Survey

[Guest guest]

Survey.

> 1. Name Ed Fitzgerald > 2. Location (city and state/province, country) Missouri> 3. Age you developed achalasia 14> 4. Age you are today 68

> 5. Your main treating doctor's name and practice location

Norton Greenberger GI Dr. Jon Moran Surgeon

> 6. How happy you are with your doctor and current medical care. Marginally happy>

7. What standard treatments they have had and their outcome (briefly 1. Three Surgeries a Heller Myotomy w/wrap 2. Wrap was taken down 14 months later. 3. Esophagectomy> 8. What alternative treatments they have had and their outcome > (briefly). Not taking any meds or treatments related to Achalasia at the present time

> 9. Something that they are greatful for (a happy note to end our > survey) After 54 years of this disease I am finally able to eat most anything in small quantities, and am extremely grateful for that.

[Guest guest]

Ed, where do you live in Missouri? I live in a suburb of St. Louis

and it's called Creve Coeur. Where did you have your surgery?

Why was the wrap taken down? Did you have the traditional surgery or

the laprascopic? I'm going to a doctor at -Jewish in St. Louis

and will have the lap March 7th. What is the esophagectomy? Does

that mean you had your esophagus removed? Please explain.

> Survey.

> > 1. Name Ed Fitzgerald

> > 2. Location (city and state/province, country) Missouri> 3. Age

you developed achalasia 14

> > 4. Age you are today 68

> > 5. Your main treating doctor's name and practice location

> Norton Greenberger GI Dr. Jon Moran Surgeon

> > 6. How happy you are with your doctor and current medical care.

Marginally happy>

> 7. What standard treatments they have had and their outcome

(briefly 1. Three Surgeries a Heller Myotomy w/wrap 2. Wrap was

taken down 14 months later. 3. Esophagectomy

> > 8. What alternative treatments they have had and their outcome

> > (briefly). Not taking any meds or treatments related to

Achalasia at the present time

> > 9. Something that they are greatful for (a happy note to end

our

> > survey) After 54 years of this disease I am finally able to eat

most anything in small quantities, and am extremely grateful for that.

[Guest guest]

Survey.

> 1. Name Fagan

> 2. Location (city and state/province, country) Virginia Beach, VA

3. Age you developed achalasia 20

> 4. Age you are today 32

> 5. Your main treating doctor's name and practice location

Dr. Trent , Gastro. Consultants

> 6. How happy you are with your doctor and current medical care. So far, so good..he sent me to motility specialists and did extensive testing>

7. What standard treatments they have had and their outcome (briefly Dilitation-painful and didn't work, 2 botox injections-the last injection lasted over a year!

> 8. What alternative treatments they have had and their outcome > (briefly). Nothing alternative yet

> 9. Something that they are greatful for (a happy note to end our > survey) After so many years of not eating, I am incredibly grateful for those days when I feel great and can eat what I want ( well, minus steak:) ) I have learned to understand what is really important in life.....

[Guest guest]

I live in Independence, MO. Surgery was done at Kansas University Medical

Center. The wrap was taken down because after 14 months as it began to cause

more trouble with swallowing and severe pain.

Yes I had the traditional thoracic surgery. Esophagectomy is the removal of

the esophagus. I have stayed in Creve Coeur several times, a nice area. I

would be glad to answer any other questions you might have.

Ed

Re: Survey

> Ed, where do you live in Missouri? I live in a suburb of St. Louis

> and it's called Creve Coeur. Where did you have your surgery?

> Why was the wrap taken down? Did you have the traditional surgery or

> the laprascopic? I'm going to a doctor at -Jewish in St. Louis

> and will have the lap March 7th. What is the esophagectomy? Does

> that mean you had your esophagus removed? Please explain.

>

>

> > Survey.

> > > 1. Name Ed Fitzgerald

> > > 2. Location (city and state/province, country) Missouri> 3. Age

> you developed achalasia 14

> > > 4. Age you are today 68

> > > 5. Your main treating doctor's name and practice location

> > Norton Greenberger GI Dr. Jon Moran Surgeon

> > > 6. How happy you are with your doctor and current medical care.

> Marginally happy>

> > 7. What standard treatments they have had and their outcome

> (briefly 1. Three Surgeries a Heller Myotomy w/wrap 2. Wrap was

> taken down 14 months later. 3. Esophagectomy

> > > 8. What alternative treatments they have had and their outcome

> > > (briefly). Not taking any meds or treatments related to

> Achalasia at the present time

> > > 9. Something that they are greatful for (a happy note to end

> our

> > > survey) After 54 years of this disease I am finally able to eat

> most anything in small quantities, and am extremely grateful for that.

>

>

>

>

>

[Guest guest]

All (forward hither and yon to all interested parties)

Would you all do me a favor and please go to this URL (geocities-forwarded

email below) and complete the survey. This will help our efforts in getting

a newborn screen for our children, particularly their fragile iron

metabolism. We see YET another interesting corrolation here that may be

preventable and testable.

Thanks

Chairperson of VOSI standard v50.3 " NEWBORN SCREENS TO DETECT ADVERSE

NEUROLOGICAL SEQUALE BEFORE VACCINATING "

www.voicesofsafety.com

Chair of Oregons Autism Autoimmunity Project

http://www.gti.net/truegrit

Pres of CHILDSCREEN, a non profit to push forward these standards to change

the laws of newborn screens, especially detecting the propensive to injury

child.

www.childscreen.org (pardon our dust).

----- Original Message -----

> Ladies and Gents,

> Can you please visit the survey and give suggestions.

> Please let me know if I should add any more questions.

> http://www.geocities.com/upadhye10/index.html

> Thank you very much.

>

> U.Padhye

>

>

> __________________________________________________

>

[Guest guest]

Dear ,

Fortunately the poll results input by YOU and YOU alone can be

altered by You by clicking on 'edit' in the oll section.

Also fortunately you do not have to undo any poll answers because you

did not answer any. So no harm done.

You are correct the Poll is for those who took the November PTCB exam

AND have used this site. This is a wayof monitoriing the quality

service of the site and if there is anyone taht I need to give

special help to and if I am meeting the needs of the community that

it serves. Sort of a self-evaluation thing. Must be the teacher in

me. Also it gives those who took the exam and studied here something

to compare themselves to because as humans that is what we do. I am

not justifying this nor am I saying that we should compare ourselves

to others nor am I saying that iti si good or bad. I am saying is

that it is human nature. And before I began 'polling' all of

my 'students' would post their grades and ask each other how they did

in a post. So I now provide an avenue to post anonymously so that

everyone can see the 'fruit'of our labor and the changes that may

need to be made, and so that test takers can compare themselves

without embarrassment or feeling 'naked and raw'.

Now here is my question to you. Do YOU feel bad that you are not

included in the poll? do you think others like yourself who may have

tuned in 'late' after the exam may want their own poll? If so I can

provide one. After all your scores and stats are equally important.

And you may wish to compare to others who did not use the site. So I

am up for it if you are. Just say the word and I will make something

up as soon as I have a moment.

I respect your honesty and integrity. Thank you for asking if

you should take the exam or not,and brining to my attntion that there

may be another need to satisfy.

In addition thank you for using this site to further educate

yourself. Congratulations on that too!

Many people who used this site until the exam was over have also

unsubscribed before the PTCB test results were in. The membership

numbers do not change much because I get new members for the next

exam study period while older members, who took the Nov exam, are

leaving. This always happens, and it distresses me. I always wonder

if they had stayed if I would find 'failures' in the polls. To date

there have been 'none'. But how accurate is that if some leave before

the results aer known?

, I failed to 'capture' them sooner with an earlier

announcement of the up coming poll, because of my own absence due to

my very ill parents hospitalized or having surgery etc. I appologize

for that. Therefore there may not be too many respondents to this

survey. You can tell the total number of respondents by totaling the

different results to the 'scores'. Yesterday there were 6

respondents. I will check after this post.

, for someone who did not use this site until after the exam,

you sure have a lot of fire in you. I do hope that you and others who

just took the November exam will stay around and help out the

next 'study round " of PTCB March 2004 test takers! You are most

welcome here.

Thank you again for your enthusiasm,

Respectfully,

Jeanetta Mastron CPhT BS Chem

Pharm Tech Educator

Founder/Owner

> Hey Jeanetta. I haven't taken the poll because I came to this site

> after taking the PTCE. I wanted to know when the results would come

> in. I thank the Lord things turned out well. Although the wait was

> long. So I wasn't sure if I should take the survey, so I didn't. No

> information is better than bad information, I'm sure you know that.

> I do feel that this website has been helping me in preparing to

> further learn more about being a CPhT. Thanks alot for that. If I

> should take the survey anyway, let me know. Otherwise, I hope more

> people take the survey. Thanks.

>

[Guest guest]

Sorry, the german word " angst " just means fear, nothing else.

> Just curious and wanted to ask you to participate:

....

> 3. The word " anger " comes from a German word, " angst " which means

> to choke. Who here has a deep rooted problem with anger, large or

> small?

[Guest guest]

Hi Diane,

I know in the early stages it seems to happen more with

chicken nuggets, sometimes steak. I know if i was rushing it happened

more. also if i got stressed. I don't have any problem with anger,

i'm kindamellow and just go with the flow. Hope this helps.

dra

> Just curious and wanted to ask you to participate:

>

> 1. In the early stages, did you usually find the problem food to

be

> meat; beef, chicken, fish etc?

>

> 2. Did you sense you were stressed or nervous or upset at the time?

>

> 3. The word " anger " comes from a German word, " angst " which means

> to choke. Who here has a deep rooted problem with anger, large or

> small?

>

> Thanks for participating..... I have some ideas on this depending

> how the survey turns out. Please be honest if you do participate.

> We may be onto something here and have figured something out many

> Drs. haven't yet.

>

> More later,

> God bless you as you do your best to deal with this,

> Love, Diane

[Guest guest]

Surveys are best done in the "polls" section. Too hard to keep track of things like that in the posts.

[Guest guest]

> Just curious and wanted to ask you to participate:

>

> 1. In the early stages, did you usually find the problem food to

be

> meat; beef, chicken, fish etc?

YES, PORK AND BEEF

>

> 2. Did you sense you were stressed or nervous or upset at the time?

>

DEFINITELY STRESSED.

> 3. The word " anger " comes from a German word, " angst " which means

> to choke. Who here has a deep rooted problem with anger, large or

> small?

I DO HAVE A SHORT FUSE (MOSTLY WHEN I HAVE WORKED MANY

HOURS WITH LITTLE SLEEP)

> I HOPE THIS HAS HELPED OUT.

when I am stressed out or upset I tend to hold my stress in my

abdomen, I can't eat. Unlike others who eat when they are stressed.

Genia

[Guest guest]

jpearse@...

Survey

Just curious and wanted to ask you to participate:1. In the early stages, did you usually find the problem food to be meat; beef, chicken, fish etc?2. Did you sense you were stressed or nervous or upset at the time?3. The word "anger" comes from a German word, "angst" which means to choke. Who here has a deep rooted problem with anger, large or small?Thanks for participating..... I have some ideas on this depending how the survey turns out. Please be honest if you do participate. We may be onto something here and have figured something out many Drs. haven't yet. More later,God bless you as you do your best to deal with this,Love, Diane

[Guest guest]

My bad. The word ANGER in ENGLISH (not German) comes from a deep

meaning " to choke " I copied something from Websters for anyone

interested...

AN'GER, n. ang'ger. [L. ango, to choke; strangle, vex; whence angor,

vexation, anguish, the quinsy, angina. Gr. to strangle, to strain or

draw together to vex. The primary sense is to press, squeeze, MAKE

NARROW; Heb. to strangle.]

Just maybe, some emotion is involved in this condition. Just maybe

our emotions are involved in this " strangling " or " choking " or

NARROW passage for food. Something to think about. I for one, am

always looking for truth, even when it hurts.

With love and prayers for all who suffer with Achalasia,

Diane

> > Just curious and wanted to ask you to participate:

> ...

> > 3. The word " anger " comes from a German word, " angst " which

means

> > to choke. Who here has a deep rooted problem with anger, large

or

> > small?

[Guest guest]

Thanks dra,

That helps a LOT! 3 out of 4!

I think you are not the only one who early on suffered from steak

and chicken. Me too! One other thing I am surveying is blood

type! Seriously! I'm type O positive. Do any of you out there

know what type you are and are many of you O? I read Type O's

(either positive or negative) offen have this sort of disorder due

to too much acidity in our stomach juices. When we are hugnry, and

begin eating too fast, something (the empty stomach full of acid)

triggers the shutting down of the valve and it clamps shut. I am

wondering if perhaps there are MORE Achalasia sufferers who are Type

O than any other type!!!???

Help me out here?

Still seeking.

Love, Diane

> > Just curious and wanted to ask you to participate:

> >

> > 1. In the early stages, did you usually find the problem food

to

> be

> > meat; beef, chicken, fish etc?

> >

> > 2. Did you sense you were stressed or nervous or upset at the

time?

> >

> > 3. The word " anger " comes from a German word, " angst " which

means

> > to choke. Who here has a deep rooted problem with anger, large

or

> > small?

> >

> > Thanks for participating..... I have some ideas on this

depending

> > how the survey turns out. Please be honest if you do

participate.

> > We may be onto something here and have figured something out

many

> > Drs. haven't yet.

> >

> > More later,

> > God bless you as you do your best to deal with this,

> > Love, Diane

[Guest guest]

WOW Genia! Yes, that deffinely helped! Thank you for responding!

So you agree that meats are the main cause or trigger. And you agree

that stress is also a factor. And you also admit to being well....

high strung, or with a short fuse, however you want to put it. LOL

(me too) I have found that when I'm really hungry, stressed, and

eat too fast, it happens most. So naturally, I try and eat more

than 3 times a day and I do not allow myself to get very very

hungry. And, I try and slow down especially during the first half

of my meal....

I also take time to pray and to find some quiet time to relax and

think, and read the Bible. This has helped so much.

I also discovered that Blood Type O's may have this more than other

types? So if you know your blood type, let me know???

Thanks again, Genia and have a wonderful, stress-free day.

Love, Diane in Florida

> > Just curious and wanted to ask you to participate:

> >

> > 1. In the early stages, did you usually find the problem food

to

> be

> > meat; beef, chicken, fish etc?

>

> YES, PORK AND BEEF

> >

> > 2. Did you sense you were stressed or nervous or upset at the

time?

> >

> DEFINITELY STRESSED.

>

> > 3. The word " anger " comes from a German word, " angst " which

means

> > to choke. Who here has a deep rooted problem with anger, large

or

> > small?

> I DO HAVE A SHORT FUSE (MOSTLY WHEN I HAVE WORKED MANY

> HOURS WITH LITTLE SLEEP)

>

> > I HOPE THIS HAS HELPED OUT.

> when I am stressed out or upset I tend to hold my stress in my

> abdomen, I can't eat. Unlike others who eat when they are stressed.

>

> Genia

[Guest guest]

Diane wrote:

>...The word ANGER in ENGLISH (not German) comes from a deep

>meaning " to choke " ...

Ever get the urge to strangle someone? Its name is anger.

notan

[Guest guest]

Hi Diane,

I am O positive. You might find some interesting reading in the books by Dr J. D'Adamo 'The Eat Right Diet' and Live Right for your type".

O type people react to certain foods and by avoiding them there is an improvement in their health and well being. I followed this diet for several years and really improved - that was before A struck. The main food I needed to avoid were wheat and milk.

Joan

Johannesburg South Africajpearse@...

Re: Survey

Thanks dra,That helps a LOT! 3 out of 4!I think you are not the only one who early on suffered from steak and chicken. Me too! One other thing I am surveying is blood type! Seriously! I'm type O positive. Do any of you out there know what type you are and are many of you O? I read Type O's (either positive or negative) offen have this sort of disorder due to too much acidity in our stomach juices. When we are hugnry, and begin eating too fast, something (the empty stomach full of acid) triggers the shutting down of the valve and it clamps shut. I am wondering if perhaps there are MORE Achalasia sufferers who are Type O than any other type!!!???Help me out here?Still seeking.Love, Diane> > Just curious and wanted to ask you to participate:> > > > 1. In the early stages, did you usually find the problem food to > be > > meat; beef, chicken, fish etc?> > > > 2. Did you sense you were stressed or nervous or upset at the time?> > > > 3. The word "anger" comes from a German word, "angst" which means > > to choke. Who here has a deep rooted problem with anger, large or > > small?> > > > Thanks for participating..... I have some ideas on this depending > > how the survey turns out. Please be honest if you do participate. > > We may be onto something here and have figured something out many > > Drs. haven't yet. > > > > More later,> > God bless you as you do your best to deal with this,> > Love, Diane

[Guest guest]

Thank you Joan for participating. Maybe stress is more related than

anger per se.... But it seems almost everyone agrees chicken or

meat of some kind is an early trigger. WHy some of us can't seem to

swallow chicken and others without Achalasia can is the question.

Meanwhile, why eat chicken? LOL

Thanks again and you have a gr8 day in South Africa.

With love and best wishes,

Diane, Fl. USA

>

> jpearse@p...

> Survey

>

>

> Just curious and wanted to ask you to participate:

>

> 1. In the early stages, did you usually find the problem food

to be

> meat; beef, chicken, fish etc?

>

> 2. Did you sense you were stressed or nervous or upset at the

time?

>

> 3. The word " anger " comes from a German word, " angst " which

means

> to choke. Who here has a deep rooted problem with anger, large

or

> small?

>

> Thanks for participating..... I have some ideas on this

depending

> how the survey turns out. Please be honest if you do

participate.

> We may be onto something here and have figured something out

many

> Drs. haven't yet.

>

> More later,

> God bless you as you do your best to deal with this,

> Love, Diane

>

>

>

> -------------------------------------------------------------------

-----------

>

[Guest guest]

Diane wrote:

Do any of you out there know what type you are and are many of you O?

I’m AB+.

I’m also a very

calm person who holds everything in, and I’m very physically affected by

stress.

I remember in the

beginning of my A, it pretty much started with the foam, and then six months

later, I started having a problem with eating just about everything, especially

breads meat and fruit. Fresh fruit has always been a tough one with achalasia, and continues to be so, but I tolerate berries very

well, so I eat lots of berries.

I’m definitely not

prone to anger…it takes a lot to get me angry. :-)

We’re all very

different Diane, but I do think that stress plays a big role in achalasia.

Sandi in No CA

Holt-

Groups Links

·

To visit your group on the

web, go to:

achalasia/

·

[Guest guest]

Diane wrote:

>.. I'm type O positive.

I'm O neg..

>... I read Type O's

>(either positive or negative) offen have this sort of disorder due

>to too much acidity in our stomach juices.

Do you have a reference for that?

> When we are hugnry, and

>begin eating too fast, something (the empty stomach full of acid)

>triggers the shutting down of the valve and it clamps shut.

There must be more to this theory, because there are a lot of type Os that

also eat fast and don't have this problem, and the little bit we have here

does not address that. Besides, I can assure you that a lot of people in

this group have stopped eating fast a long time ago, but still have achalasia.

notan

[Guest guest]

That's right. wanting to " choke " someone (anger) and choking

yourself can be connected eh?

I mean if you are all bottled up inside, and angry, maybe it can

effect your own throat or espohogus? Just a thought...

Thanks for your input.

> >...The word ANGER in ENGLISH (not German) comes from a deep

> >meaning " to choke " ...

>

> Ever get the urge to strangle someone? Its name is anger.

>

> notan

[Guest guest]

Hi ,

It seems anger may not be an issue, but stress definiely is. Yes we

are all different; I'm just trying to find some clues.

Thank you for responding to my survey. You are the first AB+ I've

heard of, but perhaps there are others. Funny how many seem to be

O... Maybe his book is right though - he said O's tend to have this

sort of disorder more than the others due to stomach acid etc...

HAve a gr8 day,

Diane

> Do any of you out there know what type you are and are many of you

O?

>

> I'm AB+.

> I'm also a very calm person who holds everything in, and I'm very

> physically affected by stress.

> I remember in the beginning of my A, it pretty much started with

the

> foam, and then six months later, I started having a problem with

eating

> just about everything, especially breads meat and fruit. Fresh

fruit has

> always been a tough one with achalasia, and continues to be so,

but I

> tolerate berries very well, so I eat lots of berries.

> I'm definitely not prone to anger.it takes a lot to get me

angry. :-)

> We're all very different Diane, but I do think that stress plays a

big

> role in achalasia.

> Sandi in No CA

>

>

> Holt-

>

>

>

>

>

>

[Guest guest]

Diane wrote:

>... WHy some of us can't seem to

>swallow chicken and others without Achalasia can is the question.

Just think for a moment, if you have a tight passage what kind of food is

going to get stuck there. Meat is stringy and lumpy, it may have a harder

time getting through than pudding. It is the tight passage not the meat

that causes the choking. You were getting achalasia therefore you began to

choke, not that you began to choke and therefore got achalasia. In my case

it was drinks that I noticed first. I would wait until I was very thirsty

and then guzzle a drink. (Often after working and breathing hard, so the

" white foam " would be thicker and dryer, seems to make a great plug). The

drink could not get through the tight passage fast enough and would pile up

until it was high enough that I choked. I choke because I was getting

achalasia. I didn't get achalasia because I choked.

> Meanwhile, why eat chicken?

Because I like it and I need to eat something. Also, I get tired of eating

the same thing every day.

notan

[Guest guest]

-

Diane,

I am type 0.

Jenifer

-- In achalasia , " Diane " <wanabthn@y...> wrote:

> Thanks dra,

> That helps a LOT! 3 out of 4!

> I think you are not the only one who early on suffered from steak

> and chicken. Me too! One other thing I am surveying is blood

> type! Seriously! I'm type O positive. Do any of you out there

> know what type you are and are many of you O? I read Type O's

> (either positive or negative) offen have this sort of disorder due

> to too much acidity in our stomach juices. When we are hugnry, and

> begin eating too fast, something (the empty stomach full of acid)

> triggers the shutting down of the valve and it clamps shut. I am

> wondering if perhaps there are MORE Achalasia sufferers who are

Type

> O than any other type!!!???

>

> Help me out here?

>

> Still seeking.

>

> Love, Diane

>

>

> > > Just curious and wanted to ask you to participate:

> > >

> > > 1. In the early stages, did you usually find the problem food

> to

> > be

> > > meat; beef, chicken, fish etc?

> > >

> > > 2. Did you sense you were stressed or nervous or upset at the

> time?

> > >

> > > 3. The word " anger " comes from a German word, " angst " which

> means

> > > to choke. Who here has a deep rooted problem with anger, large

> or

> > > small?

> > >

> > > Thanks for participating..... I have some ideas on this

> depending

> > > how the survey turns out. Please be honest if you do

> participate.

> > > We may be onto something here and have figured something out

> many

> > > Drs. haven't yet.

> > >

> > > More later,

> > > God bless you as you do your best to deal with this,

> > > Love, Diane

[Guest guest]

Diane wrote:

> I am wondering if perhaps there are MORE Achalasia sufferers

> who are Type O than any other type!!!???

Well, since Type O IS THE MOST COMMON BLOOD TYPE in the US, and since the

majority (certainly not all, but I daresay the vast majority) of the

members of this group are from the United States, simple logic tells us

that a very large percentage of us are Type O.

Debbi

[Guest guest]

Diane wrote:

> WOW Genia! Yes, that deffinely helped! Thank you for responding!

> So you agree that meats are the main cause or trigger.

I didn't read Genia's response to say this at all.

You asked: In the early stages, did you usually find the problem food to

be meat; beef, chicken, fish etc?

And Genia replied: YES, PORK AND BEEF

You asked us what foods we first had trouble swallowing, not what we think

caused our achalasia. So taking Genia's response to meat being a " problem

food " and rewording it like she's saying that meat is a " cause or trigger "

isn't an appropriate conclusion to her statement.

I also think that before using terms like " cause " or " trigger " that there

should be some sort of definition of what those words mean; without

clarification of what is meant by the terms, there's a huge potential for

misunderstanding.

For example, most people think of a " cause " as being a reason for why

something happened. The cause of chicken pox is the varicella-zoster

virus. You get chicken pox BECAUSE OF the varicella-zoster virus. The

virus is the cause. You become hypothermic BECAUSE OF the cold

temperature. The temperature is the cause. This does not translate into

the meat/achalasia scenario. You don't get achalasia BECAUSE OF the meat

--you have trouble swallowing the meat BECAUSE OF the achalasia.

Same for the use of " trigger " -- a trigger sets off a process. The sight

of a squirrel in the back yard triggers a dog's excited barking. The dog

barks BECAUSE OF the squirrel. But the squirrel wasn't in the back yard

because he wanted to hear the dog bark (well, maybe... we have some pretty

crafty squirrels around here!) But we don't have achalasia because we are

trying to swallow meat. We have dysphagia (trouble swallowing) because we

have achalasia, and we have trouble swallowing meat because we have

trouble swallowing *in general* -- it's only natural that we would have

the most trouble swallowing the items (meat) which are least likely to be

completely pulverized in the chewing process, as those items are going to

be the largest in size and therefore the most difficult to swallow for

people who have trouble swallowing.

I think that clarifying the terms that are used helps to prevent

misunderstandings and confusion for the ones who are reading the posts.

Debbi