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RE: Another of "those" rants - 7/27/2009 1:24:56 PM   
Mercnbeth


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Rule,

this slave is not sure what the policies are there in the Netherlands with regards to hospice/incapacitated elder/indigent adult care but in order to qualify for state assistance to subsidize care for an adult who cannot afford it over here in the states, the adult in question must not hold assets(real property, investments, etc.) that exceed a particular dollar amount. guidelines not only vary from state to state, but here in California, those guidelines vary in each of California's 58 counties.

she stated in the OP that she can't afford a private assisted living situation for him. in order to get any financial support from the state she would have to sign over his social security and pension benefits, which she already stated she was unwilling to do...and it might also mean that she doesn't want to sell the family home (which might still be in his name). it would most possibly be considered an asset of his as well that would have to be sold to pay for his care before any monthly subsidy from the state would kick in to pay for whatever his pension and social security benefits don't cover.

it is a difficult situation for everyone involved to be in, for sure.

(in reply to Rule)
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RE: Another of "those" rants - 7/27/2009 1:30:55 PM   
sirsholly


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Social Services can be a Godsend. 

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RE: Another of "those" rants - 7/27/2009 2:00:59 PM   
Termyn8or


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Rhi, just tryed to call you. Hopefully you were getting in some needed sleep or something. It's from a 216-759 number, I called twice to be sure I hadn't midialed.

From what you said here he is getting pretty close to gone. You would probably be happier seeing him still working, marrying a 25 year old and driving a Corvette, but that was not what life had in store for him. I'm sure that you see now the the scales are just about balanced, between him living his life in which he is miserable, and ending it. There is a time for everything, including death.

The last day I saw my Dad alive his last words to me wer get the fuck out. Really "Take your Mossberg and get the fuck out" is what he said. That doesn't bother me a bit. But beware the afterthoughts. This is no joke and death is a one way street.

The olman after his stroke tried to explain to me how frustrating it was not to be able to to do things - simple things he did most of his life. When he finally goes and you breathe that sigh of relief, throw another one in for him. I know it has been incredibly hard on you, but imagine what it is like for him. Imagine your places reversed for a minute, and I mean for one minute, you don't deserve any more punishment than that.

We kinda knew a day or two before the olman kicked it, you could tell. Sure we could've run him up to the hospital and all that but he did not want that. He wanted to die at home and he did. Dignity ? I make a joke about it but this is true. I found him face down on the floor with his pants pulled down as if to sat to the world "Kiss my ass goodbye". Realistically he was getting ready to go to bed and that's when it happened.  [think I mentioned that but not out here in the forum]

I don't know quite how to explain, but I will take a crack at it. Live or die. It is not that we don't care about you, but when you are no longer enjoying being alive, be dead. That is how our family is. Some may see us as evil fucking monsters, but so what ? Without giving concern to yourself, think about him. He is at that tipping point now probably, and is really ready.

Prepare yourself, no matter how hard you think your heart is, soon you will be sitting in the lawyer's office and he will be talking about equity and all this shit and you will be thinking about back when you were a six year old with him teaching you baseball or something. It will happen.

It all comes back. Electronics is my field, it has enabled me to make a decent living for most of my life and I excel at it. Guess who bought me my first electronics kit ? It was cool, I actually built a small radio transmitter and tuned it in on the radio. It was the coolest thing in the world at the time and impelled me to study. 

But still his last words to me were "Get the fuck out". I had learned though never to argue. First of all he was always right, and even if not, he was still right if he was in his own house.

Life is a trip babe, but think of the destination.

You have done well. As most of us want he will probably die at home, and you have helped him do that. When the day comes, you know how to get ahold of me.

It would've been good if you answered today, but I put these words in the open forum because siomeone else might know someone on theuir death bed so to speak. Death is a part of life. We handle is as such.

When the olman died the cops asked "OK, we are about to remove the body, can yoy handle this or would you like to go in the other room ?". I replied "If he is dead, that is nothing but a carcass, what was him is gone, so it is not a problem". Then they took that piece of meat to the oven and only charged about six grand to cook it.

My soul is with you. This is not the same as some things, like a 33 year old cousin who zigged when he should've zagged on a motorcycle and got his neck wound around the driveshaft of a box truck. It is not like my buddy who kind fell out in front of a bus, or his brother who fell off a roof about week later. It's also not like my buddy who had the symptoms of the onset of Huntington's disease who hung himself.

These were untimely deaths, they did not get their full measure of life. When you breathe a sigh of relief when he passes, do not feel guilty. You helped make sure he got all of the life he could.

There is nothing more you can do, so just burn a hogleg and relax. It's all part of the game.

Be well, contact me when you feel like it.

T

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RE: Another of "those" rants - 7/27/2009 2:10:33 PM   
JonnieBoy


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Peach, you are, without a doubt, one of the strongest people I have ever met (you managed to take over from me without a seam and that never ceases to amaze me). This is not an easy subject for me to comment on in "public". I will say only this ... this is a time to trust yourself.

The world is lacking the kind of twinkle you have in your eyes when they smile, I can't do much from here but tell you that.

You have a good heart and true spirit, there are few that can claim that these days. Be strong.

Pirate

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RE: Another of "those" rants - 7/27/2009 2:13:02 PM   
maybemaybenot


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Rhi:

If I might suggest : Take Dad to a good Neurologist. What you are explaining seems much more like progression of Alzhiemer's/dementia with low oxygen levels exacerbating the confusion. Is your Dad on any meds for his dementia ? Such as Namenda, Aricept ? Is he on any meds like Seroquil for his behaviors ? If not, he may need them, if he is they may need tweaked. Behavioral issues with Dementia/Alzheimers can never be " controlled ", they can be made less, but the behaviors tend to advance as the disease progresses.
You may get resistance from Hospice < I am a hospice nurse > about taking him to a nuerologist if he is on hospice for his stroke. But you are within your rights to see one. If he is on for Adult Failure to Thrive or General Debility you will not need hospice approval, just inform them you are taking him.

I would have a long talk to the hospice nurse about rails on Dad's bed. Your Dad doesn't process like you or I do. When he wants to get out of bed a rail isn't going to stop him, he is going to see it as something to climb over, because his focus will be on getting out of bed for whatever the idea of the moment is. A side rail just provides a highter place for him to fall from, hence increasing the chance of broken bones. There are things called Bed Alarms.. they are little mats that go under his sheet with a sensor and alarm. Hospice should provide one, but if not, they can be purchased at a Medical Supply Store. When his weight is on it it is quiet, the minute his weight releases from the matt, an alarm goes off, signaling you and J to go check on him.  These can also be used in his chair, when he is up. Hospice should be able to provide you with what is called a " low bed ". it goes all the way down to about 4-6 inches off the floor.  As horrible as this may sound, you can always put the mattress directly on the floor. you want him to fall from as low a point as possible, if he is going to fall.

You are doing a great job ! I know it sounds awful about taking his pension and Social Security check from him to put him in a long term care facility. But you need to start thinking about that. Not making a plan or making a decision that it is going to happen. But you need to think about..... at what point will I have no choice. What am I willing to risk,  < your health, his safety, etc> to avoid having his checks be in my control ? They do give $ 60 a month back to the patient. not alot. That day may never come, he may never get bad enough, but you need to have a plan in place in case it does happen. And you need to set a limit for yourself in that I will be the best daughter I can, but at Point X, I am still a good daughter, but circumstances are out of my control. And for Dad's health/safety and my health/safety, I need to make a change.

Is the Hospice Social Worker involved in your Dad's case ? Is he/she having these types of conversations with you ? Has the nurse reccomended you get Social Work in ?  All that should be being done. Not just when you need respite care.

From the little you have said in this thread, it ** appears ** that Dad is not declining < physically > and not getting closer to death, but is actually improving. Which could mean you have many more years of this ahead of you.

I would also suggest you look into a Dementia Support group. While it appears he is delibrately doing things and making things hard for you on purpose, you need to realize that  his ability to reason, recognize behaviors, recognize danger, recognize inappropriateness and understand is limited.  He is functioing on impulse, much like a child.  The way in which you approach him needs to be adjusted.

Hang in there !

                         mbmbn


< Message edited by maybemaybenot -- 7/27/2009 2:16:36 PM >


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RE: Another of "those" rants - 7/27/2009 4:22:40 PM   
LotusSong


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I'm sorry for your situation. I really don't have any idea what you can do. If I was in that situation and realizing I may have bitten off a bit more than I could chew,I'd go to my promary care doctor and ask for advice as a starting point. He should be able to direct you to a solution... maybe. Sometimes, in our helping, we can do more harm than good.

< Message edited by LotusSong -- 7/27/2009 4:27:15 PM >


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RE: Another of "those" rants - 7/27/2009 5:13:17 PM   
LookieNoNookie


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quote:

ORIGINAL: GreedyTop

*hugs and love* Rhi.. I wish I could do something to help....


Ditto

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RE: Another of "those" rants - 7/27/2009 6:52:49 PM   
maybemaybenot


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quote:

ORIGINAL: maybemaybenot

The way in which you approach him needs to be adjusted.





I just re read that and it came of as unkind and judgemental. It was poorly stated.
I meant that people in support groups who have been going thru this will have experiences, approaches, ways of dealing that you can use to help make your life and stress level better.
I'm sorry if I offended you.

                     mbmbn

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When tolerance is not reciprocated, tolerance becomes surrender.

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RE: Another of "those" rants - 7/28/2009 12:24:43 AM   
Termyn8or


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"Rhi:

If I might suggest "_____________".

I think it is past that. It is now a matter of waiting for the guy to die. It is unfortunate, but reality. He has had a bunch of strokes, and he is not going to get well ever.

My Dad saw that happening to himself and simply quit going. He died at home like he wanted to. I have now inherited the third house he bought. It is over.

Death is a part of life, that is what I think. If you were to be able to live forever you would not savor life.

I also agree that Rhi is one of the strongest people around here, and of all things I would actually like to give her a big hug. But she is in OK and I am in OH, and my arms just ain't that long.

T

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RE: Another of "those" rants - 7/28/2009 4:54:38 AM   
hizgeorgiapeach


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quote:

ORIGINAL: Termyn8or

If I might suggest "_____________".

I think it is past that. It is now a matter of waiting for the guy to die. It is unfortunate, but reality. He has had a bunch of strokes, and he is not going to get well ever.


It's been well past the point of "maybe he'll start getting better" for a long time, now.  It was past that point when I moved him home - which was one of the reasons that I decided to do so.  He has a DNR and AD in place - has had for years, since right after momma died - which prohibits us doing ANYTHING other than palliative care.  Due to the AD, I can't even Legally have him hospitalized for tube feeding/fluids if he decides (in his incapacitated state) that he's simply going to quit eatting - or gods forbid something like another major stroke happens and he becomes incapable of doing so. 
 
When I moved him home, he was still semi-mobile under his own power.  He's had a wheelchair since the stroke for long distances, simply because the paralysis of his left side never really eased up, but he could still walk for short distances.  Those distances - which were around 40 feet before exhaustion & lack of oxygen started getting to him - have declined to about 8 feet at this point.  His appetite fluctuates, and increasingly he simply refuses to eat unless I'm home (part of his tendency towards temper tantrums) - and then he only wants chocolate and the occassional small cheeseburger from McDonalds. (Which in and of itself is sad, since before the stroke he was very health conscious about his eatting, never touched chocolate, and Detested McD's.)  In the same 8 month span, his reliance on his nebulizer for breathing treatments has gone from every 9 or 10 hours to every 4 hours - and he Asks for treatments every 2 hours - I simply won't put more meds in it than every 4 due to his doctor's orders that he not be allowed more than that.
 
It's very much a waiting game at this point.  It has been for the Majority of the 3 years since the inital stroke.  The difference now - really - isn't between having him at home vs him living in a nursing home like he did for the first 2 1/2 years.  The difference is in how I react to things on a strictly emotional level.  For the time that he was in a nursing home, I was able to maintain a bit of ... almost clinical detachment from what was going on.  I had convinced myself that I had my grieving over and done with, simply because of the magnitude of the changes wroght by the stroke in his personality, behavior, and mental capacity.  With him Home, I haven't been able to maintain that sense of detachment - that self-deluded belief that there was no grieving left to do - that I had somehow come to terms with his mortality..... and my own.  In the month between my birthday in mid-June, and his birthday in late July, I've had to start being more honest with myself about that Mortality and the issues that surround it.  I've had to start examining my own life, to decide how and whether I want to make Changes in MYSELF while I still have time to do so.  I've had to start looking a lot more closely at the things that I Haven't done that I still Want to do - and decide whether I'm Capable of doing them, and if so, how much of my personal energies do I want to spend on those changes.  I've had to start asking myself some of the difficult questions that I've avoided seriously looking at because I was afraid of the answers within myself - do I really Want to quit smoking, loose the excess weight, and make some of the more subtle changes to personal style and personality quirks to improve who and what I am, or am I content to hide behind those things to insulate myself from the world at large, and the emotional pain it's possible for others to inflict if I actually allow myself to risk getting hurt by being truely Close to someone that I might lose?  Eventually, the mask has to be set aside - otherwise we end up the way dad was terrified he was going to end up - dying alone in a place that's little more than a warehouse for the old and useless, with no friends, family that has forgotten us, and only strangers to remember that we ever existed.  Knowing that - and knowing how much that simple concept terrifies him - I CAN'T make myself put him back in a nursing home, no matter what the emotional cost to myself in the short term.  If I did - I wouldn't be able to look myself in the eye after he does die, and I wouldn't be able to protest if it happened to myself.
 
With J here, I'm getting a lot more Physical rest, so that's rapidly ceasing to be a major factor - I get a lot more time off, and even when I'm home J answers dad's yells as frequently as I do simply so I don't have to do it All.  (He's not much help as a roomie on the housework, but at least he cleans up the messes he himself makes, and he actively avoids adding to the general sense of Chaos that's been the norm for my home since December.)  My brother has pretty much vanished himself again, since he's been made aware that dad doesn't have any money left.  I made certain he understood That back in late February/early March, when he showed up whining about how he'd gotten my Harley stolen and expected me to do something about it.  With him having disappeared because he knows dad's broke - and knows beyond doubt that I'm not about to spend even a single penny of dad's little bit of income or remaining resources bailling his worthless ass out of holes he's dug for himself with his drug use - that bit of pressure/stress has eased considerably as well.  Unfortunately, it's been a source of unhappiness/stress for dad - since dad still harbors the delusional hope that my idiot brother and I will be reconciled to each other.  I avoid mentioning my brother anywhere in dad's hearing - because I'm Not going to politely lie about the fucktard, and dad goes into a bout of serious distress - breathing difficulties, panic attack, the whole 9 yards - if he happens to overhear me telling someone the Truth about why I don't try to enlist mike's help. 
 
The social worker from the Hospice company that's working with dad keeps fairly close tabs on how things are going for me, calls every other week to check up on things and ask if there's anything I need from them or that they can do to help with the load.  The nurse comes in twice a week, plus any time I call them (like yesterday) because there's been a problem on a day she's not already scheduled to come by.  The aide comes 3 days a week to deal with dad's person hygene issues - something I arranged with the Hospice from the get-go, since I knew I wouldn't be able to deal with it myself.  (While it was never an issue with my 22 year old spawn, despite all her physical problems growing up ... there's a Huge difference between doing that for our same gender offspring, and doing so for our opposite gender Parent!  The idea of helping him with that just squicks me to the point where it simply wouldn't get done at all if someone else weren't coming in to do it, and I recognized and acknowledged that in myself from day 1.) 
 
I will, as I always seem to manage to do, pull myself out of this ongoing slump.  I am, first and foremost, a Survivor.  While I may not come out the other side completely unchanged, that's not necessarily a bad thing.  Change in and of itself is not the enemy - how we React to those changes, whether we embrace them or run to hide from them - That is the telling point.  And in the meantime, I keep going, doing what needs to be done and waiting for the point in time when there's nothing left to do for dad so that I can concentrate on the rest of my life.  When he's gone, there will be time for me - for what I want.  Time to travel to the various places I want to see but haven't yet, time to quit making excuses about why I don't more actively work on quitting smoking, or loosing weight, time to finish getting over past hurts that are so old and worn out even now as to have little real meaning yet I've stubbornly clung to like a worn out security blanket of excuses.

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RE: Another of "those" rants - 7/28/2009 5:43:24 AM   
maybemaybenot


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I completely understand and respect where you are coming from and what you are doing. And wish you all the best as you do what is best for you and your Dad.

I used the word " improving " in the hospice sense, not the " getting better " sense. Meaing: this may be more of a chronic phase of illness, with further slow declines to come, not a phase where death is expected in 6 months or less. Having minimal insight from your posting, it was just an educated guess. It was based mostly on his weight gain of almost 10% of his body weight in a short period of time. Which speaks volumes to the good care you are giving him.

                      mbmbn


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RE: Another of "those" rants - 7/28/2009 6:27:26 AM   
sirsholly


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quote:

The difference is in how I react to things on a strictly emotional level.


when i reached that point it was because i was tired. It was the type of tired that no amount of sleep was going to help.

Your strength is just amazing.


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RE: Another of "those" rants - 7/28/2009 6:41:56 AM   
hizgeorgiapeach


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quote:

ORIGINAL: maybemaybenot
Having minimal insight from your posting, it was just an educated guess. It was based mostly on his weight gain of almost 10% of his body weight in a short period of time. Which speaks volumes to the good care you are giving him.


I've figured it was more from the fact that the only thing he's willing to eat is absolutely empty calorie junk food combined with laying in bed like a lump all day.  The nursing staff at the care center he was in for 2 years made certain that he didn't simply lie in bed all the time while he was there.  There were exercise periods that they would take him to - even when he didn't particularly want to go - as well as twice a week work with one of the physical therapists in an attempt to maintain what mobility he had.  The longer he's been home, the less willing he's become to get out of bed even for things like going to the kitchen to eat meals, or come into the living room (about 30 feet from his bedroom door) to watch TV every once in a while.  You may be partially correct in this entering a more "chronic" stage.  I hope you're not, simply because the doctor was so certain when he got placed on Hospice and moved home that he only had 6 months to a year - which is what he himself said he was prepared for.  He would find it intolerable if the doctors suddenly told us that he's going to continue to linger like this - unable to do any of the things he used to do, unable even to take care of himself - for an indeterminate period longer.  I'd definately have to start keeping his medications under lock and key, like I've already had to start doing with all the guns.  (I haven't worried about my kitchen knives simply because he hasn't got the strength to walk as far as the kitchen to get one of them.  The gun safe, though, is in the closet of his bedroom - weighs more than a ton, so moving it to a different room when I moved him home was out of the question.  I just have to make certain that he doesn't know where the Key is.)
 
Most of the past year has been spent with him pushing himself to survive from one important date in his own life to the next.  When I moved him home in December, that first date was mom's birthday in mid-february.  After that, it was the anniversary of mom's death a couple of weeks later at the beginning of March.  Then it was Easter a month after that.  Then it was the anniversary of their wedding on June 1st.  Then it was his 64th birthday, which was on the 21st of this month, about a week ago. 
 
Problem is, he doesn't have any Important To Him dates left on the calander until next February when mom's birthday rolls around again.  Christmas and Thanksgiving and Halloween have never really meant anything to him.  He's had trouble for months now remember my daughters' names, much less their birthdays.  He hasn't been able to remember the anniversary of his dad's death more than 10 years ago since the inital stroke, and hasn't asked about his mother (still in a nursing home with advanced Alzheimer's) in 2 years.  Having watched the various changes over the past 8 months, listened to him talk about how ready he is for all this to be over - hell, to the point of begging me a couple of times recently to kill him and get it over with - I don't think he's got the emotional or mental strength remaining to push himself through Winter, much less the Physical Stamina it would require of him. 
 
Fall is already setting in early around here.  We've had weather for the past week that Normally doesn't set in until mid-September right around the time the State Fair hits - cooler than normal, quite wet/rainy, early morning fogs from the humidity levels, way colder than normal nighttime temps (to the point where the 102 I have the hottub set at seems quite inviting any time after 10pm.)  State health services are already gearing up for higher than usual problems with cold weather, and higher than average cases of various Flu virii.  They're also predicting another severe winter as far as ice goes - which has always been a much larger problem for this state than snow.  Last time we had a really nasty winter ice storm (Dec of '07) the power went out, and was out for 3 weeks in this neighborhood.  The nursing home he was in at the time had it's own emergency generators, which they were able to use for the week that That side of town was without power.  Just within the past 2 weeks, the power in my neighborhood has gone out 4 times due to hard thunderstorms - which meant putting him on his backup portable oxygen tanks for anywhere from 6 hours to 3 days at a time,  and convincing the doctor to prescribe him an inhaler that could be used as an emergency breathing treatment since the nebulizer requires electricty to run.  As it is, I'm seriously considering buying an emergency generator for here at home, so that if the power goes out from either thunderstorms or ice storms, I've got Something to run at least his equipment with, and perhaps keep the heat turned on if it's from ice.  (I looked into purchasing one during that last bad ice storm, but they were limited in availability, and the stores were jacking up prices due to demand to the point where what's normally a $300 emergency generator was running $800 to $1000.  If I'm smart, I'll go on the 1st when his pension comes in, and get one NOW, while they're on sale for $150 because no one is thinking about winter storms yet and the stores can't seem to get rid of what little stock they currently have.)
 
My fear (and perhaps, oddly, my hope) is that the first nasty bug that makes the rounds this winter is going to be to much for his system to handle.  One of the aides or nurses, a friend of mine stopping by to visit, who's been exposed to something but who doesn't know it yet because they aren't showing symptoms themselves - or even me or J catching something while we're not here at the house, and unknowingly bringing it home - and that's it.  Masks and Gloves will only go so far in containing contagion.   I can't Financially afford to set up/maintain a completely sterile environment to avoid the potential - and even a hospital or nursing home isn't that, except for isolation units.  (Which says nothing about the fact that I'm just not That good a housekeeper lol - I do housework because it Has to be done, and between me and my 4 cats, there's less than a snowball's chance in Hades of maintaining things absolutely sterile around here!) Nor can he be given things like Flu shots or the various anti-pnumonia shots that are available - contraindicated due to his emphasymia and already severely weakened system.  The doc figures that giving him any sort of preventative anti virals or inactive antibody type stuff would do more harm than preventative good.

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Rhi
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(in reply to maybemaybenot)
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RE: Another of "those" rants - 7/28/2009 7:21:19 AM   
Rule


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quote:

ORIGINAL: hizgeorgiapeach
If I'm smart, I'll go on the 1st when his pension comes in, and get one NOW, while they're on sale for $150 because no one is thinking about winter storms yet and the stores can't seem to get rid of what little stock they currently have.)

Buy two. Sell one for 300 dollars when it is winter.

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