SOMAVERT once daily [see Clinical Studies (14)]. A total of 108 subjects (30 placebo, 78 Somavert) completed 12 weeks of study treatment.
Overall, eight patients with acromegaly (5.3%) withdrew from pre-marketing clinical studies because of adverse events, including two patients with marked transaminase elevations, one patient with lipohypertrophy at the injection sites, and one patient with substantial weight gain. Most adverse events did not appear to be dose-dependent. Table 3 shows the incidence of adverse events that were reported in at least two patients treated with SOMAVERT and at frequencies greater than placebo during the 12-week, placebo-controlled study.
Placebo n=32 | SOMAVERT | |||
10 mg/day n=26 | 15 mg/day n=26 | 20 mg/day N=28 | ||
| ||||
Infection† | 2 (6%) | 6 (23%) | 0 | 0 |
Pain | 2 (6%) | 2 (8%) | 1 (4%) | 4 (14%) |
Nausea | 1 (3%) | 0 | 2 (8%) | 4 (14%) |
Diarrhea | 1 (3%) | 1 (4%) | 0 | 4 (14%) |
Abnormal liver function tests | 1 (3%) | 3 (12%) | 1 (4%) | 1 (4%) |
Flu syndrome | 0 | 1 (4%) | 3 (12%) | 2 (7%) |
Injection site reaction | 0 | 2 (8%) | 1 (4%) | 3 (11%) |
Dizziness | 2 (6%) | 2 (8%) | 1 (4%) | 1 (4%) |
Accidental injury | 1 (3%) | 2 (8%) | 1 (4%) | 0 |
Back pain | 1 (3%) | 2 (8%) | 0 | 1 (4%) |
Sinusitis | 1 (3%) | 2 (8%) | 0 | 1 (4%) |
Chest pain | 0 | 1 (4%) | 2 (8%) | 0 |
Peripheral edema | 0 | 2 (8%) | 0 | 1 (4%) |
Hypertension | 0 | 0 | 2 (8%) | 0 |
Paresthesia | 2 (6%) | 0 | 0 | 2 (7%) |
In pre-marketing clinical studies, approximately 17% of the SOMAVERT-treated patients developed low titer, non-neutralizing anti-GH antibodies. Although the presence of these antibodies did not appear to impact the efficacy of SOMAVERT, the long-term clinical significance of these antibodies is not known. No assay for anti-pegvisomant antibodies is commercially available for patients receiving SOMAVERT.
The data above reflect the percentage of patients whose test results were considered positive for antibodies to SOMAVERT. The detection of antibody formation is highly dependent on the sensitivity and specificity of the assay. Additionally, the observed incidence of antibody positivity in an assay may be influenced by several factors including sample handling, timing of sample collection, concomitant medications, and underlying disease. For these reasons, comparison of the incidence of antibodies to SOMAVERT with the incidence of antibodies to other products may be misleading.
The following adverse reactions have been identified during post-approval use of SOMAVERT. Because these reactions are reported voluntarily from a population of uncertain size, it is not always possible to reliably estimate their frequency or establish a causal relationship to drug exposure.
Systemic hypersensitivity reactions including anaphylactic reactions, laryngospasm, angioedema, generalized skin reactions (rash, erythema, pruritus, urticaria) have been reported in post-marketing use. Some patients required hospitalization. Symptoms did not re-occur in all patients after re-challenge [see Warnings and Precautions (5.5)].
Registry of Patients with Acromegaly Treated with SOMAVERT
ACROSTUDY is an international observational registry that captures long term safety data in patients with acromegaly treated with SOMAVERT, as used in clinical practice. Treatment dose and schedule were at the discretion of each treating physician. Although safety monitoring as per the recommended schedule was mandatory, not all assessments were performed at all time points for every patient. Because of this, comparison of rates of adverse events to those in the original clinical trial is not appropriate. In an interim report, there were 1288 patients enrolled (mean duration of treatment 3.7 years).
At the start of SOMAVERT treatment 648 patients were on SOMAVERT monotherapy for acromegaly. Of the 454 patients who had a normal AST and ALT at baseline, 4 patients had elevated tests >3 times ULN, two of whom had elevated tests >5 times ULN.
Lipohypertrophy was reported in 6 (0.5%) patients.
MRIs were compared to any previous ones, and a change in tumor volume was reported as significant locally only if the diameter increased by more than 3 mm for microadenomas or volume increased by more than 20% for macroadenomas. All MRI changes considered significant at the local reading were reanalyzed centrally. Of the 747 patients who had a MRI reported at baseline and at least once during follow up in the study, 51 (7%) were reported to have an increase by local MRI. Of these, 16 patients (2%) had confirmation of this increase, 6 patients had a decrease, 12 had "no change"; there was 1 with insufficient data and 16 patients did not have a central MRI reading.
After initiation of SOMAVERT, patients with acromegaly and diabetes mellitus treated with insulin and/or oral hypoglycemic agents may require dose reductions of insulin and/or oral hypoglycemic agents [see Warnings and Precautions (5.1)].
Pregnancy Category C. There are no adequate and well-controlled studies in pregnant women. Early embryonic development and teratology studies were conducted in pregnant rabbits with pegvisomant at subcutaneous doses of 1, 3, and 10 mg/kg/day. There was no evidence of teratogenic effects associated with pegvisomant treatment during organogenesis. At the 10-mg/kg/day dose (10 times the maximum human therapeutic dose based on body surface area), a reproducible, slight increase in post-implantation loss was observed in both studies. Because animal reproduction studies are not always predictive of human responses, SOMAVERT should be used during pregnancy only if clearly needed.
It is not known whether pegvisomant is excreted in human milk. Because many drugs are excreted in milk, caution should be exercised when SOMAVERT is administered to a nursing woman.
The safety and effectiveness of SOMAVERT in pediatric patients have not been established.
Clinical studies of SOMAVERT did not include sufficient numbers of patients aged 65 and over to determine whether they respond differently from younger patients. In general, dose selection for an elderly patient should be cautious, usually starting at the low end of the dosing range, reflecting the greater frequency of decreased hepatic, renal, or cardiac function, and of concomitant disease or other drug therapy.
In one reported incident of acute overdose with SOMAVERT during pre-marketing clinical studies, a patient self-administered 80 mg/day (2.7 times the maximum recommended maintenance dosage) for seven days. The patient experienced a slight increase in fatigue, had no other complaints, and demonstrated no significant clinical laboratory abnormalities.
In cases of overdose, administration of SOMAVERT should be discontinued and not resumed until IGF-I levels return to within or above the normal range.
SOMAVERT contains pegvisomant, an analog of human growth hormone (GH) that has been structurally altered to act as a GH receptor antagonist.
Pegvisomant is a protein of recombinant DNA origin containing 191 amino acid residues to which several polyethylene glycol (PEG) polymers are covalently bound (predominantly 4 to 6 PEG/protein molecule). The molecular weight of the protein of pegvisomant is 21,998 Daltons. The molecular weight of the PEG portion of pegvisomant is approximately 5000 Daltons. The predominant molecular weights of pegvisomant are thus approximately 42,000, 47,000, and 52,000 Daltons. The schematic shows the amino acid sequence of the pegvisomant protein (PEG polymers are shown attached to the 5 most probable attachment sites). Pegvisomant is synthesized by a specific strain of Escherichia coli bacteria that has been genetically modified by the addition of a plasmid that carries a gene for GH receptor antagonist. Biological potency is determined using a cell proliferation bioassay. Binding of Somavert to the GH receptor results in disruption of the proper binding of the second GH receptor with inhibition of functional receptor dimerization and subsequent intracellular signaling.
Stippled residues indicate PEG attachment sites (Phe1, Lys38, Lys41, Lys70, Lys115, Lys120, Lys140, Lys145, Lys158)
Shown below are the amino acid substitutions in pegvisomant, relative to human GH.
hGH | Pegvisomant |
His18 | Asp18 |
Ala21 | Asn21 |
Gly120 | Lys120 |
Arg167 | Asn167 |
Lys168 | Ala168 |
Asp171 | Ser171 |
Lys172 | Arg172 |
Glu174 | Ser174 |
Ile179 | Thr179 |
SOMAVERT for injection is supplied as a sterile, white lyophilized powder intended for subcutaneous injection after reconstitution with 1 mL of Sterile Water for Injection. SOMAVERT is available in single-dose sterile vials containing 10, 15, 20, 25 or 30 mg of pegvisomant protein (approximately 10, 15, 20, 25 and 30 U activity, respectively). Each vial 10, 15 and 20 also contains 1.36 mg of glycine, 36.0 mg of mannitol, 1.04 mg of sodium phosphate dibasic anhydrous, and 0.36 mg of sodium dihydrogen phosphate monohydrate. Each 25 mg vial also contains 1.7 mg of glycine, 45 mg of mannitol, 1.3 mg of sodium phosphate dibasic anhydrous, and 0.45 mg of sodium dihydrogen phosphate monohydrate. Each 30 mg vial also contains 2.04 mg of glycine, 54 mg of mannitol, 1.56 mg of sodium phosphate dibasic anhydrous, and 0.54 mg of sodium dihydrogen phosphate monohydrate.
SOMAVERT is supplied in packages that include a vial containing diluent. Sterile Water for Injection, USP, is a sterile, nonpyrogenic preparation of water for injection that contains no bacteriostat, antimicrobial agent, or added buffer, and is supplied in single-dose containers to be used as a diluent.
Pegvisomant selectively binds to growth hormone (GH) receptors on cell surfaces, where it blocks the binding of endogenous GH, and thus interferes with GH signal transduction.
Inhibition of GH action results in decreased serum concentrations of IGF-I, as well as other GH-responsive serum proteins such as free IGF-I, the acid-labile subunit of IGF-I (ALS), and insulin-like growth factor binding protein-3 (IGFBP-3).
Pegvisomant binds selectively to the GH receptor, and does not cross-react with 19 other cytokine receptors tested, including prolactin. Pegvisomant leads to decreased serum concentrations of IGF-I, free IGF-I, ALS, and IGFBP-3 [see Clinical Studies (14, Figure 1)].
Absorption: Following subcutaneous administration, peak serum pegvisomant concentrations are not generally attained until 33 to 77 hours after administration. The mean extent of absorption of a 20-mg subcutaneous dose was 57%, relative to a 10-mg intravenous dose.
Distribution: The mean apparent volume of distribution of pegvisomant is 7 L (12% coefficient of variation), suggesting that pegvisomant does not distribute extensively into tissues. After a single subcutaneous administration, exposure (Cmax, AUC) to pegvisomant increases disproportionately with increasing dose. Mean ± SEM serum pegvisomant concentrations after 12 weeks of therapy with daily doses of 10, 15, and 20 mg were 6600 ± 1330; 16,000 ± 2200; and 27,000 ± 3100 ng/mL, respectively.
The relative bioavailability of 1 × 30 mg pegvisomant was compared to 2 × 15 mg pegvisomant in a single dose study. The AUCinf and Cmax of pegvisomant when administered as one injection of 30 mg strength was approximately 6% and 4% greater, respectively, as compared to when administered as two injections of 15 mg strengths.
Metabolism and Elimination: The pegvisomant molecule contains covalently bound polyethylene glycol polymers in order to reduce the clearance rate. Clearance of pegvisomant following multiple doses is lower than seen following a single dose. The mean total body systemic clearance of pegvisomant following multiple doses is estimated to range between 36 to 28 mL/h for subcutaneous doses ranging from 10 to 20 mg/day, respectively. Clearance of pegvisomant was found to increase with body weight. Pegvisomant is eliminated from serum with a mean half-life estimates ranging from 60 to 138 hours following either single or multiple doses. Less than 1% of administered drug is recovered in the urine over 96 hours. The elimination route of pegvisomant has not been studied in humans.
Drug Interaction Studies
In clinical studies, patients on opioids often needed higher serum pegvisomant concentrations to achieve appropriate IGF-I suppression compared with patients not receiving opioids. The mechanism of this interaction is not known [see Drug Interactions (7.2)].
Specific Populations
No pharmacokinetic studies have been conducted in patients with renal impairment, patients with hepatic impairment, geriatric patients, or pediatric patients and the effects of race on the pharmacokinetics of pegvisomant has not been studied. No gender effect on the pharmacokinetics of pegvisomant was found in a population pharmacokinetic analysis.
Pegvisomant was administered subcutaneously to rats daily for 2 years at doses of 2, 8 and 20 mg/kg (about 2, 10 and 25-fold a single 20 mg dose in humans on an AUC basis). Long term treatment with pegvisomant at 8 and 20 mg/kg caused an increase in malignant fibrous histiocytoma at injection sites in males. Injection site tumors were not seen in female rats at the same doses. The increased incidence of injection site tumors was most probably caused by irritation and the high sensitivity of the rat to repeated subcutaneous injections.
A total of one hundred twelve patients (63 men and 49 women) with acromegaly participated in a 12-week, randomized, double-blind, multi-center study comparing placebo and SOMAVERT. The mean ±SD age was 48±14 years, and the mean duration of acromegaly was 8±8 years. Ninety three had undergone previous pituitary surgery, of which 57 had also been treated with conventional radiation therapy. Six patients had undergone irradiation without surgery, nine had received only drug therapy, and four had received no previous therapy. At study start, the mean ± SD time since the subjects' last surgery and/or irradiation therapy, respectively, was 6.8 ± 0.93 years (n=63) and 5.6 ± 0.57 years (n=93).
Subjects were qualified for enrollment if their serum IGF-I, drawn after the required drug washout period, was ≥1.3 times the upper limit of the age-adjusted normal range. They were randomly assigned at the baseline visit to one of four treatment groups: placebo (n=32), 10 mg/day (n=26), 15 mg/day (n= 26), or 20 mg/day (n=28) of SOMAVERT subcutaneouslyIGF-I. The primary efficacy endpoint was IGF-I percent change in IGF-I concentrations from baseline to week 12. The three groups that received SOMAVERT showed statistically significant (p<0.01) reductions in serum levels of IGF-I compared with the placebo group (Table 4).
Placebo n=31 | SOMAVERT | |||
10 mg/day n=26 | 15 mg/day n=26 | 20 mg/day n=28 | ||
| ||||
Mean baseline IGF-I (ng/ml) (SD) | 670 (288) | 627 (251) | 649 (293) | 732 (205) |
Mean percent change from baseline in IGF-I (SD) | -4.0 (17) | -27 (28) | -48 (26) | -63 (21) |
SOMAVERT minus Placebo (95% CI for treatment difference) | -23* (-35, -11) | -44* (-56, -33) | -59* (-68, -49) |
There were also reductions in serum levels of free IGF-I, IGFBP-3, and ALS compared with placebo at all post-baseline visits (Figure 1).
Figure 1. Effects of SOMAVERT on Serum Markers (Mean ± Standard Error) |
After 12 weeks of treatment, the following percentages of patients had normalized IGF-1 (Figure 2):
Figure 2. Percent of Patients Whose IGF-I Levels Normalized at Week 12 |
Table 5 shows the effect of treatment with SOMAVERT on ring size (standard jeweler's sizes converted to a numeric score ranging from 1 to 63), and on signs and symptoms of acromegaly. Each individual score for a sign or symptom of acromegaly (for soft-tissue swelling, arthralgia, headache, perspiration and fatigue) was based on a nine-point ordinal rating scale (0 = absent and 8 = severe and incapacitating), and the total score for signs or symptoms of acromegaly was derived from the sum of the individual scores. Mean baseline scores were as follows: ring size = 47.1; total signs and symptoms = 15.2; soft tissue swelling = 2.5; arthralgia = 3.2; headache = 2.4; perspiration = 3.3; and fatigue = 3.7.
Placebo n=30 | SOMAVERT | |||
10 mg/day n=26 | 15 mg/day n=24–25 | 20 mg/day n=26–27 | ||
Ring size | -0.1 (2.3) | -0.8 (1.6) | -1.9 (2.0) | -2.5 (3.3) |
Total score for signs and symptoms of acromegaly | 1.3 (6.0) | -2.5 (4.3) | -4.4 (5.9) | -4.7 (4.7) |
Soft-tissue swelling | 0.3 (2.3) | -0.7 (1.6) | -1.2 (2.3) | -1.3 (1.3) |
Arthralgia | 0.1 (1.8) | -0.3 (1.8) | -0.5 (2.5) | -0.4 (2.1) |
Headache | 0.1 (1.7) | -0.4 (1.6) | -0.3 (1.4) | -0.3 (2.0) |
Perspiration | 0.1 (1.7) | -0.6 (1.6) | -1.1 (1.3) | -1.7 (1.6) |
Fatigue | 0.7 (1.5) | -0.5 (1.4) | -1.3 (1.7) | -1.0 (1.6) |
Serum growth hormone (GH) concentrations, as measured by research assays using antibodies that do not cross-react with pegvisomant, rose within two weeks of beginning treatment with SOMAVERT. The largest increase in GH concentration was seen in patients treated with doses of SOMAVERT 20 mg/day. This effect is presumably the result of diminished inhibition of GH secretion as IGF-I levels fall. As shown in Figure 3, when patients with acromegaly were given a loading dose of SOMAVERT followed by a fixed daily dose, the rise in GH was inversely proportional to the fall in IGF-I and generally stabilized by week 2. Serum GH concentrations remained stable in patients treated with SOMAVERT for the average of 43 weeks (range, 0–82 weeks).
Figure 3. Percent Change in Serum GH and IGF-I Concentrations |
In the open-label extension to the clinical study, 109 subjects (including 6 new patients) with mean treatment exposure of 42.6 weeks (range 1 day – 82 weeks), 93 (85.3%) subjects had an adverse event, 16 (14.7%) had an SAE, and 4 (3.7%) discontinued due to an AE (headaches, elevated liver function tests, pancreatic cancer, and weight gain). A total of 100 (92.6%) of the 108 subjects with available IGF-I data had a normal IGF-I concentration at any visit during the study.
SOMAVERT (pegvisomant) is supplied in the following strengths and package configurations:
SOMAVERT (pegvisomant) for injection | ||
Package Configuration | NDC 6 mL vial | NDC 8 mL vial |
Single 10 mg dose vial | NDC 0009-5176-01 | NDC 0009-5176-02 |
Single 15 mg dose vial | NDC 0009-5178-01 | NDC 0009-5178-02 |
Single 20 mg dose vial | NDC 0009-5180-01 | NDC 0009-5180-02 |
Single 25 mg dose vial | NDC 0009-5199-01 | |
Single 30 mg dose vial | NDC 0009-5200-01 |
Each package of SOMAVERT also includes a single-dose vial containing Sterile Water for Injection, USP.
See FDA- approved patient labeling (Patient Information and Instructions for Use).
Inform patients (and/or their caregivers) of the following information to aid in the safe and effective use of SOMAVERT:
Advise patients (and/or their caregivers) of the following adverse reactions:
Advise patients that SOMAVERT is supplied as lyophilized powder in different strengths of 10 mg, 15 mg, 20 mg, 25 mg, and 30 mg in a sterile glass vial within a package also containing a single-dose flip top vial of sterile water (diluent) for injection. Advise patients that the stoppers on both vials are not made with natural rubber latex. Advise patients to follow the directions for reconstitution provided with each package including shaking may cause denaturation (destruction) of the active ingredient (therefore do not shake).
Advise patients that the package of SOMAVERT should be stored in a refrigerator 2 to 8°C (36 to 46°F) prior to use. It should NOT BE FROZEN.
SOMAVERT® (SOM-ah-vert)
pegvisomant for injection
What is SOMAVERT?
SOMAVERT is a prescription medicine used to treat people who have too much growth hormone (acromegaly). SOMAVERT is used to treat people who are not able to be treated or have not already been helped by surgery or radiation.
It is not known if SOMAVERT is safe and effective in children.
What should I tell my healthcare provider before I use SOMAVERT?
Before you use SOMAVERT, tell your healthcare provider if you:
Tell your healthcare provider about all the medicines you take, including prescription and non-prescription medicines, vitamins, and herbal supplements.
SOMAVERT may affect the way other medicines work, and other medicines may affect how SOMAVERT works. Especially tell your healthcare provider if you take:
If you are not sure, ask your healthcare provider or pharmacist whether you take these medicines.
Know the medicines you take. Keep a list of all the medicines you take to show your healthcare providers and pharmacists when you get a new medicine.
How should I use SOMAVERT?
What are the possible side effects of SOMAVERT?
SOMAVERT may cause serious side effects, including:
The most common side effects of SOMAVERT include:
These are not all of the possible side effects of SOMAVERT. For more information, ask your healthcare provider or pharmacist.
Tell your healthcare provider if you have any side effect that bothers you or that does not go away.
Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.
How should I store SOMAVERT?
Keep SOMAVERT and all medicines out of the reach of children.
General Information about the safe and effective use of SOMAVERT.
Medicines are sometimes prescribed for purposes other than those listed in a Patient Information leaflet. Do not use SOMAVERT for a condition for which it was not prescribed. Do not give SOMAVERT to other people, even if they have the same symptoms that you have. It may harm them.
This Patient Information summarizes the most important information about SOMAVERT. If you would like more information, talk with your healthcare provider. You can ask your pharmacist or healthcare provider for information about SOMAVERT that is written for health professionals.
For more information, go to www.Somavert.com or call 1-800-645-1280.
What are the ingredients in SOMAVERT?
Active ingredient: pegvisomant, including polyethylene glycol
Inactive ingredients: glycine, mannitol, sodium phosphate dibasic anhydrous, and sodium phosphate monobasic monohydrate
SOMAVERT® (SOM-ah-vert)
(pegvisomant for injection)
Supplies you need to give each injection of SOMAVERT. See Figure A.
The vials in the package of SOMAVERT have stoppers that are not made with natural rubber latex.
The SOMAVERT package does not come with syringes and needles.
Preparing and mixing your SOMAVERT medicine
The SOMAVERT medicine comes as a dry powder. Before you use SOMAVERT, you must mix the dry powder with the vial of diluent that comes in the SOMAVERT package.
Do not use any other liquid to mix the medicine.
Note: If you need to give 2 injections for your SOMAVERT dose, you need 2 packages of SOMAVERT to prepare 2 separate vials of medicine.
Step 1. Remove 1 package of SOMAVERT from the refrigerator about 10 minutes before you plan to give your SOMAVERT injection. Let the SOMAVERT stand at room temperature to warm up the medicine.
Step 2. Wash your hands with soap and warm water. Dry your hands well.
Step 3. Remove the plastic caps from the tops of the powder vial and the diluent vial. See Figure B.
Do not touch the rubber vial stoppers. The stoppers are clean. If the stoppers are touched by anything, you must clean them with an alcohol swab before use.
Step 4. Carefully remove the cap from the diluent syringe with the larger needle and set the cap aside on the table. See Figure C.
Step 5. Pull the plunger of the diluent syringe out to the 1 mL mark. With 1 hand, firmly hold the vial of diluent. With the other hand, push the needle of the diluent syringe straight through the center of the rubber stopper and deep into the vial. Gently push the plunger in until the air is injected into the vial. See Figure D.
Step 6. Firmly hold the diluent vial and syringe together, with the needle still deeply inserted into the vial. Carefully turn the vial and diluent syringe together upside down. Hold them at eye level. See Figure E.
Figure E |
Step 7. Slide 1 hand carefully down the diluent vial so you can firmly hold the neck of the vial with your thumb and forefinger. Hold the upper part of the syringe with your other fingers. With the other hand, slowly pull the plunger out to the 1 mL mark on the diluent syringe. See Figure F.
Step 8. Check the diluent syringe for air bubbles. If you see bubbles, tap the diluent syringe barrel until the bubbles rise to the top of the syringe. Carefully push the plunger in to push only the air bubbles back into the vial. See Figure G. If you push too much of the liquid back into the vial, pull the plunger out again to the 1 mL mark.
Step 9. Make sure that 1 mL of diluent remains in the diluent syringe. Pull the needle out of the vial. The vial should still have diluent in it. Do not use the leftover diluent in the vial.
Step 10. Push the needle of the diluent syringe straight through the stopper of the vial of powdered SOMAVERT.
Tilt the diluent syringe to the side and gently push the plunger in to inject the diluent down the inner side of the SOMAVERT powder vial. Be sure the diluent does not fall directly on the powder, but flows down the inside wall of the vial. See Figure H.
Step 11. When the diluent syringe is empty, pull the needle out of the powder vial.
Throw away the diluent vial with the leftover liquid in it. Throw away the diluent syringe and needle in the sharps container as your healthcare provider told you. See "Disposing of used needles and syringes" at the end of these instructions.
Step 12. Hold the medicine vial of SOMAVERT upright between your hands and gently roll it to dissolve the powder into a solution. See Figure I.
Tell your pharmacist and ask for another vial. Do not throw the vial away because the pharmacist may ask that you return it.
Preparing your SOMAVERT injection syringe:
Step 13. Clean the rubber stopper of the vial of SOMAVERT with an alcohol swab.
Step 14. Firmly hold the medicine solution vial and insulin syringe together, with the needle still deeply inserted into the vial. Carefully turn the vial and syringe together upside down. Hold them at eye level. See Figure K.
Step 15. Slide 1 hand carefully down the medicine solution vial so you can firmly hold the neck of the vial with your thumb and forefinger. Hold the upper part of the syringe with your other fingers. With the other hand, slowly pull the plunger out to the 1 mL mark on the insulin syringe. See Figure L.
Step 16. Check the insulin syringe for air bubbles. If you see bubbles, tap the insulin syringe barrel until the bubbles rise to the top of the syringe. Carefully push the plunger in to push only the air bubbles back into the vial. See Figure M.
Step 17. Withdraw the entire 1 mL of medicine solution from the vial. If your dose of SOMAVERT is less than 1 mL, your healthcare provider will tell you how much medicine solution to withdraw. Slowly withdraw the needle to keep the tip in the liquid until you get all the medicine solution you need out of the vial. See Figure N.
Set the syringe and needle on the table without anything touching the needle.
Selecting your SOMAVERT injection site:
Step 18. SOMAVERT is injected under the skin (subcutaneous). Injection sites may include your upper arm, upper thigh, stomach area (abdomen) and buttocks. See Figure O.
Giving your SOMAVERT injection:
Step 19. Clean your injection site with an alcohol swab. See Figure P.
Let your skin dry before you inject your medicine.
Step 20. With 1 hand, gently pinch up your skin at your injection site. See Figure Q.
Step 21. Carefully pick up the insulin syringe with your other hand and hold it like a pen. In a single, smooth motion, push the needle straight down and completely into your skin (at a 90-degree angle).
Step 22. Release your pinched skin and pull the needle straight out. See Figure S.
Step 23. Do not rub your injection area. A small amount of bleeding may happen.
If you have a small amount of bleeding, press a small clean, dry cotton pad over the area and press gently for 1 or 2 minutes, or until the bleeding has stopped. See Figure T.
Disposing of used needles and syringes:
This Patient Information and Instructions for Use has been approved by the U.S. Food and Drug Administration.
August 2014


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Volume (Year): 28 (1999)
Issue (Month): 2 (December)
Pages: 117-150
Handle: | RePEc:eee:jaecon:v:28:y:1999:i:2:p:117-150 |
Contact details of provider: | Web page: http://www.elsevier.com/locate/jae |
References listed on IDEAS
Please report citation or reference errors to , or , if you are the registered author of the cited work, log in to your RePEc Author Service profile, click on "citations" and make appropriate adjustments.:
- Lang, Larry & Poulsen, Annette & Stulz, Rene, 1995.
"Asset sales, firm performance, and the agency costs of managerial discretion,"
Journal of Financial Economics,
Elsevier, vol. 37(1), pages 3-37, January.
- Larry Lang & Annette Poulsen & Rene M. Stulz, 1994. "Asset Sales, Firm Performance, and the Agency Costs of Managerial Discretion," NBER Working Papers 4654, National Bureau of Economic Research, Inc.
- Patrick Cusatis & Lehman Brothers & James A. Miles & J. Randall Woolridge, 1994. "Some New Evidence That Spinoffs Create Value," Journal of Applied Corporate Finance, Morgan Stanley, vol. 7(2), pages 100-107.
- John, Kose & Ofek, Eli, 1995. "Asset sales and increase in focus," Journal of Financial Economics, Elsevier, vol. 37(1), pages 105-126, January.
- Comment, Robert & Jarrell, Gregg A., 1995. "Corporate focus and stock returns," Journal of Financial Economics, Elsevier, vol. 37(1), pages 67-87, January.
- Clinch, Greg & Shibano, Toshi, 1996. "Differential tax benefits and the pension reversion decision," Journal of Accounting and Economics, Elsevier, vol. 21(1), pages 69-106, February.
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Tower Bridge Superior Apartments, London Översikt
Jämför priser och boknings tillgänglighet Tower Bridge Superior Apartments, London
Tower Bridge Superior Apartments, London Detaljer
Tower Bridge Superior Apartments Hotell Översikt
Elegantly appointed set of London apartment with extensive amenities near Tower Bridge, HMS Belfast and London Bridge.
Please read carefully:
Check-in takes place at the new head office 6 Union Street, SE1 1SZ, London. Here you will receive the keys and pay the remaining balance.
Arrivals between 21:00 and midnight will be subject to a late check-in fee of GBP 20.00, arrivals after 00:00 are subject to a GBP 30.00 fee.
Please call the contact the property in order to arrange check-in, at least 1 hour before your arrival at the office. The contact details can be found in your booking confirmation.
If you would like to pay by credit card please be informed that due to charges made by credit card companies there is a 1.7% charge for most credit (and debit) card payments (4.2% in case of amex).
Please bring a photocopy of a picture ID of the person in whose name the reservation was made, and of any person paying by credit card.
A damage deposit of GBP 150 or credit card details will be required upon arrival. Groups of 6 people or more will be charged a security deposit of GBP 50 per person.
There is a fully equipped kitchen in every apartment.
Stadskartor, Hiss, Hela anläggningen är rökfri, Flerspråkig personal
Dygnet runt-bemannad reception, Bagageförvaring, Turistinformation
Trådlöst internet (Wi-Fi) utan extra kostnad i alla rum och allmänna områden (lobby/reception mm)
168 Tower Bridge Road
Tower Bridge Superior Apartments, London
168 Tower Bridge Road SE1 3LS , Storlondon Storbritannien 168 Tower Bridge Road - SE1 3LS , Storlondon , Storbritannien
Elegantly appointed set of London apartment with extensive amenities near Tower Bridge, HMS Belfast
Tower Bridge Superior Apartments, London Hotelldetaljer
Tower Bridge Superior Apartments London enjoys a convenient situation in Southwark, just a few steps from the Tower Bridge. The property is a short walk away from many museums including HMS Belfast, part of London's Imperial War Museum, the Golden Hinde, Sir Francis Drake's famous Golden Age ship and Tate Modern gallery. A 15-minute stroll to the east will lead you to London's most famous food market, Borough Market and onto the London Bridge. Furthermore, these apartments are served by 3 tube stations all within a 15-minute walk radius, offering easy access throughout the capital.
Apartment Tower Bridge offers elegantly appointed spacious two-bedroom apartments. Serviced by an elevator and a multilingual staff, every accommodation includes complimentary wireless Internet access. The apartments are excellently furnished and feature many amenities to ensure a memorable stay, whether you are visiting London for business or leisure.
The soundproofed accommodations in Tower Bridge Superior Apartments include a fully equipped kitchen with everything you need to prepare your own tasty meals. You will find extensive amenities from cookware and kitchen utensils, to a dishwasher, oven, microwave, and a fridge/freezer. Enjoy a complimentary cup of tea or coffee whilst relaxing in the living room in front of flat screen television. There is also a modern fully equipped bathroom with a drying rack, hairdryer and a washing machine.


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Star Wars Episode V: The Empire Strikes Back Behind The Scenes Photos
It's amazing that even after 30 plus years, behind the scenes photos continue to surface from one of the greatest movies of all time, 'Star Wars: Episode V – The Empire Strikes Back.'
Originally released back in 1980, 'The Empire Strikes Back' was the follow up to the film that started it all, 'A New Hope.' Imgur member joinyouinthesun decided to compile a comprehensive collection of over 66 behind the scenes photos from the iconic film depicting shots of Luke Skywalker losing his hand during the epic battle with Darth Vader, Chewbacca groping Princess Leia, the Yoda puppet as seen on the murky swamp planet of Dagobah, and of course a young George Lucas, the man responsible for creating one of the best movie franchises ever. Check out some of the photography below. [Via]
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Ambler, PA, USA < change city >
Florists (74)
Bands (61)
DJs (56)
Caterers (54)
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Limos (25)
Coordinators (23)
Videographers (21)
Wedding Fashion (16)
Invitations (15)
Officiants (15)
Decorations (11)
Favors (11)
Ceremony Musicians (9)
Ceremony Sites (234)
Reception Sites (132)
See All Vendors >
I've been shooting film/video for as long as I can remember. I inherited my grandfather's Super 8mm movie camera, and while I didn't shoot a whole lot with it, I learned at an early age to respect the power that it had. I come from a long line of film-makers and photographers...all of my extensive family owned movie cameras and still cameras, and the history of my family, as well as my own history, is very well documented :). I began my passion for documenting history as a photographer, and very quickly learned the art of shooting for that one moment, that instant in time. I brought that skill with me into videography, where I've discovered my true love, and have made very close friendships with a number of different photographers. I've modeled my skill as a wedding videographer after the art of photojournalism, and have a great many talented photographers to thank for their part in honing my craft even further.
I graduated from Hofstra University with a degree in Communications, and have been in business full time since 1995. I've also been a real estate investor for over 13 years, and am a licensed real estate agent with Keller Williams Real Estate in Blue Bell, PA. I live in Ambler, Pennsylvania with my wife, Jane, and our sons Josh & Danny. Thank you for taking the time to read more about me!
Category: | Videographers |
Address: |
Meetinghouse Road Ambler, PA 19002, USA 215-576-5500 |
More Info: | Contact > Visit Website > |
Reviews: |
1 review 1 wedding Add Your Review > |
1 rating
Michelle and Patrick's Wedding
"Apogee was just excellent for our ceremony! We only hired them for the ceremony since we were on a budget, and Matt and his team were just so great... and I totally forgot they were there! They navigated respectfully and quietly during our long, Catholic ceremony but still got all the shots. I can't say enough great things about Apogee. I knew I didn't have to worry with them, and I was right!"
Apogee Video Productions
Meetinghouse Road
Ambler, PA 19002, USA


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Water supply is likely to be the next big ecological crisis in the U.S., and this crisis likely will come as a result of drought and lack of funds for infrastructure upgrades to provide new sources of supply for a population that continues to grow. One response to America's growing water shortage might be an increased business and government focus on water conservation, water efficiency technologies, and on-site water treatment and reuse, both in homes and buildings. This situation could produce unprecedented opportunities for contractors, technology suppliers, and engineering consultants. What's more, the continued growth of LEED, especially LEED for Existing Buildings: Operations & Maintenance (LEED-EBOM), will put extra emphasis on water efficiency for building owners and designers looking for green solutions.
My report for the Mechanical Contractors Education and Research Foundation, "Water-Efficiency Technologies for Mechanical Contractors: New Business Opportunities," reviews a range of options available to building practitioners in addressing water use, ranging from water efficiency audits to rainwater harvesting, graywater reuse, high-efficiency fixtures, and cooling tower water conservation. Practitioners looking for solutions may want to consider some of the following areas.
Code Compliance
Impending code changes from both the International Association of Plumbing and Mechanical Officials (IAPMO) and the International Code Council (ICC) will facilitate adoption of local codes permitting both rainwater and graywater reuse. Code issues may make your eyes glaze over, but they are critical for opening up possibilities for reclaimed water. The IAPMO's Green Plumbing and Mechanical Code Supplement to its 2009 Uniform Plumbing & Mechanical Codes will be released in February 2010 and will include greatly enhanced requirements for water efficiency including graywater recycling and high-efficiency plumbing fixtures.
High-Efficiency Fixtures
Fixture renovations can be made at any time using a new generation of low-flow toilets, sinks, urinals, and other appliances. So-called High-Efficiency Toilets (HETs) use 20 percent less water per flush, which is 1.28 gallons, and are now required for all new product sales in California and Texas. The Environmental Protection Agency's (EPA) WaterSense program already certifies low-flow toilets, bathroom sinks, and urinals for commercial buildings. In the pipeline are low-flow showerheads, pre-rinse spray valves for commercial kitchens, and landscape irrigation controllers. The EPA has announced a WaterSense Home specification for builders that will complement the existing Energy Star program for new homes. Over time, WaterSense Homes could reduce water consumption by 20 percent, depending on the efficiency of the devices installed.
Some experts are concerned that reduced water flow might cause drain line problems, as there would be less water available to flush solids and paper, so the plumbing industry has commissioned a research project to study this issue.
Rainwater and Graywater Harvesting
Rainwater harvesting and graywater reuse are good technologies for new buildings and major renovations, since they both require dual piping systems to collect, treat, and reuse water inside the building, as well as space for possible water storage. Typically, rainwater storage systems are integrated with a building's fire-storage water tank. The storage tank often is sized to hold 50 percent or more of the water from a site's annual rainfall as creating a tank big enough to capture 100 percent of the annual rainfall usually doesn't pay since much of a site's annual rain often falls during a few big showers or storms. The harvested and treated rainwater can be used for toilet flushing, site irrigation, or to generate makeup water to compensate for loss of water to evaporation or leakage in a cooling tower.
Installing these systems in existing buildings is more costly and technically difficult. However, rainwater harvesting is gaining popularity for use in conjunction with existing buildings because it's feasible to implement an on-site treatment and reuse system to generate cooling tower makeup water or for use in landscaping, two applications that don't require installing new piping in the existing building. There also are opportunities in existing buildings for graywater reuse, a technology that involves both mechanical and landscape contractors, since most graywater captured and treated will be used on-site for landscaping.
Nonconventional technologies for on-site blackwater treatment and reuse are slowly gaining support, but probably will take another five years to gain any form of popularity. At present, their use is limited to new construction projects with educational objectives and those seeking high levels of LEED certification.
LEED-EBOM and the New Water-Efficiency Technologies
All LEED rating systems now require a 20 percent reduction in water use as a prerequisite for certification. In 2009, the fastest growing LEED system was LEED-EBOM, which added about 1,700 registered projects totaling more than 400 million square feet through the end of September alone. Retrofits are the next huge water conservation opportunity, and LEED-EBOM certification is an important driver of both energy and water retrofits.
LEED-EBOM's water efficiency prerequisite mandates that a project reduce water use 20 percent below the LEED baseline. The baseline assumes that all building fixtures meet the 2006 Uniform Plumbing Code or the 2006 International Plumbing Code. The baseline is raised 20 percent from the code limits for buildings completed in 1993 or later and 60 percent for buildings constructed prior to 1993. For example, let's consider the case of a building completed in 1990 with 100 water closets flushing at 3.5 gallons per flush (gpf). The current code is 1.6 gpf, so the baseline would be 2.56 gpf (1.6 gpf plus the 60 percent baseline adjustment). To meet the prerequisite, you'd have to reduce water use by about 27 percent, which means you'd have to change out roughly 50 percent of the toilets to fixtures that meet the new codes (94 gallons required savings divided by 1.9 gallons savings per fixture). At today's water rates in most cities, a building owner would make money doing this, since future water savings would more than pay for the costs of the upgrade.
LEED-EBOM awards up to 14 points for water efficiency attainments and a project may attain additional bonus points for exemplary performance or for meeting regionally significant water-use reduction targets. However, water conservation is doubly important when you consider that the process of capturing, storing, transporting, distributing, and treating water consumes significant amounts of electrical power.
I recommend that contractors, engineers, manufacturers, and system designers have a single point of responsibility inside their companies for tracking the progress of water-related technologies and the associated opportunities. For example, there are immediate business opportunities in water audits, as well as water-efficient fixture retrofits. Further, contractors, engineers, manufacturers, and designers should gain experience with cost-effective retrofit opportunities now while on-site water efficiency and recycling is still in a developmental stage.
Jerry Yudelson is principal at Yudelson Associates in Tucson, Ariz., and the author of Dry Run: Preventing the Next Urban Water Crisis. To view his full report on water efficiency technologies and the business opportunities associated with them, visit greenbuildconsult.com.


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We post a lot of miserable and mediocre posters here on Cinema Blend, so when some movie artwork comes around that is actually good, we like to celebrate it. Enter the new poster for John Cameron Mitchell's Rabbit Hole.
Having caught the film at AFI Fest earlier this month (you can read my review here), I can assure you that the artwork reflects well on a truly fantastic film. The movie stars Nicole Kidman and Aaron Eckhart as two parents who have lost their young son in a car accident and are faced with the incredible struggles in trying to overcome the tragedy. Check out the new poster below, which premiered over at Cinematical, and join me after for some analysis. While the clip doesn't show the lighter side of the film that I loved so much, this is a truly great poster. Though not nearly as simple as the movie's first one-sheet, the new artwork beautifully displays the range of grief experienced in the film while also effectively showing off its two main actors. I also love that the bars are of uneven sizes, which adds a perfect touch and makes everything seem a little off-kilter, reflecting the emotional state. In summation: this is how you make a poster, people. For more on Rabbit Hole, head on over to our Blend Film Database and be sure to check the film out when it hits theaters on December 17.
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Starring Monogram's low-budget answer to Gene Autry, the rather colorless Jimmy Wakely, this minor music Western was actually disapproved for export on the grounds that it depicted what the censorship boards deemed "general lawlessness." The "lawlessness" depicted centers around Denny (Dennis Moore), impersonating a federal agent after being falsely accused of killing Bruce Carter (Hugh Prosser), a guest at the Mesa Inn. As it turns out, the dead man isn't what he claimed to be, either, but with the help...more
All Song of the Range cast + crew photos


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Marthe Keller doesn't have any movies playing in theaters.
If you feel like heading out, check out other movies in theaters.
My Best Enemy
Bobby Deerfield
The Formula
Funeral in Berlin
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Toute une Vie
Marathon Man
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August 29th, 2011, 07:29 PM | #1 |
Senior Member
SOLD - 3 Jeep XJ doors, near mint, no rust
$50 per door. $100 for all three yeah, I'm a big dummy... bought these to swap onto my 97 XJ and they are just a little bit different shade of steel blue. They are in great shape. Have both fronts and the driver's rear. Passenger front has a HINT of seem rust on the INSIDE, none from the outside. A few tiny dinks/scratches here and there, but I'd say with a buffing wheels and a rubber hammer, they could be made all but perfect... No glass in the fronts. Rear has main glass, but the 1/4 window is busted out. Doors are manual locks and windows. No idea if the speakers work, but they're included! I believe these came from a '99 Cherokee Sport. I WILL trade these for a nice JCR style front or rear bumper, some Bushwacker style fender flares, offroad lights, some black d-window or soft 8 style wheels 15x8, etc, etc. What I am NOT looking for in trade is anything out of your boxes of stock takeoff parts that are cluttering up your garage. Please don't offer me a stock anything. Also not looking for lift parts. Just want to recover my money. $75 each, picked up. I live in Milan, work in Belleville. Thanks Last edited by DetroitStyle; January 7th, 2012 at 04:36 PM. |
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September 30th, 2011, 12:10 PM | #10 |
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October 12th, 2011, 12:52 PM | #14 |
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If there is any way I can get these I would give you your price. It is the whole shipping thing that is a pain. I do not really trust UPS or anyone because they would come in beat to pieces. If we can keep in touch about travels, maybe it would work to meet up somewhere. I am in Lafayette, IN and within a 1/2 mile of an I-65 exit if anyone might be able to help.
January 1st, 2012, 08:04 PM | #15 |
Senior Member
Still have these... no Jeeps anymore, so $100 for all three. They are just taking up space. You can pick them up from me in Milan during the day and Belleville during the evenings....
January 4th, 2012, 08:29 AM | #17 |
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This rail is plumbed into the system in the same way as a standard radiator would be and must be fitted with valves to enable its use with the central heating system. Made from 100% stainless steel, it wont rust, flake or corrode. Furthermore, its easy to clean and blemishes or light scratches can be polished out with relative ease. Each size comes with standard brackets (85mm length) and profile valves. Please see below for overall projections: Whitsand 400 - overall projection of 140mm Whitsand 520 - overall projection of 165mm Whitsand 620 - overall projection of 165mm Please note: Not all of our ranges are on display in our furniture departments. Please call your nearest John Lewis to check before you visit. Interest Free Credit: If you buy this product in our shops, its eligible for Interest Free Credit, which is available when you spend 1000 or more on selected home products. Terms and conditions apply: find out more
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a keepsake
Saturday, May 26, 2012
it is no secret around this blog
that i am a purger,
and do not tend to exhibit hoarding tendencies.
ok, maybe with fabric and yarn.
there is something very cathartic
about purging, getting rid of the clutter
and stuff you just dont need.
i have not kept many of chace's baby clothes.
i sent them all to my nephew,
but even if i did not have someone to pass them
down to, i know i would not have kept them.
i mean, let's be honest.
chace does not want a box of his clothes
to put his child in 30 something
years from now.
but he might want a quilt
made from those clothes.
a keepsake to pass on to future generations
that is actually useful and does not cause clutter.
the above quilt was made for valerie's
daugther gianna.
she asked me a few months ago, if i could
make a quilt out of her clothes.
of course i said yes.
i have seen other quilts made out of clothes,
but they seemed disjointed, random.
there was no connection between the clothes used.
i knew that i wanted mine quilt
to look different,
to stand out,
to be unique.
i solved this by using a group of fabrics
to tie the pieces of clothing together.
the center of each square is the detail
that valerie wanted to keep.
i think my favorite is gianna's footprints
taken after she was born
and put on her father's scrubs.
( he is an ED doctor).
i loved making this quilt.
it turned out much better
than i imagined.
now i need to make one for chace.
oh, and if you would like
your own keepsake quilt
i am now taking orders.
9 comments:
- AnonymousMay 26, 2012 at 5:53 PM
We love it! Brought us to tears, it was made with love and it shows. The attention to every detail is amazing !
ReplyDelete How beautiful! You did a wonderful job of bringing the disparate fabric together so that it all blends in such a lovely way. You are very talented.
ReplyDeleteBeautiful quilt!
Addy loves the quilt you made for her - she reaches for it every night to sleep with.
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