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Dr. Gregory Pais, ND
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Home arrow Naturopathic News arrow Issue #121 October 2012
Issue #121 October 2012
  1. INTRODUCTION
  2. PESTICIDES CAUSE ILLNESS
  3. VITAMIN D SUPPLEMENTS HELP LOW-RISK PROSTATE CANCER
  4. ROUNDUP MEANS MORE PESTICIDES, NOT LESS
  5. HOW TO AVOID ARSENIC IN RICE
  6. COMMON ANTIBIOTICS CAUSE LIVER DAMAGE
  7. HERE COMES THE SUN
  8. WEBSITE SERVICES
  9. FACEBOOK
  10. SUPPLEMENT CHOICES
  11. VITAMIN D TESTING
  12. EMERSON ECOLOGICS
Welcome to this issue of Naturopathic News, issue #121. It's my mission to help you find optimal solutions to health problems. This newsletter is one way to do that. The more educated you are about your health options the better able you will be to take control of your health. If you would like to stop receiving my newsletter please send me an email and let me know. If you have a friend or family member who you think would appreciate the information provided, send me their email address. 


PESTICIDES CAUSE ILLNESSES
Pesticides pervade the environment, from the air we breathe to the food we eat, and they are making children sicker than they were a generation ago, a new report warns.
More than 1 billion pounds of pesticides used annually nationwide have contributed to an array of health problems in youth, including autism, cancer, birth defects, early puberty, obesity, diabetes and asthma, the Pesticide Action Network North America, an environmental group in Oakland, said in a report released 10/9/12.

The authors' conclusions were based on dozens of recent scientific studies that have tied chemicals to children's health, and their report sought to bring collective meaning to those findings.

"One of the things that is also really clear from science is that children are just much more vulnerable to pesticide exposure," said co-author Kristin Schafer, senior policy strategist at Pesticide Action Network North America. "In terms of how their bodies work and defense mechanisms work, how much (pesticides) they're taking in pound for pound, they're eating more, drinking more, breathing more than an adult, and are much more susceptible to harms that pesticides can pose."

Some of the strongest recent findings to emerge suggest that exposure to pesticides, even at low levels, can disrupt brain development in children when they are in the womb and throughout their youth, the authors said.

That may explain why rates of developmental disabilities, such as autism and attention deficit hyperactivity disorder, or ADHD, have ballooned in the last decade.
More than 400,000 of the 4 million children born annually in the United States are estimated to be affected by neurodevelopmental disorders.

One-third of all neurodevelopmental disorders are caused either directly by pesticides and other chemicals or by genetics and exposure to environmental factors, the National Academy of Sciences estimates. Exposure to pesticides has also been linked to lower IQ levels in children.

California has taken significant steps toward becoming aware of pesticides in the environment and reducing them, the authors said. A 2000 state law required school districts to report pesticide use on school grounds, and those in San Francisco, Palo Alto, Santa Barbara and Los Angeles, among other cities, have adopted programs to manage pests in safer ways. A law passed a year later allowed for the restriction of pesticide spraying near schools, day care centers and other sites.

Even with stricter laws in place, the authors said, the pesticide industry should be prevented from selling agricultural products that can harm children. In addition, pesticides should be kept out of homes, schools, parks and other places intended for children, and farmers should ease off pesticides, they said.
DR. PAIS'S COMMENTS: It's the 50 year anniversary of the publication of Rachel Carson's "Silent Spring". I guess we really are doomed to repeat history if we don't study it.


* VITAMIN D3 SUPPLEMENTS HELP PATIENTS WITH LOW-RISK PROSTATE CANCER
Scientists at Medical University of South Carolina in Charleston, South Carolina, USA suggest that taking vitamin D supplements in relatively high doses can help men with localized or low risk prostate cancer who are under surveillance.

The study led by D.T. Marshall and colleagues showed 55% of patients with localized prostate cancer who were treated with 4000 IU of vitamin D supplements for one year decreased the Gleason score or the number of positive cores.

The researchers reported in the Journal of Clinical Endocrinology and Metabolism that vitamin D3 supplementation did benefit the majority of the patients with low-risk prostate cancer. The researchers concluded "Patients with low-risk prostate cancer under active surveillance may benefit from vitamin D3 supplementation at 4000 IU/d."

The study included 52 patients with diagnosed low-risk prostate cancer and 48 competed one year of supplementation and 44 could be analyzed for both safety and efficacy of vitamin D supplementation.

Prostate cancer is expected to be diagnosed with in more than 230,000 men and the disease and its complications kill about 40,000 each year in the United States, according to the National Cancer Institute.
Vitamin D3 Supplementation at 4000 International Units Per Day for One Year Results in a Decrease of Positive Cores at Repeat Biopsy in Subjects with Low-Risk Prostate Cancer under Active Surveillance. JCEM 2012 97: 2315-2324; doi:10.1210/jc.2012-1451
DR. PAIS'S COMMENTS: Did you read about this story or hear about it on tv? No? Why do you think that is? Don't you think if there was a drug that reduced prostate cancer markers in 55% of patients it would be in all the headlines? Your MD would be giving you free samples and it would be the latest pharmaceutical wunderkind. Why isn't that happening with Vitamin D?

A 1 year supply of Vitamin D3 at 4000 IU per day only costs about $45.50 or 12.5 cents per day. No drug company can make money off something so inexpensive. There aren't any all expenses paid Caribbean trips for docs handing out this supplement. So you wouldn't hear about this simple, inexpensive preventive. And that's a sad state of affairs.


ROUNDUP MEANS MORE PESTICIDES, NOT LESS
The rapid adoption of a single weed-killer for the vast majority of crops harvested in the United States has given rise to superweeds and greater pesticide use, a new study suggests. And while crops engineered to manufacture an insect-killing toxin have reduced the use of pesticides in those fields, the emergence of newly resistant insects now threatens to reverse that trend.

Farmers spray the herbicide glyphosate, widely sold under the Monsanto brand Roundup, on fields planted with seeds that are genetically engineered to tolerate the chemical. Found in 1.37 billion acres of corn, soybeans, and cotton planted from 1996 through 2011, this “Roundup Ready” gene was supposed to reduce or eliminate the need to till fields or apply harsher chemicals, making weed control simple, flexible, cheap, and less environmentally taxing.

In fact, this system has led farmers to use a greater number of herbicides in higher volumes, according to the study, published this week in the peer-reviewed journal Environmental Sciences Europe.

“The reason farmers adopted the technology as rapidly as they did is, in the early years, it worked very well — you couldn’t screw it up,” said the study’s author, Charles Benbrook, a research professor at Washington State University’s Center for Sustaining Agriculture and Natural Resources. Indeed, in the first six years of commercial use, crops genetically engineered to tolerate herbicides or resist insects reduced pesticide use by 31 million pounds, or about 2 percent, according to Dr. Benbrook’s analysis of data from the Department of Agriculture.

Yet by 2011, herbicide-resistant crop technology had increased herbicide use in the United States by 527 million pounds, according to the paper. Corn and cotton crops engineered to fend off rootworm, European corn borer and other crop-destroying insects by manufacturing toxins from the soil bacterium Bacillus thuringiensis, or Bt, reduced insecticide applications by 123 million pounds, or about 28 percent, from 1996 to 2011.

But over all, pesticide use last year on each acre planted with a genetically engineered crop was about 20 percent higher than on acres not planted with genetically engineered crops. And today, Dr. Benbrook writes, “a majority of American soybean, maize, and cotton farmers are either on, or perilously close to a costly herbicide and insecticide treadmill.”
Some farmers, however, seem to be stepping off. Dr. Benbrook said he was surprised to find that cotton farmers started to cut back on glyphosate around 2007-8. “It’s only down a few percent, but the upward trajectory of glyphosate stopped,” he said. The typical rate had risen to around three full applications of glyphosate per crop year. “Farmers basically said, ‘I’m not going to apply it a fourth time — it’s just not worth it,’ ” he said.

The vicious cycle of pesticide use begetting resistance, and ultimately more pesticide use, hardly comes as a surprise. A National Research Council report published in 2010 warned that, “Eventually, repeated use will render glyphosate ineffective.” To limit the evolution of glyphosate-resistant weeds, the report advised, farmers should rotate herbicides or mix glyphosate with other chemicals.

Warnings about the mechanisms for pesticide resistance go back as far as the modern environmental movement. The latest study echoes alarms first raised 50 years ago in Rachel Carson’s “Silent Spring,”, the book that “awoke the public to the manifold dangers for the environment and human health posed by the wanton use of chemical pesticides,” as David Heckel, a professor at the Max Planck Institute for Chemical Ecology in Jena, Germany, writes in a comment in the latest issue of the journal Science.

The ecological harm of chemical pesticides multiplies on itself, Ms. Carson argued. First, many of these chemicals are indiscriminate, killing not only pests but also the predators and parasites that help to keep them at bay. Second, surviving pest populations become increasingly resistant to the applied toxins with each generation, as those most susceptible to the toxins die off. It’s natural selection in overdrive.

As a result, more and more chemicals are required for pest control. According to Dr. Heckel, pesticide resistance has been recorded in more than 450 arthropod species since the publication of “Silent Spring” in 1962.

Yet the 50 years since the book’s publication, “a paradigm shift in dealing with this global problem has also occurred,” Dr. Heckel writes. Government mandates require farmers in the United States and Australia to sow a certain percentage of each Bt field with non-Bt seed, with the goal of ensuring that some insects susceptible to the toxin survive and mate with any survivors from the Bt crop.

Research from the University of Illinois and the Center for Science in the Public Interest suggests that the proportion of farmers complying with the mandate is shrinking.  Yet the strategy of putting brakes on natural selection by providing “susceptibility refuges” in tandem with high doses of the Bt toxin “are working so far in most cases” to delay resistance, Dr. Heckel writes. “Forewarned by the long history of insecticide resistance, the deployment of transgenic crops for insect control has incorporated resistance management plans from the beginning,” he writes. “Unfortunately, this has not been the case for transgenic crops engineered for herbicide tolerance, and agronomists must now follow entomologists in learning the hard lessons of the past 50 years.”
DR. PAIS'S COMMENTS: Realize that when you use Roundup you are buying into the cycle of genetically engineered organisms requiring more pesticides. The solution isn't more pesticides. The solution is voting with your pocket book (no Roundup, Nutrasweet, or Bt toxin) to protect the health of yourself, your family, and the environment. Support organic. Spend the money to eat healthy now. Or spend money to address health problems down the line. For the last 20+ years Monsanto has been experimenting on us with their genetically modified ingredients. It's time we said No.


BEST WAYS TO AVOID ARSENIC IN RICE
The Federal Drug Administration is investigating research that has found some rice contains inorganic arsenic levels being characterized as "worrisome." Their review of the research may result in their finally setting a maximum limit of inorganic arsenic in our foods.

That's all well and good but we need to know where the arsenic comes from and how we can avoid it. The FDA's data found inorganic arsenic levels between 3.5 and 6.7 micrograms per serving in their sampling. And a recent Consumer Reports study found similar levels. But this really is not news.

Numerous studies have been published over the past decade documenting arsenic content in rice grown from around the world. Dr. Andrew Meharg, a professor of biogeochemistry at the University of Aberdeen, has led or been part of the research teams in many of these studies.

In 2007, Dr. Meharg led a study that measured arsenic levels among rice grown throughout the U.S. He and his team analyzed 107 samples of rice grown in Louisiana, Mississippi, Texas, Missouri, and Florida, and 27 samples of rice grown in California.

Meharg and his team found that the 107 southern US and central US rice samples averaged .30 micrograms per gram of arsenic (equivalent to 4.4 micrograms per serving), and the California rice samples averaged 0.17 micrograms/gram (ppm) (about 2.5 mcg per serving).

However,  organic brown rice grown in California had the lowest levels of all 134 samples, with 0.10 micrograms/gram. This is equivalent to about 1.5 micrograms per serving - far less than the "worrisome" levels found in the FDA and Consumer Reports data. This indicates that organic rice will most likely be significantly lower in arsenic.
It should also be noted that these findings were on total arsenic content. Organic arsenic is a natural component of soils and is considered a trace mineral necessary for health.

Inorganic arsenic is another issue altogether. Inorganic arsenic has been found to be carcinogenic.

Dr. John Duxbury of Cornell University studied U.S. rice samples from different regions and found the total arsenic content averaged only 22% inorganic, while Dr. Meharg's findings showed that the percentage of inorganic arsenic to total arsenic content averaged 42%. This is explained by the fact that different soils have different levels of chemical contamination.

Organic arsenic in its unoxidized form is not necessarily harmful to the body in trace amounts. The body utilizes and metabolizes this form. The inorganic forms – oxidized versions such as arsenic oxides or arsenic trioxide, are produced with synthetic chemicals. These are the forms that have been found to be the most carcinogenic, although large amounts of organic arsenic are considered harmful and possibly even carcinogenic.

In other words, organic arsenic is readily present in natural soils, while inorganic arsenic is found in soils that have been sprayed with arsenic-based chemical pesticides, or watered with water containing chemicals high in arsenic. And since the plants will readily retain and store both forms, foods grown in soils that undergo chemical spraying - or have in the past - will contain higher levels of inorganic arsenic.

For example, cotton has been known to contain some of the highest levels of arsenic among U.S. crops. This is because cotton crops have historically been sprayed heavily with arsenic-based pesticides to control boll weevils.

Accordingly, Louisiana rice – where a fair amount of rice is grown in soils previously farmed in cotton – had the highest levels of arsenic in Dr. Meharg's research. Louisiana rice had 0.66 micrograms/gram of arsenic. This means that the arsenic levels of the organic rice were 15% of the arsenic levels of the Louisiana conventional (non-organic) rice.

In addition to cotton, fruit trees were sprayed with lead hydrogen arsenate for many decades. Now, conventional fruit trees are often sprayed with disodium methyl arsenate (DSMA) or monosodium methyl arsenates. These yield oxidized arsenic, but without the lead. Oxidized arsenic is also used in wood preservatives, antifungals and many other chemicals.

While there is no arsenic standard in food, there is an arsenic standard for drinking water, set by the U.S. Environmental Protection Agency. Using the average arsenic levels found in Dr. Meharg's research, one would have to consume over 115 grams (almost 4 ounces) of rice to exceed the EPA's standard of 10 micrograms/liter, equivalent to 10 parts per billion (ppb). The average American consumes only about 12 grams of rice per day. Asian Americans, however, average more than 115 grams of rice in a day.

A more recent Meharg study from Spain showed that most rice-based infant formulas - which used conventionally grown rice from around the world - also contained high arsenic content.

Other studies by Dr. Meharg found that arsenic levels in rice milk often exceed the U.S. as well as E.U. arsenic drinking water limits. Dr. Meharg and his team found that 80% of rice milk samples tested from supermarkets in 2008 exceeded the 10 microgram/liter limit. Rice cakes and crackers also contained higher levels of arsenic according to another study.
Dr. Meharg's research also found that cooking rice in good water lowered inorganic arsenic content.
Market basket survey shows elevated levels of As in South Central U.S. processed rice compared to California: consequences for human dietary exposure. Environ Sci Technol. 2007 Apr 1;41(7):2178-83
DR. PAIS'S COMMENTS: The research clearly indicates that eating organic rice will dramatically lower one's total arsenic exposure. Organic rice will lower one's exposure to inorganic arsenic to an even greater degree because these fields are not sprayed with arsenic oxide-rich chemicals. Organic rice may also contain traces of inorganic arsenic due to the fact that inorganic arsenic is floating in our atmosphere from pollution, and some of our polluted waterways contain chemicals. Soils used for non-organic farming in the past may also contain arsenic. But conventional rice contains these and more, caused by a constant barrage of arsenic-loaded chemicals being sprayed on the crops.

Choosing organic rice grown in farming regions that have been farmed organically or lay fallow prior to being farmed will assure an even lower arsenic content in the rice. One of these growers is Lundberg Farms, a long-time California family farm that has been growing organic rice for decades.


COMMON ANTIBIOTICS CAUSE LIVER DAMAGE
In a nine-year population study, Canadian researchers have determined that at least two fluoroquinolone-based antibiotics – commonly given to patients with respiratory infections, diarrhea, conjunctivitis and other infections — cause acute liver damage.

The researchers analyzed liver injury cases for different antibiotics over nine years in a hospital population from Ontario. The antibiotics studied included moxifloxacin, levofloxacin, cefuroxime axetil and ciprofloxacin. They studied cases where patients were prescribed antibiotics at some point between 2002 and 2011. They matched the patients with other patients of the same age and sex that were given other antibiotics. Liver damage cases were compared to patients prescribed the antibiotic clarithromycin. None of the study population had a history of liver injury or disease prior to the study.

The researchers found that those patients given the moxifloxacin antibiotic had more than double the risk of acute liver injury, while those given levofloxacin had almost twice the risk of liver damage when compared to those taking clarithromycin. Moxifloxacin and levofloxacin are both fluoroquinolones.

The study population yielded 144 patients who suffered from severe liver injury inside of 30 days from the time they began taking one of these antibiotics. Of those 144 patients, over 60% of them – 88 patients – died of liver complications as a result of their use of these antibiotics.

While the comparison of these antibiotics to clarithromycin might make clarithromycin look like it does not cause liver damage, that is not the case. Studies have shown that clarithromycin also can cause two types of acute liver injury. These include increased serum aminotransferase levels and jaundice. These forms of liver damage can occur from a week to three weeks after beginning treatment or they can increase over time with longer prescription periods.

Raised serum aminotransferase levels can be dangerous in the short run, sometimes causing fatality. Jaundiced liver damage, however, can cause long term damage to the liver resulting in weakened liver function for years after the prescription.

Liver damage is not the only risk of fluoroquinolone antibiotic therapy. Other possible adverse side effects of these medications include peripheral neuropathy, photosensivity and phototoxicity (skin damage from sun), intestinal cramping, psychotic reactions and intestinal infections including severe Clostridium difficile infections.
"Fluoroquinolone therapy and idiosyncratic acute liver injury: a population-based study." CMAJ. 2012 Aug 13.
DR. PAIS'S COMMENTS: Research has confirmed the connection between antibiotic therapy and sometimes-deadly Clostridium difficile infections. In a review of 1,138 studies published by the Healthcare Infection Society, deaths from Clostridium difficile infections associated with antibiotic prescriptions more than doubled between 1999 and 2004. And the recurrence of Clostridium difficile infections despite specific antibiotic treatment reached as high as 36% in some of the studies.

Other research has shown that Clostridium difficile infections can be prevented using probiotics. A meta-study that reviewed 34 studies including 4,138 patients found that using probiotics cut the risk of Clostridium difficile infection by half for those using antibiotics.


HERE COMES THE SUN
My eBook, "Here Comes The Sun: Preventing Chronic Disease With Vitamin D", is now available for purchase.

The best way to order my book is to mail a check (made out to Dr. Pais) for $9.95 to my office address below. Drop me an email saying your "check is in the mail" and I will immediately email you my book.

I would appreciate any comments or feedback once you've finished reading it. Enjoy!


WEBSITE SERVICES
Here are some pages that are of particular interest:

Store: There are 354 products from Emerson listed on this page. If yours isn’t one of them please let me know and I will add it so you can order online. This is particularly convenient after hours or on the weekend. Of course, you can always order by phone from Emerson at 800-654-4432.

Newsletter: Here you will find all 116 issues of my health newsletter, "Naturopathic News”.

Optimal Health Points: This is my blog that I update periodically. Check out my latest post, “No Deaths From Vitamins, Minerals, Amino Acids Or Herbs”.


FACEBOOK
Come join my fan page at www.facebook.com/NaturalDoc 
Help me bring information, news, and stories about natural medicine to the Facebook community. 

For those of you who don’t know, Facebook is a social networking website. Users can add friends and send them messages, and update their personal profiles to notify friends about themselves. Additionally, users can join networks organized by city, workplace, and school or college. 

Facebook pages help you discover new artists, businesses, and communities as well as those you already love. On my fan page www.facebook.com/NaturalDoc I post discussions that you can join in with and relay breaking health news related to disease prevention, clinical nutrition, and ways to make you healthier. 

I’m looking forward to exploring this community with you. See you there!


LET ME HELP YOU MAKE WISE SUPPLEMENT CHOICES
As is often the case, a recent new patient asked if I would review their choice and use of supplements and herbs. Why does this happen so often? For many, taking a vitamin or herb is their introduction to natural medicine. Their desire to be healthier drives them to take supplements and herbs. The death, pain, discomfort, and side effects experienced with over the counter and prescription drugs compel people to look elsewhere. It’s very different with supplements and herbs which, when used correctly, have an incredibly low risk of harm.

Some people take this to an extreme and take every supplement or herb that someone tells them is ‘good for them’. It might be a clerk, an internet ‘expert’ source, or a friend who is marketing the latest or greatest fad. Most of these individuals or companies have no professional training or experience in the medical use of the supplements or herbs that they’re selling. The people they’re selling to come into my office with 5, 10, 15, or more supplements that they’re taking. Sometimes it’s been so long since they started taking them that they don’t remember why they’re doing it. When I ask, they can’t tell me what, if anything, a particular product is doing for them. Yet, they can be quite fearful of stopping any of these items, as if their health would careen off a precipice without them.

Why do I think my approach is any different? Partly, it’s because of my background. I’ve literally been working with nutritional supplements since 1974. That’s 36 years assessing the quality and effectiveness of supplements. Beginning in 1980 I started working with Western and Chinese herbs. The quality of herbs used and how they’re combined together has the greatest effect on the efficacy of the final product. Because I’ve grown, identified, harvested, and produced medicinal herbal products I recognize a good formula when I see one.

Licensed naturopaths like me receive the most extensive academic and clinical training in the use of nutritional supplements and herbal medicines of any professional in the United States. Nothing can substitute for such hands on experience, especially when you see, and are responsible for, the results of your treatments. Very different from the clerk in the store, or coworker who’s part of a MLM scheme. 

What I’m offering to is easy access to this experience and training. Both for you and your family. If you have questions about the supplements or herbs you are taking, or are thinking about taking, now is the time to ask. Send me an email with the brand and name of the product you’re taking. Let me know that you want to bring the bottles in at your next visit, so I can see what you’re taking. Start a discussion on my Facebook fan page. Either way I’ll give you honest feedback about what I think is good, or what isn’t. We’ll fine tune what you’re taking to maximize effect and eliminate waste. 

Let me hear from you and we’ll get started. 


GET YOUR VITAMIN D TEST WITH ZRT LABORATORY
It just happened again the other day. A patient sent me a copy of the Vitamin D test she just had done. With frustrating results. The wrong test was done. After all these years, and all the information available, MDs and laboratories still order the wrong test. What a waste of money and time. 

For a long time I looked for a home Vitamin D test. One that would be simple, easy, and accurate to do on your own. I finally found one. ZRT Laboratory in Beaverton OR. ZRT emphasizes research and technological innovation. 

Until now, venipuncture blood serum has been the standard medium for testing Vitamin D. ZRT has developed and refined Vitamin D testing in blood spots. A few drops of blood from a quick and nearly painless nick of the finger, placed on a filter paper to dry are all that is needed. The total 25 (OH) Vitamin D is then determined by liquid chromatography/tandem mass spectrometry (LC-MS/MS). This method has been shown to be as accurate as the assay standard.

Ordering A Vitamin D Test 
ZRT allows anyone to order a Vitamin D test kit for $95 plus shipping and have it sent to their home. ZRT will let me prepay for kits and send them to my office for $55 each, plus $8 shipping. I am charging $65 per kit for patients to cover the total. 

If you are interested in getting a Vitamin D test done through my office please prepay so I can order you a kit. Then you can either pick it up at my office or have it shipped to your home. Once you’ve taken the sample and sent it back to ZRT it’s only a matter of time before your results are sent back to me. I can even look at them online before the mail arrives.

If your doctor has refused to order a Vitamin D test or worse, ordered the wrong one, this is the fastest, least expensive, most accurate way to do it ourselves. Once we know what your Vitamin D levels are, the next step is making sure that you achieve optimum levels for prevention of disease and maintenance of health.


EMERSON ECOLOGICS
I am often asked what supplements I recommend. Many of you have been surprised to discover that I favor food over pills; lifestyle changes over fads. I have been working with nutrition for over 30 years, herbs for over 20 years. Where and when appropriate I recommend them to my patients. I strive to act from knowledge, experience, and research.

Emerson Ecologics (800-654-4432) carries almost all of the nutritional supplements and botanical extracts that I think are useful. Their customer service is excellent and their delivery is reliable (often only 2-3 days to this region). It’s a great way to get physician quality products at reasonable prices. 

To offset the cost of shipping, reference my name when you establish your account and receive a 10% discount on every order. If you have any questions about these items feel free to email me.

That’s it for this issue of Naturopathic News. If you’ve thought a bit extra or learned something new, then I achieved my goal. As usual, if you have questions or concerns brought up by these subjects, let me know. 

Gregory Pais, ND, DHANP
580 E. 3rd. St.
Williamsport PA 17701
570-320-0747 
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