Missed part 1? Click here!

Undereducated about the Unknowns

I know, I know. So far this hasn’t been a very positive post and for a condition that effects a large proportion of people, I don’t want to scare anyone. Like always, my goal is to educate and that is why I go into detail about these things—for some people they need to know the why before they understand the solution. As such, let’s go into the way we approach Obesity and weight loss and see how we solve it. Short answer: it's very difficult, not easy, and requires lots of encouragement and motivation for everyone involved but the payoff is huge. As a pharmacist working in addiction and psychiatry, part of my job is to recommend agents to assist someone’s treatment. Because of my background I feel that I have a unique perspective on medical issues because I am the drug expert and so I can balance the drug benefit with the side effects of other drugs OR complications of other conditions. That being said, no size fits all and everyone needs a different approach.
Currently I work with many individuals with weight loss challenges due to behavioral conditions (such as Binge Eating Disorder), their medication regimens, or genetics. One of the most important aspects of recommending a weight loss agent is understanding the mechanism of why that person’s calorie intake is more than their calorie expenditure. This section refers to a person who may not be aware of what goes into a proper calorie intake and how to balance intake and output. In a sense this is the field of Nutrition and is where Dieticians come in (please note that registered Dieticians are medical professionals with a degree in Nutrition which enables them to perform medical nutrition counseling and diagnose or treat nutritional illnesses. Depending on the state, a nutritionist does not have a license to practice Medical Nutrition).
​
https://preview.redd.it/98sl29auyf1c1.png?width=685&format=png&auto=webp&s=286907f8e24a0568620f4b6e88dd6844092dac15

• The essentials of Nutrition come down to the idea of Energy Balance or how energy is taken into the body, generated, and then expended. A positive energy balance is when more energy is taken in and then stored resulting in weight gain while a negative energy balance is where less energy is taken in than used so fat stores must be used. Remember that the goal of eating food is to make energy which is represented by the molecule ATP (produced by the Mitochondria!). However, depending on the kind of activity done, we may not have enough stored ATP in the body to cover the activity and thus have to use other means of ATP production.
  • When we are at rest, the activities we do such as swiping your thumb on a screen and moving your eyeballs to read do rapidly deplete the amount of stored ATP—this is why you can sit all day without feeling winded. If we perform a more intense activity, such as walking, the stored ATP is used incredibly quickly (lasts <10sec) and we have to use Aerobic Metabolism to create ATP while doing the activity. Aerobic Metabolism utilizes oxygen to make ATP and is incredibly efficient which enables us to do low-impact activities for an extended period, like walking down a hallway. As the impact level of the activity increases or the length of time increases the body switches from Aerobic Metabolism to Anaerobic Metabolism which is ATP production when oxygen is not available. This isn’t to say that your muscles have 0 oxygen when you are running but more that oxygen demand (moving the muscle) is much higher than oxygen supply (oxygen capacity of red blood cells). As such, the body utilizes Anaerobic Metabolism which produces ATP for energy but also Lactic Acid which causes that muscle pain after exercising.

​
https://preview.redd.it/7v1qf36vyf1c1.png?width=749&format=png&auto=webp&s=695b1d377401be23f6cd4a6145cde5a789545cfc

• To make it simple, Aerobic Metabolism is used in low-impact activities while Anaerobic is used short bursts of high-impact (like a 2-min workout) OR prolonged high impact activity (like crossfit or HIIT exercises). Now that we understand that, we can see what kind of energy source is used in what kind of metabolism. As you can see, Fatty Acids are part of Aerobic Metabolism but only after about 1.5-2hrs of activity. What this means is that in order to burn fat you need to burn your Liver glucose stores (called Glycogen) first and then you can start burning fat. So the 20 minute treadmill run while great for raising your mood and improving blood vessel health may not touch the fat in your belly.
• This brings us to the other aspect of Nutrition—diet. Now this is where the lack of words to describe the science is cumbersome. Someone’s food intake, aka their diet, is different from dieting (cutting out certain foods) which is different from following a Diet (capital D), a more strict set of food guidelines. I don’t have the training to discuss what is a good Diet but I can talk about what are the necessary components of what makes up a good diet (lower case d). In general, it is all about ensuring you have the essential nutrients and reduce the intake of weight gaining foods. Essential nutrients like Vitamins, Minerals, Trace Elements, essential Amino Acids are required from our food in order to live and there are lots of sources online about which foods create balanced meals that fit your preferences. What is nonessential is carbohydrates, proteins, and fats (except omega-3 fatty acids). Yeah, kinda weird to think that the main components of our foods are nonessential but what that means is that we can change it up as needed to fit your current need.
  • Carbohydrates are a group of macromolecules that consist of carbon, hydrogen, and oxygen and are very energy rich. Carbs come in two flavors: nondigestible and digestible. Nondigestible carbs are the dietary fiber we need to ensure that our stools can form solidly and move along the intestines. There are lots of types of fibers but the one for weight specifically is Viscous Fiber which forms a gel in the intestines to reduce sugar and fat absorption. Unprocessed oats, flaxseeds, asparagus, beans, and Psyllium Husk are great sources of Viscous Fiber which help reduce the amount of fat and sugar we take in from our food. Digestible carbs on the other hand are the sugar we normally think, the sweet stuff like glucose, sucrose, fructose, and starches. All digestible carbs can result in weight gain but it all depends on the amount you eat. The essential of a diet is not what you eat but how much you eat; so yes you can have some cake one day but you should abstain for the next few days.
  • Unsurprisingly the fat we eat can be absorbed into the body and used to make fat that is stored. Animal products and processed foods are highest in fats that are likely to be stored while plant based fats and oils are less likely to be stored (more likely to be immediately used as energy).
  • Finally proteins which are not required for weight loss but are essential for muscle gain and the best way to promote further energy expenditure after exercise is to promote muscle synthesis. Essentially, when we exercise the muscle is damaged either by the flexing of the muscle or by the lactic acid produced and so needs to recover with protein in our diet. In order to use the protein the body needs to spend energy which can be done in the form of using more stored fat. Thus, eating protein while trying to lose weight can provide additional benefits.
  • So what does this all mean in terms of the exercise we were talking about before? Well remember that in order to burn fat someone needs to exercise about 1.5 hours to burn through stored glucose stores. Now this can be really cumbersome but the way around this is to starve the Liver of glucose to rebuild those glucose stores. By keeping a low-carb diet, your liver wouldn’t be able to use dietary glucose to rebuild the Glycogen stores and instead have to use more fat! As such, keeping the amount of glucose in your diet low aids in getting to the 1.5 hours sooner and can facilitate using fat as a main energy source when you are at rest.
• Now diet and exercise is all well and good but there is a big factor here that we have to consider: ability to diet and exercise. Yes physical ability is a major aspect but this is why this section is titled Undereducated—for individuals who are lower socioeconomic status (SES) they have a harder time achieving the necessary diet and exercise goals to find significant weight loss. Is this because they are uneducated? No, most Obese people of any SES know that eating better and exercising will make them lose weight, but performing those actions uses another major commodity: time. Unfortunately, those of lower SES face several challenges that make it extremely difficult to lose weight: often they are working lower wage jobs meaning that more time is spent working and less time available for exercise. Combine this with the higher cost of living, especially when caring for children, and lower SES correlates heavily with buying cheaper foods which are often not the most nutritious. If a parent has to feed 4 children with a few dollars, they will use sources of food that maximize the value of that dollar—this means processed foods filled with salt and fat to make them taste good. This is part of the benefit of food stamp programs which enable lower earning families to purchase more nutritious foods. But this is where the undereducated part comes in.
  • For many people they think that a weight loss meal is salad, and while its not wrong, its a lot of what is in the meal. Part of my work in college working in a food kitchen was helping families understand how to maximize the benefit of the canned or frozen vegetables and fruits they have access to rather than feeling that healthy food is only fresh produce. A person can accomplish the same nutritive goals on frozen or canned vegetables as they can on fresh or raw foods and often on a smaller budget. I highly encourage those who are on a limited budget to get in touch with their local food bank—often they can connect you with a dietician who can guide you through how to cook nutritious meals on a small budget and for a large family. Please know that diet and exercise is extremely possible even with added time constraints.

And a quick buck was made

Okay I think we have come to the part that people were really waiting for—the drugs! Please take this next section as educational only and to merely inform you of the thinking behind weight loss agents. You must talk to your doctor or pharmacist before starting, stopping, or changing any medications including herbals, supplements, or illicit substances. The first group of medications we will look at are those with an FDA approved indication for weight loss:
​
https://preview.redd.it/aje1kjcwyf1c1.png?width=1013&format=png&auto=webp&s=c9c8f3471356fd2778b72b85b8e2d8d101656daa

• First up we have Orlistat, a medication that does not require a prescription in the United States to use. Orlistat is an inhibitor of stomach and pancreas Lipases, a type of enzyme responsible for breaking down dietary fats. This means that when someone takes Orlistat the fats they eat are unable to be broken down for absorption and instead stay in the stool for excretion. When used correctly, about ¼ to ⅓ of dietary fat isn’t absorbed and there is a sizeable reduction in LDL (bad cholesterol). While its nice its over the counter, Orlistat has some…major drawbacks. The biggest is it’s tolerability—because Orlistat prevent fat digestion, most of the fat stays in the intestines causing oily stools, urgent diarrhea, and smelly flatulence. In its official documentation the term “explosive diarrhea” is used. Now, to avoid these unfortunate side effects a person should meals that are high in fat (no more than 30% of their daily recommended fat amount). Now this begs the question: is Orlistat effective in losing weight because of how it works or because people avoid fat like its poison to prevent explosive diarrhea? Either way someone should expect to lose around 15 lbs at 6 months of regular use which is nothing to sneeze at.
  • Speaking of over the counter weight loss aids we should talk about a few. One of the biggest ingredients included in these supplements is Caffeine. Caffeine is thought to work by increasing someone’s metabolic rate or in other words to increase the amount of energy someone uses while at rest. Part of this is because the heart is working harder (Caffeine increases heart rate) but there is some more systemic effects that are not explained by simple increased fight or flight effects. I can’t find the source I heard this from, because I believe I learned it during a seminar, but somewhere near 65% of OTC weight loss supplements have some form of Caffeine in them. Caffeine can be listed by itself or be hidden in an herb like green tea, yerba mate, green coffee beans, kola, guarana, yaupon, and dozens more. I'm not anti-caffeine, I drink plenty of it everyday but these supplements often have people exceeding the safety limit of caffeine by combining these herbs together. Caffeine can worsen anxiety, put significant strain on the heart, and isn’t recommended for pregnant women. Just be careful!

​
https://preview.redd.it/qpk65tdxyf1c1.png?width=985&format=png&auto=webp&s=8fd493d116ac5136b4198cce07aabd612c28dd54

• One supplement that used to be on the market in the US and is now banned is Ephedra. Ephedra is preparation of the chinese herb Ma Huang which contains the alkaloid Ephedrine and Pseudoephedrine. Both chemicals are part of the stimulant class of medications and when used in large enough doses will cause appetite suppression. Essentially these chemicals stimulate the fight or flight region of the nervous system which suppress the urge to eat. This is actually the reason why stimulants like Amphetamine (Adderall) and Methylphenidate (Ritalin) are used off-label to treat Binge Eating Disorder and help weight loss. Suppressing the urge to eat helps the person eat correct portion of food or prevent binge episodes thus reducing calorie intake. One OTC product that was extremely popular in the late 1990s and early 2000s was Hydroxycut which heavily marketed itself on TV and on the unregulated internet. In 2003 the Missouri Attorney General sued the company over their claims that Hydroxycut was “clinically proven” to burn fat but the case was settled out of court. Later in 2003 the NYT uncovered hidden documents that showed Hydroxycut knew its product didn’t work and have tampered with documents in another lawsuit in Oklahoma to show otherwise. Regardless, the usage of Hydroxycut wasn’t significantly hampered but due to its widespread use and unscrupulous advertising, the FDA banned Ephedra in 2004 after 155 deaths were attributed to the herb. It was the first time a supplement was banned in the US. Hydroxycut then switched to using Hydroxycitric Acid which required a lower dose than the Ephedra based formulations. The company failed to advertise the change in dosing and dozens of cases of serious liver failure resulting in liver transplant were reported and at least one death (19yo male). Hydroxycut is now mostly Caffeine.

​
https://preview.redd.it/m15fi14yyf1c1.png?width=806&format=png&auto=webp&s=4517fd0e1941338b3eb9c9c35d885cf963b3d597

• Similar to the stimulants is Bupropion which is combined with the opiate antagonist Naltrexone in the product Contrave. Bupropion is an antidepressant that causes a raise in Dopamine and Norepinephrine in the brain while Naltrexone works by preventing endorphins from binding to the opioid receptor in the brain. Together its thought that Contrave works in Hypothalamus to reduce pro-eating stimulation as well working in the Mesolimbic Dopamine Circuit to reduce the reward feedback someone feels when eating. In a sense, the drugs work by causing someone to be less hungry and then reduce the pleasurability of eating. Contrave can be incredibly useful in people who are mindless snackers (such as eating large quantities of food when not paying attention) or for binge eating disorder. The benefit of using this medication over the stimulants like Adderall or Ritalin because it helps treat the cause of the Obesity (overeating) rather than just preventing the symptom (weight gain). Generally people see around a 25lb weight loss around 6 months.
  • Similar to Contrave is another combination product: Phentermine and Topiramate in the branded product Qsymia. This combo pill utilizes the stimulant Phentermine which comes from the same class as Adderall and Methylphenidate to suppress appetite and Topiramate, originally an anti-epilepsy medication that is thought to suppress appetite, increase satiety, and reducing pleasure from eating. Qsymia produces similar results to Contrave.

​
https://preview.redd.it/99xetdlyyf1c1.png?width=860&format=png&auto=webp&s=b0743068c48b595de6c0353dbe89eab81043b381

• Okay, this brings us to a very controversial medication in the pharmacy world: GLP-1 agonists. If you remember from earlier I described how White Fat releases the appetite-suppressing hormone Leptin due to the stomach and intestine releasing GLP-1. GLP-1 is released when the GI tract detects carbohydrate or fat rich foods and their release triggers a cascade resulting in long term appetite suppression. LIkewise it is believed that the very common side effect of nausea and vomiting reduces the desire to eat. So in a lot of ways, they are working the same as the stimulants are—reducing appetite but not really touching the reason for overeating. GLP-1 agonists like Semaglutide (Wegovy) and Liraglutide (Saxenda) are used primarily for their influence on Insulin in Type 2 Diabetics to help lower blood sugar levels and reduce A1c, a marker of overall health in Diabetes. In diabetes, the clinical benefits of GLP-1s cannot be understated on the heart, kidney, liver and many other organs. In non-Diabetes weight loss? Well…don’t get me wrong they do work—people usually see a 15 lb loss at about 6 months but they miss the mark in the same way that the stimulants do. They prevent symptoms but don’t really help the underlying cause for why someone might be Obese.
  • The other aspect that I am always weary of is when drugs become “popular” in the media and especially with celebrities. Many celebrities and social media influencers are touting the benefits of GLP-1 agonists, i.e. the weight loss, but the consequence of this fad is that Diabetics who rely on this drug are unable to get it anymore. There is a massive shortage in GLP-1 agonists for people who could use another agent with similar efficacy but are using GLP-1s due to the social media presence. Likewise the weight loss isn’t sustained—at about 1 year the weight loss plateaus and after stopping only around 50% maintained the weight loss. Compare this to the other agents we’ve talked about who had a sustained weight loss around 80% and the choice is clear. Another aspect I have against these drugs for weight loss is the use of a side effect as a selling point—the rate of nausea is about 44% which means that someone is making themselves sick in order to lose weight. This is not a life I would put my patients on.

Finally, I have to talk about the pills mills, or I guess injection stations since the GLP1s are injectable medications, that have popped up around Wegoxy and Saxenda. Weight loss is an extremely tough, emotional, and sometimes unbearable process. For some individuals it is the worst trigger to think about and I really do feel for the people who have tried good eating and exercising but are unable to do it. This is why I believe that weight loss agents should be used just prior to or at the same time diet and exercise routines are implemented. While the drugs are effective, the true power in sustained and increased weight loss is by learning to eat properly and exercise consistently. That being said, I am the kind of person who is results driven and to be encouraged to lose weight I would need to see the pounds come off first before I would feel comfortable starting a diet or exercise. For some its that initial loss due to the drug that pushes them to go for the walk around the block, take the stairs, or choose an apple over a bakery item. I believe in the drug’s ability as much as I believe in the initial push to get the process going. But, and this is the sticking point for me, the process should be an active collaboration between the patient and the healthcare provider. I don't think giving a weight loss agent with a) educating the person on how to diet and exercise, b) follow up on the challenges of implementing those lifestyle modifications, and c) allowing weight loss despite a sedentary lifestyle is okay. I want the best for my patients and sometimes that means giving a boost in the beginning, guiding through the process, and encouraging when things get tough.
One of the trends we are seeing right now is telehealth doctors prescribing GLP-1s. Telehealth is awesome because it connects people to healthcare providers when local doctors aren’t available—but in these cases it is just a formality for a drug to be prescribed. Weight loss needs to be a concerted effort on both people and unfortunately those only prescribing GLP1 agonists are doing it to make money at the expense of the patient. This was the same for doctors that prey on men searching for erectile dysfunction medications, the same for doctors preying on people who believe they have ADHD but haven’t gotten a formal neurologist or psychiatrist and are put on unnecessary stimulants, and now it is the same for weight loss. Drug companies are using social media influencers to push drugs on people—imagine if that was OxyContin. There are dozens of online health clinics and telehealth companies whose sole goal is to get people on high cost drugs to make money. I’d hate to see a wave of pancreatitis and gallstones because due diligence wasn’t being applied.
Okay, I’m off my soapbox. Regardless, weight loss is a difficult topic because there is no easy solution. There is no drug that cures Obesity and it takes time and effort to have the sustained benefit that people are looking for. Remember that weight loss is the first goal, the second is preventing the weight from coming back. Drugs do the first, diet and exercise do the second. Both work together.
Cheers!

1973 - The Jackson 5, are in the studio recording "Call On Me", for Motown Records in Detroit, Michigan
1983 - CIAO 2001 magazine[Italy] featured Michael on their cover
https://preview.redd.it/2c5cyhtqk3mb1.jpg?width=227&format=pjpg&auto=webp&s=88ee01fca26446f261869154591bd3b3fac07235
1988 - On the 2nd leg of the BAD World Tour, Michael performs at Parkstadion (closed-2008) in Gelsenkirchen, Germany to an audience of 52,000 fans
1988 - Joepie magazine featured Michael on the cover
https://preview.redd.it/hsnh7eisk3mb1.jpg?width=225&format=pjpg&auto=webp&s=a8ecde0a9f79385c870c3bc031855bd4a834d8cb
1992- On the Dangerous World Tour, Michael performs at the Friedrich-Ludwig-Jahn-Stadion in Berlin Germany to an audience of 35,000 fans
1993- On the Dangerous tour, Michael performs the first of two nights at the Taipei Municipal Stadium in Taipei, Taiwan to an audience of 40,000 fans
https://preview.redd.it/xwlmtc0vk3mb1.jpg?width=669&format=pjpg&auto=webp&s=5778e8dc19355be94026f2d31b0887567c4e481d
https://preview.redd.it/oia4zc6wk3mb1.jpg?width=514&format=pjpg&auto=webp&s=f23e0ffd4d8c5b3cbdb03f8d49601ae685ab14a2
1994- Michael and Lisa Marie leave the Côte d'Azur and head back to Paris.
https://preview.redd.it/6zhgwxnyk3mb1.jpg?width=238&format=pjpg&auto=webp&s=7b8e2c9208b129dcb2e4c0f29de9c939a9e57b19
Their final destination is Euro Disneyland Amusement Park. They stay in the Royal Suite, located on the 3rd floor of the Disneyland Hotel
https://preview.redd.it/otbpq390l3mb1.jpg?width=800&format=pjpg&auto=webp&s=a61c2e6bf49aa31cc322915883e4bfb2825dc623
https://preview.redd.it/d4sgaxw1l3mb1.jpg?width=800&format=pjpg&auto=webp&s=0d0ee3f336ef98265cddcfcc4da8fcbc0a6c957e
https://preview.redd.it/caj5bde3l3mb1.jpg?width=597&format=pjpg&auto=webp&s=a0d28f94f0495d3b202992cbc5996c5964df6a14
1994 – Woman’s Day magazine features Michael on the cover with the caption: "Jacko Finally Tackles Those Evil Charges"
1997- Michael cancelled a performance at the Olympic Stadium in Barcelona, Spain, because the local promoter had failed to meet financial and technical requirements for the Tour.
1999 - Michael attended the 4th Kora All-Africa Music Awards in Sun City, South Africa where he was given a Lifetime Achievement award.
https://preview.redd.it/ruwywf46l3mb1.jpg?width=483&format=pjpg&auto=webp&s=d54de8d2c221051f115e3f702019d0d261972ca0
Michael presents Nelson Mandela and his 'Nelson Mandela Children's Fund' with a check for 1 million (a portion of the proceeds from the Michael Jackson and Friends concerts in Seoul, South Korea and Munich, Germany)
The former President declaring the following on the donation:

“The trustees of the Children’s Foundation and myself would like to express our deepest appreciation to our friend, Michael Jackson. He is a supporter of worthy causes and I’m happy that the foundation is tonight one of his benefitions (sic). […] And the contribution of Michael Jackson, I hope, will inspire people not only in our country, but throughout the world, to follow his example and to bring a measure of happiness to our children. […]”

https://preview.redd.it/r4vtg9w7l3mb1.jpg?width=612&format=pjpg&auto=webp&s=031f2ae87f65d22c61c600daf25a9e68225cc0a1
2008 - The Jacksons were named BMI Icons at the 8th Annual Urban Awards ceremony, held at the Wilshire Theater in Beverly Hills. The invitation-only event also honored the world's premier R&B, Rap and Hip-Hop songwriters, producers and publishers of the past year's top urban music.
Four of the Motown Legends - Tito, Jackie, Marlon, Randy - except Michael & Jermaine, reunited onstage to accept the Lifetime Achievement prize from sister Janet at the ceremony.
https://preview.redd.it/ddjgk8qal3mb1.jpg?width=612&format=pjpg&auto=webp&s=b7af2d133fcad2a9bac479b266f91011d54b91e7
https://preview.redd.it/jancbyecl3mb1.jpg?width=371&format=pjpg&auto=webp&s=1bd6dd2726152eb22f2d0d4b21d77c0948acc67e
The Jacksons did not perform at the event, and it was also attended by their father Joseph, mother Katherine and sisters LaToya and Rebbie Jackson.
Following the acceptance of the icon award, the Jackson brothers posed on stage for photos with father Joseph, mother Katherine and sisters Janet, LaToya and Rebbie
https://preview.redd.it/i2f6l0lel3mb1.jpg?width=300&format=pjpg&auto=webp&s=fcf2fc50f79af0294c297b5331d8840c8bd1e137
2013 - Jackson VS AEG Trial Day 79
No Jackson family members are in court today.
Dr. Paul Earley Testimony
Jackson cross
Dr. Earley's cross continued. Boyle started out by asking Earley about his experience writing articles for medical publications and any conflicts of interest. Earley said he had written two or three peer-reviewed articles. He said some were published in European journals. Boyle then showed Earley the conflict of interest policy for the journal where the AEG-funded article ran. The policy states potential conflicts of interest should be disclosed on the cover sheet when the article is submitted. Earley said he did disclose that AEG Live paid for the research funding as spelled out in the policy. AEG's payments were listed on the article's 7th page. Earley said he had no control over where the disclosure was listed, that was the journal's decision. The first item was the Propofol Study that he published at the beginning of 2013. Dr. Earley said the published report had a different format so it was not on the front page of the report. Under tough questioning, he insisted that he did not have a conflict of interest as an AEG consultant with having AEG pay for the study. He testified he was not trying to hide the AEG connection saying that was ridiculous. He was asked if the 22 medical pros in the propofol study funded by AEG are still alive? Dr. Earley did not know. Wasn't part of study. The journal article focused on case studies of 22 medical professionals who had a propofol addiction. Boyle asked if they were all alive. Dr. Earley said didn't know and he couldn't contact the people in the study due to medical privacy laws.
Jackson lawyer Kevin Boyle also grilled Earley over his nondisclosure that he was working as a paid consultant in AEG Live's defense when he submitted the study for publication in a medical journal. He said the concert promoter did not try to influence his findings, which were published in March in the Journal of Addiction Medicine
Boyle also showed Earley the ethical guidelines of the American Society of Addiction Medicine, which state members should only provide general information about addiction and not offer diagnosis on celebrities or other public figures. Boyle questioned whether Earley's blog posts on Michael violated those guidelines. Earley said he didn't think they did. As yesterday, he was questioned about the blog he wrote a few weeks after Michael died. He restated he did not characterize Michael as an addict. Boyle, this morning, also showed Earley a second blog post he wrote on 12/5/11 that had the headline: "Murray Convicted -- Addiction Wins". Earley said he wrote the post to draw attention to an article written by friend and journalist William C. Moyers. Despite the title, he says he's not saying Michael was an addict. At the time on the blog, Earley was an AEG consultant. He said the title had Addiction winning not Michael and Addict. Asked about a line in the blog "another superstar going to oblivion", Earley said the purpose of blog is to talk about addiction.
Q: When he posted blog did he ask AEG permission?
A: No
Q: Consult AEG?
A: No
After more AEG questions Earley, exasperated, said he was tired of this!
Boyle pressed Earley on his use of the term addiction, again asking whether he'd made up his mind about Jackson's case by then. Earley said he hadn't made up his mind about Jackson and was merely trying to draw attention to the problem of addiction.
Boyle: "You were referring to Michael Jackson"
Earley: "I was referring to the addiction problem, so the answer is no"
By this point, Earley was already doing research for AEG Live, although the company hadn't agreed to fund his study by then. Boyle asked about Earley's payments on the case. The doctor estimated he'd been paid $80-90k on the case, not including his testimony
Earley had overcome a drug addiction about 30 years ago. He was asked details. He used several drugs including oxycodone and heroin. He was almost homeless and had his medical license suspended. He was in treatment for 9 months and got clean. Earley spoke extensively today about his own addiction to opioids and how he was able to be rehabilitated and keep his medical license. Boyle asked if Earley was relying on his own experiences as the basis for his opinions in the case. The doctor said only to a small extent. Earley was very candid about his addiction, saying he was at one point nearly homeless and had to relinquish his medical license. He was criminally charged with writing prescriptions to himself under false names and went into treatment. His work in the addiction medical field grew out of his recovery and rehabilitation. His issues were in the early 1980s, he said. Earley said his drugs of abuse were oxycodone, heroin, codeine and hydrocodone. Boyle repeatedly commended him on his recovery. The attorney asked Early whether in the depths of his addiction, his prognosis was grave. "Yes it was", Earley responded. Earley said in response to one question about his recovery that while he survived, many of his colleagues with addiction have not. The doctor said it was a miracle, by the "grace of God" that he survived. Many of his patients have been addicted physicians
Boyle asked the doctor whether during his addiction, he had a concert promoter involved in his life & medical care. Earley said he didn't. Boyle asked about the role of a family's love in the recovery of an addict. Earley said it was important in his early stages of recovery. "Michael had a lot to live for", Earley said of Jackson and his love for his children, which could have aided in a recovery. Boyle asked whether Jackson having full time access to a doctor like Conrad Murray would be a trigger for his addiction. Earley said Jackson had access to the doctor, but it was the doctor's responsibility to be a gatekeeper to drugs and medications
Asked about the Physician Desk Reference, Earley checked and propofol was not in the book. Can't get the drug with a prescription. PDRs are for General Practitioners not some specialized fields like Anesthesiologists or some cancer drugs. One last thing from the morning session, according to Jackson's attorney a common name for Propofol is 'Milk of Amnesia', it's even in wikipedia
In general, there were a lot of delays in testimony today. Lots of sidebars and objections and some charts that had to be quickly redone. One such delay happened when Boyle asked Earley to find the entry for propofol in the 2009 edition of the Physicians Desk Reference. The Physicians Desk Reference, AKA PDR, has detailed entries on many drugs. It's the book Cherilyn Lee used to discuss propofol with Michael. Earley couldn't find the entry in the PDR so Boyle asked partner Brian Panish to locate it. He couldn't find it either. It turns out another lawyer, Michael Koskoff, had ripped out the pages on propofol while questioning another witness, Dr. Levounis. There's Laughter in the courtroom
They continued about the drugs that were found at Michael's house. The list of drugs found at the house but not in Michael's body according to the Coroner report was Lidocaine and Ephedrine. From there they moved on to Demerol. Dr. Earley said he was only aware of 3 cases that a person died of an overdose given by a doctor. Attorney Boyle tried to make the case that dying of Demerol administered by a doctor was more rare than being trampled by an elephant or hit by tsunami. With a graph showing Michael's Demerol Injections from Dr. Klein, in the last couple months of his life. He went only 4 days until May 5th
Attorney Boyle made the point that on May 6th AEG Exec Paul Gongaware sent Dr. Murray the email 'Done, $150,000'
Boyle's examination after lunch focused on the times that Jackson requested propofol over sleep _ they said in court it was four times. That wouldn't include anesthesiologist Dr. David Adams, who Jackson approached in 2009 but didn't discuss propofol by name. Boyle showed a chart listing those requests by Jackson, adding the 5/6/09 date that AEG exec Paul Gongaware said Murray's deal was done. Boyle's point was that Jackson didn't request propofol from anyone else after Murray was working with Michael on the This Is It tour
Then Earley was questioned if Propofol can mask the symptoms of Demerol withdrawal. He said it can mask some of those symptoms
On to Michael's general health.
Q: No evidence of heart, kidney, diabetes?
A: No
Q: Blood Pressure?
A: Coroner report says no pressure!
AEG redirect
On redirect Earley says he didn't see the Gongaware email until court. They put back up the Propofol slide with info added. Added:
Jan 2006 - Michael starts to see Dr. Murray
2/4/09 - Michael says Dr. Salvit Murray is his personal physician
4/6/09 - Dr. Murray makes the first order for propofol
4/28 - Murray orders more
5/12 - More
6/6/09 - More
AEG's lawyers point to Murray ordering propofol before that date. Boyle later noted Gongaware's testimony about talking to Murray about working on the tour and his request for $5 million. That happened 3 to 5 weeks before the May email indicating Murray's deal was done. Cahan showed Earley and the jury a chart that listed Murray's first treatments of Michael in 2006, and propofol shipments from April-June 2009
Earley said in response to a question by Cahan that before Jackson's death, propofol addiction was virtually unknown by the public. Cahan asked the doctor about his blog posts. He said he didn't think they were an issue because he wasn't making any diagnoses
Dr. Earley wrote his first Blog in 2009, 6 weeks after Michael died. He said he learned of the propofol overdose in news reports. He said he had begun seeing propofol cases in medical pros in 2008. He started cataloging cases to look at them at a later date and possibly do a study at a later date. Study funded by AEG.
A second blog was brought up that Earley posted when Dr. Murray was convicted. The first line written by another addiction doctor. It was attributed to him in the second line of the blog. That was read to the jury.
Earley was asked whether Michael should have avoided doctors. He said "no, he needed treatment but he needed to disclose all his conditions"
Jackson recross
On recross Dr. Earley was questioned about the Study. He is asked about a conflict of interest with AEG funding he says it didn't affect the result. Findings were very uncommon addiction for medical pros. 1.6% are addicted. Half use other drugs. More women are addicted and there is a rapid decline. Addicts commonly are depressed and have had child trauma
Earley told the details of his addiction. Used for about 5 years. Wrote prescriptions with other names for self and was arrested. He went to drug court and was sentenced to the program where he is now. His license was suspended but he got it back. Program is why he is alive.
On recross, Dr. Fivner was brought up. After a 5 minute sidebar in chamber Earley testified that Fivner had a suspended license at the time. Boyle took back over and asked some questions about Earley's co-author on his AEG-funded propofol study. It turns out Earley's co-author had his medical license suspended due to some addiction-related legal problems. He wasn't working in medicine at the time the study was written. Earley said his co-author has since had his license reinstated and is working in New York
Boyle also asked Earley about whether he had any control over how AEG used his study in the case. The doctor said no. Earley said he also didn't have control over how the plaintiff's used his research, or any other research that's been published. Boyle likened AEG's payments to Earley's research as similar to private money turning into a nuclear weapon. "This is a small study. I'm not building the atomic bomb", Earley responded
At the end of his questioning Boyle asked Earley about his opinion that you can't blame an addict for their addiction. "In medicine, we don't talk about blame", Earley said. This opinion was played earlier in the case for the jury
AEG redirect
On direct testimony he said the co-author of a study on propofol addiction funded by AEG Live and used in their defense in the Michael Jackson wrongful death trial lost his medical license for writing illegal drug prescriptions, according to testimony. Dr. Torin Finver was hired to help with the AEG Live study after he lost his job at a pizza parlor and took a job driving a Goodwill truck, said Dr. Paul Earley, who testified as an expert witness for the concert promoter. Finver was "destitute, dead broke, and I wanted to help him," Earley, himself a recovering heroin addict, testified. Earley testified that he never disclosed to AEG Live lawyers that his co-author had lost his medical license.
In his blog he characterized Michael's prognosis as grave. Earley says he treats many grave patients. That is why he is good. He never gives up
Jackson recross
Boyle ended by asking Earley if he was aware that Murray ordered more than four gallons of propofol for Jackson. The doctor said he was
Court transcript

Disclaimer: Some of these events have unknown May dates. They are identified with a '*'
1971 - Maybe Tomorrow, the 5th album by The Jackson 5 enters both the Billboard US Black and Pop Albums charts in the USA. It will reach #1 on the Black Albums chart & #11 on the Pop Chart
https://imgur.com/a/oc3isPE
1973 - The Jackson 5 play at the Festival Hall in Osaka, Japan
https://youtu.be/m_kyZ1MlDEk
1974 * - Michael and his brothers record background vocals for Stevie Wonder’s song “You Haven’t Done Nothin’” at the Record Plant studios in Hollywood. The politically aware song would reach # 1 on both the pop & soul charts
https://youtu.be/0SEGHvLElxc
1981* - Michael goes to East Sussex to stay with Paul & Linda McCartney. He records two songs for Paul’s upcoming solo album : “Say Say Say” & “The Man*

Michael rang up, and said he wanted to work together. I said, ‘What do you mean?’ He said, ‘I wanna make some hits, you know?’ I said, ‘Sounds good.’ So he came over.
We sat around upstairs in my office in London, I grabbed a guitar and ‘Say, Say, Say’ came out of that. He helped with a lot of the words. It’s not a very wordy song, but it was fun working with him because he’s enthusiastic. But again it’s nothing like working with John. At that stage with Michael, you weren’t even talking about a writer, more just a vocalist and a dancer. But he said, ‘Let’s make a couple of hits’, and that’s exactly what we did.
- Paul McCartney, from *Conversations with McCartney

https://imgur.com/a/wylMvxJ
https://youtu.be/aIwTJ1Dl8jU
1984 - Michael is on the cover of Ebony magazine's '100 Most Influential Black Americans' issue
https://imgur.com/a/37IAvMQ
1986 - Michael, Elizabeth Taylor, Lionel Richie & Mikhail Baryshnikov attend the LA Bullet Opening Night party in Los Angeles
https://imgur.com/a/20JKEqH
1987* - Quincy Jones sets up a meeting between Michael & Prince
Prince turned down the collaboration, following a secret meeting at Jackson's mansion.

“We invited [Prince] out to Michael’s house to sing on Bad, and he was very intelligent about it,” says Jones, 83.
“Prince was always competing with Michael. So I told Michael, ‘you sit there and Prince sits there, so it won’t look like we’re ganging up on him to do the record’.
“It was a beautiful meeting, a funny meeting, and [Prince] said ‘you don’t need me on this, it’s going to be a number one anyway’ – which it was.”
Prince did not leave without handing “a lot of funny presents” for Jackson, cryptically addressed to “Camille”, added Jones.

1989- Michael is seized by armed police after being mistaken for a robber while shopping in disguise with Jimmy Safechuck at Zales jewellers in Simi Valley. Police were called after employees reported a suspicious person
The encounter happened about 5 p.m. in the Sycamore Plaza Mall. Wearing a wig, mustache and fake teeth, Jackson was looking at rings.
Employee Julie Andrews (not the singer), said she became suspicious because he kept adjusting his mustache and looking in a mirror. Another Zales store had recently been robbed by men wearing disguises.
Employees summoned security guard H. N. Edwards, who asked the suspicious character to step outside. Why was he wearing a false mustache? Edwards demanded.
“I have to,” he answered. “I’m in disguise. I’m Michael Jackson.”
“My first thought was this guy had gotten off the elevator between floors,” Edwards said
Jackson said the disguise was necessary to avoid being mobbed.
Edwards asked him to remove the mustache. He did and, sure enough, fans began gathering and asking for autographs(he obliged)
“The officers were convinced he was who he said he was & he went on his way,” Officer Diane Sliester said
"Jackson and a boy he was with visited a gift store and bought several toy figurines and a pair of heart-shaped sunglasses",Sliester said, "Then they drove away in a brown Mercedes-Benz"
https://youtu.be/l3DyN8Jvnz4
1992-The single “Someone Put Your Hand Out” is released in Europe as an exclusive Pepsi promotional single, to promote the upcoming Dangerous World Tour.
https://imgur.com/a/23ZtFPc
1992-Michael is in Washington to accept his 2nd Point Of Light Award from President Bush.
In 1990, the Point of Light Foundation created by President Bush SR, was to encourage American citizens to lend their services to the community in "a call to action."
President Bush presented Michael with an award acknowledging him as a Point of Light Ambassador. The award was in recognition to Jackson's efforts in inviting disadvantage and under privliged kids to his ranch, as well as giving his time to visiting hospitals, orphanages, assisted living homes and hospices.
Jackson spoke briefly at an East Room ceremony in which the president honored 21 winners of the 1992 President's Annual Points of Light Awards, a culmination of National Volunteer Week. In his speech, Michael stated, "I believe each person can make a difference in the life of someone in need. That is what a point of light is"
"I know each person can make a difference in the life of someone in need," Jackson said. "I love you all."
https://imgur.com/a/0rqP48Z
https://youtu.be/Qn0df421ffg
While in Washington , Michael visits a little girl, Raynal Pope, who was mauled very badly by four dogs on March 21 in District Heights, Maryland.
When Jackson first heard about the brutal attack four weeks ago, he immediately placed a call to Children's Hospital to speak with Raynal, who was in intensive care, but her mother, Jackie Pope, didn't believe it was really him. When he called back the next day, Pope believed and put the phone next to Raynal's ear. Jackson blew Raynal a kiss and promised to visit her.
After the Points of Light ceremony, he decided to fulfill his promise to Raynal. Twenty minutes later he was on her doorstep.
Raynal, her 5-year-old sister Myja, and her cousins Tianna, 6, and Vincent, 10, played hide-and-seek with Jackson ("He hid in the closet!" squealed Raynal) and wrestled around and danced during the 45-minute visit.
Jackson posed for pictures. And he signed a red leather "Beat It" jacket that Raynal's father, Michael, bought during the "Thriller" hysteria a decade ago. "We're going to frame it," Jackie Pope said.
Before he left, Jackson gave Raynal a kiss on the cheek. And she got to give him one back. "His face was soooooooft!" she exclaimed.
https://imgur.com/a/eR2gCD7
1993 - Everedde McCrimnon, 33 year old man of Los Angeles, was arrested for repeatedly attempting to scale the front gate of the Hayvenhurst estate. He was twice escorted from the compound by security guards.
He was arrested after a motorist told officers he had seen a man scaling the gate.
McCrimmon, who is free on $250 bail, had to be subdued during his arrest because he refused to obey commands from the officers and shouted obscenities
“Several other people have been prosecuted for attempting to gain entrance to the Jackson property, but this is the first case in the past few years”, said Deputy City Atty. Laura Van Eyk
1994* - Michael starts working on a remake of a musical named The Seven Faces Of Doctor Lao with special effect specialist Stan Winston.
Jackson's spokesman says he is 'in active development' on a musical remake of The Seven Faces of Dr. Lao, a fantasy for Turner Pictures Worldwide with Jackson in the title role. The original 1964 film starred Tony Randall as seven characters. Jackson's updated version is about a traveling minstrel 'who brings miracles -- and a little mayhem -- to a distressed urban community,' according to his publicist. 'Michael Jackson has been interested in 'Dr. Lao' for some time, and he is actively involved in all the creative aspects of the development process,' Jackson's manager Sandy Gallin said. 'He's very excited that it is being done.' Jackson has been keeping a low profile since aborting his world tour last November.
“One [project] was to remake 7 Faces of Dr. Lao, which was a Tony Randall film… and the other was to remake Angels with Dirty Faces”, says Rusty Lemorande(Captain Eo producer). “Michael was a huge James Cagney fan. Michael loved both projects. And everything was going great. And then the first scandal hit. Suddenly, nobody wanted to touch him. It was quite sad that it never happened, because it was very important for Michael to be in movies. He used to talk about Elvis Presley’s career and say, ‘If Elvis hadn’t made all those films, he wouldn’t be as remembered as he was.’”
1996* - Debbie Rowe visits Michael on the set of the “Ghosts” short film and announces that she’s pregnant with their baby.
She rode her Harley Davidson motorcycle to meet Michael on the Van Nuys Airport set of his short film “Ghosts” and break the baby news.
The photo of Rowe riding her Harley Davidson with Michael on the back (still in makeup while shooting his “Ghost” video), was taken that day. According to Rowe,she told him that she needed to talk to him alone, without the ubiquitous film crew that followed him
​
https://i.redd.it/i557jpz1f7xa1.gif
Michael was getting ready to do a shoot but she convinced him to hop on back of her Harley so they could find a private spot to talk.
“I said, ‘You’re going to be a dad!’ I'm pregnant,” Rowe recalled. “He was so excited, he ran around the tarmac screaming.”
1999 -Michael Jackson receives a charity award at the Bollywood Awards held at the Nassau Veterans Memorial Coliseum in New York. He is dressed in a black Indian suit designed by Manish Malhotra. He accepts a special “Humanitarian Award” from London-based industrialist S.P. Hinduja for his role in promoting the cause of global peace.
https://imgur.com/a/8nxgjAW
https://youtu.be/VPQWbg1TbLI
2001* - Michael, Frank, Grace & the kids check in the Sheraton Bel Harbour in Miami Beach where Michael completes the recording & mixing of Invincible with Bruce Swedien, Rodney Jerkins & Teddy Riley.
Michael meets Dr Alex Farshchian who becomes his personal physician.
Farshchian treated Michael in 2001- 2003. He said that Michael was having an issue with his ankle prior to the Madison Square Garden shows and that he had to rehearse. The doctor said that; “And he had an ankle issue that was more like a sprained ankle that was not healing and he had to continue to dance on it. He made an appointment like everybody else,” Dr Farshchian said
Jackson and Farshchian met when Michael was being treated for a broken foot after slipping on stairs at his Neverland ranch. Farshchian, according to the Mirror, traveled with Jackson in 2002 and 2003 and was in the room during the infamous baby-dangling incident. The friendship and doctor-patient relationship is said to have fizzled after the Martin Bashir interview and subsequent trial.
2001* - Michael meets comedian Chris Tucker through Gavin Arvizo. Michael & Chris become friends& record a new version of “Don’t Stop Til You Get Enough” for the soundtrack of Rush Hour 2
They actually first briefly met in the early 1990s, when Tucker was starting out as a stand-up comedian
Fast forward to 2001:

"I was in New York for two days waiting to meet MJ," Tucker recalled to GQ. "I took a private jet there. I said, well, I ain't heard from him, I got to go. Took a private jet back to LA and as soon as I landed, I had a message: 'Michael Jackson wants to meet you tomorrow morning.' I was still on the plane. I went up to the captain and said, 'I'll pay you whatever you want to take me back to New York.'"
Tucker told GQ that he and Jackson later became close friends, and Jackson encouraged him to take on more work in Hollywood.

2002* - It was reported that Michael Jackson wanted to direct his first movie. Michael loved the book so much that he wanted to make an adaptation of Jennings Michael Burch's book, They Cage the Animals at Night. Bryan Michael Stoller & Michael Jackson were scheduled to co-direct the motion picture. Mel Gibson hired Stoller to write the screenplay adaptation of Burch's book, with Stoller and Jackson signed to co-direct. Stoller was also mentoring Michael Jackson and his three children on film making
2002 - Celebrate the Magic Foundation's 1st Magic Life Award
Michael is honored for making the world a better place, standing up for children and humanity in NYC.
"It was up to the citizens of the world, especially our children, to confirm who is deserving of this honor. This makes the Magical Life Award truly unique, in that it is an award from the hearts of children, and those adults who still have the heart of a child."
When given the opportunity to vote for the person that inspired them the most, to stay in touch with the Magic of their inner child, thousands of children from around the world, voted for Michael Jackson
2002* - Katherine, Jackie, LaToya, Tito, Janet, Rebbie & Randy stage an intervention at Neverland to help Michael on his prescription-drug dependency.
But after her other children told her they believed he was addicted to prescription drugs despite Michael's denial, she participated in an intervention at his Neverland ranch in 2002.
“I knew he was taking them (pain pills) but I didn’t know he was abusing them,” Katherine told the jury. She said Michael was upset when the family staged the intervention "because when we got there, there was nothing wrong with him.” The intervention, she added, didn't really take place because Michael Jackson was upset and yelled at his family, and Katherine Jackson became embarrassed to be there, she testified
2009* - Conrad Murray ordered Ephedrine for Michael in early May but he told the pharmacy owner that it was for Himself. Did Michael know he was being given Ephedrine? Witnesses state that Michael’s weight dramatically decreased in the last weeks prior to his death. Ephedrine causes rapid weight loss

Prosecutor: During the same conversation in early May, did Dr. Murray inquire about what you might call energy formulations?
Tim Lopez (owner of Applied Pharmacy): Yes, we had a brief conversation about some sort of formulation that would give increased wakefulness or more energy
Prosecutor: Did Dr. Murray indicate to you during the inquiry about the energy formulation that it was HE HIMSELF who was in need of an energy formulation?
Tim Lopez : Yes*

2013 - Jackson v AEG trial day 3
Today's court session was only one hour as one of the alternate jurors had a funeral to attend.
Nobody from the Jackson family was present at court
Det. Martinez's testimony resumed with him discussing documents on Murray's finances he obtained during his investigation
The detective had to explain how he got the documents; authenticate them - so they can be entered into evidence. Some documents were obtained with subpoena, others public record
Attorneys argued about the docs they want to admit as evidence. Defense objected to a bunch of docs, saying they weren't authenticated. AEG attorney objected to admission of several of the documents, saying it wasn't clear whether they were public records. Judge sustained many of the objections. Judge also had testy exchanges with Jacksons attorney Panish with Judge telling him to move along. After several minutes of discussions, Judge said to put the exhibits/evidence issues aside; she wanted better use of jurors' time
Martinez testified about eviction notices for Conrad Murray's medical offices (2007 & 2009) and other liens issued against the doc. The detective also walked jury through Murray's credit reports, which were obtained through a subpoena
Income and Expense Declaration filed with San Diego Court shows Dr. Murray's net month disposable income was negative $2,706.33 in July 2009
Panish asked Martinez about 5 day notice to pay rent or quit -- Dr. Murray owed $7,058.38 in business rent, had an eviction note and tax liens
One 2007 judgment against Murray in Missouri ordered him to pay $135,000. There were also eviction notices for his medical business and liens for being behind on child-support payments
Panish: What's the relevance of Dr. Murray having delinquent taxes?
Martinez: shows more evidence of him being in financial dire straits
Panish listed several other docs showing Dr. Murray's liens & unpaid bills in an effort to show the jury the doctor was in financial distress
Panish: did you check Dr. Murray's credit?
Martinez: yes, by serving grand jury subpoena on experian, equifax and transunion
"If anyone would have run the credit report, they would have got the same information?" Panish asked. "Yes", Martinez said
The credit report shows Dr. Murray was current on some of his accounts. Panish noted Murray was paying some debts but defaulted on his home
Panish is trying to show the jury that a simple background check on Dr. Murray would show AEG that the doc was in deep financial troubles
Jackson attorney, Panish showed the jury documents showing Murray's debts, including those for student loans, homeowner association fees, and bills from medical firms and cellphone companies. His Las Vegas home, on which he owed $1.6 million, was in foreclosure
"Student loans, credit cards, credit medical companies, cell phone companies, funding companies, there were all kinds of debts", Panish said
Orlando obtained docs from state licensing medical boards regarding Dr. Murray to check his status and if he had any disciplinary actions
Martinez told reporters he got Murray's phone records and focused on a 12 hour period between June 24 and June 25, 2009
Martinez: "For criminal liability, that 12 hours of care, from when he arrived at the house until he called 911, was pertinent"
Martinez was asked about the calls Murray made to Nicole Alvarez ( his girlfriend), including one he made in the back of the ambulance on June 25, 2009. The detective said he didn't know what Murray and Alvarez discussed
11:26 am-- received phone call, possibly Michael Amir Williams
1:08 pm -- made call to Nicole Alvarez while in the ambulance
Call was a bit over 2 minutes (133 seconds). Martinez did not know for sure what they were talking about, questioned Alvarez about it
Detective Martinez also testified about a search warrant he served on Alvarez's apartment in August 2009. Martinez said he didn't find any of Murray's belongings. The detective said he only found one slip of paper with Murray's name on it in Alvarez's apartment. He says he found that odd
"He was living there and none of his stuff was there", Martinez said
Panish: "Do you have an opinion as to the substance of that call?"
Martinez: "Yes",explaining that he had interviewed Alvarez and served a search warrant at her house.
Panish: "What was determined?"
Martinez: "I found one piece of paper with Dr. Murray's name & that had fallen behind the door of a cabinet in the entire apartment (where) he'd been staying at (for) at least two months", Martinez replied.
Panish asked whether he found that suspicious.
"Yes", Martinez replied, "He was living there, and none of his stuff was there"
Martinez indicated that Dr. Conrad Murray may have requested help from mistress in covering his tracks
Hearing:
AEG agreed to stipulate Michael Jackson is dead, but need to think about stipulating that Dr. Murray is the cause of his death
Panish: "I'm asking for a stipulation that Michael Jackson died and the cause of death. Are you willing to stipulate that Michael Jackson died?"
Putnam: "Absolutely."
Panish: "Are you willing to stipulate that the cause of his death was Dr. Murray?"
Putnam: "That you've never asked before. Let me look at what that means"
AEG's attorney asked judge to take some witnesses out of order, since they have to travel for work. Jacksons added more witnesses too.
Jackson's lawyers said they believed they could locate Michael's longtime nanny and confidante, Grace Rwaramba, and plan to call her as a witness as the trial proceeds.
"We couldn't find her, no one could find her", lawyer Kevin Boyle said of the last-minute addition, "But we think we're going to be able to find her, hopefully"
Court transcript

According to manufacturers, diet pills use natural ingredients capable of prolonging life and containing alcohol used in medication or flavoring. One thing’s for sure, never take diet pills as substitute for cutting calories without the doctor’s recommendation. There are simple but important steps to be followed when taking diet pills:
CLICK HERE TO ACCESS NOW
1.Never crush diet pills to mix in drinks or soups. Take it whole with a full glass of water.
2.Diet pills causes a person to urinate more frequently due to its diuretic effect. This could lead to dehydration, thus, causing complications. As a pre-caution, it is best to drink eight glasses of water everyday while on diet pills.
3.Take only the recommended dosage. Taking more than required will not help you lose weight but increase the risk of side effects.
4.Heartbeat should be less than 86 beats per minute. Stop taking the pills if it reaches 90 or higher that is why regular checking of pulse is a must.
5.Always follow the instructions set by the dietician and/or doctor and not only rely on what’s enclosed in the box. Also diet pills will only work as expected if diet plan is being followed.
6.After three months, stop taking the diet pills. Common diet phenylpropanolamine is safe to use only up to sixteen weeks. Other studies show that it can cause health problems if taken under one month.
​
https://preview.redd.it/2zb7t2cp3r891.jpg?width=255&format=pjpg&auto=webp&s=5a5d78277ecc3920738c1a81e27e299a915c70b0
There are two kinds of diet pills; one is the prescription only diet pills and the over-the-counter diet pills.
​
Prescription Diet Pills - are drugs regulated by the Food and Drug Administration agency which side effects are monitored, maybe advertised and prescribed under certain dosages. The most popular of these is Xenical, which is licensed for long-term use. However, this too has it’s own side effects, diarrhea, oily and unexpected fecal discharge are just some. Therefore, users are advised to take a low fat diet plan.
​
While Over-the-Counter Diet Pills are categorized as food substitute and are unregulated. Beware that these diet pills are not Federal authorities tested and may cause serious side effects up to and including death.
​
Aside from a dietician, local pharmacists can also help in determining the pills that are safe and not for each person’s case. Just be extra careful about the so-called “natural” or “organic” ingredients. Not everything that comes from a natural source is safe. One example is Ma Huang, which is a botanical source of ephedrine known as a stimulant and being studied for potential side effects.
​
Those who have or have a family history of prostate problems, thyroid disease, mental illness, high blood pressure, and heart problems should avoid taking diet supplements. The same applies to those who’ve had seizures or strokes. If someone is taking cold medicines, especially those with decongestants, diet pills should not be taken. Whether it be a prescription or an over-the-counter diet pill, the dangers are unvarying with other similar drugs which controls the brain to reduce appetite and includes chest pains, hair fall, fever, depression, and even impotence.
​
And as a general rule, don’t ever try to take diet drugs if pregnancy is suspected. Persons that are allergic to sulfites and tartrazine should also avoid taking diet pills. And those who are under 18 years or over 60 years of age should consult their doctor first prior to taking any dietary drugs, especially if they rely on over-the-counter stimulants used as a replacement for increase exercise.
​
CLICK HERE TO ACCESS NOW