OK, this is a pretty weak stretch for this week's "Book" theme for Happy Caturday but what can I say. It was a busy, busy week and this was the best I could do. Partly I was busy taking walks and photos of blossoms, but I was also busy working. I took Jimmy and Mack into work yesterday so one of our vets, who is getting certified in doing echocardiograms, could practice on them. They were angels for the procedure but as you can see, they were not thrilled to be there. My own sweet Jimmy hissed at me and Mack wouldn't look at me. When asked if this photo reminded him of a book, George replied, "The Damned". I decided I couldn't use swear words in the title of my photo but it did crack me up.

 

Happy Caturday: Books

Comments turned of because after much deliberation due to health concerns, this time more concerning Jonathan we have decided to go on holiday as previously planned as the requested Echocardiogram showed no sign of being imminent. Finalized all arrangements and you guessed it yesterday he was rang and asked if he could attend the hospital for one on Saturday...to everyone's consternation he politely declined it. They had our holiday dates in their system and he has been waiting since March so Que Sera Sera...

Have no idea if we will have any internet or not so wishing all of you the very best for now and happy clicking :))

Every week, for Happy Caturday, I end up posting something that is not what I wanted and I spend my whole caption describing what went wrong. This week is no exception. The theme for Happy Caturday is "Patterns". On Wednesday, I had the bright idea to put some kibbles underneath our patio table in the backyard and take photos of whichever cat chose to participate in the photoshoot. I knew the sun shining down would create cool shadow patterns on the fur. Obviously, from Wednesday morning through the present, we've had nothing but overcast skies, rain, fog, drizzle, thunderstorms... everything but the sun necessary to create patterned shadows. So I thought I'd take the easy way out and photograph the striking patterns in Mack's fur. It wasn't until I looked at the photo that I realized his patterns were shaved off so a doctor could practice doing echocardiograms on him.

 

So, this is the best I could do for patterns. Please use your imaginations to fill in the shaved area of Mack's fur!

 

Happy Caturday: Patterns

For those of you who have asked about Benni's health condition this is the story. Back months ago she seemed to hyperventilate a lot and we thought it was excitement at having Kerri and Alex here etc. But it's gotten so bad the least exertion causes her to pant in great pants.

 

We went to the vet a few weeks ago and she had a complete workup, X-rays, blood work, urinalysis, the whole deal short of an echocardiogram. Nothing "blatantly" wrong but "maybe" heart because her tongue turns gray when this happens. So no walking, no exertion of any kind. Benni feels good as far as eating and wanting to play and doesn't understand why no walks and no running after her ball.

 

I'm going to try to get her to the park like this photo this morning shows, so she can roll in the grass and enjoy the outdoors when it's still cool. We park and walk only to the grass and she rolls and then lies still. She panted excessively today from just rolling.

 

Benni isn't young, 12 in Sept. and she's a big dog so my heart hurts for what may come. On good advice from Laura and others, I'm just trying to enjoy each day and love her and hope to keep her as long as she enjoys her life. She's my best friend and last dog because of my own age.

  

Sorry si toutes les photos de Chouette se ressemblent, mais elles sont prises dans les mêmes circonstances à chaque fois. Cet après-midi elle va chez la vétérinaire pour contrôler sa tension, comme demandé par la vétérinaire qui lui a fait subir dernièrement l'échocardiographie.

 

Sorry if all the pictures of Chouette look the same, but they are taken in the same circumstances each time. This afternoon she goes to the vet to check her blood pressure, as requested by the vet who recently performed the echocardiogram on her.

Hospital has been amazing. Of all the dozens of nurses, technicians, porters, doctors, and surgeons that I’ve interacted with, only one nurse was less than amazing. I’ve had CT, MRI, EEG, echocardiogram, X-ray, and probably other scans I’ve forgotten. I’ve spent six nights in hospital. Three square meals a day. Oxygen, monitors, constant vigilance. Countless checkins with six or seven doctors - rock stars, but kind, friendly, and not condescending. Surgery with top-of-their field surgical team. More constant vigilance. More checkins with doctors (several a day). Release plan and prescriptions explained and given on time. Phone number of the surgeon in case there’s an issue. His office will call me for an follow up appointment in 4-6 weeks. And there will be no bill. Nothing. It’s really incredible. Our healthcare system in Canada is not without flaws, don’t get me wrong. But for emergencies like this, they really do it right.

I really needed this good news. Approximately 15 hours of driving, the cost of an echocardiogram and cardiologist checkup, staying with friends (amidst this covid nightmare), but to get the all clear, priceless.

Josie is doing fine.

Josie has been off her diuretics for a few months now thanks to my local vet here who said she doesn't need them. It was a bit nerve racking in the first few days off them because she appeared to be having distress breathing at times, but that passed, and she's just fine now.

She's still on fortekor. On occasion I have forgotten to give it to her and she'll get a dose one and a half days since the previous dose, she seemed ok but I'm too scared to test her off it. The only way I can safely take her off it is to have an echocardiogram in Sydney, three and a half hour drive, and that will determine the thickness of the walls of her heart and if they have reduced or not.

I can get someone to drive me while I pacify her in the car, but I'm still very nervous to put her through the stress with her heart condition. The vet that did Josie at Sylvania has left that clinic, and she managed to do the echocardiogram without sedating Josie, she had a way with her to calm her down and make her still enough. I would be working with a different vet if I took her to Sydney. Sedation could kill her. Everything is a risk.

Dans une heure je pars avec Chouette pour son échocardiographie, je donnerai des nouvelles demain.

 

In an hour I'm leaving with Chouette for her echocardiogram, I'll give you an update tomorrow.

Thank you, SO much, to EVERYONE that had a thought to spare in regards to my precious Sakura and her health.

 

We went in last night for her "grade 3 heart murmur" (pretty serious stuff) and after listening to her heart for a good 5 or 10 minutes, the specialist decided he did not even hear a heart murmur. We did a quick echocardiogram, just to be absolutely certain, and her heart is clean as a whistle! (A very bloody whistle?)

 

I guess these mistakes happen and it is difficult to tell irregular breathing apart from a serious heart murmur.

 

He did, however, say that she was chubby. Haha!

I have been putting off this upload for the entire week. Truth be told, it's hard to talk about.

 

Our vet called to let us know that Sakura has a heart murmur, that doesn't appear to have been there when she was younger, which points to heart disease. We've been referred to a specialist and she is receiving an echocardiogram tomorrow.

 

I could just hope for the best and not worry, but that's not in my nature. Maybe you guys can be optimistic for me.

Bon et bien voici les nouvelles de Chouette suite à son échocardiographie. Elle a une "cardiomyopathie hypertrophique" (CMH) = un épaississement des parois du muscle cardiaque. Les causes sont multiples mais déjà l'hyperthyroïdie et les causes rénales ont été exclues par la prise de sang. Il reste à vérifier sa tension, ce qui sera fait dans un second temps la semaine prochaine. Après il y a aussi des causes congénitales et/ou indéterminées. Toujours est-il que pour le moment elle n'a pas de traitement (sauf s'il s'avérait qu'elle a trop de tension), mais annuellement elle devra être contrôlée.

 

Well, here is the news of Chouette following her echocardiogram. She has a "hypertrophic cardiomyopathy" (HCM) = a thickening of the walls of the heart muscle. The causes are multiple but already hyperthyroidism and renal causes have been excluded by the blood test. Her blood pressure needs still to be tested, which will be done in a second step next week. There can also be congenital and/or undetermined causes. In any case, for the moment she has no treatment (unless it turns out that she has too much blood pressure), but she will have to be checked annually.

Jake is doing better. He was iagnosed with congestive heart failure this month at age 12 yr. 8 mo. He started on Vetmedin and it has really helped. He is back to being my happy boy, but older and wiser. He is still on orders to be a couch potato. I do have to post pictures of him watching more TV as that is his most exciting thing to do these days. He loves shows that feature dog and human bonding. He also still enjoys boat rides, but we have to be careful he does not get over heated.

 

He is happy here after a photo shoot in the yard that did not yield good images. He still had a good time running around and playing with Jasmine. He gets overheated when running around and in the heat. But he calmed down quickly and re-regulated. He is back to being my happy boy, and we treasure every moment.

 

He sees the doggie cardiologist in July for an echocardiogram, and la consult to see if any other meds might help also.

 

Taken and uploaded 5/31/21, 2021 05 15 to 31 a r72 Glow DB Tdnai DogsFlowersSAiling-5310306 (1 of 1) OLYMPUS DIGITAL CAMERA

Click here to read my first post about her and see the photos of us getting her from her horrible previous "home": www.flickr.com/photos/dogislove/1795544836/

 

And here's the MOST RECENT UPDATED THREAD!!!: www.flickr.com/photos/dogislove/2250902536/

 

An update regarding donations being made directly to the veterinarian have been added below!

 

We have met our minimum target of $3000, which is wonderful!!! That is the low end quote of Amelia's expected treatment, so we're realistically expecting to need much more than that. And if spinal surgery is deemed necessary in the end, this number could go WAYYY up. We're hoping that does not happen, but we'll have to cross that bridge IF we get there. Thank you all who have donated so far. Every penny is appreciated!!!

 

************************************************************************************

CONDENSED VERSION (this page was & still is getting LONG!!! - lol)

 

Amelia left NCARES in November to go to Great Dane rescue to be subsequently placed in the home waiting for her. Amelia's GI problems worsened again, and we felt it best to wait until she was healthy before her adoption. This just hasn't happened, unfortunately.

 

Amelia goes from extreme diarrhea where she has uncontrollable leakage, to being impacted...and she is currently having he bladder & bowels expressed several times per day, and every few days she returns to the vet to have it done more completely. Since battling a horrible UTI, and finding blood & yeast in her stool, a herniation was found in her colon, which may explain the reason she is not able to strain to have a bowel movement, and may also be putting pressure on her urethra, preventing her from urinating normally. Another possible factor in her not being able to relieve herself normally could be the severe fractures from physical abuse that were seen on her radiographs, which have resulted in severe spondylosis & degenerative joint disease in her spine as they have healed. Despite such abuse and neglect, she still remains sweet and loving and trusting of humans. Truly amazing and inspirational.

 

Gloria, the rescuer who has been taking such wonderful care of Amelia, called me in tears last week, sobbing as Amelia licked her face. We had discussed that if Amelia required very expensive vet care to fix her problem, we just wouldn't be able to help her financially and we would have to have her euthanized. Our worst fears were actually facing us as she sat there with Amelia at the vet's office and she was told of the various tests & surgeries that lay in Amelia's future to diagnose & treat her.

 

Here's a breakdown of the complex coordination of events that will be coming together over the course of Amelia's treatment so everyone can sort of know "the game plan".

 

**Amelia's regular vet, Westbury Veterinary Clinic (WVC), is still waiting for some pancreatic test results to come back (in about a week).

 

**There are two separate offices in the same clinic...Veterinary Surgical Care (VSC) for surgeries and Veterinary Medical Care (VMC) for internal medicine. These two offices are run as two separate business in the same office. They do not overlap their billing at all.

 

**VMC (Dr. Nicastro & Dr. Jameson) will be responsible for doing Amelia's MRI, Echocardiogram if needed, CAT Scan if needed, and any other skilled diagnostic tests that may be necessary. Amelia has been referred here for her MRI which will be scheduled on 1/30/08 with Dr. Nicastro. This is the soonest open appointment. (Amelia was taken to WVC on 1/21, for another thorough bowel & bladder expression - this will be done probably several times by WVC to keep her comfortable until her surgery can be scheduled.)

 

**VSC (Dr. Bianucci) will be responsible for repairing Amelia's herniated colon, and at the same time any biopsies if necessary based on the pancreatic bloodwork which will be back to VSC by then. This surgery will happen hopefully the day after her referral appt on 1/30 to VSC-Internal Medicine.

 

**Once she recovers from the hernia repair, since it is the most urgent, we'll get her referred again to VSC-Surgery, who will do Amelia's myelogram to evaluate the damage to her spine to see if spinal surgery is necessary to improve the spondylosis & degenerative joint disease. If so, they would also do the actual spinal surgery if deemed necessary once those tests are in.

 

Phew!!! Amelia could have her own planning committee!!! lol For now we have the vet listed as VSC-Surgical for donations b/c we KNOW she will be having her hernia repaired and that's where the most expensive procedures will be done. Luckily, a lot of donations have been sent via Fundable.com and PayPal and checks mailed to NCARES in her name, so those funds can be sent directly where they are needed when they are needed.

 

Amelia is only about 2 years old, so she has lots of life left to live, and she's spent all of it except a few months being beaten and starved. She deserves this chance that all of you are making possible.

 

So, send this to anyone & everyone you know...if everyone who heard about this donated $1, it would be a miracle.

 

Donations can be made in several ways:

 

1. Donate via PayPal on Amelia's "Fundables" page at:

www.fundable.com/groupactions/groupaction.2008-01-20.5964....

We set the goal lower than we really need b/c if the goal is not met, all pledges are lost. But the goal has been met, so we're good to go there!

 

2. Donate via PayPal to North Carolina Animal Resource Education Services by using the email address MATTNELIZABETH@aol.com (the invoice will tell you it is going to the NCARES organization), or mail to NCARES, 741 Old Marshall Hwy, Asheville, NC 28804. Just put "Amelia" in the subject line/message somewhere.

 

3. THE VET'S OFFICE WILL NOT ACCEPT CREDIT CARD PAYMENTS BY PHONE. TO DONATE DIRECTLY TO THE VET'S OFFICE, YOU MAY SEND A CHECK MADE OUT TO THEM (SEE BELOW)...BE SURE IT HAS YOUR PHONE NUMBER, ADDRESS, AND DRIVERS LICENSE # PRINTED/WRITTEN ON IT OR THEY WILL NOT ACCEPT IT.

 

MAIL THE CHECK TO NCARES AT 741 OLD MARSHALL HWY, ASHEVILLE, NC 28804. WE WILL TAKE ALL THE CHECKS WE RECIEVE WITH US TO PAY THE BILL ONCE THE ACCOUNT IS CLOSED OUT.

 

If any extra is recieved by check, we will either return your check to you, or you may give us permission to make it out to either NCARES or to one of the other two vets who will be treating Amelia. Remember, checks made out to NCARES are tax-deductible, while those made out to the vet are not.

 

Vet's info:

veterinarymedicalcare.com/Home.html

Veterinary Surgical Care

Dr. Henri Bianucci, DVM

Mt. Pleasant, SC

843-884-2441

Gosh, I soooo hate asking for money, but it is not for me, it is for this sweet girl, so I have to do it. Thank you in advance to anyone and everyone who can give any amount at all! And if you can't donate, send prayers, well-wishes, & healing thoughts :)

Up until about a month ago, Henry never showed any particular interest in stuffed animals. When we took him in for the echocardiogram, the staff gave him a teddy bear, which stays in his crib most of the time.

 

Pooh, on the other hand, goes with him for naps in our bed.

After an echocardiogram today or tomorrow, I will be able to go home 🌹🌸💕😻💙🌈🌹💐

_________________________________________

Baked Turkey, Sweet Potatoes & Carrots. and Sweet Peas

———————————————————————————-

 

I was admitted to the hospital on Thursday with fluid in my lungs. This has been cleared out using intravenous diuretics.

 

I was diagnosed with CHF. Chronic Heart Failure. This is being treated successfully with medications.

 

After my echocardiogram, tomorrow, I hope to be released from the hospital.

 

Blessed Be The Lord🌹

I'm posting these pics of Emory to share with you a bit of bad news received today.

 

Emory's heart has been acting up. He went in for tests [ echocardiogram] and was also suppose to take a 4-hour treadmill stress test but the latter was cancelled and he's now scheduled to see his cardiologist next week to discuss having a heart valve replaced. Not sure what all that entails...but it has me worried.

 

Therefore, I will not be coming back to Flickr full time for awhile as we have lots of appointments pending w/ drs, accountant [ it's tax time] our attorney [ need to get a power of attorney --as we've neglected to do so ], and need to replace our worn out SUV with a new one this month....

 

So, I can't be spending "hours" on the computer when I have so much to deal with right now.

 

I'll visit your streams tonight--but after that my visits will be sporadic until all is done--

Elliott Smith

 

Yay! My active cancer treatment is finished today, hopefully forever! I spent the morning at one hospital having an echocardiogram to check my heart function (it's better now than when I started), and the afternoon having cycle 18 of Herceptin. I've lived the past 18 months of my life on a three week cycle, being systematically poisoned each time. I'm glad this is over, but it feels strange to no longer live life in three week chunks. Anyway, for now all I need to concern myself with is getting fit in order to have reconstructive surgery, and then wait for the next check up which will be in about 5 months time.

 

Feeling tired, bruised, but good :)

2022: A Year Unlike Any Other

By Andrew J. Karagianis

January 2, 2023

 

You know how there are some years where you just plod along and nothing really happens out of the ordinary, whereas there are other years where you experience something huge and life-changing?

 

My headline story of 2022 is that it’s the year in which I became a father. Definitely life-changing! The year was pretty evenly split into Ally being pregnant for the first half, and our baby’s first almost-six-months in the second half. But, because it’s me, you’re going to get all the minutiae of 2022, and not just a one-paragraph summary. Someone suggested years ago that I try to write a TL;DR version, but that’s not my style. I am a creator, not just a consumer. Plus, now that I have a kid, there’s someone who may be genuinely interested in reading about the details, many years from now.

 

So in light of that, I think it’s no longer appropriate to call this a summary of 2022, but rather, it’s my story of 2022.

 

Ally and I rang in the new year in bed – Get your mind out of the gutter! We had watched a show about Betty White (who died earlier that day), read our books, and went to sleep, only to be awoken by fireworks later.

 

The first song I listened to in 2022 was “You Said It All” by Ozzy Osbourne.

 

I was given the order to work exclusively from home again on January 7th to start January 10th, although it was an internal order rather than a provincial mandate this time. Fine by me!

 

In early January, I started typing a document to my as-yet-unborn child, documenting who their family members were – particularly those who have already died, since knowledge of their lives is fading, as they had the misfortune (or good fortune?) to have lived their lives before the age of the Internet.

 

On the week of January 19th, a local rabbit took up residence in our back yard. I would see him outside sitting by the shed during the day whilst working from home. After a week or two, I noticed I hadn’t seen him for several days, so that was that. Maybe he got evicted from his hole in the ground.

 

Also in January, I started typing a retrospective trip journal for my Europe 2008 trip, because I love writing trip journals but hadn’t started writing them yet back in 2008. In so doing, I realized there were parts of that trip that I didn’t really remember or have photo evidence for, so I got the idea to try to find the Europe 2008 pics that didn’t make it to Flickr in an attempt to fill in the blanks. I got my old 2003 eMac from storage on January 23rd, and fired it up on January 30th. It worked perfectly fine, but I discovered that I had deleted the vast majority of my pictures from that computer several years earlier (I hadn’t even turned the eMac on since 2013). I did find a few salvageable Europe 2008 pics on it, though, so that means it wasn’t a complete dead end. I transferred a handful of them to my red external hard drive via my blue 16GB USB key, and started posting them in a new album on Flickr on January 31st. I also decided I’d go back to the storage unit, because I knew I had also saved those pictures onto CDs (it was the late 2000s, remember). On February 5th, I got them, and started transferring them from the CDs to a USB key via my MacBookPro (which also still works), then plugged the USB key into my iMac, to transfer straight to my red external hard drive. I found lots of pics that I had no memory of taking, so it was neat to see those because it was like they were from a completely different trip. And to my delight, lots of the pics on the CDs were good enough to post online! I posted 26 to Flickr before I got back on track with posting my Europe 2020 pictures.

 

Ally got another ultrasound on January 31st, and she found out the baby’s permanent gender identity. We had talked about not finding out until the baby was born, but I guess curiosity got the better of her. The next day, I cracked, and Ally told me it looks like we’d be having a girl!

 

I’m going to take a few paragraphs to talk about external events now, because the winter of 2022 was pretty bad in that regard, if you recall. From late January into February, libertarian terrorists from the Flu Trux Klan and funded largely by American supporters held Ottawa hostage, in one of the biggest national embarrassments of my lifetime, protesting mandates that were largely Provincial (not Federal) in nature, and meant to save their lives. Remember, lives > jobs. Thankfully, peace, order, and good government prevailed over the American-style mentality of “give me liberty and give them death.”

 

Then within days of the Freedumb Convoy protestors being cleared out, Vladputeen decided to invade Ukraine, wreaking havoc on the global food supply and on my investments, which dropped in value by almost 20% this year. As of today, it still hasn’t escalated to nuclear war, which is remarkable, but I guess time will tell how that plays out.

 

And of course, the Omicron variant continued to rage across the planet, as governments (in Canada at least) gave up on mandates for fear of another armed trucker protest. Thankfully Omicron disease was less lethal than 2021’s Delta variant, but maybe that’s also because so many people have been vaccinated now.

 

Speaking of COVID-19, as I type this, it’s been nearly three years since this whole fiasco began. Remember how at the very end of December 2019, or in the early days of January 2020, you first heard the word “coronavirus”? Yeah. I still haven’t gone to a movie in a theater since December of 2019, or eaten indoors in a restaurant since March of 2020, or taken the TTC since June of 2020. But I did eat at my first family meal since 2019 on Thanksgiving this year, so that was an important step for me. That’s how long it took for me to feel moderately safe taking my mask off around other people who weren’t my wife and child. Remember folks, the virus doesn’t care if you’re family; the virus just sees another human and thinks “Mmm, fresh meat!”

 

Anyway, back to the personal stuff!

 

Throughout the winter, I lifted weights at home as an alternative to walking on the icy sidewalks.

 

In early March, Terrance had a fall and we took him to the vet. He was okay.

 

On March 23rd, we were awoken to the sound of two douchebags breaking into our shed and trying to steal stuff during a pissing rainstorm. Ally yelled at them through the window while I went outside to the front and saw them casually walk away empty-handed.

 

On March 26th, I went planespotting for the first time in an hwhile. On March 28th, I found out that my prediabetes had improved significantly, which I was very happy about. My fasting blood glucose went from 6.6 in September 2021 down to 6.1 in March 2022.

 

… Only to be overshadowed by finding out a few days later that I might have high blood pressure. That worried me throughout April as I kept getting worse results at the pharmacy machines. I got a few readings at my doctor’s office (as high as 161/97), and she referred me to a cardiologist to do some testing first.

 

On April 17th, I started shooting another roll of APS film for the first time since September 2021. It turned out awful. Every picture was blue, or as someone else put it, only the cyan showed up. In spite of this discouraging result, you could tell that the lens was doing its job perfectly well, and so I tried again. I almost became obsessed with APS film in the spring and I even had a dream about it. In fact, 2022 would be the year of film for me. Even though I got back into film photography in 2020, it really took off in 2022. I shot 20 rolls in 2022, and am on roll # 21 right now. That’s far more than I shot in any previous year, and it’s almost as many rolls as I shot during my entire childhood and youth. I also joined a Facebook group for APS film.

 

Sometime around April 20th, I planted a seed from Terrance’s seed mix, and within a few days it had sprouted and started growing quickly. Wanting to keep it safe from tree rats, I put it outside in a big planter and covered it with chicken wire. Over the summer it turned into a long pumpkin vine with nice yellow flowers, but the neighborhood vermin kept biting them off (the flowers on the vine that extended beyond the chicken wire).

 

On May 4th, Ally and I started a 5-week online parenting class hosted by a nurse from St. Joseph’s Hospital. I think I remember the nurse’s mannerisms and way of speaking more than I remember the content of the class, but we met some other first-time-parents-to-be on that class, and swapped Instagram usernames (yes, usernames) with each other.

 

On Monday May 9th, I went to the cardiology clinic to do an echocardiogram and an EKG, and then got my blood pressure checked and it was 111/71! So that was baffling, but good news. Then they hooked up a Holter monitor and I went home to wear it for three days, during which time I couldn’t get a shower. The Holter monitor was pretty painless, but by Tuesday day my chest started itching, as the tech had to shave parts of it in order to stick the electrodes on. I ripped it all off on Thursday morning at the designated time, and had a nice shower that evening right after work-from-home.

 

In mid-May, I first heard the term “Monkeypox”, and how it had been found in Canada, and how we had been told not to panic. Ugh, not again!

 

Thankfully, monkeypox didn’t seem to take off (in the media at least) to anywhere close to the same degree that COVID-19 did. Obviously a lot of people have gotten it, but I don’t personally know any of them, unlike COVID.

 

On May 22nd, I shot my first-ever roll of 35mm film. Yes, ten years shooting film as a kid/teenager and two years shooting it as an adult, and not once had I used the most-popular format. Until now. I carefully popped and wound a roll of Fujifilm into my grandfather’s old Kodak Retinette camera (which I later found out was probably made in 1957), and tried out this ancient technology. It turned out better than I expected, so that was encouraging. I joined a Facebook group dedicated to Kodak Retina and Retinette cameras.

 

Throughout the spring, Ally would regularly put my hand on her belly and I would feel the baby kicking or moving around. By May or June, I could feel more-distinct parts; perhaps a foot or a knee.

 

On May 28th (my 5th wedding anniversary; hard to believe it’s been 5 years already!), I went to Mom’s house for her 60th birthday party. Elliot ordered an ice cream truck and I got lots of pictures, so that was a good time.

 

Throughout May and June, I continued working, taking film pics, and going on bike rides as we awaited the arrival of our bébé. On June 15th, I bought a Canon EOS Elan IIe 35mm film SLR on eBay for $70. I liked the Retinette, but the lens isn’t connected to the viewfinder, so getting the right focus distance involves making your best guess. When it works out, it looks great, but it doesn’t always work out. So I got a film SLR that I could use my detachable lenses with.

 

On I believe June 12th, I met Rob Chew from Flickr; we walked around Roncesvalles and I took the Retinette for that outing.

 

Not wanting to take any chances getting stuck in traffic 30km from home when Ally’s water broke, I decided to take my parental leave at the start of her 39th week. On my first day of parental leave, we went to the Zoo for the first time since 2016. I saw Andrew and Jay, and got some good APS film pics, but we only got to see Indo, Africa and Savannah, as it would have been too much walking for Ally to visit my old slacking grounds of Eurasia.

 

On June 23rd, I started a public Instagram account for my film pics -- @36filmpics.

 

Ally’s due date came and went, but still no bébé. We went on walks, and she did exercises, and went to midwife appointments, but still no bébé. It was decided that she would be induced. On the morning of Saturday July 2nd, I took my last photo of Ally with her belly visible, a week past her due date, with my little old Kodak Advantix T500 APS film camera. We went to St. Joe’s that evening, and Ally had a Foley catheter installed (yes, Ally reviewed and approved this story before I posted it). We went home at 12:12am.

 

On Sunday July 3rd, we got up before 6:15am and got to the hospital at 8:06am; the longest day of Ally’s life (her words). And I documented everything! We were brought to the birthing room just before 9:00am. A doctor broke Ally’s water at 9:49am, and started her on oxytocin at 10:29am. Ally’s contractions were getting more frequent by 12:40pm, but by mid-afternoon she was in more pain. Around 4:30pm she said she felt like pushing, but the anesthesiologist wasn’t available to give an epidural until around 5:50pm. At 10:10pm, Ally was fully dilated, and a nurse said we’d talk about pushing in an hour or two, so we tried to sleep a bit. We woke up at 11:53pm.

 

Ally started pushing at midnight, and I have never seen her strain like that before. Her face was beet-red, her eyes were squeezed shut, and I felt so bad for her. After an hour being assisted by me, a nurse and the midwives, the doctor came back and determined that the baby’s head was still not engaged, so Ally would have to have a c-section. It was not what Ally wanted to hear, but she was brave. They wheeled her into the OR around 1:23am while the midwives took me to get suited up into scrubs. I waited in the hall for about 20 minutes with my camera (digital this time; I couldn’t take any chances with film in a moment like this), and then the midwife student brought me into the OR and around the table, and I sat on a metal stool near Ally’s head. She was awake, so I held her hand. Barely two minutes after I sat down, the midwife told me to get my camera ready. On cue, I stood up and took two pictures of our baby, only about ten seconds old, covered in blood, screaming, and very much alive.

 

Rae was born at 1:54am on Monday July 4th, 2022, nine days after her due date. At that moment, I became a father, and we love her more than she will ever know.

 

A pediatrician and respiratory therapist roughly massaged and patted Rae to get the lung fluids out on a table nearby (which happens with c-section babies), while Ally looked over and I took a few pictures. Then the midwife brought Rae over to rest on Ally’s chest and took a few pictures of us while the doctors repaired Ally’s body.

 

The midwives led me out of the OR after less than ten minutes while the doctors finished patching Ally up. I went to a recovery room and took off my shirt, and the midwives put Rae on my chest. She immediately started rooting toward my nipple, but I told her she wouldn’t get much there. A few minutes later, Ally was hwheeled in on a bed and held Rae to breastfeed her for the first time. Ally looked exhausted, but completely natural at being a mother.

 

So many things happened that day that it’s sort of a blur. Due to my work benefits, we got a private room, which we were grateful for. I finally got ready for bed around 4:10am. We hardly slept at all that first night, but it’s all worth it, for the little girl that we now have in our lives.

 

Rae had jaundice, so we had to stay in the hospital a bit longer than expected. After two and a half days full of feeding, crying, and napping, we were given the go-ahead to go home at 8:04am on Wednesday July 6th. But it was delayed when the nurse found out that Ally needed to see an obstetrician first. That didn’t happen, but she was given a prescription, so we packed up the rest of our things and left the hospital with Rae in the car seat around noon.

 

I spent the next month and a half with Ally, getting to know our baby together and figuring out how to be parents. I took 8 weeks off work for parental leave (the maximum that EI would pay for), so we went on a lot of walks and spent a lot of time outside this summer. We went to the Centennial Park Conservatory; the Beltline Trail; Sam Smith Park; the Humber River Recreational Trail; and I took Rae on a walk around Leslieville and Little India (our old stomping grounds) one afternoon while Ally went to the dentist.

 

On July 20th, Ally and I got our 4th COVID-19 vaccines. This time, I felt like crap the next day, but I was back to normal the following day.

 

On August 2nd, we took Rae on her first roadtrip/overnight trip, to Spring Lake Resort just outside Algonquin [Provincial] Park. Ally and I had gone there in 2018 and thought it’d be a safe place as far as COVID was concerned, as there were no shared indoor hallways (it’s a multi-storey motel). We went into Algonquin and Arrowhead Provincial Parks and I got some nice film pics, and we took Rae on her first ride in a canoe. I also found out on that trip that Good Shepherd was looking for a GACW again, as Akua had left. I guess I was right in my assumption back in 2020 that they wouldn’t find funding to hire me back as a GACW, but they must have had enough funding to keep Akua going. I declined to apply, because the external circumstances that made the GACW job a good job in the past were largely gone. I didn’t live nearby anymore; the pandemic still exists, and so on. During that trip, I found out that my Canon EOS IX Lite APS SLR camera had stopped working, so that pissed me off. I bought a new one in October, and by “new” I mean “new used”, since those cameras haven’t been made since 2001.

 

On August 13th, I went up to Vicki’s cottage for Dad’s 60th birthday party, and the following weekend I went to Wasaga Beach for a Shaka Wasaga tiki bar cruise, also for Dad’s birthday.

 

On August 15th, I went back to work. I found out that while I was away, 7 coworkers had ceased to work at the organization, and another full-timer took a job somewhere else and went down to relief. But I thankfully didn’t come back to a shitshow in terms of workload. Nobody was calling angrily or asking WTF was going on with their referral, although there was a backlog of referrals. Most of the actual waitlist was made up of guys who I’d interviewed prior to my parental leave; only about 8 guys had been interviewed while I was away. But I guess that shows how irreplaceable I was, right? Right!

 

At some point in the summer, I gave my old Canon EOS Rebel XSi camera to Heather, as Matt wanted it.

 

On August 27th, I went to ServiceOntario and downgraded my F licence to a G licence rather than do the written test again. After almost ten years, it wasn’t needed anymore – my employer got rid of the bus while I was on parental leave. I decided that I won’t be taking any more jobs in the future that require driving, as it’s too much of a liability.

 

On September 4th, I was out for a walk with Rae by myself, and sat down on a bench to feed her a bottle of formula. A woman of about 50 and presumably her teenage daughter stopped, looked at me, and said “God bless you, sir!” I went home and told Ally about how that’s all I had to do, as a man, to receive praise from a random stranger about my parenting skills. As much as I complain about some aspects of parenting, I do realize that Ally does the vast majority of the work. But I spend 40 hours a week at my job (plus about 8 hours a week commuting), so that’s the trade-off, as neither of us can do it all.

 

Ally got me what will probably be our last cake from Hype Food Co. for my birthday (as the company is moving to Quebec). I took my 37th birthday off work and we went on our second overnight roadtrip with Rae; this time to go to a few places around Lake Erie. We went to Turkey Point Provincial Park and walked a trail and sat on the beach. Being mid-September, there were hardly any other people there, but the flies were biting and there were wasps aplenty…perhaps that’s part of the reason why. The next day, we went to the Long Point Bird Observatory and Long Point Provincial Park. I got frustrated with Rae, and sat on the beach with Ally after going for a walk by myself, talking about the challenges of parenting that I wasn’t ready for. In my life in general, I take steps to prevent problems from happening, every day, with pretty much every decision, but with Rae, it felt like I wasn’t able to do that. I felt ineffective.

 

On September 20th, as I was stuck in another traffic jam on the way to work, I sat in a mostly-silent rage about my reputation being affected by other people’s fuck-ups (i.e., me being late for work because of other people’s car accidents). As I sat in my car eating lunch later that day, I e-mailed a therapy organization and said I need help dealing with stress. They got back to me that afternoon and that evening I spoke to a therapist. I spoke to another the next day, and decided to start working with her. The idea is to learn how to better prevent and deal with stress so I can be a good role model for Rae.

 

On September 22nd, I took the GO train to work for the first time ever, after being repeatedly made late for work due to the aforementioned traffic jams. I ended up taking the train to/from work 6 or 7 times in the fall, and it was a good idea. I got way more exercise on those days; I could read my book; I didn’t have to worry about liability (the main thing motivating me to take transit); and I didn’t catch COVID, either (which was the main thing keeping me from taking transit). However, at $16/day, I can’t justify taking the GO train every day. It only costs $4/day in gas, and driving saves me about an hour each day. So unfortunately, transit will remain an occasional thing, done for health benefits rather than saving time or money.

 

Around the same date, I found out we had our first client COVID cases and COVID outbreak at work – remarkably, it didn’t happen until two and a half years into the pandemic. They isolated the clients and it didn’t spread out of control, so that was fortunate. As much as I’m often on edge about people not taking the still-existing pandemic seriously enough anymore, my workplace has been very effective (and/or lucky) in keeping it under control thus far.

 

On November 6th, Ally and I got our flu shots. On November 15th, I got an ambulatory blood pressure monitor, to wear for 24 hours and figure out what’s really going on with my blood pressure. Turns out my daytime readings were okay, but my nighttime readings were a little high, so the cardiologist told me to eat less salt. He also said he’d arrange a sleep study to look into sleep apnea. If it’s not one thing, it’s something else!

 

Work really slowed down in the second half of November, as we knew we weren’t admitting any more men to treatment for a few months due to the staffing shortage. It was nice to catch my breath and allow my heart rate to slow down – and that’s no joke; my Fitbit graph shows a clear and persistent decrease since that time, compared to the previous two months where it was go-go-go all the time. On December 14th, I passed the ten-year mark with that organization. I didn’t get a card this time, though.

 

In late November, in another act of nostalgia, I moved aside the storage locker door and resurrected my very first camera; a Kodak Star 110, given to me by Granny and Grandad for Christmas of probably 1994. Why? More like “Why not?” I hadn’t used that camera in about 23 years. I shot a roll between November 28th and December 17th, and am waiting for it to come back from West Camera. ‘pparently 110 film is even more troublesome than APS film to develop, so I was told to expect a two-week wait for scans.

 

The only problem with all this film photography in 2022 is that it’s very expensive, especially considering I have a perfectly-good DSLR that takes better-quality photos on a huge memory card that I only had to buy once. Each roll of film costs between $9-$17 to buy, and about $13 to develop. So it hasn’t been a cheap year in terms of photography, but I have to say, shooting film has been a challenge I’ve enjoyed.

 

On December 18th, we put Rae in the crib to sleep at night for the first time, finishing her time sleeping in the bassinette in the bedroom with us for her first five-and-a-half months. It’s been more difficult for Ally and I because now we have to walk to another room to tend to Rae when she wakes up, but she had reached a milestone as far as the bassinette manufacturer’s instructions were concerned, so…safety first! Ally and I were sad about that change. Ally had said around November that she doesn’t want the bébé to grow up, and I felt the same way. It seems like yesterday that Rae’s head easily fit in the palm of my hand, and now she’s almost 18 pounds. She sits up in her high chair and eats pulverized vegetable slop a few times a day now. Pretty soon she’ll be walking, having temper tantrums in the grocery store, asking to borrow my car, and paying from her six-figure income for me to move into a reputable retirement home. Dad told me this summer that kids grow up in the blink of an eye, and these first almost-six-months have flown by indeed. On December 28th, we packed up the bassinette and brought it back to Gill, from whom we borrowed it.

 

I’ve learned lots of things about babies this year, having had no experience with babies since my sister was born in 1992, when I was a kid myself. For example:

 

•Babies will be laughing one second; freaking out the next (this was our motto for Rae for the first few months. Call me a jerk, but we needed humor).

•Babies will fuss and whine while you’re satiating their basic need for food or milk. They don’t understand cause-and-effect yet.

•Babies will wake up before the sun and not go back to sleep, which is okay during the workweek when I also get up before the sun, but they do it on weekends, too.

•Sometimes a car ride will make them fall asleep, and sometimes a car ride will make them scream bloody murder.

•Sometimes nothing works to calm an upset baby, whereas other times it’s easy to placate them simply by lifting them up in the air like Rafiki in the Lion King, except facing you, the baby-holder.

 

But for now, I’m 37, and she’s still a baby. So I’ll enjoy this time with her, before she starts telling me to fuck off and that I don’t understand, or before she starts using words out of context like “mid”, “vibe”, or “mood”. Of course, by the time she’s a teenager, those improperly-used words, like their Gen-Z proponents, will be cheugy.

 

Anyway, here we are at the beginning of 2023. Although the pandemic is not over, I have a wife and a baby and a job and a roof over my head. I’ve already set up an RESP for Rae (because science knows how much a postsecondary education will cost by the time she’s 18 – either it’ll be free, or it’ll be a million dollars). And although my health has started showing some cracks in the last few years that shouldn’t have become visible in my 30s and considering my body weight, at least they were identified early enough to make changes and incorporate them into my lifestyle before it’s too late. Let’s finish off this year’s summary with a few lists, shall we?

 

Books read in 2022 (in order):

1.Homo Deus: A Brief History of Tomorrow by Yuval Noah Harari (finished in 2022)

2.With the Old Breed by Eugene Sledge (if you’ve watched The Pacific, Eugene Sledge is the solider portrayed by Joseph Mazzello, a.k.a. Tim from Jurassic Park).

3.Talking to Canadians by Rick Mercer

4.You’re Going to be a Dad! By Daddilife Books

5.Canada’s Baby Care Book by Drs. Friedman & Saunders/The Hospital for Sick Children (perhaps if I had finished this book, I would better know how to take care of Rae).

6.The Underground Railroad: Authentic Narratives and First-Hand Accounts by William Still.

7.Confess by Rob Halford (the book I enjoyed most in 2022)

8.21 Things You May Not Know About the Indian Act by Bob Joseph

9.How to Prevent the Next Pandemic by Bill Gates

10.An Embarrassment of Critch’s by Mark Critch

11.Son of Hitler by Del Col/Moore/McComsey/McClelland

12.The Bullet: Stories from the Newfoundland Railway by Robert Hunt (started)

 

Indeed, 2022 was just as much a Newfoundland renaissance year for me as any previous year, even though it’s now been five years since I’ve been back, and seven years since I’ve been back to St. John’s. But with three Newfoundland[er] books; a Newfoundland-based TV show; four Simani songs and four Great Big Sea songs purchased, I think that counts.

 

TV shows watched in 2022:

•Son of a Critch

•Lincoln’s Dilemma

•The Boba Fett Show

•The Obi-Wan Kenobi Show (probably my favorite show of 2022)

•The G Word with Adam Conover (some of it, anyway)

•The Kids In The Hall Revival Show

•Our Great National Parks (narrated by my man-crush, Barack Obama)

•The first few seasons of Seinfeld again

•The Crown Season 5

•The Harry & Meghan Ruin Everything Show

 

A sample of songs I got into in 2022:

•“Bad Boy (Razor Ramon)” and “Snake Bit (Jake ‘The Snake’ Roberts)” by Jim Johnston

•“Turbo Lover” and “You’ve Got Another Thing Coming” by Judas Priest

•“Catfish’s Maw” and “Face Shrine” from The Legend of Zelda: Link’s Awakening

•“The Rock Show” and “Try, Try, Try” by Rockabye Baby!

•“Santa’s a Bayman Like Us” by Shanneyganock

•“Step Into Christmas” by Elton John

•“If Not For You” by George Harrison

•“Head First” by Home

•“Mining Melancholy” from Donkey Kong Country 2: Diddy’s Kong Quest

 

I went through a bit of a Queen revival in the summer. I bought Ozzy’s new album (Patient Number 9) and the Chili Peppers new album (Unlimited Love), but I wasn’t impressed with either. The songwriting just wasn’t there in Ozzy’s album. The songwriting on the Chili Peppers album was okay, and it was nice to hear John Frusciante back with them, but there weren’t any songs on it that I loved.

 

I hardly recorded any music in 2022, especially compared to 2021. I didn’t record any original songs; just a drum solo, some birds out the window; a few attempts to get Terrance and Rae to vocalize; a part of a cover song that Ally and I were working on, and an interview with Nanny in which I forgot to record the first half (whoops!).

 

I was a bit less active on Flickr this year (184 photos/videos posted) vs. last year (211 posted), but that’s still quite a lot. The reason I couldn’t post as often in 2022 is because Rae and Ally were sleeping in the bedroom (which is also my computer room) in the mornings while I was getting ready for work, and I tended not to use the computer after work, so I was really only posting pics on weekends from mid-August to mid-December.

 

Favorite things in 2022 not otherwise specified:

•Store: West Camera

•Snack food: Yogurt mixed with low-sugar ice cream, frozen berries, cinnamon and peanuts.

•Health: Finding out my fasting blood glucose had improved since last year.

•People: Seeing my baby daughter smile at me.

•Work: The afternoon commute occasionally being faster than usual for no apparent reason.

•Quotes:

----“Yeah, that’s right”/”It’s gonna be rough” – David Puddy;

----“Here I am” – Steve Bridges as George W. Bush;

----“I’m terribly sorry I’m dressed as a tree…shall we get unhappily married?” “I don’t want to marry you; I hate you; yes.” – Princess Diana and Prince Charles as portrayed by Kieran Hodgson;

----Saying “Take the piss” when I mean “Take a piss”.

•Politics: The local Big Development city councillor being ousted and replaced by a woman of color, who surprisingly got elected in Ford Nation.

•Travel: Actually being able to go on two multi-day trips with a newborn baby, even if they were frustrating at times and I haven’t left the province in almost three years.

 

And there you have it! Tune in again next year for my Story of 2023!

 

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2022Collage.jpg

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You can read all the details in my first comment below, but I wanted to highlight the GRAND TOTAL ESTIMATE of $3850-$7850 (this includes what we've spent since fundraising began) . The high end could go much higher depending on what is found on Monday.

 

We have already spent $1598.62 since we started accepting donations on Amelia's behalf. (plus, I spent about $1000 before we realized we were going to have to ask for help, but that is not included here - I just want you all to know I have joined you all in donating *grin*).

 

The estimate for Monday's appt is $2250-$6250, and that big range depends on whether he only does the MRI/C-T scan, or if he decides to go on and perform surgery while she's under anesthesia.

 

So, I'm going to close out our Fundables page now so I can go ahead and get the money we have raised to pay this BIG bill on Monday, and will start up another one so anyone who still wishes to donate can do so. THANK YOU ALL!!!!

 

*****************************************************************************

 

BACKGROUND:

 

Click here to read my first post about her and see the photos of us getting her from her horrible previous "home". You must see these photos to understand fully where Amelia comes from: www.flickr.com/photos/dogislove/1795544836/

 

And click here to go to the original plea for help to see the outpouring of support since the beginning! :)

www.flickr.com/photos/dogislove/2200816474/

 

New thread - Friends of Barbaro now helping bring attention to Amelia :) forums.prospero.com/alexbrown/messages?msg=19552.1

 

ARGNC also has her listed unde Special Needs Pets :)

www.argnc.com/spon.html

 

Amelia left NCARES in November after being rescued from a life on a chain to go to Great Dane rescue, where she would be subsequently placed in a home that was waiting for her. However, Amelia's GI problems worsened again, and we felt it best to wait until she was healthy before her adoption. This just hasn't happened, unfortunately.

 

Amelia goes from extreme diarrhea where she has uncontrollable leakage, to being impacted...and she is currently having he bladder & bowels expressed several times per day, and every few days she returns to the vet to have it done more completely. Since battling a horrible UTI, and finding blood & yeast in her stool, a herniation was found in her colon, which may explain the reason she is not able to strain to have a bowel movement, and may also be putting pressure on her urethra, preventing her from urinating normally. Another possible factor in her not being able to relieve herself normally could be the severe fractures from physical abuse that were seen on her radiographs, which have resulted in severe spondylosis & degenerative joint disease in her spine as they have healed. Despite such abuse and neglect, she still remains sweet and loving and trusting of humans. Truly amazing and inspirational.

 

Gloria, the rescuer from CSCADR who has been taking such wonderful care of Amelia, called me in tears on 1/17, sobbing as Amelia licked her face. We had previously discussed that if Amelia required very expensive vet care to fix her problem, we just wouldn't be able to help her from a financial standpoint and we would have to have her euthanized. Our worst fears were actually facing us as she sat there with Amelia at the vet's office and she was told of the various tests & surgeries that lay in Amelia's future to diagnose & treat her. We couldn't accept the fact that in her 2 short years on this earth she would fight to survive horrible abuse and neglect, then finally her lucky day would arrive when we rescued her, only to be killed because her treatment would cost too much.

 

Here's a breakdown of the complex coordination of events that will be coming together over the course of Amelia's treatment so everyone can sort of know "the overall game plan".

 

**There are two separate offices in the same clinic...Veterinary Surgical Care (VSC) for surgeries and Veterinary Medical Care (VMC) for internal medicine. These two offices are run as two separate business in the same office. They do not overlap their billing at all.

 

**VMC (Dr. Nicastro & Dr. Jameson) will be responsible for doing Amelia's MRI, Echocardiogram if needed, CAT Scan if needed, and any other skilled diagnostic tests that may be necessary. Amelia had her refferral appt here today, 1/30/08, with Dr. Nicastro. (Amelia was taken to WVC on 1/21, for another thorough bowel & bladder expression - this will be done probably several times by WVC to keep her comfortable until her surgery can be scheduled.)

 

**VSC (Dr. Bianucci) will be responsible for repairing Amelia's herniated colon, and at the same time any biopsies if necessary based on the pancreatic bloodwork which will be back to VSC by then. This surgery will happen hopefully very soon after her referral appt on 1/30 to VSC-Internal Medicine.

 

**Once she recovers from the hernia repair, since it is the most urgent, we'll get her referred again to VSC-Surgery, who will do Amelia's myelogram to evaluate the damage to her spine to see if spinal surgery is necessary to improve the spondylosis & degenerative joint disease. If so, they would also do the actual spinal surgery if deemed necessary once those tests are in.

 

Phew!!! Amelia could have her own planning committee!!! lol For now we have the vet listed as VSC-Surgical for donations b/c we KNOW she will be having her hernia repaired and that's where the most expensive procedures will be done. Luckily, a lot of donations have been sent via Fundable.com and PayPal and checks mailed to NCARES in her name, so those funds can be sent directly where they are needed when they are needed. See below for info on donating directly to the vet's office before calling/sending money directly to them.

 

Amelia is only about 2 years old, so she has lots of life left to live, and she's spent all of it except a few months being beaten and starved. She deserves this chance that all of you are making possible.

 

So, send this to anyone & everyone you know...if everyone who heard about this donated $1, it would be a miracle.

 

Donations can be made in several ways:

 

1. Donate via PayPal on Amelia's "Fundables" page at:

www.fundable.com/groupactions/groupaction.2008-02-08.7850...

We set the goal lower than we really need b/c if the goal is not met, all pledges are lost. But the goal has been met, so we're good to go there!

 

2. Donate via PayPal to North Carolina Animal Resource Education Services by using the email address MATTNELIZABETH@aol.com (the invoice will tell you it is going to the NCARES organization), or mail to NCARES, 741 Old Marshall Hwy, Asheville, NC 28804. Just put "Amelia" in the subject line/message somewhere.

 

3. THE VET'S OFFICE HAS DECIDED TO ACCEPT DONATIONS BY CHECK OR CREDIT CARD, AS LONG AS EACH DONATION IS $50 OR MORE (this is to hopefully minimize the number of separate transactions on her bill). IF PAYING BY CHECK, YOU MAY MAIL THE CHECK TO THE VET DIRECTLY.

 

If any extra is recieved by check, we will either return your check to you, or you may give us permission to make it out to either NCARES or to one of the other two vets who will be treating Amelia.

Vet's info:

veterinarymedicalcare.com/Home.html

Veterinary Surgical Care

930A Pine Hollow Rd.

Mt. Pleasant, SC 29464

843-884-2441

Gosh, I soooo hate asking for money, but it is not for me, it is for this sweet girl, so I have to do it. Thank you in advance to anyone and everyone who can give any amount at all! And if you can't donate, send prayers, well-wishes, & healing thoughts :)

I was at the local hospital for an echocardiogram this morning and saw this interesting fire evacuation device.

 

Hereio Jake Stockwell of the We're Here! group has chosen the

Post and Run group for today's visit.

Two good friends of mine and I went out for a shoot...of me. One just recently got a new D200 (and wanted to experiment) and the other used my camera. Both are amateurs yet did a wonderful job, I think! We had so much fun!

 

So, here I am very much pregnant...37 weeks, actually. The longest pregnancy of my life. This baby has been considered at high risk for many things, one being Fetal Heart Block. So I've made tiring drives to bigger cities for echocardiograms and so forth almost every week throughout the pregnancy. Just that has made this incredibly long for me. Now that I'm nearing the end, I've been "released" from the Cardiologists (! yay !) and can finally have a bit more down time, but it hasn't been very possible to get things done and enjoy the last few weeks because I am SO BIG and SO uncomfortable. Baby measured at 6 lbs at 34-1/2 weeks...then at 36-1/2 weeks he measured at 7 lbs 14 oz so he is definitely gaining the 1 lb a week as he should, but that also means by the time I have my c-section, Sept 17th, he could very well be reaching 10 lbs. (I keep thinking to myself, is that even possible?! My first baby was 6-1/2 lbs and my 2nd was 8lbs 3oz.) Thankfully I don't have to reach the 40 weeks point (or later) as I am having a planned c-section. My first two babies were emergency c-sections, so this time I'm foregoing any sort of labor and just getting this rapidly growing boy OUT :) 12 more days!!!! I can't wait to meet him...

******JAKE WILL BE GOING FOR HIS ECHOCARDIOGRAM THURSDAY NOV 29TH AT 9 AM********

 

All is ok here. Just very busy with night shifts and regrettably no spare free time for Flickr.

 

Jake and Bailey seem well.

 

But Jake's regular vet is encouraging us that we take Jake to the Cardiologist vet specialist, to do the echocardiogram.

 

Jake had a high ProBNP test about a month ago.

www.idexx.com/view/xhtml/en_us/smallanimal/reference-labo...

 

www.idexx.com/pubwebresources/pdf/en_us/smallanimal/refer...

 

The ProBNP may be falsely high as Jake does have asthma... But he also has had a heart murmur since birth and the Vet wants to rule out any cardiac problems.

 

I have ruled the stress of taking him the 30 min car ride each way to see the specialist, against possibly not treating something that may be going on with him...(Even though he shows no present overt signs of anything wrong...)

 

Such a hard decision to make.. and the consult and echo are not cheap. Over $550.00.

 

I pray I am doing the right thing for Jake?

I would never forgive myself if he had a cardiac condition that could be treated with meds.

Sometimes I fell I should just let him "be a cat!"

 

Wish us luck Nov 29th. ;-))

 

Hope you are all doing well. Miss you and seeing your great pics.

Abstract

Alchemy was the synthesis or transmutation of all elements in perfect balance to obtain the philosopher’s stone, the key to health. Just as alchemists sought this, so health practitioners always seek the best possible practice for optimal health outcomes for our patients. Best practice requires full knowledge—a little information can be dangerous. We need to serve our apprenticeship before we master our profession. Our profession is about improving health care. While the journey may start at medical school, the learning never ceases. It is not only about practising medicine, it is about the development of the practitioner. Professional practice requires systematic thinking combined with capacity to deal morally and creatively in areas of complexity and uncertainty appropriate to a specific context. It requires exemplary communication skills to interact with patients to facilitate collaborative decision making resulting in best practice. The synthesis of scientific and contextual evidence is a concept which applies to all disciplines where theoretical knowledge needs to be transferred to action to inform best practice. Decisions need to be made which take into account a complex array of factors, such as social and legal issues and resource constraints. Therefore, journey towards best practice involves transmutation of these three elements: scientific knowledge, the context in which it is applied and phronesis, the practical wisdom of the practitioner. All science has its limitations and we can never know all possible contextual information. Hence, like the philosopher’s stone, best practice is a goal to which we aspire but never quite attain.

 

Evidence-based practice, lifelong learning, postgraduate education

Issue Section: Editorial

Introduction

Alchemy was the synthesis or transmutation of all elements in perfect balance to obtain the philosopher’s stone. It was about the creation of a ‘panacea’, the elixir of life, a remedy to cure all diseases, the key to health. Just as alchemists sought this, so health practitioners always seek the best possible practice for optimal health outcomes for our patients.

 

Best practice requires full knowledge—a little information can be dangerous. We need to serve our apprenticeship before we master our profession. Our profession is about improving health care. While the journey may start at medical school, the learning never ceases. It is not only about practising medicinebut also about the development of the practitioner.

 

Professional practice requires systematic thinking combined with capacity to deal morally and creatively in areas of complexity and uncertainty appropriate to a specific context. It requires exemplary communication skills to interact with patients to facilitate collaborative decision making resulting in best practice. The synthesis of scientific and contextual evidence is a concept applies to all disciplines where theoretical knowledge needs to be transferred to action to inform best practice. Decisions need to be made which take into account complex array of factors, such as social and legal issues and resource constraints. Therefore, journey towards best practice involves transmutation of these three elements: scientific knowledge, the context in which it is applied and phronesis, the practical wisdom of the practitioner.

 

Clinical practice can be considered to be the sum of scholarship and professionalism. Scholarship is about empirical knowledge, research evidence, science and logic. We need to know how to assess the quality of evidence, judge the relevance and value of new knowledge to our own practice and determine whether this new knowledge is practice confirming or practice changing. Thus, the basis of our practice is scientific scholarship but we also need to learn the art. Professionalism is about the understanding and application of contextual knowledge and professional expertise, it is about artistry and judgement. We need both clinical reasoning and ethical decision making.

 

Alchemy was about integration across domains. The basic elements of water, fire, air and earth and core processes of decomposition, sublimation, distillation, amalgamation, fermentation and purification needed to be precisely combined and balanced to attain the philosopher’s stone. Similarly, clinical practice involves the domains of both scholarship and professionalism. For best practice, we must consider the prevalence of a condition, its diagnosis and treatment and its likely prognosis. However, in our management of patients, we must also consider the interplay of many other factors—the law, human rights and dignity, issues of equity for all patients, the potential benefits and harms of intervening or not intervening, the role of the professional and the emotional responses of all involved (Fig. 1).

 

FIGURE 1

Domains of alchemy and domains of clinical practice

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Domains of alchemy and domains of clinical practice

 

Alchemy involves finding perfect combination of planetary metals (such as silver, copper and mercury) and mundane elements (such as potassium and sulphur) to transmute matter into the elixir of life. The alchemist studied and practised for many years striving to reach this goal. In the same way, to determine best practice, we need to know the scientific evidence. Randomized controlled trials can demonstrate whether intervention is effective. This knowledge may be strengthened if we combine trials in systematic reviews and meta-analyse. We need to know how well a test will pick or miss a diagnosis. Case-controlled studies help us identify factors, which contribute to a particular disease. Qualitative research brings narrative to our numbers, adds the why and how to our results (Fig. 2).

 

FIGURE 2

Types of matter and types of evidence

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Types of matter and types of evidence

 

However, in practice, evidence needs to be assessed from perspective of a particular patient. Many things contribute to what decisions are actually made. These include both the patient and the practitioner’s values, numerous attributes of the patient (such as their age and their co-morbidities), their family and the community in which they live, their culture and local policy. Limited resources may mean that the ideal test or treatment is not affordable. For example, evidence indicates that heart failure should be diagnosed on basis of an echocardiogram, but if patient does not have access to this test, then the clinician may rely on symptoms and signs. Best management might include use of beta blockers, but if the patient has asthma, which this drug exacerbates, alternative treatments must be chosen. A child with bacterial pneumonia requires antibiotics, but relatives of elderly demented and chronically ill person with this condition may decline such treatment for their family member.

 

Best practice is the transmutation or synthesis of knowledge. However, all science has its limitations. What has been found to be true for particular population may not be generalizable to another. Furthermore, we can never know all possible contextual information. For example, we may not be able to predict that a person will have allergic reaction to drug we give them. Hence, like the philosopher’s stone, best practice is a goal to which we aspire but never quite attain.

 

Scientific knowledge is incomplete. It is always undergoing change and being added to. We need skills to access and critically appraise new knowledge as research progresses. Likewise, the context changes with every patient, and patient’s needs and values change over time. Professional expertise also requires self-reflection and evaluation of the outcomes of our decisions. All this evidence goes back into the mix and contributes to future decision making (Fig. 3). This is the process of lifelong learning—how the apprentice achieves mastery.

 

FIGURE 3

Synthesis of knowledge into best practice

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Synthesis of knowledge into best practice

 

The principle of the synthesis of scientific and contextual knowledge, funnelled through the wisdom of the practitioner, applies to health care in the realms of clinical and forensic practice, research, education and dissemination of information.

 

Clinical practice

Cecil Lewis, the founding Dean of my Medical School, emphasized that most health care takes place in the community not in the hospital and that doctors should treat patients holistically—body, mind and spirit. He believed it important for doctors to be well-rounded people and their education should include both science and humanity. He introduced a 3-month elective in the final year for students to spend 3 months doing whatever they passionate about, something to feed their soul, be it music, art, science or medicine. Combining theoretical knowledge with real life situations begins with clinical practice.

 

Alchemists were early doctors, in search of potions to promote healing. This is an intent that doctors still seek, applying scientific knowledge within a particular context to assist our patients to heal. My first general practice experience job was as a locum in Blaengwynfi, a mining village in South Wales. I shared the on-call roster with Dr Julian Tudor-Hart, a GP from the neighbouring village Glyncorrwg. I found him to be a truly inspirational GP. Julian was working with his patients to make their lives healthier through systematically checking their blood pressures and helping them to change their lifestyles—getting them to look at their diet, their smoking and exercise or lack of it. These Welsh villages very impoverished and the GPs who worked there did twice as much work for half pay of those working in more affluent areas. Julian taught me that the people most likely to need health care were the least likely to receive it. It was only many years later that I learned that Julian is an icon of general practice in the UK and that his ‘inverse care law’ is famous.1

 

I worked as a doctor in Jamaica for 2 years, where the health need was great. There I experienced first-hand how best practice has to be tempered by the circumstances and what is available. I ran a health centre just out of Kingston where there had been no doctor for a number of years and ∼20 000 people in the catchment area. However, there was a great team of auxiliary staff whom I trained to deliver health talks to the large group of people who would sit in shade of the mango trees waiting to see the doctor. The staff would also write labels, count pills and put into bottles the drugs I used to wheedle from the Ministry depot in downtown Kingston. After every 20 patients, I would stop consulting and dispense my own prescriptions. Patients were instructed to bring back pill bottles for recycling. I used to estimate patients’ haemoglobin levels by the strength of copper sulphate solution in which a drop of their blood would float. While a public laboratory was available at the downtown hospital, generally this was not an accessible option due to resource constraints (most patients could not afford the bus fare) and the potential associated harms (gun wars in ghettos made travelling there dangerous).

 

Forensic practice

Transmutation of scientific and contextual knowledge also applies to forensic practice. This involves examining all available evidence about the circumstances, applying what we know from scientific literature and then assessing whether the evidence may confirm or refute that alleged events occurred or were committed by person accused. Both the presence and the absence of evidence need to be considered. Sometimes evidence points to guilt. The accused may then plead guilty or be found guilty at trial. Sometimes evidence points to innocence. The charges may then be dropped or the accused found not guilty. Other times, it provides an estimate of probability or improbability. Crimes do not have to be proved; only that person is guilty beyond reasonable doubt.

 

The roles of the clinical and forensic practitioner are different, and you cannot serve Hippocrates and Hammurabi at the same time. The clinician serves Hippocrates, the Healer. This role is to relieve suffering, provide treatment and prevent further illness or injury and the duty of care is to the patient. The forensic physician serves Hammurabi, the lawgiver. Here, the role is one of evidence gathering with the basic tenet of impartiality. The role is to provide expert opinion and the duty of care is to the Court. While both roles require the synthesis of scientific and contextual evidence, clinicians called upon as expert witnesses need to make this distinction between their therapeutic and forensic responsibilities. Before a hearing, there is a complainant not a victim and a defendant not an offender. Both clinical and forensic practitioners should treat complainants with compassion and respect, and this treatment should also be afforded to the accused.

 

Research

The alchemist was researcher, constantly experimenting to find philosopher’s stone. He was looking for the perfect balance not only of ingredients but also of processes. Primary care research needs to study not only the prevalence, diagnosis, management and prognosis of disease but also issues such as how to communicate our knowledge to our patients. Clinical decisions may require the complex weighing up of the potential benefits and harms of each course of action. There are numerous ways to communicate this—as relative or as absolute risk, odds, numbers needed to treat or natural frequencies, positively or negatively framed, as numbers or in pictures.2 Our methods of communication will influence how well our patients understand the possible consequences of a management decision and may also actively encourage or discourage them from making particular choices. Using only relative risk may be manipulative. For example, if we tell a patient that one drug has double the chance of a particular side-effect compared to another, the impact of this information is likely to be very different if the risk changes from 1 in 20 to 1 in 10, than if the risk increases from 1 in 20 000 to 1 in 10 000. There is no single optimal method of communicating information on potential benefits and harms, but research can assist us to find the best way to impart knowledge to ensure truly collaborative decision making.

 

Education

Because knowledge is always changing, clinicians need to embark on a journey of lifelong learning and those with knowledge need to pass it on to others. A network of schools of alchemy existed for over millennia, starting in ancient Egypt and Mesopotamia, spreading to India, Persia and the Far East, on through classical Greek and Roman civilizations to the medieval Islamic world and then medieval Europe. The science and art of alchemy were passed down to students by master alchemists.

 

Postgraduate education needs to follow the same model of combining scholarship and professionalism. In all clinical disciplines, practitioners need the tools to access and critically appraise new knowledge as research progresses to assess the quality of evidence and its relevance to their own practice. This knowledge can then applied in context of individual patients. Professional expertise also requires self-reflection and the assessment of outcomes of decisions. Postgraduate students need to be able to look at research knowledge from populations and ask:

 

Should this confirm or change my practice?

 

Are these findings realistic—is this test or intervention available, will it be used and will it be worthwhile?

 

Is it relevant to this particular patient?

 

How does it apply to patients with other conditions and preferences?

 

What are relative gains and risks for my patient?

 

They can explore their own and other colleagues’ clinical reasoning and decision making in specific scenarios. This enables them to reflect on the weight they give different components, such as exploring and explaining relative benefits and harms of intervening or not intervening and issues relating to the law, equity and human rights and dignity.

 

Publication

Finally, our ever-growing body of knowledge needs to circulated. The philosophy of alchemy persisted for >2000 years. The findings of alchemists were recorded in texts and scrolls and disseminated in their schools and libraries. The best way to disseminate primary health care knowledge is via our peer-reviewed indexed medical journals. Primarily, this is the publication of original research. However, while scientific evidence can help inform best practice, sometimes there is no evidence available or applicable for a specific patient with his or her own set of conditions, beliefs, expectations and social circumstances. Evidence needs to be placed in context. General practice is art as well as a science. Quality of care lies also with nature of clinical relationship, with communication and truly informed decision-making. We also need to publish editorials, viewpoints, commentaries and reflections that explore areas of uncertainty, ethics, aspects of care for which there is no one right answer.

 

Conclusions

In the journey from apprentice to master, we gain knowledge and practical wisdom along way. As clinicians, researchers and teachers, we are all on a journey of lifelong learning, constantly adding and re-evaluating knowledge to practice the best that we can.

 

academic.oup.com/fampra/article/28/2/123/636458

Uno has been diagnosed with Mitral Valve Disease. The vet found a heart murmur during a routine exam so we had an echocardiogram done last week. While his heart is healthy for now, I know this is a degenerative disease. Fortunately, no other symptoms, so the current treatment is minimal and he does not have to be on medication. This just breaks my heart.

 

He doesn't seem to know anything's wrong, and is his same, silly self. Here he is in the horse pasture on Friday, keeping an eye on Chance as he grazes before sunset.

I've been experiencing breathlessness lately. After visiting my doctor I had a 24 hour ECG and was referred to the hospital. I had a video conference with a consultant, followed a week later by an echocardiogram. Then a week after that I'm in hospital just having had a pacemaker fitted to keep my heartbeat rate up to the right speed.

Two good friends of mine and I went out for a shoot...of me. One just recently got a new D200 (and wanted to experiment) and the other used my camera. Both are amateurs yet did a wonderful job, I think! We had so much fun!

 

So, here I am very much pregnant...37 weeks, actually. The longest pregnancy of my life. This baby has been considered at high risk for many things, one being Fetal Heart Block. So I've made tiring drives to bigger cities for echocardiograms and so forth almost every week throughout the pregnancy. Just that has made this incredibly long for me. Now that I'm nearing the end, I've been "released" from the Cardiologists (! yay !) and can finally have a bit more down time, but it hasn't been very possible to get things done and enjoy the last few weeks because I am SO BIG and SO uncomfortable. Baby measured at 6 lbs at 34-1/2 weeks...then at 36-1/2 weeks he measured at 7 lbs 14 oz so he is definitely gaining the 1 lb a week as he should, but that also means by the time I have my c-section, Sept 17th, he could very well be reaching 10 lbs. (I keep thinking to myself, is that even possible?! My first baby was 6-1/2 lbs and my 2nd was 8lbs 3oz.) Thankfully I don't have to reach the 40 weeks point (or later) as I am having a planned c-section. My first two babies were emergency c-sections, so this time I'm foregoing any sort of labor and just getting this rapidly growing boy OUT :) 12 more days!!!! I can't wait to meet him...

Taken while waiting for my echocardiogram. Better safe than sorry, especially for us seniors. One also wears a mask and gloves. A common story for the time being.

I began breast cancer treatment on October 9, 2014, the day I went to my doctor after finding a lump in my breast. The preliminary diagnosis was cancer. I needed a full mammogram and biospy to rule out, or in, cancer. Three days of hell ensued over that weekend before I could get in to get a mammogram.

 

A few days later I had a thorough mammogram on both breasts, and had an immediate very painful breast biopsy. I went through a battery of tests to check to see if the cancer had spread to any of my bones, brain, tissues or organs. I was fortunate that the cancer had only gotten into two lymph nodes in my axilla (armpit). I had numerous doctor's appointments and intensive medical tests during that three week period. I was exhausted by the time I had to start chemotherapy. I wanted a vacation, but time was of the essence to get this cancer under control. My life was a whirlwind of anxiety and fear. I had aggressive breast cancer and it needed to be treated, immediately. Our lives turned upside down in a matter of days. I had to learn to cope and quickly get my mind around what was happening. I did just that with the help of my very supportive husband, my two brother's in law who are MDs, and after talking with my surgeon and medical oncologist. We had a plan, and I was ready to start the battle of my life.

 

On October 29, 2014, I started 6 rounds of grueling chemotherapy - consisting of Carboplatin, Taxotere, Herceptin & Perjecta (once every three weeks) through February 10, 2015. I became bald seventeen days after starting chemotherapy. It was a very cold winter with no hair and not feeling good.

 

On March 10, 2015, I had a left breast modified radical mastectomy and removal of 31 axillary lymph nodes, with an immediate phase 1 breast reconstruction surgery. My tissue pathology showed a complete pathological response to chemotherapy. I am cancer free.

 

Three weeks later, I began 7 weekly 50cc injections of saline into the tissue expander implant to reach the maximum size for my eventual permanent breast implant. The tissue expander is under my chest wall muscle, creating a pocket for the eventual permanent breast implant. The tissue expander process is uncomfortable to say the least.

 

On June 3, 2015, my last major treatment began with 28 rounds of radiation therapy on my upper left chest, axilla and neck area. The radiation therapy caused a minor second degree burn on my collarbone and energy sapping fatigue.

 

I completed one year of Herceptin infusions on September 30, 2015. In the late winter of 2016, I will have sufficiently healed and recovered from radiation therapy to have phase 2 of my breast reconstruction surgery. I have to go for periodic 2D echocardiograms to monitor my heart functions. Herceptin can cause heart damage in a very small percentage of patients. So far, my heart has been fine. I gained a slight amount of weight during my months of rehabilitation, and I am going to the gym three days per week to regain my strength and endurance. My doctor is amazed at my progress and recovery. I have lowered my blood pressure and lost 11 lbs., since September. I can now walk at least 1.8 miles on the treadmill in 40 minutes. That is remarkable because I could barely walk across the room due to exhaustion during chemotherapy.

 

I am thankful to be alive and for my excellent team of doctors and medical personnel who have helped me along the way to wellness. I am slowly getting my energy back so I can return to my love of photography.

 

Thanks for enduring my long absence while I went through this challenging health journey in my life.

When you have an echocardiogram test at the Cardiac Screen clinic in London, you will be asked to undress to the waist and lie down. A small amount of lubricating jelly, which may feel a bit cold, will be applied to your chest to help us get a clear picture. You will then feel the probe moving across your skin as we examine your heart from different angles, and you might be asked to turn onto your side for a different perspective. The whole procedure should take no more than half an hour.

4th Update:

I am still in the hospital one day after my angiogram which showed two severe blockged arteries and one partially blocked, No wohder the slightesr exertion had become so exhausting. They moved my surgery up to tomorrow, Friday, May 6th. It's worrisome and reassurng at the same time.

 

My children are texting me and emailing photos, and that is wonderful. Cecily has been in and out when she is not teaching, and she brought my laptop when it was decided to kep me here.

 

Thanks again for all your supportive cmments and prayers. I really appreciate you all. I am feeling good and I am watching the patients who have been here a while, post-op, doing their ten walks per hour as their recovery exercises.

 

Yesteday they had me do a lung capacity test for a baeline. I hit the brass bell at the top of the tube. That will be my baseline to monitor my recovery. I have a 95% chance of recovering. Baruch HaShem!

 

Mise à Jour 4:

Je suis toujours à l'hôpital un jour après mon angiographie qui montre deux graves artères blockged et un partiellement bloqués, n wohder l'effort slightesr était devenue tellement épuisant. Ils ont déménagé mon opération jusqu'à demain, le vendredi 6 mai. C'est inquiétant et reassurng en même temps.

 

Mes enfants me textos et des courriels des photos, et c'est merveilleux. Cécile a été dans et hors quand elle n'est pas l'enseignement, et elle a apporté mon ordinateur portable quand il a été décidé de me kep ici.

 

Merci encore pour tous vos cmments de soutien et les prières. J'apprécie vraiment que vous tous. Je me sens bien et je regarde les patients qui sont ici depuis un certain temps, post-op, faire de leurs dix promenades à l'heure que leur guérison exercices.

 

Hier, ils m'avaient faire un test de capacité pulmonaire pour un baeline. J'ai frappé la cloche de cuivre au sommet du tube. Ce sera ma base pour le suivi mon rétablissement. J'ai 95% de chance de récupérer. Baroukh Hachem!

_____________________________________

 

3rd Update:

Thank you all, for your comments, inquiries, and good wishes... To answer your questions. This is making me feel a bit embarrassed. It makes me seem so self centered. Oh well, so what? And, you don't have to read it...;)) smile smile..

 

On the other hand, it is a novel and interesting (to me anyway) way to keep a journal. Which I would not do otherwise. Another thought: My feelings of nervousness and anxiety are probably not unique to me, so it may help others... I remember my dear Flickr friend Nancy talking about her husband's upcoming operation. It gave me a chance to pray for them, and it seemed to help them to know that friends were thinking about them.

Enough of this preamble...

 

I am easily exhausted, and I have chronic chest pain again... I suspect some of it is now due to mental processes...

On Wednesday I will go to the hospital for my angiogram. That is a procedure in which a fluorescence sensor is inserted through the groin, with an iodine tracer, that looks for blockages in my arteries. If there are any, they can be bypassed in the same surgery in a few weeks to repair my Mitral valve.

I am nervous, but happy. Shabbat Shalom... Good Shabbos..

 

troisième mise à jour:

Merci à vous tous, pour vos commentaires, questions, et souhaits ...

 

Je suis facilement épuisé, et j'ai des douleurs thoraciques chroniques à nouveau ...Je soupçonne certaines d'entre elles est maintenant en raison de processus mentaux ...

Mercredi, je vais à l'hôpital pour mon angiographie. C'est une fluorescence capteur inséré dans l'aine, avec un traceur d'iode, qui cherche des blocages dans mes artères. Si y en a, ils peuvent être contournés dans le même temps opératoire dans quelques semaines pour réparer ma valve mitrale.

Je suis nerveux, mais heureux.

Shalom Shabbat ... Chabbath Bon ..

_________________________________

 

2nd Update:

Miss Cecily, Raf, and I attended a one hour class today at Carondelet Heart And Vascular Institute about the operation, pre, during, and post. They gave us quite a presentation, with viewgraphs projected on the screen. The hospital stay for the Mitral valve repair is 4 to 7 days. Then there is a 4 to 6 week recovery at home, with home care staff... I must not lift more than 5 pounds, somewhat less than 2 kilo. A gallon of water almost twice that.

 

Also no coughing and no lifting arms above my chest. I have to hold a pillow against my chest doing many things to prevent tearing apart the wired together breast bones. this sounds very worrisome. I have to deal with that.

______________________________

 

1st Update: I can have the heart surgery to repair my very leaky Mitral Valve in as little as two weeks. However, ny family are recommending doing it after school graduations and performances so they can help during my post-op recovery.

 

That makes sense. Many friends are telling us that the recovery period is quite long. At services last night, a member of my Shul (his wife's wedding gown is in the Jewish Museum set) said it took him a year to recover from the same surgery.

 

Miss Cecily, Raf, and I will be attending a one hour class today at Carondelet Heart And Vascular Institute about the operation, pre, during, and post.

 

First Visit To My Heart Surgeon to see if I am a candidate for a Mitral Valve repair operation, and to find out what's inolved.

 

Mise à jour : je peux avoir la chirurgie cardiaque pour réparer ma très fuite valve mitrale en aussi peu que deux semaines. Toutefois, la famille ny recommandons de le faire après l'école et graduations performances afin qu'ils puissent aider lors de ma convalescence post-op.

C'est logique. Beaucoup d'amis nous disent que la période de récupération est très longue. La nuit dernière des services, un membre de ma Shul (robe de mariée de sa femme est dans l'ensemble Musée juif) a dit qu'il lui a fallu un an pour récupérer de la même intervention chirurgicale.

Miss Cecily, Raf, et je participerai à une classe une heures aujourd'hui à Carondelet Heart and Vascular Institute de l'opération, avant, pendant et après.

 

Close-up of Mitral Valve Prolapse (Click-Murmer Syndrome) The ultrasound tests showed that my mitral valve prolapse is getting worse. The valve leaks "A LOT" of blood.

 

My Cardiologist asked about my exercising. I said i can't even walk a few blocks with others without getting exhausted. He said this leakage is why that happens. After the surgery to repair the valve, i will be able to really exercise and not get so tired!! He said "It will change your life!" I am definitely looking forward to that!

   

IMG_1074_2

Día 271 de Cuarentena. 49 Días más de Trump.

(Waiting for echocardiogram. The walls are flesh-colored.)

Blog: sharonfrost.typepad.com/day_books

5 1/2 x 7 in double page spread; watercolor, ink, whatever on Stillman and Birn Epsilon Soft cover.

 

#brooklynmethodisthospital #echocardiogram #coronavirus

On our way home. When birds land on these wires they male up musical notes.

3rd Update: Thank you all, for your comments, inquiries, and good wishes... To answer your questions. This is making me feel a bit embarrassed. It makes me seem so self centered. Oh well, so what? And, you don't have to read it...;)) smile smile..

 

On the other hand, it is a novel and interesting (to me anyway) way to keep a journal. Which I would not do otherwise. Another thought: My feelings of nervousness and anxiety are probably not unique to me, so it may help others... I remember my dear Flickr friend Nancy talking about her husband's upcoming operation. It gave me a chance to pray for them, and it seemed to help them to know that friends were thinking about them.

Enough of this preamble...

 

I am easily exhausted, and I have chronic chest pain again... I suspect some of it is now due to mental processes...

On Wednesday I will go to the hospital for my angiogram. That is a procedure in which a fluorescence sensor is inserted through the groin, with an iodine tracer, that looks for blockages in my arteries. If there are any, they can be bypassed in the same surgery in a few weeks to repair my Mitral valve.

I am nervous, but happy. Shabbat Shalom... Good Shabbos..

 

Merci à vous tous, pour vos commentaires, questions, et souhaits ...

 

Je suis facilement épuisé, et j'ai des douleurs thoraciques chroniques à nouveau ...Je soupçonne certaines d'entre elles est maintenant en raison de processus mentaux ...

Mercredi, je vais à l'hôpital pour mon angiographie. C'est une fluorescence capteur inséré dans l'aine, avec un traceur d'iode, qui cherche des blocages dans mes artères. Si y en a, ils peuvent être contournés dans le même temps opératoire dans quelques semaines pour réparer ma valve mitrale.

Je suis nerveux, mais heureux.

Shalom Shabbat ... Chabbath Bon ..

 

2nd Update: Miss Cecily, Raf, and I attended a one hour class today at Carondelet Heart And Vascular Institute about the operation, pre, during, and post. They gave us quite a presentation, with viewgraphs projected on the screen. The hospital stay for the Mitral valve repair is 4 to 7 days. Then there is a 4 to 6 week recovery at home, with home care staff... I must not lift more than 5 pounds, somewhat less than 2 kilo. A gallon of water almost twice that.

 

Also no coughing and no lifting arms above my chest. I have to hold a pillow against my chest doing many things to prevent tearing apart the wired together breast bones. this sounds very worrisome. I have to deal with that.

 

1st Update: I can have the heart surgery to repair my very leaky Mitral Valve in as little as two weeks. However, ny family are recommending doing it after school graduations and performances so they can help during my post-op recovery.

 

That makes sense. Many friends are telling us that the recovery period is quite long. At services last night, a member of my Shul (his wife's wedding gown is in the Jewish Museum set) said it took him a year to recover from the same surgery.

 

Miss Cecily, Raf, and I will be attending a one hour class today at Carondelet Heart And Vascular Institute about the operation, pre, during, and post.

 

First Visit To My Heart Surgeon to see if I am a candidate for a Mitral Valve repair operation, and to find out what's inolved.

 

Mise à jour: je peux avoir la chirurgie cardiaque pour réparer ma très fuite valve mitrale en aussi peu que deux semaines. Toutefois, la famille ny recommandons de le faire après l'école et graduations performances afin qu'ils puissent aider lors de ma convalescence post-op.

C'est logique. Beaucoup d'amis nous disent que la période de récupération est très longue. La nuit dernière des services, un membre de ma Shul (robe de mariée de sa femme est dans l'ensemble Musée juif) a dit qu'il lui a fallu un an pour récupérer de la même intervention chirurgicale.

Miss Cecily, Raf, et je participerai à une classe une heures aujourd'hui à Carondelet Heart and Vascular Institute de l'opération, avant, pendant et après.

 

Close-up of Mitral Valve Prolapse (Click-Murmer Syndrome) The ultrasound tests showed that my mitral valve prolapse is getting worse. The valve leaks "A LOT" of blood.

 

My Cardiologist asked about my exercising. I said i can't even walk a few blocks with others without getting exhausted. He said this leakage is why that happens. After the surgery to repair the valve, i will be able to really exercise and not get so tired!! He said "It will change your life!" I am definitely looking forward to that!

   

IMG_1074_2

I was pregnant this winter. After spending most of 2016 trying, we finally got a positive test in early December. We had planned to share the news in February, once I was in my second trimester and had checked the 13-week ultrasound off the list. Unfortunately, that announcement never happened. The doctors spotted a possible issue with the baby's heart on the ultrasound, and after another ultrasound a week later, the baby was diagnosed with a rare congenital heart defect called Ebstein’s anomaly. (The valve between the right atrium and right ventricle had formed too far down, impairing its function and putting more strain on the now-enlarged right atrium.) One more ultrasound followed at 16 weeks, and then we had a very long echocardiogram and consultation with the pediatric cardiologist a couple days later. He confirmed what I had feared after I first researched the condition: this baby’s chances of survival were not good, especially given that the problem was this apparent so early in the pregnancy. In addition to Ebstein's anomaly, the cardiologist identified probable pulmonary atresia, meaning that the valve regulating the flow from the heart to the lungs didn't appear to be functional either. With the normal pathway blocked, the blood was having to go back through the right atrium and out of a hole that would normally close on its own before birth. If the baby survived, she would need multiple heart surgeries, and her heart would still never have normal function, shortening her life expectancy significantly. But that was the best case scenario. With almost 24 weeks left of pregnancy, her chances of even making it to term before heart failure were pretty slim. We had our 4-year-old son to consider as well, and in the end, we decided that it would be best to terminate this pregnancy and (hopefully) try again.

 

We started the 3-day D&E process last Tuesday, at 17 weeks. For my picture that day, I shot the tulips that my college friends had sent, setting them on a cabinet in the nursery.

Following an ECG at my doctor's surgery I have been referred to hospital for an echcardiogram. It was all very straightforward. It's a pity I only got my arm, and a bit of my face in a mask, in the photo.

(The F train, Brooklyn. Underground on the way to echocardiogram.)

Blog: sharonrost.typepad.com/day_books

7 x 14 in. double page spread; watercolor, ink. whatever on Stonehenge.

Ecocardiogramo, Hospital Metodista de Brooklyn. Solo dos paradas en el subte. (Echocardiogram. Only two stops on the subway.)

Blog: sharonfrost.typepad.com/day_books

3 1/2 x 11 in double page spread; watercolor, ink, whatever, on Moleskine soft cover notebook.

  

#subways #ftrain #brooklyn #echocardiogram

One of the more feeble pictures. I try and have the pictures have a wee bit of relationship to my day. So, the things of note today were; go with Jennifer visit Uncle Ho (and Dragon Mama) in Heart Transplant Unit ICU, and buy trout chow for the turtles as long as we were out that way. Although I brought the camera along, I left it in the car. Uncle Ho would have understood as he is a photographer, but I figured I would let him have his pnuemonia in peace. And then, at The Feed Store in Summit, they had a couple dinky roosters in this cage. I set the timer for three shots, and this one is the best of the bunch. So, not a great shot at all, but a good story of my day you get instead.

 

While we were by Uncle Ho we got to watch him get an echocardiogram. Great fun. I am overdue for one as I am a heart patient also, but I ignore mine and hope it goes away. Has worked fine so far.

 

We had to take Jake back to his regular vet yesterday afternoon.

 

His breathing was rapid >35/min and he was listless. Not his usual "Jake" sell.

Dr W wanted to see him in view of the echocardiogram findings last week. (moderate cardiac hypertrophy.)

 

Dr W said the echo findings was "NOT good news."

He did 2 chest X-rays of Jake's lungs but did not see any fluid build-up or pulmonary edema.

 

Dr W contacted the cardiologist specialist and found out Jake's thyroid was normal. So that is not the cause of his heart problems. (...Unfortunately..... as the thyroid condition could be treated by medication.) Also not due to high blood pressure as his BP was normal.

So Jake's condition is due to genetic causes.

 

There is no real treatment for the hypertrophic cardiomyopathy. Only supportive measures used to treat the symptoms.

 

For now Jake will start on an blood thinner called PLAVIX, (Like Aspirin) to prevent any stroke or blood clots from his malfunctioning heart. (1/4 tab a day)

 

Today Dec 4th I came home from night shift and Jake ate well, but still breathing rapidly.. NOT panting...NOT purring. He is lying next to me on my bed.

 

Please pray for my special boy. I hope he can still have many good days ahead and bounce back, but I will not let him suffer.

 

One day at a time I guess.

Thank you all.

 

Metamfetamin kan brukas

Bipacksedel

Information till förskrivare

Diskutera här påFlickr om metamfetamin alltid behöver vara bra eller dåligt, eller om det finns mera nyanserade sätt att se på det hela.

  

Metamfetamin kan missbrukas och

-Metamfetamin kan missbrukas: se konsekvenserna

och missbruket ökar snabbt. Speciellt farligt för personer med ADHD då missbruk av metamfetamin reglerar ned densiteten på dopaminreceptorerna.

 

Metamfetamin - the faces of meth

Klassiker om vad som händer med metamfetaminmissbrukaren, åldrandet och tänderna. Blicken, huden och ödesränderna.

 

Meth större hjärna med mindre innehåll

Vad som händer i hjärnan hos Meth missbrukare, hjärnan växer på grund av att den svullnar och densiteten på dopaminreceptorerna regleras ned. Men också att metamfetamin rätt använt kan vara bra samt varför. Skillnaden mellan enantiomererna hur hur otroligt olika de verkar.

 

Metamfetamin & ADHD + Hel dokumentär

Hel dokumentärfilm från National Geographic om världens farligaste drog: Metamfetamin,

 

Den här dokumentären kanske om inte annat kan förklara lite av varför Metamfetamin fått det rykte som det har, vilka konsekvenserna av ett missbruk blir osv. Ãven om dokumentären inte alls förklarar att personer med ADHD löper en ökad risk att fastna i ett metamfetaminmissbruk och att det på sikt kommer att göra problemen mycket värre tack vare att höga doser reglerar ned antalet och densiteten på dopamin receptorerna. Så att det som frälser dig också kommer att döda dig har kanske aldrig varit sannare än här.

 

Metamfetamin de direkta & indirekta skadeverkningarna

-Se Oprahshow nedan om metamfetaminmissbruk

-ohämmad sex med främlingar och sambanden

 

Fler och fler rapporter kommer om metamfetamin eller crystal meth som en del föredrar att kalla det men skadeverkningarna av ett missbruk direkt säger kanske inte så mycket om de indirekta skadeverkningarna av missbruket, vilket varit väldigt vanligt och utbrett i vissa kretsar i bland annat New York.

    

Marknadsföringen av Meth amfetamin till gravida

Den Pengakåta pillerindustrin har genom åren haft en rad smaklösheter för sig förutom att dölja resultat som talar till sitt preparats nackdel så manipuleras och har det manipulerats en hel del igenom åren. En speciellt intressant grupp att kränga "de nya supervetenskapliga" produkterna till har varit kvinnor, ofta med någon skavank som medicinjättarna inte alls varit sena med att marknadsföra med vetenskap som täckmantel. Det kan vara den feta kvinnan, den okåta kvinnan, den otacksamma kvinnan eller bara kvinnan som inte hinner med att städa rent i hemmet. Eller varför inte suggan som blivit på smällen och fettnat till? Behöver inte hon lite metamfetamin?

 

så här farligt lever användarna

 

Metamfetamin utbrett i hela skåne

 

ny dödsdrog sprider ut sig

 

DN Metamfetamin 1 2 3

 

SvD 1 2 3 4 5

 

Sydsvenskan 1 2 3

  

Produktbeskrivning på Engelska

 

METH

Teratogenic effects: Pregnancy Category C. Methamphetamine has been shown to have teratogenic and embryocidal effects in mammals given high multiples of the human dose. There are no adequate and well-controlled studies in pregnant women. METH tablets should

not be used during pregnancy unless the potential benefit justifies the potential risk to the fetus. Nonteratogenic effects: Infants born to mothers dependent on amphetamines have an increased risk of premature delivery and low birth weight. Also, these infants may experience symptoms of withdrawal as demonstrated by dysphoria, including agitation and significant lassitude.

  

Usage in Nursing Mothers: Amphetamines are excreted in human milk. Mothers taking amphetamines should be advised to refrain from nursing.

Pediatric Use: Safety and effectiveness for use as an anorectic agent in children below the age of 12 years have not been established. Long-term effects of methamphetamine in children have not been established (see WARNINGS). Drug treatment is not indicated in all cases of the behavioral syndrome characterized by moderate to severe distractibility, short attention span, hyperactivity, emotional lability and impulsivity. It should be considered only in light of the complete history and evaluation of the child. The decision to prescribe METH tablets should depend on the physicianâs assessment of the chronicity and severity of the childâs symptoms and their appropriateness for his/her age. Prescription should not depend solely on the presence of one or more of the behavioral characteristics. When these symptoms are associated with acute stress reactions, treatment with METH tablets is usually not indicated. Clinical experience suggests that in psychotic children, administration of METH tablets may exacerbate symptoms of behavior disturbance and thought disorder. Amphetamines have been reported to exacerbate motor and phonic tics and Touretteâs syndrome. Therefore, clinical evaluation for tics and Touretteâs syndrome in children and their families should precede use of stimulant medications.

  

ADVERSE REACTIONS

The following are adverse reactions in decreasing order of severity within each category that have been reported: Cardiovascular: Elevation of blood pressure, tachycardia and palpitation. Fatal cardiorespiratory arrest has been reported, mostly in the context of abuse/misuse. Central Nervous System: Psychotic episodes have been rarely

eported at recommended doses. Dizziness, dysphoria, overstimulation, euphoria, insomnia, tremor, restlessness and headache. Exacerbation of motor and phonic tics and Touretteâs syndrome. Gastrointestinal: Diarrhea, constipation, dryness of mouth, unpleasant taste and other gastrointestinal disturbances.

Hypersensitivity: Urticaria.

Endocrine: Impotence and changes in libido.

Miscellaneous: Suppression of growth has been reported with the

long-term use of stimulants in children (see WARNINGS).

DRUG ABUSE AND DEPENDENCE

Controlled Substance: METH tablets are subject to control under

DEA schedule II.

  

Abuse: Methamphetamine has been extensively abused. Tolerance, extreme psychological dependence, and severe social disability have occurred. There are reports of patients who have increased the dosage to many times that recommended. Abrupt cessation following prolonged high dosage administration results in extreme fatigue and mental depression; changes are also noted on the sleep EEG. Manifestations of chronic intoxication with methamphetamine include

severe dermatoses, marked insomnia, irritability, hyperactivity, and personality changes. The most severe manifestation of chronic intoxication is psychosis often clinically indistinguishable from schizophrenia. Abuse and/or misuse of methamphetamine have resulted in death. Fatal cardiorespiratory arrest has been reported in the context of abuse and/or misuse of methamphetamine.

 

OVERDOSAGE depressive symptoms should be adequately screened to determine if they are at risk for bipolar disorder; such screening should include a detailed psychiatric history, including a family history of suicide, bipolar disorder, and depression. Emergence of New Psychotic or Manic Symptoms: Treatment emergent psychotic or manic symptoms, e.g., hallucinations, delusional thinking, or mania in children and adolescents without a prior history of psychotic illness or mania can be caused by stimulants at usual doses. If such symptoms occur, consideration should be given to a possible causal role of the stimulant, and discontinuation of

treatment may be appropriate. In a pooled analysis of multiple short-term, placebo-controlledstudies, such symptoms occurred in about 0.1% (4 patients with events out of 3482 exposed to methylphenidate or amphetamine for several weeks at usual doses) of stimulant-treated patients compared to 0 in placebo-treated patients.

Aggression: Aggressive behavior or hostility is often observed in children and adolescents with ADHD, and has been reported in clinical trials and the postmarketing experience of some medications indicated for the treatment of ADHD. Although there is no systematic evidence that stimulants cause aggressive behavior or hostility, patients beginning treatment for ADHD should be monitored for the appearance of or worsening of aggressive behavior or hostility. There is some clinical evidence that stimulants may lower the convulsive threshold in patients with prior history of seizures, in patients with prior EEG abnormalities in absence of seizures, and, very rarely, in patients without a history of seizures and no prior EEG evidence of seizures. In the presence of seizures, the drug should be discontinued. Visual Disturbance Difficulties with accommodation and blurring of vision have been reported with stimulant treatment.

 

PRECAUTIONS

General: METH tablets should be used with caution in patients with even mild hypertension. Methamphetamine should not be used to combat fatigue or to replace rest in normal persons. Prescribing and dispensing of methamphetamine should be limited to the smallest amount that is feasible at one time in order to minimize the possibility of overdosage. Information for Patients: The patient should be informed that methamphetamine may impair the ability to engage in potentially hazardous activities, such as, operating machinery or driving a motor vehicle.

 

The patient should be cautioned not to increase dosage, except on advice of the physician. Prescribers or other health professionals should inform patients, their families and their caregivers about the benefits and risks associated with treatment with methamphetamine and should counsel them it its appropriate use. A patient Medication Guide is available for METH. The prescriber or health professional should instruct patients, their families, and their caregivers to read the Medication Guide and should assist them in understanding its contents. Patients should be given the opportunity to discuss the contents of the Medication Guide and to obtain answers to any questions they may have.

 

Drug Interactions: Insulin requirements in diabetes mellitus may be altered in association with the use of methamphetamine and the concomitant dietary regimen. Methamphetamine may decrease the hypotensive effect of guanethidine. METH should not be used concurrently with monoamine oxidase inhibitors (see CONTRAINDICATIONS). Concurrent administration of tricyclic antidepressants and indirect- acting sympathomimetic amines such as the amphetamines, should be closely supervised and dosage carefully adjusted. Phenothiazines are reported in the literature to antagonize the CNS stimulant action of the amphetamines.

  

INDICATIONS AND USAGE

Attention Deficit Disorder with Hyperactivity: METH tablets are indicated as an integral part of a total treatment program which typically includes other remedial measures (psychological, educational, social) for a stabilizing effect in children over 6 years of age with a behavioral syndrome characterized by the following group of developmentally inappropriate symptoms: moderate to severe distractibility, short attention span, hyperactivity, emotional lability, and impulsivity. The diagnosis of this syndrome should not be made with finality when these symptoms are only of comparatively recent origin. Nonlocalizing (soft) neurological signs, learning disability, and abnormal EEG may or may not be present, and a diagnosis of central nervous system dysfunction may or may not be warranted. Exogenous Obesity: as a short-term (i.e., a few weeks) adjunct in a regimen of weight reduction based on caloric restriction, for patients in whom obesity is refractory to alternative therapy, e.g., repeated diets, group programs, and other drugs. The limited usefulness of METH tablets (see CLINICAL PHARMACOLOGY) should be weighed against possible risks inherent in use of the drug, such as those described below.

  

CONTRAINDICATIONS

METH tablets are contraindicated during or within 14 days following the administration of monoamine oxidase inhibitors; hypertensive crisis may result. It is also contraindicated in patients with glaucoma, advanced arteriosclerosis, symptomatic cardiovascular disease, moderate to severe hypertension, hyperthyroidism or known hypersensitivity or idiosyncrasy to sympathomimetic amines. Methamphetamine should not be given to patients who are in an agitated state or who have a history of drug abuse.

  

WARNINGS

Tolerance to the anorectic effect usually develops within a few weeks. When this occurs, the recommended dose should not be exceeded in an attempt to increase the effect; rather, the drug should be discontinued (see DRUG ABUSE AND DEPENDENCE).

Serious Cardiovascular Events

Sudden Death and Pre existing Structural Cardiac Abnormalities

or Other Serious Heart Problems:

Children and Adolescents: Sudden death has been reported in association with CNS stimulant treatment at usual doses in children and adolescents with structural cardiac abnormalities or other serious heart problems. Although some serious heart problems alone carry an increased risk of sudden death, stimulant products generally should not be used in children or adolescents with known serious structural cardiac abnormalities, cardiomyopathy, serious heart rhythm abnormalities, or other serious cardiac problems that may place them at increased vulnerability to the sympathomimetic effects of a

stimulant drug.

Adults: Sudden deaths, stroke, and myocardial infarction have been reported in adults taking stimulant drugs at usual doses for ADHD. Although the role of stimulants in these adult cases is also unknown, adults have a greater likelihood than children of having serious structural cardiac abnormalities, cardiomyopathy, serious heart rhythm abnormalities, coronary artery disease, or other serious cardiac problems. Adults with such abnormalities should also generally not be treated with stimulant drugs. Hypertension and other Cardiovascular Conditions: Stimulant medications cause a modest increase in average blood pressure (about 2-4 mmHg) and average heart rate (about 3-6 bpm), and individuals may have larger increases. While the mean changes alone would not be expected to have short-term consequences, all patients should be monitored for larger changes in heart rate and blood pressure. Caution is indicated in treating patients whose underlying medical conditions might be compromised by increases in blood pressure or heart rate, e.g., those with pre-existing hypertension, heart failure, recent myocardial infarction, or ventricular arrhythmia. Assessing Cardiovascular Status in Patients being Treated with Stimulant Medications: Children, adolescents, or adults who are being considered for treatment with stimulant medications should have a careful history (including assessment for a family history of sudden death or ventricular arrhythmia) and physical exam to assess for the presence of cardiac disease, and should receive further cardiac evaluation if findings suggest such disease (e.g., electrocardiogram and echocardiogram). Patients who develop symptoms such as exertional chest pain, unexplained syncope, or other symptoms suggestive of cardiac disease during stimulant treatment should undergo a prompt cardiac evaluation.

Psychiatric Adverse Events

Pre-existing Psychosis:

Administration of stimulants may exacerbate symptoms of behavior disturbance and thought disorder in patients with a pre-existing psychotic disorder. Bipolar Illness: Particular care should be taken in using stimulants to treat ADHD in patients with comorbid bipolar disorder because of concern for possible induction of a mixed/manic episode in suchpatients. Prior to initiating treatment with a stimulant,

 

METH®

Methamphetamine

Hydrochloride

Tablets, USP only

 

DESCRIPTION

METH® (methamphetamine hydrochloride tablets, USP), chemically known as (S)-N,α-dimethylbenzeneethanamine hydrochloride, is a member of the amphetamine group of sympathomimetic amines. It has the following structural formula:

 

CLINICAL PHARMACOLOGY

Methamphetamine is a sympathomimetic amine with CNS stimulant activity. Peripheral actions include elevation of systolic and diastolic blood pressures and weak bronchodilator and respiratory stimulant action. Drugs of this class used in obesity are commonly known as âanorecticsâ or âanorexigenicsâ. It has not been established, however, that the action of such drugs in treating obesity is primarily one of appetite suppression. Other central nervous system actions, or metabolic effects, may be involved, for example. Adult obese subjects instructed in dietary management and treated with âanorecticâ drugs, lose more weight on the average than those treated with placebo and diet, as determined in relatively short-term clinical trials.

The magnitude of increased weight loss of drug-treated patients over placebo-treated patients is only a fraction of a pound a week. The rate of weight loss is greatest in the first weeks of therapy for both drug and placebo subjects and tends to decrease in succeeding weeks. The origins of the increased weight loss due to the various possible drug effects are not established. The amount of weight loss associated with the use of an âanorecticâ drug varies from trial to trial, and the increased weight loss appears to be related in part to variables other than the drug prescribed, such as the physician-investigator, the population treated, and the diet prescribed. Studies do not permit conclusions as to the relative importance of the drug and non-drug factors on weight loss.

  

The natural history of obesity is measured in years, whereas the studies cited are restricted to a few weeks duration; thus, the total impact of drug-induced weight loss over that of diet alone must be considered clinically limited. The mechanism of action involved in producing the beneficial behavioral changes seen in hyperkinetic children receiving methamphetamine is unknown. In humans, methamphetamine is rapidly absorbed from the gastrointestinal tract. The primary site of metabolism is in the liver by aromatic hydroxylation, N-dealkylation and deamination. At least seven metabolites have been identified in the urine. The biological half-life has been reported in the range of 4 to 5 hours. Excretion occurs primarily in the urine and is dependent on urine pH. Alkaline urine will significantly increase the drug half-life. Approximately 62% of an oral dose is eliminated in the urine within the first 24 hours with about one-third as intact drug and the remainder as metabolites.

  

METHAMPHETAMINE HAS A HIGH POTENTIAL FOR

ABUSE. IT SHOULD THUS BE TRIED ONLY IN

CLINICAL PHARMACOLOGY. HAVE A NICE DAY.

 

Bara metylfenidat rekommenderas av de europeiska kontrollmyndigheterna för behandling av ADHD

  

51:365-

 

So.....

 

A lot of you have been so kind in asking how we are, so here is your update.

 

Topher for sure has acute rheumatic fever, with a touch of acute rheumatic childhood arthritis. Acute just means that it came up suddenly. Rheumatic means it has to do with the joints. It can effect your heart valves and cause cardiac arrest, which is why it is so dangerous. His joints swell and are even associated with a rash now and then.

 

He has to see the rheumatologist and the pediatric cardiologist every 6 months, with occasional EKG's and echocardiograms. The treatment is penicillin, but our family has a history of allerfies to it, so he will be going to see an allergy specialist to determine if he is allergic or not. The penicillin has a 98% rate of keeping away strep throat, which is what caused his sickness in the first place. If he catches strep ever again for his whole life, his heart is at major risk.

 

He will need to be on meds until he is 25 years old, can you believe that? I truly thought the doctor was joking to make us feel better. He can't become a teacher or a doctor or any other profession where he will be in close quarters with people who are prone to get strep. If he has a roommate or wife or child that gets it, he has to go back on the medication and leave the area immediately. They are not playing around!! He is lucky that he gets to stay in school.

 

This is so frustrating to me. I am grateful that if he has to be sick, it is this and not a car wreck or cancer or something a thousand times worse. But this is still hard, and i am sad and tired. It has taken me 2 weeks to tell you all b/c i just don't want it to be happening. I'm ready to except it and just do our best.

 

As for Toph? He is the coolest, most understanding, laid back person i know. He takes it all in stride and finds a way to make it okay for himself. I am so relieved that he is not your normal 11 year old. He's gonna be just fine.

 

My mouth is better, back on solid foods but nothing gummy until my cap or bridge or whatever comes in.

 

The washer flooded the garage AGAIN and we lost our use of a washer, so we just better hope our clothes don't get dirty until they go out of style, lol!

 

My camera...well, you've all had enough bad news for today! Hahaha!

 

Thanks for caring, everyone, i'm so grateful to my support team here at flickr.com!! :)

Día 271 de Cuarentena.

Blog: sharonfrost.typepad.com/day_books

5 1/2 x 7 in double page spread; watercolor, ink, whatever, on Stillman and Birn Epsilon soft cover.

 

#subways #ftrain #coronavirus

Jake had his echocardiogram and saw the cardiologist today. Nov 29 2012.

 

Jake has MODERATE cardiomyopathy. (Enlargement of the heart. Thickening of the heart walls.)

There are 3 degrees. Mild, moderate or severe.

 

The Vet explained that Cardiac hypertrophy can be caused by 3 things.

The heart muscle may thicken due to 1) high blood pressure, 2)Hyperthyroid disease or 3)genetic causes.

 

Jake's blood pressure was normal.

 

The vet drew some blood to test for a hyperactive thyroid gland. We will have the results tomorrow. If elevated Jake would be put on thyroid pills. If the thyroid is normal then his cardiomyopathy must be due to genetic causes.

 

If due to genetics the Vet would put Jake on a blood thinner (Tiny amount of Aspirin or Plavix) to prevent blood clots breaking off and going to the limbs, lungs or brain.

  

So we will know what other treatment the vet will decide in the next day of so, once the thyroid results are in.

 

He recommends staying on the Fortakor as this will help both the kidneys and heart, and continuing the flovent for asthma.

He saw a small amount of fluid on Jake's lung X-ray from October, when he had his "spell" and fell off my bed.

 

I guess the news could be a lot worse.

Could have been severe instead of moderate disease. The PRO bnp test alerted us to do the echo, and some heart disease was found. Hopefully we can find the right treatment and keep Jake as healthy and happy as possible.

 

Right now Jake is unfazed by the whole vet visit, echo, blood draw and car ride.

His owner is a nervous wreck.

He is curled up next to me after devouring a huge lunch and purring contently.

 

Thank you all for your well wishes and support!!!

It means a lot to me.

xoxoxoxoxox

 

********Saturday update.******* Thyroid results not available yet. Will update when the T4 results are in.

Studio Loft, Studio M Hotel, Singapore

 

My apologies, it's really been a while, was caught into weekend duties and some pre-wedding prepwork discussion with wifey. Most importantly, did spent quality times with her kins these days.

 

Thanks for the concern, greatly appreciated. Went through the last part of the echocardiogram test which they missed out, confirmed my heart system has variance than usual. The heart specialist commented this is still common to them as one of my out blood flow have biggish than others. (Just like others have 6th fingers) Overall, my heart and its system are still in good shape, but that would not able to justify my passed out episodes.

 

In bio term they called it Vasovagal Syncope. I had done Google bit on this and even I explained to the specialist that I don't standing for long periods, I drink 2 glasses of waters every morning so I don't think I am "dehydrated". That essentially when I do running and the fainting will kicked in right after I stop running after 5-7 minutes. I did it couple of times during January, just that end of Feb it occur out of sudden.

 

The only explanation is my low blood pressure happened during these 2 episodes and most probably decrease in blood flow to the brain causing it (One occurred in the tilt test). Also job stressful could be one of the key concerns, of course there are more causing this too. Currently am under monitoring and advised not to do any aggressive exercise. Just begin with slow walk until it sweat and slowly increase by walking to the slope and so on. Another thing found is that my high cholesterol too, so I have to watch out my diet and pair with my non-aggressive exercise too. The next visit to the heart specialist will be 4 July, and some test will need to be done prior the meet up.

 

Once again, I am grateful for those spent some of their times came to me to understand my situation. Will keep you posted once i have an update.

  

You must see this on large View On White and View On Black

 

----

P/s : This is new Camera Raw v6 editing, CS5 parts can be seen in the commentary too.

 

The chemo treatment went well today. Zooie actually had an echocardiogram and cbc before the treatment. He also got dosed with Benadryl (to prevent an allergic response) and a steriod prior to the chemo. The chemolytic agent was infused slowly over 30 minutes. Those of us that remained in the room during the preparation and infusion of the drug were required to wear masks and gloves. Zooie was the perfect patient and stayed almost completely still during all the procedures. I was able to stay with him the whole time and rub his neck and body. It seems all he needs to stay calm is to have me nearby.

 

Now we wait to see if he has any side effects. The most common side effect is low white count. He may also have nausea, vomiting, and/or diarrhea. We have to be very careful about where he pees and keep him away from where other dogs walk. The chemo is excreted in the urine and is quite toxic so Zooie will have his own special pee spots for the 48 hours after chemo.

 

Thank you so much for your best wishes, thoughts and prayers for my boy. Just look at that sweet face. I can't begin to imagine a single day without him.

Sunday, 28 September 2008.

 

40 Years in 40 Days [ view the entire set ]

An examination and remembrance of a life at 40.

 

For the 40 days leading up to my 40th birthday, I intend to use my 365 Days project to document and remember my life and lay bare what defines me. 40 years, 40 qualities, 40 days.

 

Year 39: 2006-2007

 

At the beginning of October, 2006, Kurt and I were beside ourselves with excitement. Kurt's team, the Cardinals, and my team, the Tigers, would meet in the World Series. We joked about how romantic and perfect it was, and we trash-talked each other's teams, gently ribbing and teasing when someone made an error or struck out.

 

I would miss part of that series, however, because I was in the hospital. I'd had an episode of heart palpitations while driving to work. I'd always had occasional palpitations, even as a teenager, but they were always over just as soon as they'd begun. This time, they didn't stop. I felt my field of vision closing in front of me, so I pulled over to the side of the road, sure I was going to pass out. I thought, you've got to be kidding me. This is how I'm going to go? Sitting by the side of the highway during the morning commute to my soulless corporate cubicle? And then it stopped. I sat there for a minute, just breathing and making sure that it really was over, then got back on the road and drove to my office. When I got there, I told my boss what had happened, and that I needed to go to the hospital to get checked out.

 

When I walked into the emergency room and told them that I thought I was having heart trouble, they didn't even bother writing my name down before whisking me back into the treatment area. They hooked me up to every conceivable machine, did a CT scan, and took vials of blood to test. Nothing turned up. They suspected it was a combination of stress, lack of sleep, and having just finished a course of prescription decongestants, but they kept me overnight for observations anyway. They set me up in a room in the cardiac wing with wires hanging from my chest and abdomen. Nurses down the hall monitored my heart rate and blood pressure. The next morning, they did an echocardiogram (heart ultrasound). Still nothing. It was time to face facts, the doctor said. I was too stressed. I needed to chill out. I rolled my eyes. There was no way that was going to happen. In addition to the stressful job, I had also begun taking design and metalworking classes to indulge my interest in jewelry design. My schedule wasn't going to be getting any easier for months. Then, as if to mock his own admonition to relax, he informed me that the CT scan had turned up a mysterious mass on my liver. And thus began my weird health odyssey.

 

The doctors suspected that the mass on my liver was a giant hemangioma (basically a big, blood-filled, internal birthmark), but they needed to do an MRI to be sure. The MRI confirmed the diagnosis. I had a very large blood-filled sac on my liver, and if it broke open, I could die. Unfortunately, the surgery to remove it would be just as likely to kill me, so my best option was to simply make sure I never got hit really hard in the liver. Well, OK.

 

The MRI, in turn, had turned up something looking suspiciously like gall stones. I was immediately scheduled for a consultation with a gastrointestinal surgeon. The surgeon was iffy on whether or not to remove the gall bladder. If I didn't want kids, he said, it was a no brainer: leave it in. If I had any plans to get pregnant in the future, then it was a bit more complicated. If I had a gallstone attack while pregnant, it could be both excruciating and dangerous, but, he noted, also highly unlikely. I was having some symptoms that were somewhat consistent with gall stones, but he felt they were likely something more pedestrian, like IBS. He shoved me along to a gastroenterologist.

 

The gastroenterologist (who for all the world looked exactly like a guy I once had a huge crush on) decided he'd better do a colonoscopy and endoscopy. I reported for "duty" and just as the doctor (who, did I mention, looked exactly like a guy I once had a huge crush on?) sat down to go to work, I gratefully slipped under the anesthesia. When I awoke, I had a vague memory of choking on something, and nothing else. Kurt stayed at my bedside while I slowly came out of the fog, breaking wind like a frat boy at a Mexican rodeo. Now that's love, I thought. The -oscopies didn't turn up anything, either, and so I walked away from my medical odyssey with nothing but a smaller bank account and a paranoid desire that nobody ever punch me in the liver.

 

That was not to be the end of my trials and tribulations, though. In late July, shortly before my brother was to come to Chicago for a visit, my apartment was invaded by bird mites. The closet in my bedroom featured a mysterious portal to the outside. It had been boarded up loosely and, other than some idle speculation as to what its original purpose was, I didn't think much about it. That spring, some pigeons had begun nesting there, and when the babies hatched it set up such a ruckus that I couldn't sleep whenever they were awake. I anxiously awaited the day the babies would leave the nest. Unfortunately, when they did, the mites that had been feeding on them, poured into the house through the portal in search of other food. They found me.

 

The next month was hell. Pest control could do nothing to stop them. Despite them having told me that they wouldn't be interested in biting me because I was not a bird, my body was covered, head to toe, with painful welts. I began to research the problem on the internet, and what I uncovered filled me with horror and hopelessness. Bird mites are notoriously hard to get rid of, seem almost random in their choice of target (often leaving others in the same house untouched), and impervious to most pest control chemicals. Their life cycle can be rapid, reproducing and multiplying after just days, or they can adjust to sub-optimal environments by slowing their life cycle. I felt trapped and doomed, and I needed to get out, so I just walked away. I took myself and the cats and some clothing (dryer heat is one of the few things that kills the mites outright) and left the apartment and almost everything I owned. I got the cats cleaned up at the vet, and then moved in with Don W., an old roommate and friend of mine from college. I got in the shower with my clothes on, stripped down in the hot water, put my clothes in a garbage bag, and enjoyed the feeling of being safe once again. I lived with Don W. for the next three months, until I was able to get a short-term lease on a furnished apartment near work. I was planning to move to Kentucky to be with Kurt in January.

 

Kurt, meanwhile, had plans of his own. My birthday happened to fall on Homecoming weekend that year, and he had something special in mind for a birthday gift. On Friday night (the night before my birthday), as we were getting into our sleeping bags in the tent, Kurt asked me to wait a moment before going to sleep. He had something he wanted to show me. He turned around and fumbled around in his bag in the corner of the tent. When he turned back to me, he was holding out a small white box, opened to reveal a ring. He put it in my hands and said, "I don't want to live another day having to introduce you as just my girlfriend." We cried and laughed and hugged until our eyes grew too droopy to see clearly, then snuggled back down into our sleeping bags and fell asleep.

 

Who am I?

 

I am moderately healthy, actually.

 

By all rights, I should be a complete wreck. The genetic odds are stacked against me: diabetes, heart disease, cancer, mental illness. The lifestyle odds are stacked against me. I'm fat and have spent many years abusing the hell out of body. And yet, I seem to have remained mostly untouched by the worst of what should have come to me by now. I'm probably living on borrowed time, but for now, it seems to be working.

 

I credit the generous application of bacon.

 

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