Saturday, February 13, 2021

The Cockroach Catcher: Reviews





Kindle comes in very handy, literally. Yes a 3rd generation gadget that allows you to store and read books and other printed material.   You can pack with you thousands of books on this device that weighs less than a paperback.



This has inspired me to launch a Kindle edition of The Cockroach Catcher (yes, the book).   More importantly, the Kindle edition costs a fraction of the physical copy.  If you do not yet own a Kindle, you can simply download the free Kindle software and read Kindle books on your iPhone, iPad , iPod touch & your Personal Computer. You can read the book within seconds from ordering.        US Verson






Here are some reviews:

I purchased Dr Am Ang Zhang's book last November and placed it at the bottom of my ‘to read’ pile – I should not have done so.

Holidaying earlier this year – I decided that ‘The Cockroach Catcher’ would be my holiday read (even though it was still only half way up the pile) – it was a good decision.

Am Ang takes you on a fine journey from his poor beginnings in China to his education in Hong Kong, his life and experience at medical school, his decision to enter psychiatry leading to a post as registrar at The Tavistock Clinic  and to his role as a consultant paediatric psychiatrist within the NHS (and many interesting places in between).

Dr Zhang had a common sense approach to the children in his care, intuitively finding the answer to their problems, cases ranging from sleep and toileting problems to those of anorexia, autism and psychosis - although towards the end of his career, red tape and ‘guidelines’ were to impact on his practice.

His book also gives insight as to how we as parents may influence the mental health of our children and how childhood is being medicalised when behaviours are due to lack of parental authority and/or guidance and are not psychiatric illness at all.

Although the back cover summary describes the book as a work of fiction, the contents are based on a good and a very real doctors’ journey through medicine.  It is a must read for all those either working in medicine or interested in child psychiatry and indeed childhood itself, and an invaluable read for parents who have concerns regarding their children’s mental health.

It is a fascinating well penned book with references documented in the footnotes and is available from  Amazon.  Visit the cockroach catcher here


Anna :o]

©2016 Am Ang Zhang

5.0 out of 5 stars
Format:Paperback
We all have stories to tell with regard to our experiences as physicians. Zhang is one of our medical school classmates who took it to a different level by writing and publishing a book. The book details how it all started, from the time his family moved to Hong Kong from China, to his years in medical school, to his experience as a child psychiatrist in the UK. The book is full of interesting case studies of actual patients he saw and the challenges he faced dealing with them.
I was captivated by many of the interesting stories in the book. It’s a must-read for all students of psychiatry. It also makes for good reading material for anyone during their leisure moments.

From another doctor friend:

The Cockroach Catcher has evoked many images, memories, emotions from my own family circumstances and clinical experience.

My 80 year old Mum has a long-standing habit of collecting old newspaper and gossip magazines. Stacks of paper garbage filled every room of her apartment, which became a fire hazard. My siblings tricked her into a prolonged holiday, emptied the flat and refurbished the whole place ten years ago. ……My eldest son was very pretty as a child and experienced severe OCD symptoms, necessitating consultations with a psychiatrist at an age of 7 years. The doctor shocked us by advising an abrupt change of school or we would "lose" him, so he opined. He was described as being aloft and detached as a child. He seldom smiled after arrival of a younger brother. He was good at numbers and got a First in Maths from a top college later on. My wife and I always have the diagnosis of autism in the back of our mind. Fortunately, he developed good social skills and did well at his college. He is a good leader and co-ordinator at the workplace. We feel relieved now and the years of sacrifice (including me giving up private practice and my wife giving up a promising administrative career ) paid off.

Your pragmatic approach to problem solving and treatment plans is commendable in the era of micro-managed NHS and education system. I must admit that I learn a great deal about the running of NHS psychiatric services and the school system.

Objectively, a reader outside of the UK would find some chapters in the book intriguing because a lot of space was devoted to explaining the jargons (statementing, section, grammar schools) and the NHS administrative systems. Of course, your need to clarify the peculiar UK background of your clinical practice is understandable.

Your sensitivity and constant reference to the feelings, background and learning curves of your sub-ordinates and other members of the team are rare attributes of psychiatric bosses, whom I usually found lacking in affect! If more medical students have access to your book, I'm sure many more will choose psychiatry as a career. The Cockroach Catcher promotes the human side of clinical psychiatric practice in simple language that an outsider can appreciate. An extremely outstanding piece of work indeed.

From Australia:

I have finished reading The Cockroach Catcher and thoroughly enjoyed it.

Zhang, I particularly liked the juxtaposition and paralleling of your travel stories and observations with your case studies, Of course, I could appreciate it even more, knowing the author and hearing your voice in the text. Because I’m dealing with anorexia, ADD and ADHD students I was very interested in your experiences with patients and parents and your treatment. Amazing how many parents are the underlying causes of their offspring’s angst. It was an eminently readable text for the medically uninitiated like me. Keep writing, Zhang
 Squid ©2010 Am Ang Zhang
From another doctor:

Absolutely riveting! Brings me back to working (in NHS psychiatry) when work was really interesting! The tone is quite conversational; it is like hearing you telling stories. I ordered more copies for my family and friends.

I knew it would be very special and it sure is. To us your trainees it is like going back on the rotation to have the joy of working with you again. The difference is that l can now learn at leisure from this book. Congratulations.
The book is very well written and makes very easy and interesting reading even for the laymen. You learn a lot about the Health System, a lot about child psychiatry and a lot about the growing up and development of the author.

Fascinating account of child psychiatry cases, including some creative yet effective treatments. Anyone who is a parent or around children or really anyone at all actually will find the book surprising, entertaining, thought-provoking, funny and moving.

The book makes me realize the difficult decisions with which a doctor is so often faced, the need for him to have faith in himself and, coupled with that, the need for continued idealism and enthusiasm. These don't, of course, apply only to doctors but are particularly important for them.

Great book. I have bought one to give to my son on his birthday.



And CC, your book is amazing! I am only on page 44 but so far, so wonderful. I think how you turned this anorexia patient around just goes to show what human interaction rather than tick box protocols can do in a short period of time and at low cost too. This is an exemplary illustration on perhaps one of the reasons why a good health system like the one in Singapore can not be fully implemented in Britain. it's the change of perceptions and methodology to suit that's difficult.

And, as a city girl, I found your early life in villages fascinating and very enriching for a bright child like yourself, I suppose, had I been your mother, I too would have not asked you any questions when you were told to leave that school ... but the school supplier of cockroaches! [shiver]Dearime! I run a mile when I see one, let alone catch them and dissect them! boys will be boys after all, now that I know that you weren't joking. you are a cockroach catcher, not only of the soul, but for real! @@

The book is a must read doc, I am really enjoying it :-)”


From the LUL
U.com website, where you can preview the chapter Seven Minute Cure and if you so wish, order a copy of the book (after creating your own account):

Fascinat
ing! What a great read. Just reading the one chapter made me want to read the whole book. Thank you!
A beautiful opening! A piece written with of all that wit, intelligence and sarcasm! The author has managed to illustrate a boring NHS subject in the most interesting of ways. He has convinced me to read on. The NHS should urgently seek help and advice from this doctor!
Thank goodness for doctors like these!! If the rest of the book is as good as the preview chapter then it will be a fantastic resource for practitioners and the public. 
Fascinating preview chapter. I can't wait to read more.
Horrah for the doctor. Chapter 1: The Seven Minute Cure. The doctor overcame the obstacles faced from the establishment and freed a young child from her prison. Great read.
Other reviews and feedback:
Absolutely riveting! Brings me back to working (in NHS psychiatry) when work was really interesting! The tone is quite conversational; it is like hearing you telling stories. I ordered more copies for my family and friends.
I knew it would be very special and it sure is. To us your trainees it is like going back on the rotation to have the joy of working with you again. The difference is that l can now learn at leisure from this book. Congratulations.
The book is very well written and makes very easy and interesting reading even for thelaymen. You learn a lot about the Health System, a lot about child psychiatry and a lot about the growing up and development of the author.
Fascinating account of child psychiatry cases, including some creative yet effective treatments.  Anyone who is a parent or around children or really anyone at all actually will find the book surprising, entertaining, thought-provoking, funny and moving.
The book makes me realize the difficult decisions with which a doctor is so often faced, theneed for him to have faith in himself and, coupled with that, the need for continued idealism and enthusiasm. These don't, of course, apply only to doctors but are particularly important for them.
Great book. I have bought one to give to my son on his birthday.
(Note: both father and son are doctors.)




I was in Special Education for many years. I just love the way you dealt with the girl who was bullied, and the boy with Behaviour Disorder. I am buying two more copies, one for my friend who is a psychologist and one for a colleague in Special Education.

I wish I had read your book when I was headmistress. I would have had so much more insight into why some of the pupils behaved the way they did.
I have been a school counsellor for 15 years and we have had regular recommendations on books to read. None of them taught us as much as your book, which would have been very useful for our weekly screening meeting discussions.
Reading the book and his blog, you cannot help admiring the author's width and depth of knowledge, the light-heartedness, the humility, the humane and the human side of people.
You learn a lot about the Health System, a lot about child psychiatry and a lot about the growing up and development of the author. 
What a book! I cried a little. I laughed a little. I know I should not. 
Your stories are amazing. I really enjoy reading it. 
My wife cannot put your book down and I shall not be able to get my hands on it until she has finished.
I was horrified by some of the gruesome cases and agonised at the suffering of some of your patients. But there are moments of laughter and smile at Dr Zhang's wit in handling the cases and patients.
Am Ang, thank you for a wonderful book. You know I could not put it down. My husband is now reading it and he said it is such an easy read as he thought it was all going to be heavy and clinical.
You have such a way with the little ones. What about the 12 year old pretending to be three and a half! My goodness.
Just the village life can fill a book. (Seriously an in-depth version will be much welcome!) Book two can be Life at HKU. And so on... Fascinating!
Having grown up in farming country, I love the Chapter on The Village. I know it is different but so much about village life just clicked with me. Makes me wants to go home to have a look. I would like you to write more about yourself. Just all the little details you are so good with.
I wish I had your book when I was bringing up my kids. I am giving each of my two children a copy. I decided to put down Pillars of The Earth for a while and start your book on a flight. I could not put it down to go to sleep. Wow: it makes so much sense.
I did expect the cover photo to be one of yours – after all, the creative mind needs full exposure, artistic and otherwise. I was just recommending it to some friends.
I never imagine I can have so much fun and gain so much knowledge by reading a book of this sort by, of course, an author with a sense of humour and a deep understanding of human nature. I really enjoyed reading it. Life could be so much easier if we had the chance to do what we like, to let our thoughts be shared by someone we trust, to make sugar pills of nasty encounters and so on and so forth for bearing more positive thinking. Just by a mere short conversation, which hit exactly at the 'dead pit' of the hiccup boy, the hiccup was over. Human nature is just like that. After reading the author's accounts of his cases, I wish I could also be endowed with such wit and wisdom, not so much for curing others, but to let my own body and soul remain healthy and sound always.
Love it. I read it in three days flat. Not only should parents read it; I think all those in the medical profession should read it. There is so much common sense. I am recommending it to my book club. Will you come and talk to them about it?




Anne of Green Gables 

Friday, February 12, 2021

Bright Young Doctors & Rainbow: NMDA & Autoimmune Encephalitis

In Medicine, it is amazing what the Bright Young Doctors can offer. In my day and now!


Forty years ago, a patient of mine was unconscious for 23 days and it was mother's belief that it was through prayer that her daughter was saved. I did not know anything about NMDA or Autoimmune Encephalitis then nor did Queen Square.

The Bright Young Doctor in my days:

" A good doctor is one who is not afraid to ask for help but he must also know where to ask.
         “Get me Great Ormond Street.”
         “I already did.”
         She is going to be a good doctor.
         “Well, the Regional unit said that they had no beds so I thought I should ring up my classmate at GOS and she talked to her SR who said “send her in”.”
         Who needs consultants when juniors have that kind of network?  This girl will do well.
         “Everything has been set up. The ambulance will be here in about half an hour and if it is all right I would like to go with her.”
         “Yes, you do and thanks a lot.”   ............."                     full ChapterHERE


But perhaps God works through his people in his own way. Discoveries in Medicine should therefore enhance our faith rather than the other way round.

It took nearly 40 years for the real answer to her prayers to really emerge.

 ©2012 Am Ang Zhang


The Bright Young Doctor now:

I was staying at our resort in Boquete and was having dinner with three friends all of them with medical connections. One was in hospital administration and one a nurse. The husband of the nurse was a pharmacist. Somehow the conversation drifted into medical topics and knowing that I am a Child Psychiatrist the pharmacist started talking about his nephew who was nearly sent to a mental institution as he suffers from catatonia and doctors eventually diagnosed schizophrenia and put him on antipsychotics. Luckily the catatonic symptom probably saved him as some bright young thing just read the book Brain On Fire and gave him the Clock Test. That led to the NMDAR antibody testing that proved positive. He responded well to the treatment regime that has been developed and is off all antipsychotic medication.

My Teratoma patient was lucky as she belong to that group that improved without further treatment once the Teratoma was removed. She eventually had a baby.


The Power of Prayers & Teratoma: Brain & NMDA!


Anti-NMDA Receptor Encephalitis

NEW ORLEANS — A mysterious, difficult-to-diagnose, and potentially deadly disease that was only recently discovered can be controlled most effectively if treatment is started within the first month that symptoms occur, according to a new report by researchers from the Perelman School of Medicine at the University of Pennsylvania. The researchers analyzed 565 cases of this recently discovered paraneoplastic condition, called Anti-NMDA Receptor Encephalitis, and determined that if initial treatments fail, second-line therapy significantly improves outcomes compared with repeating treatments or no additional treatments (76 percent versus 55 percent). The research is being presented at the American Academy of Neurology's 64th Annual Meeting in New Orleans.

565 cases! Not so rare!

The condition occurs most frequently in women (81 percent of cases), and predominately in younger people (36 percent of cases occurring in people under 18 years of age, the average age is 19). Symptoms range from psychiatric symptoms, memory issues, speech disorders, seizures, involuntary movements, to decreased levels of consciousness and breathing. Within the first month, movement disorders were more frequent in children, while memory problems and decreased breathing predominated in adults.

My patient was under 18 and presented with catatonia symptoms. She later lose consciousness and was ventilated.

"Our study establishes the first treatment guidelines for NMDA-receptor encephalitis, based on data from a large group of patients, experience using different types of treatment, and extensive long-term follow-up," said lead author Maarten TitulaerMD, PhD, clinical research fellow in Neuro-oncology and Immunology in the Perelman School of Medicine at the University of Pennsylvania. "In addition, the study provides an important update on the spectrum of symptoms, frequency of tumor association, and the need of prolonged rehabilitation in which multidisciplinary teams including neurologists, pediatricians, psychiatrists, behavioral rehabilitation, and others, should be involved."

The disease was first characterized by Penn's Josep Dalmau, MD, PhD, adjunct professor of Neurology, and David R. Lynch, MD, PhD, associate professor of Neurology and Pediatrics, in Annals of Neurology in 2007. One year later, the same investigators in collaboration with Rita Balice-Gordon, PhD, professor of Neuroscience, characterized the main syndrome and provided preliminary evidence that the antibodies have a pathogenic effect on the NR1 subunit of the NMDA receptor in the Lancet Neurology in December 2008. The disease can be diagnosed using a test developed at the University of Pennsylvania and currently available worldwide. With appropriate treatment, almost 80 percent of patients improve well and, with a recovery process that may take many months and years, can fully recover.

Teratoma: finally!

In earlier reports, 59 percent of patients had tumors, most commonly ovarian teratoma, but in the latest update, 54 percent of women over 12 years had tumors, and only six percent of girls under 12 years old had ovarian teratomas. In addition, relapses were noted in 13 percent of patients, 78 percent of the relapses occurred in patients without teratomas.
As Anti-NMDA Receptor Encephalitis, the most common and best characterized antibody-mediated encephalitis, becomes better understood, quicker diagnosis and early treatment can improve outcomes for this severe disease.
The study was presented in a plenary session on Wednesday, April 25, 2012 ET at 9:35 AM at the American Academy of Neurology's annual meeting.
[PL01.001] Clinical Features, Treatment, and Outcome of 500 Patients with Anti-NMDA Receptor Encephalitis

Anti-NMDA-receptor encephalitis: case series and analysis of the effects of antibodies

Of 100 patients with anti-NMDA-receptor encephalitis, a disorder that associates with antibodies against the NR1 subunit of the receptor, many were initially seen by psychiatrists or admitted to psychiatric centres but subsequently developed seizures, decline of consciousness, and complex symptoms requiring multidisciplinary care. While poorly responsive or in a catatonic-like state, 93 patients developed hypoventilation, autonomic imbalance, or abnormal movements, all overlapping in 52 patients. 59% of patients had a tumour, most commonly ovarian teratoma. Despite the severity of the disorder, 75 patients recovered and 25 had severe deficits or died.

Related paper:

Anti-NMDA Receptor Encephalitis: Diagnosis, Psychiatric Presentation, and Treatment


Chapter 29  The Power of Prayers

The following is extracted from The Cockroach Catcher: Chapter 29 The Power of Prayers.
According to old Chinese advice, it is wise never to discuss politics or religion even amongst best friends.           Religious belief can often blur judgement in the wisest of people. In psychiatry it is sometimes not easy. This is particularly true in cases of florid psychosis, which often presents with symptoms of hallucination, delusion and even vision.         I remember my early days of psychiatry in a mental hospital in Hong Kong. Yes, it was the days of 2000-bed hospitals. Yes, it was the days of Medical Superintendents who had supreme power and all doctors of whatever rank and experience were Mental Health Officers with special authority to sign papers for compulsory admissions. The forensic unit was contained within the same complex.         Those were the days when we encountered psychosis in the raw so to speak. All the colony’s really mad people were admitted to this one place set in the furthest corner of the colony. In our year seven of us decided without much discussion that we all wanted to go into psychiatry. That was over 10% and all had quite idealistic reasons. It was perhaps a bit of a disappointment to our parents that we did not pursue a more conventional specialty that might provide us with more status and financial reward. Then there was the fear of contamination that somehow one might become mad too. Recent day medical students are said to shy away from psychiatry for these same reasons.         Education seems to have little effect on superstition.                                     ......................................….read the full ChapterHERE



Cahalan's new memoir is called Brain On Fire-My Month of Madness.      

Brain on Fire      

                     

Wednesday, February 10, 2021

Food Labels: Mislabel or Mislead


Not quite, just like faked Kona Coffee, it is still caviar but a cheaper species.

Looks like the big boys are moving in as the pickings are better with the rich and famous who can’t tell their burgundies, coffees or now caviar.

I think I like to get those cheap stuff that could pass as fakes.

The Guardian:

Is fine dining having its Apollo 13 moment? I know it's not on the same scale as "Houston, we have a problem," but when Laura King had to call Fortnum & Mason and Harrods to say, "There might be a problem with the sevruga," it can't have been her easiest day at the office.

King is the founder and co-owner of the eponymous King's Fine Foods, the UK's largest supplier of caviar with a client list that includes Buckingham Palace, the Groucho Club and Claridge's, as well as the nation's poshest grocers.

Random DNA tests taken back in October at King's premises in Richmond have revealed that what was labelled as top-grade sevruga, the eggs from Acipenser stellatus sturgeon, was actually the roe of Acipenser ruthenus, considered considerably less fine by those who know and care about these things.



 

The Cockroach Catcher has always been amazed that in a short time under pressure form consumer groups and the government, food manufacturers and supermarkets managed to produce detail analysis of the product they sell so that consumers can be clear what they are “consuming”!

What he was amazed was how healthy most foods were: sugar free, trans-fat free, cholesterol free. Even when the product has cheese.

Wow! Modern food processing technology! Or was it modern labelling technology!


Then he remembered Ribena. You can read about it here>>>>>



 Vancouver ©2012 Am Ang Zhang


I happened to be in one of the world’s most livable city and imagine my surprise when I read this in:



Global News:  https://globalnews.ca/news/236395/canadian-nutrition-label-claims-often-wildly-misleading-tests-show/
Tests unveil misleading food labels
Bad nutrients understated, good ones overstated

By Sarah Schmidt, Postmedia News April 20, 2012

Some of the world's biggest food brands and leading organic labels have understated the amount of bad nutrients — such as fat, sugar and sodium — in their products, or overstated the good ones, internal government tests show.

Kraft, Frito Lay, Unilever and Heinz are among the big names with a product that flunked Canadian Food Inspection Agency (CFIA) testing, conducted to see if nutrition claims on labels live up to their billing.

Loblaw's popular President's Choice brand had multiple "unsatisfactory" tests on products ranging from cereal to spaghetti.

Premium brands like Amy's Kitchen, Eden Organic, Natur-a, Kashi and Yves Veggie Cuisine also fell short on composition claims, as did Canadian food-makers like B.C.-based Sun-Rype Products Ltd. and Quebec-based Aliments Fontaine Sante.
No Sugar:

Among the breads and baked goods tested, Fenwicks "no sugar added" cookies (too much sugar)

Iron:
In the snacks category, Krispy Kernels Inc.'s Island mixed nuts claimed to contain 90 per cent of the recommended daily intake of iron per serving. Samples tested by CFIA found contained a fraction of that: 10.5 per cent.

A sampling of other findings shows the huge discrepancies that can exist between labels and ingredients.

Cholesterol:
Some snacks boasting a "No cholesterol" message on their label showed levels ranging from 4.3 milligrams (Lays Smart Selections chips) to 10.5 mg (Barbara's Cheesepuff Bakes) per portion, according to CFIA tests.

(PepsiCo says its own tests on Lays chips, conducted after CFIA informed the company of the agency's eight unsatisfactory tests involving samples of three Smart Selections chip products, showed the claim was accurate.)

Kraft made the same no-cholesterol claim for its Ritz "Real Cheddar Cheese" crackers, but CFIA testing showed the crackers contained 3.2 mg per portion. Dare's cinnamon snap biscuits contained 4.9 mg, CFIA testing showed.

These discrepancies pale in comparison to the findings of two canned snail products picked up from Dollarama stores in Regina. The products of Indonesia, branded as "Beaver" and "Pacific Pride," contained 147 mg and 131 mg of cholesterol per serving respectively, not zero as claimed.
Vitamins:

Canned foods from Unico (pizza sauce), Primo (vegetable soup), Stokely (pumpkin) and Amy's (refried beans, butternut soup) all fell short of their vitamin claims. So did Eden Organic's vegetable spirals, President's Choice organic pasta sauce, Fontaine Sante spinach dip and Island Farms yogurt.

Of the 40 products found to be overstating the amount of vitamins in their products, Yves Veggie Cuisine Ground Round (Mexican flavour) and a prepared pasta dinner by Olivieri Creations stood out for being wildly inaccurate.

The label on Yves Veggie Cuisine Ground Round, a product of the Hain Celestial Group, said each serving contained 80 per cent of the daily value of vitamin A, but CFIA testing showed 3 per cent. And a pre-packaged tortelloni and chicken dinner by Olivieri Creations claimed to contain 110 per cent of the daily value of vitamin C per serving, but CFIA found a serving contained only 1.1 per cent.

Sun-Rype, Oasis and Bolthouse Farms were among the juice brands that overstated — by about double — the amount of a vitamin.
Two juices from Dewlands fared worse; each boasted 35 per cent of the daily value of vitamin A, butnone was detected in either.

Omega acids:
Big-brand products that failed to live up to their omega-3 or omega-6 fatty acid claims included President's Choice Angus burgers, Kraft House Italian dressing and Country Harvest tortillas. Hellmann's mayonnaise under-delivered on the amount of polyunsaturated fatty acids, as did Kashi's honey almond flax cereal.

Specialty products that overstated one these so-called "good fats" include Natur-a soy beverages, So Good fortified soy beverage, Ruth's cereal, and Mom's Healthy Secrets cereal.

GoldSeal canned salmon, Ocean's canned salmon, Our Compliments salmon burgers and High Liner salmon were among the fish products that overstated the amount of omega-3 or omega-6 fatty acids.

Salt:
Some products pitched as reduced in sodium didn't live up to their billing, including Heinz "25 per cent less sodium" Dora the Explorer vegetable and pasta soup, Eden Organic "low salt" canned green lentils, rice and beans, R.W. Knudsen Family "low sodium" vegetable cocktail, "50 per cent less sodium" President Choice crackers, and "low sodium" President's Choice tomato and roasted red pepper soup.

There were also "unsatisfactory" discrepancies in three different Bread Works Bakery "low in sodium" cracker products, with one containing 277.8 mg of sodium, not 70 mg, according to CFIA tests.

Two different cans of Unico artichokes, picked up four months apart, were found to be saltier than claimed on the Nutrition Facts Table.

Calories:
"Light tasting" Nutriwhip testing showed 68 calories per portion, not 20 as claimed on the label. A green tea beverage from Tempest Tea claimed to contain just 5 calories, but testing showed 106 calories per portion.


If it could happen in Canada, do you think it could happen here?

Twitter:



First Posted as 

Food Labels: Real or Really? April 21, 2012.