Avocados: The Other Fruit

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Here is another one of my favorite foods and it can be easily added to your meal without a lot of preparation! Avocados have a lot of essential nutrients such as vitamin A, B, C, E and K, copper, iron phosphorous, copper, as well as fiber, protein, and antioxidants.

Health benefits are many including helping to maintain a healthy heart. Avocados contain B6 and folic acid which help regulate homocysteine levels. Elevated homocysteine levels are associated with an increased risk of heart disease.  Avocados can help lower cholesterol levels, decrease triglycerides and LDL (bad cholesterol) and increase HDL (good cholesterol). Lower cholesterol levels and may help protect against strokes. One avocado contains about 23% of the daily recommended value of folic acid which is known to decrease certain birth defects such as neural tube defects and spina bifida.

Avocados have polyphenols and flavonoids which are antioxidants and anti-inflammatory compounds that decrease inflammation and some degenerative disorders. Antioxidants help prevent cell damage and as a result my help slow the aging process and boost your immune system. They may also help prevent breast cancer and inhibit the growth of prostate cancer.

Avocados are high in monounsaturated fats and fiber, both of which can help with insulin resistance and stabilize blood sugar levels.

Avocados are also high in fat with ½ of an avocado containing 10 gm of fat 7 of which are monounsaturated and 1.5 grams saturated fat. They are high in calorie as well so should be used sparingly.

Ways to enjoy avocados:

  • Fresh slices on a salad
  • Guacamole
  • Try mashing some avocado and using in place of mayonnaise
  • Add some slices to your favorite sandwich or tacos
  • Stuff an avocado half with your favorite tuna or chicken salad

Homemade Guacamole

3 avocados, mashed
1 tomato, finely chopped
1-2 tablespoons minced onion
Chopped fresh cilantro
1 Jalapeño pepper, finely chopped
Salt to taste
Lime juice to taste

Nutritional Information
Serves 4
Calories 262
Fat 22.2 grams
Cholesterol 0 mg
Carbohydrates 18 gm
Fiber 11.4 gm
Protein 3.7 gm

What Grandma DON’T KNOW About Birth Control

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Weeding out myth and ridiculous to uncover the truth

[blockquote3]Grandma says: “Birth control gives you cancer.”
Doctor says: “Nope!”[/blockquote3]

Now why would anyone take the doctor/provider’s word against that old wives’ tale / urban legend without an explanation? I submit to you that your doctor really cares to take good care of you and not expose you to anything harmful where the risk outweighs the benefits. I know this is not enough to convince grandma, so hear me out. But first, we’ll let grandma give her side of the story.

First of all, what type of cancer? It’s easy to say, but explain please… C’mon grandma explain it to me. Well, she can’t.

For the most part, hormonal birth control works by preventing ovulation… the process were the egg is released in search of the baby-making sperm. Barrier contraceptives (condoms, etc…) keep the sperm from meeting the egg but do nothing to prevent ovulation. Back to hormonal birth control (pills, patch, vaginal ring, Depo-Provera shot, etc…) which prevent ovulation. These are very low dose in general, and act by decreasing hormones that come from the brain and act on the ovary. Since the ovary is not stimulated, it does not ovulate. Here’s an interesting fact that grandma don’t know. Scientific theory has it that monthly ovulation (being off birth control) may increase risk of ovarian cancer. Each month a cyst forms, ruptures, and damages the ovary. The ovary then has to fix itself over and over and over again. At some point an error occurs in the repair process and may lead to cancer. So, preventing ovulation prevents this constant monthly repair and decreases the chance of a cancer inducing error occurring. It’s actually been shown that a woman who takes birth control for a total of 15 years or more, will decrease her risk of ovarian cancer by 90%. Booyah grandma! How do you like ‘dem apples.?!

[blockquote3]Grandma says: “Birth control makes you infertile.”
Doctor says: “Wrong again granny.”[/blockquote3]

Again, most birth control is so low dose that it’s out of your system pretty quickly. The only common birth control that takes a while to get out and may delay ovulation is Depo-Provera… so it may take longer to get pregnant after Depo, but it doesn’t make you infertile. As for the other forms of birth control, the return to fertility is fast… sometimes too fast leading to an unplanned surprise. 🙁 As a matter of fact, many fertility doctors and I myself use birth control for a few months prior to a patient trying to conceive. These help to control and regulate hormones such as insulin and testosterone, which may be elevated in certain patients. When elevated, these hormones prevent ovulation and conception. So by regulating these hormones, fertility can actually be increased in the few months after coming off birth control. So for infertility patients, I usually use birth control in the few months before starting fertility drugs. Grandma means well, but she don’t know, don’t show, or don’t care about what went on in med school (okay fine, I stole that line from Boys in the Hood).

[blockquote3]Grandma says: “Birth control makes you fat.”
Doctor says: “mmmmmm well maybe.”[/blockquote3]

Most forms of birth control weigh less than 5-10 pounds before they’re used. Does birth control go in your body and expand a thousand fold like Elven bread (Lord of the Rings)? I haven’t seen a study on this, but I’m pretty sure the answer is no. So why the weight gain?

Well, the Depo-Provera shot can make you hungry… which leads to eating more… which leads to weight gain. Will power / diet control, exercise, and good genetics can minimize weight gain. The textbook says Depo-Provera causes an average yearly weight gain of 5 pounds. I’ve seen many woman gain more and some who gain nothing at all. I’ve even seen a few lose weight while on the shot.  So, granny might be right when it comes to “the shot” or Depo-Provera causing weight gain.

Other forms of birth control, including the patch, vaginal ring, and pills have not proven to be associated with weight gain. As a matter of fact, one study found that married women on the pill gained weight while single women on the pill lost weight. So, other than “the shot,” there is no proof that the other forms of birth control cause weight gain.

Lesson Learned

So when someone gives you an opinion, whether it be wise ol’ grandma, a know it all friend, or a nosy neighbor, you can do one of two things. You can nod and smile all the while ignoring them in your head and then ask your provider. Or you can, in the most sarcastic of tones, ask them where they went to medical school… wait for the silence… wait for it… and respond with a “that’s what I thought,” then ask your doctor. I prefer the latter, which if you didn’t know already, I’m sure you do now. 🙂

Remember, The Truth will set you free. Now give granny a hug and a kiss.

What Exactly is a Pap Smear Checking For?

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As gynecologists, we help our patients through some very personal experiences: the dreaded pelvic exam, birth control, miscarriage, pregnancy, menopause, sexually transmitted infections, and so on. Discussing your cholesterol with a stranger just isn’t the same as discussing a first pregnancy or starting birth control. It is a very special part of our job. The pap is something I talk about everyday. Most women understand that they need to “get a pap to get checked down there.” But what exactly is a pap checking for? And why do you have to keep getting them?

The pap is a screening test for cervical cancer. The cervix is at the top of your vagina, and it is part of the outer uterus. We use a small brush (imagine a small toothbrush) to collect some cells from your cervix. It goes to a lab, and a specialist looks at your cells under a microscope. If the cells look abnormal, we do more tests because we are trying to prevent or detect the worse case scenario – cancer. But most times the result is simply normal or abnormal cells, which isn’t as serious but still very important. These abnormal cells can persist and ultimately develop into cancer. We can surgically remove these abnormal cells to help prevent cervical cancer. This is the gist of the pap test, and this part is fairly clear to most women.

Explaining the role of HPV testing casts a fog on all of the above, and this is usually the turning point in the discussion. Recent research has linked the human papilloma virus (HPV) to cervical cancer. We now know that certain types of this virus is what causes the abnormal cells found on paps. More importantly, the HPV virus also causes most types of cervical cancer. This is very important for two reasons: the HPV test effects the way paps are managed by health care providers and it also stresses the importance of the HPV vaccine.

But before I can even answer why it is so important for the patient’s future, I am often confronted with a question regarding the patient’s past. How did I get this virus? The virus is passed from one person to another during sexual contact, i.e. genital skin-to-skin contact. This type of contact can include vaginal, anal and oral sex. This virus is so prevalent that if you have ever had sex, the chances of having this virus is over 80% for your lifetime. In contrast, less than 10% of American women have chlamydia per year. HPV is the most common sexually transmitted infection. It’s like “the common cold” of sexual activity. Almost everyone you know has had the common cold right? The kicker about HPV is that it is a completely asymptomatic infection; there are no sniffles or sore throat, no discharge or pain. This means you will never know who gave it to you (because almost everyone has had it!). That part is not important, so it is not worth interrogating your partner over it.

It can overstay its welcome, and hang around for years. You may have gotten it on prom night five years ago, or you may have picked it up from your fiancé. And unfortunately there is no treatment for it. No pills, no shot. We just have to wait for the body to naturally clear the infection, which it usually does in about 90% of young people within two years of acquiring the infection.

But all of this, while important, is a bit irrelevant to what we are going to do about your abnormal pap smear. That’s our job, to figure out what to do next. Your job? With regards to HPV and your pap smears, here are the take home points:

  • Don’t stress about a positive HPV test. There is no treatment for it, and unlike an acute gonorrhea infection, it doesn’t mean that you or your current partner have been unfaithful.
  • Most women who have or have had HPV do not actually develop cervical cancer. But most women who have cervical cancer have the HPV virus.
  • Stop smoking. Smoking is like a power bar for the HPV virus, it helps it grow, which is not what we want.
  • Use condoms, but remember that a condom does not cover the entire genital area, and HPV can still be transmitted through contact of the exposed skin.
  • Keep your follow-up appointments with us. Even if your abnormal cells are not severe enough to warrant a surgical procedure to remove them today, the cells may become more abnormal in 6 months, or they may be completely normal next year. And wouldn’t that be a relief?
  • If you are under the age of 26, get the Gardasil vaccine. It’s a vaccine that can prevent a cancer. How fascinating and amazing is that!

Blueberries Pack Big Punch

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It is amazing what great things this little berry packs for its small size. Now is the time to take full advantage of these little gems. Crops are coming in and prices are good.

Why are they so amazing? First of all, blueberries contain the highest antioxidant capacity of all the fresh fruits. Blueberries are very rich in anthocyanin which is linked to many health benefits by reducing free radicals. Reducing free radicals in the body helps delay aging and can lower the risk of developing certain cancers especially colon cancer.

The high fiber content of blueberries coupled with the antioxidant effect can help dissolve the “bad cholesterol” and actually help strengthen the heart muscle. The fiber content in blueberries can help reduce episodes of constipation.

Blueberries pack vitamin C, B complex, vitamin E, vitamin A, copper,  selenium, zinc and iron which helps to build the immune system and help prevent bladder infections.  Coupled with the anthocyanin blueberries may help prevent your brain cells from dying thus improving memory.  These anthocyanosides are also linked to slowing down visual loss. These compounds can help prevent or delay many of the age-related visual problems such as macular degeneration, cataracts, and myopia to name a few.

How can you enjoy these little fruits?

  • Make a fresh fruit salad using fruits of your choice, sprinkle a little sugar substitute and mix or add a dollop of whipped topping
  • Add fresh blueberries to your yogurt
  • Try adding them to your pancakes, waffles, muffins, oatmeal or cereal
  • Make a parfait layering yogurt, blueberries and low-fat granola
  • Toss some in your green salad
  • My daughter eats them straight from the container and I have trouble keeping them stocked
  • During peak season when blueberries are on sale I will portion them out in 1 cup amounts and freeze them for use later

Try this enjoying blueberries as a nice frozen snack on a hot afternoon or after dinner dessert.  I put a batch in the freezer then worked in the gardens for a couple of hours. The combination of the frozen blueberries with the lemon yogurt was very refreshing after being in the Texas heat.

Using a toothpick, dip fresh blueberries in lemon yogurt. Place on a cookie sheet lined with waxed paper. Freeze for a couple of hours. If you do not have lemon yogurt on hand use your favorite flavor.

Remember that ½ cup of these small super foods is one serving of carbohydrates.

The Two-Year Old Rule

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I’m often asked by my patients whether they can eat certain foods, drink alcohol, be around people who smoke or smoke themselves, etc.  Whenever I’m asked these questions, I apply what I call the “Two-year old rule.”  I ask the patient to imagine that their baby is already born and is two years old, sitting in a high chair.  Then I ask the question, “would you give the food, drink or cigarette to your two year old?”  Usually the answer is a chuckle and “no”.  Then I explain that a woman who is pregnant should assume that anything she puts into her body would probably make it to her baby.

When talking about foods, two important questions to ask are; is it healthy for the woman and her baby and, is there any chance of it making them sick?  Take ‘junk food’ for example.  While tasty, there is generally a lot of sugar and/or fat with little in the way of nutritional value (i.e. protein, vitamins, minerals, etc.).  I get the part about it being tasty, but why waste a meal on something that is only going to grow your hips and not your baby?  Another food category is uncooked or raw foods such as raw seafood or meat.  Eating these can increase your risk for food-borne illness. Besides making you very sick, even worse than bad morning-sickness sick; the bacteria can make your baby sick as well.  So save the sushi for after you deliver, and wash your hands really well when cooking with raw meat.

Next is alcohol.  We don’t know of a “safe” amount of alcohol that a pregnant woman can ingest and not harm her baby.  We know that ingesting an ounce of alcohol a day (1 glass of wine, 1 beer, or 1 shot) significantly increases a women’s risk of her baby having Fetal Alcohol Syndrome.  There is also some newer research that suggests this risk is present at even lower amounts of alcohol consumption.  So again, if you wouldn’t give a shot, beer or glass of wine to a 2 year old (and you shouldn’t) then don’t give them to your baby when you’re pregnant.

Then there is caffeine.  Found in all sorts of yummy things: coffee, tea, soda and … CHOCOLATE!  According to the March of Dimes, pregnant women should limit their caffeine intake to less than 200mg a day, which is about 1 twelve-ounce cup of coffee.  Milk chocolate has around 7mg of caffeine per ounce, and dark chocolate about 20mg per ounce but they also come with a lot of sugar (remember those hips).

Finally, there is smoking.  Short answer: DON’T.  I know that it is hard to quit (nicotine is more physically addictive than cocaine), but do it for yourself and your baby.  Again, the two-year old analogy: would you leave a two year old next to the tail pipe of a running car?  Basically it’s the same stuff as cigarette smoke.  Smoking increases your risks of preterm delivery, low birth-weight baby, and a baby with increased chances of having SIDS (Sudden Infant Death Syndrome), asthma, learning disabilities and other issues.  I’ll stop my rant about smoking for now, but here is a website with some helpful quit-smoking advice: women.smokefree.gov.

So while you are pregnant, just think ahead to when your little one is two, sitting in a high chair, covered in strained peas and carrots… I mean, sitting there like an angel daintily eating cheerios with their fingers, and be glad that you made those healthy choices during your pregnancy.

Scholarship in Memory of Dr. David Wollenman

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Dr. David Wollenman was an icon for obstetrics and gynecology here in Irving, TX for over 33 years and brought over 7000 babies into this world. He brought cutting edge surgical techniques to Irving that he learned through experience and at continuing education programs. It was largely due to his influence that we have many of the continuing education goals and current practices here in Irving. He passed from this world in July 2011 after battling against an aggressive form of brain cancer. Because of his love for the Irving area, the medical field, continuing education and medical advancements, and just because of the person he was, MacArthur OB/GYN is honored to sponsor a scholarship in his memory.

The scholarship is awarded to an Irving ISD graduating senior with academic achievement with an emphasis in math and science and current or previous participation in a teen pregnancy program. This year, the scholarship was awarded to Jennifer Consuelo-Martinez.

Jennifer attends Jack E. Singley Academy and will be graduating in the top ten percent of her class. She plans on attending college after graduation and wants to pursue a Bachelor’s degree in Law Enforcement or Criminology.  She also hopes to work with the Irving Police Department while in college. After finishing college, she is planning on enrolling in the police academy and continuing her journey to becoming a police officer.

The road here has not been easy for Jennifer, but she has done a great job. Living in a single parent home with limited resources for most of her life, she has fought the odds and done well. Her biggest challenge, and where she has shined the most, has been in her becoming a teen mother. Her daughter is precious to her and she wants to be a role model for her. She gives much credit to the Irving TAPPS program in helping to guide her with the day to day needs for her as a mother and for her baby.  She credits TAPPS with helping her become a good mother and helping her to stay on track towards reaching her goals.

Jennifer has been involved with many school activities in addition to taking care of her daughter. She elected president of the Criminal Justice club and the captain for her police explorer post. Over the last 4 years, she’s done more than 300 hours of community service including career day with elementary schools, feeding the homeless, helping Army Veterans, Big Brothers and Sisters, police training, crime watch parties, and even dressing up as McGruff the crime stopping dog. Jennifer thinks of others first and seeing a smile on other peoples’ faces really makes her day.

Dr. Wollenman is the reason I ended up here in Irving, so he has forever impacted my life. He was a mentor to me and to many, and I can’t say enough great things about him. I am so grateful to have known him. He would have been happy to know and see Jennifer get this award and to help her get closer to her goals.  I too am proud of this wonderful young lady and am happy that MacArthur OB/GYN has been able to give her this scholarship, while honoring Dr. John David Wollenman.

Participating in Clinical Trials

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As a physician, I believe that I wear many hats. Among them are: healer, teacher and student. Since joining MacArthur OB/GYN in 2011, I found that one way to combine these hats into one was by becoming a clinical investigator on the research studies that our office participates in. The impetus for MacArthur OB/GYN to join in these studies came from my partner, Dr. Jeff Livingston, who has a passion for educating patients.

So how does being a clinical investigator in a research study help my patients? For one thing, it offers patients the chance to receive a new treatment or therapy that may help their condition. The study may also involve following patients for an extended period of time and this outcome data may result new knowledge that results in large-scale changes to doctors’ clinical practice. Also, we are able to attract patients who may have been outside our practice; and helping more people in the community is definitely a good thing.

So what clinical studies are we participating in at this time? We are participating in 5 clinical studies, and they are:

  1. A study of a medication to treat Interstitial Cystitis/Bladder Pain Syndrome
  2. A Post-market study looking at the long-term outcomes of two types of sling procedures for urinary incontinence
  3. A study of a medication to treat endometriosis
  4. A study of a medication to treat uterine fibroids
  5. A study of a medication to treat yeast infections.

Each study has specific inclusion and exclusion criteria. In addition, patients generally receive the study medications for free and are compensated for their time. In order to participate, a patient may be identified by one of our doctors as being potentially eligible, or a patient can contact our office and express an interest in participating; in which case they would be scheduled to see one of the doctors who is either the Principle Investigator or Sub-investigator for the particular study.

Hopefully reading this will encourage you if you have one of these conditions (IC/Bladder Pain, Urinary Incontinence, Endometriosis, Fibroids, or Chronic Yeast Infections) to contact Veronica Almanza at 214-223-5479. She can explain the study to you in more detail and arrange a visit with one of our physicians. We are here to help.

Snacking Made Easy

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Snacks. I find it hard sometimes to come up with an easy, healthy, quick snack that is portable and can be munched on at my desk between patients. And at 6:30 in the morning, who is thinking about what will be happening at 10:00am anyway, right? Here as a great snack idea that can be made ahead and give you several servings to last you through the week. No extra brain energy exerted before the coffee kicks in!

The salsa can also be used to top your favorite beef, chicken or fish.

Corn Salsa

1 15 ounce can black beans, rinsed and drained
1 cup frozen corn, thawed
1 large tomato, chopped
1 jalapeno pepper, chopped
2 green onions, thinly sliced
2 tablespoons fresh cilantro
2 tablespoons lime juice
½ teaspoon ground cumin
Salt to taste

Combine all ingredients in a bowl and toss. Serve with fresh vegetables or homemade whole grain pita chips.

Serves about 16
Serving size: ¼ cup

Nutritional information:
Calories 32
Total fat 0 grams
Carbohydrates 7 grams
Fiber 2 grams

Remember to add the carbohydrates from the pita chips! If you use the celery sticks then you can enjoy ½ cup and count this as one of your servings of carbohydrates or starches.

The Daily Show and Health Information Exchanges

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Recently on The Daily Show, a very interesting topic was covered — the lack of interoperability of electronic health records. This was a huge surprise to me as one would not expect the Comedy Central to cover a topic frequently discussed only by health information technology policy wonks.

During the satirical editorial, John Stewart lambasted the fact that the electronic health records from the VA system are unable to communicate with the electronic health records of the Department of Defense. He pointed out the illogic of having two large departments in the United States government having two different systems that cannot exchange information with each other.

While his editorial was hilarious and brilliant, it failed to recognize that the lack of EHR interoperability is one of the central problems in the entire U.S. health system. It is not just these two government agencies that cannot communicate; the problem is much bigger affecting virtually every doctor’s office and every hospital in the country. Health information technology experts have been shouting from the rooftops about the need to create a seamless way to share health data for a long time.

In fact, solving this problem is one of the primary aims of the Affordable Care Act through the creation of health information exchanges. Here is the basic problem. A patient goes to the doctor and has blood work done. That lab result will go from the lab back to the doctor. If the patient goes to another doctor or hospital, that lab result is not available for review by the new health provider. The new doctor is likely to simply repeat the test. Now multiply this situation thousands of times across the U.S. health system every day and add in radiologic studies, pathology reports, medication list and others and you can easily see the billions of dollars wasted because these independently operating systems cannot talk to each other. The Affordable Care Act created financial incentives to encourage physician adoption of electronic health records. It also created incentives to facilitate data sharing as part of a program called Meaningful Use.

Ironically, the technology needed to solve the problem of independently operating electronic medical record systems not communicating with each other already exists. This is accomplished through the creation of health information exchanges (HIE). Basically, a HIE allows medical information to be shared from one system to another. This means a patient’s health information can live in the cloud and follow them wherever they go. The seamless sharing of health information allows each health provider to have the most updated information to make the best healthcare decisions. This cuts cost, saves time, prevents medical errors and makes life easier for patients and doctors.

So, if the technology to solve this problem already exists why, has it not been done already? There is no easy answer to this question and in my opinion it is unfathomable why HIEs are not up and running everywhere. HIEs are not new.

They exist in some parts of the country with some success (Indiana). Most believe widespread adoption is on the horizon. Policy makers have mostly agreed now on the accepted standard for information sharing. This had been the central “choke point” to developers of this technology. Other issues are EHR vendors hesitate to provide access to proprietary information. Hospitals have concerns about sharing valuable demographic information with competitors. There are many other excuses and all are valid concerns. But while the execution of health information sharing is delayed real people suffer.

John Stewart drew attention to the health concerns veterans — those fighting for our country. He put a face on an important topic that needs to be solved now. He also brought a rather mundane and boring health IT topic to the forefront of pop culture.

One of the keynote addresses at the HIMSS13 this year was delivered by President Clinton. He acknowledged that healthcare costs are approximately 18 percent of GDP, and healthcare costs of other developed countries are in the range of 11 percent to 12 percent of GDP. Healthcare costs at this level are not sustainable especially as baby boomers reach an age that will place a higher level of demand on healthcare.

The emphasis of the keynote address was on the importance of using technology in reducing healthcare costs. Government, business, physicians, hospitals, insurance companies and patients all want to avoid unnecessary tests and have the information timely for patient care.

Technology is available. What is lacking is the will of key leaders to do it now. John Stewart brings an issue that is solvable to “main” street. It is good to laugh at ourselves, but this is not laughing matter.

Easter

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I did some research on some of the popular Easter candies that line the store shelves at this time of year. They are all so tempting! All are wrapped in pretty packages to attract your attention. What is that pretty foil wrapper really hiding?

[table type=”striped_minimal”]
[trow]
[thcol]Candy[/thcol]
[thcol]Calories[/thcol]
[thcol]Fat (g)[/thcol]
[thcol]Carbs (g)[/thcol]
[thcol]Sugar (g)[/thcol]
[/trow]
[trow]
[tcol]1 Cadbury Solid Milk Chocolate Easter Bunny[/tcol]
[tcol]890[/tcol]
[tcol]48.6[/tcol]
[tcol]101.2[/tcol]
[tcol]97.1[/tcol]
[/trow]
[trow]
[tcol]1 Reese’s Reester Bunny[/tcol]
[tcol]760[/tcol]
[tcol]40[/tcol]
[tcol]88[/tcol]
[tcol]72[/tcol]
[/trow]
[trow]
[tcol]1 Dove Solid Chocolate Easter Bunny[/tcol]
[tcol]230[/tcol]
[tcol]13[/tcol]
[tcol]25[/tcol]
[tcol]24[/tcol]
[/trow]
[trow]
[tcol]4 Lindt Mini Bunnies[/tcol]
[tcol]220[/tcol]
[tcol]15[/tcol]
[tcol]20[/tcol]
[tcol]15[/tcol]
[/trow]
[trow]
[tcol]9 Brachs Malted Easter Eggs[/tcol]
[tcol]200[/tcol]
[tcol]8[/tcol]
[tcol]32[/tcol]
[tcol]23[/tcol]
[/trow]
[trow]
[tcol]1 Nestle’s Crunch Nest Egg[/tcol]
[tcol]180[/tcol]
[tcol]9[/tcol]
[tcol]25[/tcol]
[tcol]20[/tcol]
[/trow]
[trow]
[tcol]1 Reese’s Peanut Butter Egg [/tcol]
[tcol]180[/tcol]
[tcol]10[/tcol]
[tcol]80[/tcol]
[tcol]16[/tcol]
[/trow]
[trow]
[tcol]1 Cadbury Chocolate Crème Egg[/tcol]
[tcol]150[/tcol]
[tcol]6[/tcol]
[tcol]24[/tcol]
[tcol]20[/tcol]
[/trow]
[trow]
[tcol]35 Jelly Belly Assorted Jellybeans[/tcol]
[tcol]140[/tcol]
[tcol]0[/tcol]
[tcol]35[/tcol]
[tcol]32[/tcol]
[/trow]
[trow]
[tcol]4 Peep Marshmallow Bunnies [/tcol]
[tcol]130[/tcol]
[tcol]0[/tcol]
[tcol]33[/tcol]
[tcol]29[/tcol]
[/trow]
[/table]