Saw the doctor yesterday

Yesterday I had a check up at the doctor's office. I have the ultimate in doctors- he LISTENS to me and responds accordingly.
My labs were pretty good, I've lost 12#, and my lungs didn't have any crackles or wheezes (YAY!!!!!!). I got my scripts for various meds I needed.
I've been whining for several months about my right ankle feeling broken. I had an Xray done a couple weeks ago and yesterday I told him about the pain and we read the Xray report together- NO fracture. However, I do have a moderate amount of osteoarthritis in that joint that is giving me fits. I knew something was wrong. So I have a special splint on it's way to wear for a few months till the ankle settles down.
Another of my complaints was this rash I've had for weeks. It's on both my arms, and only on the tops of them. I thought it could be eczema, but he said no, it was a photo reaction to sunlight caused by one of my meds. Oh, yeah.. I'm supposed to stay out of direct sunlight.. but I never had a beautiful deck before and I LOVE sitting out on it. Okay, he says, sunscreen on the arms every time I go outside and suggested a long sleeved shirt to cover them also. Ugh.. 94* and I will be wearing a long sleeved shirt. It could be a lot worse.

I filled 9 gallons of water in jugs this morning and proceeded to water my tiny postage stamp garden. The tomatoes are looking very healthy- all 7 of them. The most of them have blossoms- I got a late start planting. My climbing beans are going up the trellis and onto the deck rails. The flower bed off the deck is coming along fine... I discovered 2 potato plants growing in there too.
It's starting to warm up here- 86* at the airport and it's almost noon.
Gotta pick up scripts today and get Wendell a pair of special sun glasses..

According to the CDC.. statistics for influenza 2008 to May 2009:

During week 19 (May 10 - 16, 2009),
influenza activity decreased in the United States, however there are still higher levels of influenza-like illness than is normal for this time of year.
One thousand seventy-four (15.1%) specimens tested by U.S. World Health Organization (WHO) and National Respiratory and Enteric Virus Surveillance System (NREVSS) collaborating laboratories and reported to CDC/Influenza Division were positive for influenza.
The proportion of deaths attributed to pneumonia and influenza (P&I) was below the epidemic threshold.
Two influenza-associated pediatric deaths were reported.
The proportion of outpatient visits for influenza-like illness (ILI) was below the national baseline. One of the ten surveillance regions reported ILI above their region-specific baseline.
Five states reported geographically widespread influenza activity, 13 states reported regional activity, the District of Columbia and 15 states reported local influenza activity; 16 states reported sporadic influenza activity, and one state reported no influenza activity.

INFORMATION

We hear so much about liberalism being a mental disorder.. so I started checking out some of the obvious ones.. here's what I found.

Freud argued that the human mind and personality are made up of three parts:

The id:
a primitive part of the personality that pursues only pleasure and instant gratification.

The mind of a newborn child is regarded as being completely "id-ridden", in the sense that it is a mass of instinctive drives and impulses, and demands immediate satisfaction. This view equates a newborn child with an id-ridden individual—often humorously—with this analogy: an alimentary tract with no sense of responsibility at either end.

The id is responsible for our basic drives such as food, sex, and aggressive impulses. It is amoral and egocentric, ruled by the pleasure–pain principle; it is without a sense of time, completely illogical, primarily sexual, infantile in its emotional development, and will not take "no" for an answer. It is regarded as the reservoir of the libido or "love energy".

The ego:
that part of the personality that is aware of reality and is in contact with the outside world. It is the part that considers the consequences of an action and deals with the demands of the id and superego.

The ego mediates among the id, the super-ego and the external world. Its task is to find a balance between primitive drives and reality [the Ego devoid of morality at this level] while satisfying the id and super-ego. Its main concern is with the individual's safety and allows some of the id's desires to be expressed, but only when consequences of these actions are marginal. Ego defense mechanisms are often used by the ego when id behavior conflicts with reality and either society's morals, norms, and taboos or the individual's expectations as a result of the internalization of these morals, norms, and their taboos.

The word ego is taken directly from Latin, where it is the nominative of the first person singular personal pronoun and is translated as "I myself" to express emphasis.

In modern-day society, ego has many meanings. It could mean one’s self-esteem; an inflated sense of self-worth; or in philosophical terms, one’s self. However, according to Freud, the ego is the part of the mind which contains the consciousness. Originally, Freud had associated the word ego to meaning a sense of self; however, he later revised it to mean a set of psychic functions such as judgment, tolerance, reality-testing, control, planning, defense, synthesis of information, intellectual functioning, and memory.

It is said to operate on a reality principle, meaning it deals with the id and the super-ego; allowing them to express their desires, drives and morals in realistic and socially appropriate ways. It is said that the ego stands for reason and caution, developing with age. Sigmund Freud had used an analogy which likened the ego to a rider and a horse; the ego being the rider while the id being the horse. The horse provides the energy and the means of obtaining the energy and information need, while the rider ultimately controls the direction it wants to go. However, due to unfavorable conditions, sometimes the horse makes its own decisions over the rocky terrain.

The superego:
contains our social conscience and through the experience of guilt and anxiety when we do something wrong, it guides us towards socially acceptable behaviour.

The super-ego tends to stand in opposition to the desires of the id because of their conflicting objectives, and its aggressiveness towards the ego. The super-ego acts as the conscience, maintaining our sense of morality and proscription from taboos.

The Sociopath

Antisocial behaviour..

Three or more of the following are required:

1. Failure to conform to social norms with respect to lawful behaviors as indicated by repeatedly performing acts that are grounds for arrest.
2. Deceitfulness, as indicated by repeatedly lying, use of aliases, or conning others for personal profit or pleasure
3. Impulsivity or failure to plan ahead
4. Irritability and aggressiveness, as indicated by repeated physical fights or assaults
5. Reckless disregard for safety of self or others
6. Consistent irresponsibility, as indicated by repeated failure to sustain consistent work behavior or honour financial obligations
7. Lack of remorse, as indicated by being indifferent to or rationalizing having hurt, mistreated, or stolen from another.

Common characteristics of people with antisocial personality disorder include

• Persistent lying or stealing
• Recurring difficulties with the law
• Tendency to violate the rights and boundaries of others (property, physical, sexual, emotional, legal)
• Substance abuse
• Aggressive, often violent behavior; prone to getting involved in fights
• A persistent agitated or depressed feeling
• Inability to tolerate boredom
• Disregard for the safety of self or others
• A childhood diagnosis of conduct disorders - this is not a symptom but "a history of"
• Lack of remorse, related to hurting others
• Superficial charm
• Impulsiveness
• A sense of extreme entitlement
• Inability to make or keep friends
• Recklessness, impulsivity

• People with a diagnosis of antisocial personality disorder often experience difficulties with authority figures
• research shows a high proportion of these traits amongst CEOs of major corporations

Dissocial behaviour

Specifically, the dissocial personality disorder is described by the World Health Organization by the following criteria:

1. Callous unconcern for the feelings of others and lack of the capacity for empathy
2. Gross and persistent attitude of irresponsibility and disregard for social norms, rules, and obligations.
3. Incapacity to maintain enduring relationships.
4. Very low tolerance to frustration and a low threshold for discharge of aggression, including violence.
5. Incapacity to experience guilt and to profit from experience, particularly punishment.
6. Marked proneness to blame others or to offer plausible rationalizations for the behavior bringing the subject into conflict.
7. Persistent irritability

Attempts to correlate dissocial personality disorder have had methodological problems.
Although a high percentage of prisoners in England and Wales were shown in one survey to fulfill the criteria for a dissocial personality, since the diagnosis of dissocial personality includes a disregard for social rules and norms, it is not surprising that the same individuals commits crimes.

According to one source on the Sociopath,

Some of the common features of descriptions of the behavior of sociopaths.

• Glibness and Superficial Charm
  
  
• Manipulative and Conning
  They never recognize the rights of others and see their self-serving behaviors as permissible. They appear to be charming, yet are covertly hostile and domineering, seeing their victim as merely an instrument to be used. They may dominate and humiliate their victims.
  
  
• Grandiose Sense of Self
  Feels entitled to certain things as "their right."
  
  
• Pathological Lying
  Has no problem lying coolly and easily and it is almost impossible for them to be truthful on a consistent basis. Can create, and get caught up in, a complex belief about their own powers and abilities. Extremely convincing and even able to pass lie detector tests.
  
  
• Lack of Remorse, Shame or Guilt
  A deep seated rage, which is split off and repressed, is at their core. Does not see others around them as people, but only as targets and opportunities. Instead of friends, they have victims and accomplices who end up as victims. The end always justifies the means and they let nothing stand in their way.
  
  
• Shallow Emotions
  When they show what seems to be warmth, joy, love and compassion it is more feigned than experienced and serves an ulterior motive. Outraged by insignificant matters, yet remaining unmoved and cold by what would upset a normal person. Since they are not genuine, neither are their promises.
  
  
• Incapacity for Love
  
  
• Need for Stimulation
  Living on the edge. Verbal outbursts and physical punishments are normal. Promiscuity and gambling are common.
  
  
• Callousness/Lack of Empathy
  Unable to empathize with the pain of their victims, having only contempt for others' feelings of distress and readily taking advantage of them.
  
  
• Poor Behavioral Controls/Impulsive Nature
  Rage and abuse, alternating with small expressions of love and approval produce an addictive cycle for abuser and abused, as well as creating hopelessness in the victim. Believe they are all-powerful, all-knowing, entitled to every wish, no sense of personal boundaries, no concern for their impact on others.
  
  
• Early Behavior Problems/Juvenile Delinquency
  Usually has a history of behavioral and academic difficulties, yet "gets by" by conning others. Problems in making and keeping friends; aberrant behaviors such as cruelty to people or animals, stealing, etc.
  
  
• Irresponsibility/Unreliability
  Not concerned about wrecking others' lives and dreams. Oblivious or indifferent to the devastation they cause. Does not accept blame themselves, but blames others, even for acts they obviously committed.
  
  
• Promiscuous Sexual Behavior/Infidelity
  Promiscuity, child sexual abuse, rape and sexual acting out of all sorts.
  
  
• Lack of Realistic Life Plan/Parasitic Lifestyle
  Tends to move around a lot or makes all encompassing promises for the future, poor work ethic but exploits others effectively.
  
  
• Criminal or Entrepreneurial Versatility
  Changes their image as needed to avoid prosecution. Changes life story readily.

Other Related Qualities:

1. Contemptuous of those who seek to understand them
2. Does not perceive that anything is wrong with them
3. Authoritarian
4. Secretive
5. Paranoid
6. Only rarely in difficulty with the law, but seeks out situations where their tyrannical behavior will be tolerated, condoned, or admired
7. Conventional appearance
8. Goal of enslavement of their victim(s)
9. Exercises despotic control over every aspect of the victim's life
10. Has an emotional need to justify their crimes and therefore needs their victim's affirmation (respect, gratitude and love)
11. Ultimate goal is the creation of a willing victim
12. Incapable of real human attachment to another
13. Unable to feel remorse or guilt
14. Extreme narcissism and grandiose
15. May state readily that their goal is to rule the world

NOTE: In the 1830's this disorder was called "moral insanity." By 1900 it was changed to "psychopathic personality." More recently it has been termed "antisocial personality disorder" in the DSM-III and DSM-IV. Some critics have complained that, in the attempt to rely only on 'objective' criteria, the DSM has broadened the concept to include too many individuals. The APD category includes people who commit illegal, immoral or self-serving acts for a variety of reasons and are not necessarily psychopaths.

The Psychopath

Psychopaths have only a shallow range of emotions and lack guilt, says Hare. They often see themselves as victims, and lack remorse or the ability to empathize with others. "Psychopaths play on the fact that most of us are trusting and forgiving people," adds Seto. The warning signs are always there; it's just difficult to see them because once we trust someone, the friendship becomes a blinder.

"Psychopaths don't discriminate who it is they lie to or cheat," says Seto. "There's no distinction between friend, family and sucker."

What you can do is look at how often someone lies and how they react when caught. Psychopaths will lie over and over again, and where other people would sincerely apologize, a psychopath may apologize but won't stop.

How do you make sure you don't get fooled when you're hiring someone to baby-sit your child or for any other job? Hire based on reputation and not image, says Willson. Check references thoroughly. Psychopaths tend to give vague and inconsistent replies.

They're our friends, lovers and co-workers. They're outgoing and persuasive, dazzling you with charm and flattery. Often you aren't even aware they've taken you for a ride -- until it's too late.

THE MALIGNANT PERSONALITY:

These people are mentally ill and extremely dangerous! The following precautions will help to protect you from the destructive acts of which they are capable.

First, to recognize them, keep the following guidelines in mind.

(1) They are habitual liars. They seem incapable of either knowing or telling the truth about anything.

(2) They are egotistical to the point of narcissism. They really believe they are set apart from the rest of humanity by some special grace.

(3) They scapegoat; they are incapable of either having the insight or willingness to accept responsibility for anything they do. Whatever the problem, it is always someone else's fault.

(4) They are remorselessly vindictive when thwarted or exposed.

(5) Genuine religious, moral, or other values play no part in their lives. They have no empathy for others and are capable of violence. Under older psychological terminology, they fall into the category of psychopath or sociopath, but unlike the typical psychopath, their behavior is masked by a superficial social facade.

The malignant type is a coward and will not expose himself or herself to personal danger if he or she can avoid it.

PEAK-FLOW

Peak-flow is a method of monitoring an asthma patient. It involves using a small plastic meter. Mine looks like the one on the far left. One of the respiratory therapists gave me this meter last fall, and though I haven't been good about keeping a record of my PF, I could likely have seen this latest asthma exacerbation had I been doing so.

The PF rate is based on a person's age, height, sex, and race. My personal target is 430 lpm. I run substantially lower. Based on the PF readings, one can manage asthma before it becomes a more serious problem , and address that problem quickly. There is a color coded marker on my gauge that tells me at a glance if I'm in the red, green or yellow zone.


The green zone is the 'all clear' area. It indicates reasonably good control of asthma.

The yellow zone signals 'caution'. Airways are narrowing and a bit of extra treatment might be needed. Symptoms can improve or worsen depending on what you do now.


The red zone indicates a medical alert- severe airway narrowing may be occurring. It's time to notify the doctor or seek help.

It's important to know the readings, but even more important to have a plan of what to do when the time comes.

To chart a PF , a special grid is used. I use a very simple one that shows my ups and downs twice a day. I also write in the actual reading from my meter.

The meter itself is simple to use. Take a really deep breath and then give a burst of air emptying the lungs. The procedure is done 3 times, and the best reading is used to mark on the grid. You cant breathe out too much, but you can breathe out too little.

COMMON COLD

From the NIAID:

Sneezing, scratchy throat, runny nose—everyone knows the first signs of a cold, probably the most common illness known. Although the common cold is usually mild, with symptoms lasting 1 to 2 weeks, it is a leading cause of doctor visits and missed days from school and work.

Children have about 6 to 10 colds a year. One important reason why colds are so common in children is because they are often in close contact with each other in daycare centers and schools. In families with children in school, the number of colds per child can be as high as 12 a year. Adults average about two to four colds a year, although the range varies widely.

Seasonal changes in relative humidity may affect the prevalence of colds. The most common cold-causing viruses survive better when humidity is low—the colder months of the year.
Cold weather also may make the inside lining of your nose drier and more vulnerable to viral infection.

More than 200 different viruses are known to cause the symptoms of the common cold.

There is no evidence that you can get a cold from exposure to cold weather or from getting chilled or overheated.

There is also no evidence that your chances of getting a cold are related to factors such as exercise, diet, or enlarged tonsils or adenoids. On the other hand, research suggests that psychological stress and allergic diseases affecting your nose or throat may have an impact on your chances of getting infected by cold viruses.

You can get infected by cold viruses by either of these methods.

• Touching your skin or environmental surfaces, such as telephones and stair rails, that have cold germs on them and then touching your eyes or nose
• Inhaling drops of mucus full of cold germs from the air

Symptoms of the common cold usually begin 2 to 3 days after infection and often include

• Mucus buildup in your nose
• Difficulty breathing through your nose
• Swelling of your sinuses
• Sneezing
• Sore throat
• Cough
• Headache

Fever is usually slight but can climb to 102 degrees Fahrenheit in infants and young children. Cold symptoms can last from 2 to 14 days, but like most people, you’ll probably recover in a week.

If symptoms recur often or last much longer than 2 weeks, you might have an allergy rather than a cold.

Colds occasionally can lead to bacterial infections of your middle ear or sinuses, requiring treatment with antibiotics. High fever, significantly swollen glands, severe sinus pain, and a cough that produces mucus may indicate a complication or more serious illness requiring a visit to your healthcare provider.

There is no cure for the common cold, but you can get relief from your cold symptoms by

• Resting in bed
• Drinking plenty of fluids
• Gargling with warm salt water or using throat sprays or lozenges for a scratchy or sore throat
• Using petroleum jelly for a raw nose
• Taking aspirin or acetaminophen—Tylenol, for example—for headache or fever

Nonprescription cold remedies, including decongestants and cough suppressants, may relieve some of your cold symptoms but will not prevent or even shorten the length of your cold.

Moreover, because most of these medicines have some side effects, such as drowsiness, dizziness, insomnia, or upset stomach, you should take them with care.

Nonprescription antihistamines may give you some relief from symptoms such as runny nose and watery eyes, which are symptoms commonly associated with colds.

Never take antibiotics to treat a cold because antibiotics do not kill viruses. You should use these prescription medicines only if you have a rare bacterial complication, such as sinusitis or ear infection. In addition, you should not use antibiotics “just in case,” because they will not prevent bacterial infections.

Although inhaling steam may temporarily relieve symptoms of congestion, health experts have found that this approach is not an effective treatment.

There are several ways you can keep yourself from getting a cold or passing one on to others.

• Because cold germs on your hands can easily enter through your eyes and nose, keep your hands away from those areas of your body
• If possible, avoid being close to people who have colds
• If you have a cold, avoid being close to people
• If you sneeze or cough, cover your nose or mouth, and sneeze or cough into your elbow rather than your hand.
• Handwashing with soap and water is the simplest and one of the most effective ways to keep from getting colds or giving them to others. During cold season, you should wash your hands often and teach your children to do the same. When water isn’t available, CDC recommends using alcohol-based products made for disinfecting your hands.
• Rhinoviruses can live up to 3 hours on your skin. They also can survive up to 3 hours on objects such as telephones and stair railings. Cleaning environmental surfaces with a virus-killing disinfectant might help prevent spread of infection.
• 
  

from the CDC

Seasonal Influenza

What is influenza (flu)?

Influenza, commonly called "the flu," is caused by the influenza virus, which infects the respiratory tract (nose, throat, lungs). Unlike many other viral respiratory infections, such as the common cold, the flu causes severe illness and life-threatening complications in many people.

What are the symptoms of the flu?

Influenza is a respiratory illness. Symptoms of flu include fever, headache, extreme tiredness, dry cough, sore throat, runny or stuffy nose, and muscle aches. Children can have additional gastrointestinal symptoms, such as nausea, vomiting, and diarrhea, but these symptoms are uncommon in adults. Although the term "stomach flu" is sometimes used to describe vomiting, nausea, or diarrhea, these illnesses are caused by certain other viruses, bacteria, or possibly parasites, and are rarely related to influenza.

When is the flu season in the United States?

In the United States, the peak of flu season can occur anywhere from late December through March. The overall health impact (e.g., infections, hospitalizations, and deaths) of a flu season varies from year to year. CDC monitors circulating flu viruses and their related disease activity and provides influenza reports each week from October through May.

How does the flu spread?

The main way that influenza viruses are spread is from person to person in respiratory droplets of coughs and sneezes. (This is called "droplet spread.") This can happen when droplets from a cough or sneeze of an infected person are propelled (generally up to 3 feet) through the air and deposited on the mouth or nose of people nearby. Though much less frequent, the viruses also can be spread when a person touches respiratory droplets on another person or an object and then touches their own mouth or nose (or someone else’s mouth or nose) before washing their hands.

Does the flu have complications?

Yes. Some of the complications caused by flu include bacterial pneumonia, dehydration, and worsening of chronic medical conditions, such as congestive heart failure, asthma, or diabetes. Children may get sinus problems and ear infections as complications from the flu. Those aged 65 years and older and persons of any age with chronic medical conditions (such as asthma, diabetes, or heart disease) are at highest risk for serious complications of flu.

How do I find out if I have the flu?

It is very difficult to distinguish the flu from other viral or bacterial causes of respiratory illnesses on the basis of symptoms alone. A test can confirm that an illness is influenza if the patient is tested within the first two to three days after symptoms begin. In addition, a doctor's examination may be needed to determine whether a person has another infection that is a complication of influenza.

How soon will I get sick if I am exposed to the flu?

The time from when a person is exposed to flu virus to when symptoms begin is about one to four days, with an average of about two days.

How long is a person with flu virus contagious?

The period when an infected person is contagious depends on the age and health of the person. Studies show that most healthy adults may be able to infect others from 1 day prior to becoming sick and for 5 days after they first develop symptoms. Some young children and people with weakened immune systems may be contagious for longer than a week.

Is the “stomach flu” really the flu?

No. Many people use the term "stomach flu" to describe illnesses with nausea, vomiting or diarrhea. These symptoms can be caused by many different viruses, bacteria or even parasites. While vomiting, diarrhea, and being nauseous or "sick to your stomach" can sometimes be related to the flu – more commonly in children than adults – these problems are rarely the main symptoms of influenza. The flu is a respiratory disease and not a stomach or intestinal disease.

FLU VACCINE

The single best way to protect against the flu is to get vaccinated each year.

There are two types of vaccines:

• The "flu shot"—an inactivated vaccine (containing killed virus) that is given with a needle, usually in the arm. The flu shot is approved for use in people older than 6 months, including healthy people and people with chronic medical conditions.

• The nasal-spray flu vaccine—a vaccine made with live, weakened flu viruses that do not cause the flu (sometimes called LAIV for “Live Attenuated Influenza Vaccine”). LAIV (FluMist®) is approved for use in healthy people 2-49 years of age* who are not pregnant.

Each vaccine contains three influenza viruses-one A (H3N2) virus, one A (H1N1) virus, and one B virus. The viruses in the vaccine change each year based on international surveillance and scientists' estimations about which types and strains of viruses will circulate in a given year.

About 2 weeks after vaccination, antibodies that provide protection against influenza virus infection develop in the body.

When to Get Vaccinated

October or November is the best time to get vaccinated, but you can still get vaccinated in December and later. Flu season can begin as early as October and last as late as May.

Who Should Get Vaccinated

In general, anyone who wants to reduce their chances of getting the flu can get vaccinated. However, it is recommended by ACIP that certain people should get vaccinated each year. They are either people who are at high risk of having serious flu complications or people who live with or care for those at high risk for serious complications. During flu seasons when vaccine supplies are limited or delayed, ACIP makes recommendations regarding priority groups for vaccination.

People who should get vaccinated each year are:

1. People at high risk for complications from the flu, including:
   • Children aged 6 months until their 5th birthday,
   • Pregnant women,
   • People 50 years of age and older, and
   • People of any age with certain chronic medical conditions;
   • People who live in nursing homes and other long term care facilities.
     
     
2. People who live with or care for those at high risk for complications from flu, including:
   • Household contacts of persons at high risk for complications from the flu (see above)
   • Household contacts and out of home caregivers of children less than 6 months of age (these children are too young to be vaccinated)
   • Healthcare workers.

Use of the Nasal Spray Flu Vaccine

It should be noted that vaccination with the nasal-spray flu vaccine is always an option for healthy persons aged 2-49 years who are not pregnant.

Who Should Not Be Vaccinated

There are some people who should not be vaccinated without first consulting a physician. These include

• People who have a severe allergy to chicken eggs.
• People who have had a severe reaction to an influenza vaccination in the past.
• People who developed Guillain-Barré syndrome (GBS) within 6 weeks of getting an influenza vaccine previously.
• Influenza vaccine is not approved for use in children less than 6 months of age.
• People who have a moderate or severe illness with a fever should wait to get vaccinated until their symptoms lessen.

Vaccine Effectiveness

The ability of flu vaccine to protect a person depends on the age and health status of the person getting the vaccine, and the similarity or "match" between the virus strains in the vaccine and those in circulation. Testing has shown that both the flu shot and the nasal-spray vaccine are effective at preventing the flu.

Vaccine Side Effects (What to Expect)

Different side effects can be associated with the flu shot and LAIV.

The flu shot: The viruses in the flu shot are killed (inactivated), so you cannot get the flu from a flu shot. Some minor side effects that could occur are

• Soreness, redness, or swelling where the shot was given
• Fever (low grade)
• Aches

If these problems occur, they begin soon after the shot and usually last 1 to 2 days. Almost all people who receive influenza vaccine have no serious problems from it. However, on rare occasions, flu vaccination can cause serious problems, such as severe allergic reactions. As of July 1, 2005, people who think that they have been injured by the flu shot can file a claim for compensation from the National Vaccine Injury Compensation Program (VICP).

LAIV (FluMist®): The viruses in the nasal-spray vaccine are weakened and do not cause severe symptoms often associated with influenza illness. (In clinical studies, transmission of vaccine viruses to close contacts has occurred only rarely.)

In children, side effects from LAIV (FluMist®) can include

• runny nose
• wheezing
• headache
• vomiting
• muscle aches
• fever

In adults, side effects from LAIV (FluMist®) can include

• runny nose
• headache
• sore throat
• cough

*On September 19, 2007 the U.S. Food and Drug Administration approved use of the nasal influenza vaccine LAIV (FluMist®) for healthy children ages 2-4 years old (24-59 months old) without a history of recurrent wheezing, as well as for healthy persons ages 5-49 years who are not pregnant. Previously, approval was for healthy persons ages 5-49 years who are not pregnant.

MRSA

As you know, I work in a hospital and we are progressive in working around MRSA.. more so than many hospitals. Butler Hospital got some bad press earlier this year because of our % of MRSA patients. There was good reason for this.. we screen every patient on admission and discharge~ so we know who has it and who needs isolation.
Most hospitals don't screen patients unless they have a suspicious infection. We have a large percentage of nursing home patients and nursing homes (community living) is where you will find rampant MRSA.
Having MRSA is not the end of the world. There are worse things you may have to deal with.
I looked up some articles in the Mayo Clinic (my old tried and true favorite) and this is long, but worth the read if you are concerned that the next time you go to the grocery store you might get more than the best meat bargain.
By the way MRSA is pronounced "Mersa".


Methicillin-resistant Staphylococcus aureus (MRSA) infection is caused by Staphylococcus aureus bacteria — often called "staph." Decades ago, a strain of staph emerged in hospitals that was resistant to the broad-spectrum antibiotics commonly used to treat it.
Dubbed methicillin-resistant Staphylococcus aureus (MRSA), it was one of the first germs to outwit all but the most powerful drugs. MRSA infection can be fatal.

Staph bacteria are normally found on the skin or in the nose of about one-third of the population. If you have staph on your skin or in your nose but aren't sick, you are said to be "colonized" but not infected with MRSA. Healthy people can be colonized with MRSA and have no ill effects, however, they can pass the germ to others.

Staph bacteria are generally harmless unless they enter the body through a cut or other wound, and even then they often cause only minor skin problems in healthy people. But in older adults and people who are ill or have weakened immune systems, ordinary staph infections can cause serious illness called methicillin-resistant Staphylococcus aureus or MRSA.

In the 1990s, a type of MRSA began showing up in the wider community. Today, that form of staph, known as community-associated MRSA, or CA-MRSA, is responsible for many serious skin and soft tissue infections and for a serious form of pneumonia.

Vancomycin is one of the few antibiotics still effective against hospital strains of MRSA infection, although the drug is no longer effective in every case. Several drugs continue to work against CA-MRSA, but CA-MRSA is a rapidly evolving bacterium, and it may be a matter of time before it, too, becomes resistant to most antibiotics.

Signs and symptoms
Staph infections, including MRSA, generally start as small red bumps that resemble pimples, boils or spider bites. These can quickly turn into deep, painful abscesses that require surgical draining. Sometimes the bacteria remain confined to the skin. But they can also burrow deep into the body, causing potentially life-threatening infections in bones, joints, surgical wounds, the bloodstream, heart valves and lungs.

Risk factors
Because hospital and community strains of MRSA generally occur in different settings, the risk factors for the two strains differ.

Risk factors for hospital-acquired (HA) MRSA include:
A current or recent hospitalization. MRSA remains a concern in hospitals, where it can attack those most vulnerable — older adults and people with weakened immune systems, burns, surgical wounds or serious underlying health problems. A 2007 report from the Association for Professionals in Infection Control and Epidemiology estimates that 1.2 million hospital patients are infected with MRSA each year in the United States. They also estimate another 423,000 are colonized with it.

Residing in a long-term care facility.
MRSA is far more prevalent in these facilities than it is in hospitals. Carriers of MRSA have the ability to spread it, even if they're not sick themselves.

Invasive devices.
People who are on dialysis, are catheterized, or have feeding tubes or other invasive devices are at higher risk.

Recent antibiotic use.
Treatment with fluoroquinolones (ciprofloxacin, ofloxacin or levofloxacin) or cephalosporin antibiotics can increase the risk of HA-MRSA.

These are the main risk factors for community-acquired (CA) MRSA:

Young age.
CA-MRSA can be particularly dangerous in children. Often entering the body through a cut or scrape, MRSA can quickly cause a wide spread infection. Children may be susceptible because their immune systems aren't fully developed or they don't yet have antibodies to common germs. Children and young adults are also much more likely to develop dangerous forms of pneumonia than older people are.

Participating in contact sports.
CA-MRSA has crept into both amateur and professional sports teams. The bacteria spread easily through cuts and abrasions and skin-to-skin contact.

Sharing towels or athletic equipment.
Although few outbreaks have been reported in public gyms, CA-MRSA has spread among athletes sharing razors, towels, uniforms or equipment.

Having a weakened immune system.
People with weakened immune systems, including those living with HIV/AIDS, are more likely to have severe CA-MRSA infections.

Living in crowded or unsanitary conditions.
Outbreaks of CA-MRSA have occurred in military training camps and in American and European prisons.

Association with health care workers.
People who are in close contact with health care workers are at increased risk of serious staph infections.


Screening and diagnosis

Doctors diagnose MRSA by checking a tissue sample or nasal secretions for signs of drug-resistant bacteria. The sample is sent to a lab where it's placed in a dish of nutrients that encourage bacterial growth (culture). But because it takes about 48 hours for the bacteria to grow, newer tests that can detect staph DNA in a matter of hours are now becoming more widely available.
In the hospital, you may be tested for MRSA if you show signs of infection or if you are transferred into a hospital from another healthcare setting where MRSA is known to be present. You may also be tested if you have had a previous history of MRSA.

Treatment

Both hospital and community associated strains of MRSA still respond to certain medications. In hospitals and care facilities, doctors generally rely on the antibiotic vancomycin to treat resistant germs. CA-MRSA may be treated with vancomycin or other antibiotics that have proved effective against particular strains. Although vancomycin saves lives, it may grow resistant as well; some hospitals are already seeing outbreaks of vancomycin-resistant MRSA. To help reduce that threat, doctors may drain an abscess caused by MRSA rather than treat the infection with drugs.


Prevention

Hospitals are fighting back against MRSA infection by using surveillance systems that track bacterial outbreaks and by investing in products such as antibiotic-coated catheters and gloves that release disinfectants.
Still, the best way to prevent the spread of germs is for health care workers to wash their hands frequently, to properly disinfect hospital surfaces and to take other precautions such as wearing a mask when working with people with weakened immune systems.
In the hospital, people who are infected or colonized with MRSA are placed in isolation to prevent the spread of MRSA to other patients and healthcare workers.Visitors and healthcare workers caring for isolated patients may be required to wear protective garments and must follow strict handwashing procedures.

What you can do

Here's what you can do to protect yourself, family members or friends from hospital-acquired infections.
Ask all hospital staff to wash their hands before touching you — every time.
Wash your own hands frequently.
Ask to be bathed with disposable cloths treated with a disinfectant rather than with soap and water.
Make sure that intravenous tubes and catheters are inserted and removed under sterile conditions; some hospitals have dramatically reduced MRSA blood infections simply by sterilizing patients' skin before using catheters.
Preventing CA-MRSAProtecting yourself from CA-MRSA — which might be just about anywhere — may seem daunting, but these common-sense precautions can help reduce your risk:
Keep personal items personal. Avoid sharing personal items such as towels, sheets, razors, clothing and athletic equipment. MRSA spreads on contaminated objects as well as through direct contact.
Keep wounds covered. Keep cuts and abrasions clean and covered with sterile, dry bandages until they heal. The pus from infected sores often contains MRSA, and keeping wounds covered will help keep the bacteria from spreading.
Sanitize linens. If you have a cut or sore, wash towels and bed linens in hot water with added bleach and dry them in a hot dryer. Wash gym and athletic clothes after each wearing.
Wash your hands. In or out of the hospital, careful hand washing remains your best defense against germs. Scrub hands briskly for at least 15 seconds, then dry them with a disposable towel and use another towel to turn off the faucet. Carry a small bottle of hand sanitizer containing at least 62 percent alcohol for times when you don't have access to soap and water.
Get tested. If you have a skin infection that requires treatment, ask your doctor if you should be tested for MRSA. Many doctors prescribe drugs that aren't effective against antibiotic-resistant staph, which delays treatment and creates more resistant germs.

What's an Ejection Fraction anyway?

Wendell saw the GI specialist today.. all is good. No problems. The GI upset over the weekend was likely just the milk he drank that he said was lumpy, but didn't smell bad..so.. he drank it.

No comment here. Better to be mute on that issue.

I also saw my doctor today for a check up on the asthma.. he says I still have some wheezes, but not like before- I'm progressing in a right direction. I'll be on the inhalers till the snow flies, then wean off for the winter and start up again next March likely. HOORAY!

We discussed the results of my echocardiogram also that I had done this month. It was super.

No problems.. my ejection fraction is 70%... fabulous for my age. Most 40 yr olds can't have that good a reading. HAH! Well, I do have a minute amount of aortic stenosing but that is to be expected for me, and it's minimal and won't need watched for a few more years. He mentioned that I still have my murmur, but it's stable. The murmur was the reason I had the echo done in the first place. My dentist suggested that I check with my PCP to see if he still wanted antibiotics prior to any treatments, that the latest information is that SBE prophylaxis is not necessary. Well, let's see.. I take 2Grams of Amoxicillin once every 6 months to get my teeth cleaned.. versus the possibility of endocarditis which either will kill me or leave my heart majorly weak after months of the 'big gun' antibiotics.. I'll opt for the Amoxicillin. That's what the doctor said too.

Huh?? What's an ejection fraction?

Well, it's really quite simple..You have 2 systems in your heart. The top of the heart has 2 chambers called atrium that receive blood and the 2 lower chambers called ventricles pump blood out of the heart.

The left ventricle pushes oxygenated blood into arteries and from there it goes to your body.

Blood is received into the right atrium and pushes it into the right ventricle that pumps blood to the lungs where it picks up oxygen. It comes back to the left atrium and is then deposited in the left ventricle and the process continues over again. Valves in the heart prevent blood from backing up.. (regurgitation). When the left ventricle forces the blood out into the body, it is called ejection. It's a big pump, but not all the blood gets pumped out. There is always a little bit left behind for the next heart beat. The amount that is pumped out is called the ejection fraction and is expressed in a percentage.

Now don't you feel smart? Class dismissed.

SEPTIC SHOCK

Septic shock is a condition caused by an infection in the bloodstream (sepsis) in which blood pressure falls dangerously low and many organs malfunction because of inadequate blood flow.
There are several causes of shock, one of which is sepsis.
Septic shock occurs most often in newborns, people older than age 50, and people with a weakened immune system. People whose white blood cell counts are low (such as those who have AIDS or cancer or are receiving chemotherapy) and people who have a chronic disease (for example, diabetes or cirrhosis) are at greater risk of developing septic shock.
Septic shock is caused by cytokines (substances made by the immune system to fight an infection ) and by the toxins produced by some bacteria. These substances cause the blood vessels to widen (dilate), which results in a drop in blood pressure. Consequently, blood flow to vital organs—particularly the kidneys and brain—is reduced. This reduction in blood flow occurs despite the body's attempts to compensate by increasing both the heart rate and the volume of blood pumped. Eventually, the toxins and the increased work of pumping weaken the heart, resulting in a decreased output of blood and even poorer blood flow to vital organs. The walls of the blood vessels may leak, allowing fluid to escape from the bloodstream into tissues and causing swelling. Leakage and swelling can develop in the lungs, causing difficulty breathing (respiratory distress).
Symptoms and Diagnosis
Often, the first indications of septic shock are confusion and reduced mental alertness; these symptoms may be evident 24 or more hours before blood pressure drops. Other early symptoms may include a shaking chill; a rapid rise in temperature; warm, flushed skin; a rapid, pounding pulse; excessively rapid breathing; and blood pressure that rises and falls. Urinary output decreases. Tissues with poor blood flow release excess lactic acid into the bloodstream, causing the blood to become more acidic, which results in malfunction of many different organs. In later stages, the body temperature often falls below normal.
As septic shock worsens, several organs may fail. For example, the kidneys may fail, resulting in very low or no urine output and the accumulation of metabolic waste products (such as urea nitrogen) in the blood. The lungs may fail, resulting in breathing difficulties and a reduction in the level of oxygen in the blood. The heart may fail, resulting in fluid retention and swelling of tissues. Additionally, blood clots may form inside blood vessels.
To confirm the diagnosis of septic shock, a doctor may take and analyze blood samples. High or low levels of white blood cells, a decrease in the level of oxygen, a reduction in the number of platelets, excess lactic acid, and increased levels of metabolic waste products are all signs that a person may be in septic shock. A doctor may also use a fingertip sensor to monitor the level of oxygen in the blood. An electrocardiogram (ECG) may show irregularities in heart rhythm, indicating inadequate blood supply to the heart. Blood cultures are performed to identify the infecting organisms. Because there are other causes of shock besides sepsis, additional tests may be needed.
Treatment and Prognosis
As soon as symptoms of septic shock are apparent, the person must be admitted to an intensive care unit for treatment. Large amounts of fluid are given intravenously to increase the blood pressure. Drugs are given to increase blood flow to the brain, heart, and other organs. Extra oxygen is given. If the lungs fail, the person may need a mechanical ventilator to help breathing.
High doses of intravenous antibiotics are given as soon as blood samples have been taken for laboratory cultures. Until the laboratory identifies the infecting bacteria, two or more antibiotics are usually given together to increase the chances of killing the bacteria.
Any abscesses are drained, and any catheters that may have started the infection are removed. Surgery may be performed to remove any dead tissue, such as gangrenous tissue of the intestine. Despite all efforts, more than 25% of people with septic shock die.
(Merck Manual)

WENDELL ARTHROSCOPY

Wendell is doing well post surgery..home and not even using the crutches.. He has a cane that he's using for balance, but the pain is so much less. He had a bad tear that the doctor repaired.
Thanks, JJ, for providing his transportation and moral support too..

CLOUDY AND 44 DEGREES

It's nearly 3am.. I'm awake.. I fell asleep a while ago, but awoke with my fingers aching and refusing to bend without some degree of pain. It's the weather again.. seems to play a huge part in the aches and pains I experience.
I wont' be writing long.. it is mildly uncomfortable now to try to type on a keyboard.
Wendell had a better day yesterday. His GI problem seems to be alleviating now. Thanks for all your prayers on his behalf.
My grandmother had a treatment for diarrhea- barley or barley water. She boiled the barley and then drank the water.. it works. So for 2 days I've made chicken barley soup .. or maybe I should say Barley chicken soup? It had a LOT of barley in it. We like that grain so it was a pleasure to add twice as much to our soup. I'll be getting more in the near future. Wendell said he actually is feeling some better. That's a good sign.
Today, Monday, will be a busy one after the good rest we got yesterday. I'm gainfully employed, but have some responsibilities to deal with before I leave for work. One of these is making sure our new medical insurance cards get to the orthopedic surgeon. They arrived Saturday, and though it's just a name change and not a benefit change, it still has to be reported to our doctors. So, yesterday I sat down and figured out how to send a fax. Now I know that seems silly to you if you have a lot of computer knowledge, but for me it was a major accomplishment. The fax is in the computer and also on my printer. I had to bring up a program and fill out the information it required, and then I called one of the girls at work and sent a fax to them with the request that they return it so I would know it got through. I did it! Fabulous. Now I can just fax the card to the doctor.
I have been wanting to know how to fax with my equipment here because of the office also. I make 2-3 trips into town /week that would be unnecessary if I could make the fax work.. so tomorrow we shall see if it is feasable to do so. I'm all for time savers !
JJ sent me an email .. she says Palm Springs is unseasonalbly chilly, but sunny. Glad to hear it. She will attend her seminar today and then do some sight seeing while they are there .. they arrive home late Wednesday night. Pray for a safe journey if you would.
I'm headed back to bed.. I hope I can go back to sleep.Morning comes swiftly, and I want to have enough rest to make it to midnight.
Be careful if you are driving tonite.. dense fog warning out there..

Take 2 Tylenols & call me in the morning

As a nurse, I like to educate. Influenza is in mid season.. Here's some information for you all..

Influenza, or flu, is a highly contagious acute infection of the respiratory tract, and is very common during the winter.
It usually appears as an epidemic and naturally school children are hit in the highest numbers. At risk are the very young, the elderly, those who are immunosuppressed and those who have chronic diseases.

Influenza is caused by a virus which mutates with lightning speed, or so it would seem. It is spread by droplet by inhalation, or by indirect contact.. eating or drinking from an infected person's glass.

Weakness, fatigue, muscle aches, headache, fever of 101-102, sneezing or runny nose are the symptoms. Most people recover from the flu, but those who are at risk tend to develop complications- like pneumonia.

What do you do if you develop influenza?

• bedrest- you won't want to be up and running anyway- your body heals as you sleep, so you might as well
• Drink extra fluids -the CDC suggests 1 full glass of water or juice every hour
• Tylenol (acetaminophen) for the aching and pain. No aspirin for children

At what point should you call the doctor?

• after 3 days of fever of 102
• if you develop heavy mucus and have difficulty breathing
• relapse after good improvement

How can it be prevented?

• Wash your hands frequently and teach children to follow your example
• Cover your mouth when coughing or sneezing- use tissues- and dispose of them properly
• Flu shot- you have to be immunized a week to 4 months before exposure for the shots to be effective. They are inactivated viruses (dead) from several strains of the most prevalent mutated viruses. The shots are about 67-92% effective. These vaccines are developed from eggs, so if you are allergic to eggs, you should talk to your doctor before receiving the immunization. In rare cases, neurologic disorders can develop from the vaccine.
  
• Flu-Mist is another vaccine given during flu season. It is a live virus sprayed into the nose. Not recommended for those in the risk groups or pregnant women.
• If you know your resistance is down, stay away from shopping malls,theaters or crowded places during the epidemic. Keep your distance from people who are sneezing and coughing.
• There are anti-flu medications you can take if you can be diagnosed within the first 24-48 hours. Amantadine and Rimantadine are two of these. Relenza is an inhaled powder and Tamiflu, an oral med, are used to lessen the symptoms of influenza. Don't use the Relenza if you have lung problems.

As the Boy Scout motto says "Be Prepared" if there is an epidemic in your area.

• Keep a week's supply of canned meats, veggies, and fruits on hand
  
• Dry cereals or granola
• Peanut butter or nuts
• Crackers
• Fruit juices
• Bottled water
• Canned soups
• Extra prescription supplies- don't drop below a week's supply
• Soap and alcohol based hand wash
• Meds for fever- Tylenol or ibuprofen
• Thermometer
• Anti-diarrheal meds
• Fluids with electrolytes
• Tissues, toilet paper, disposable diapers
• Garbage/waste bags

Stay healthy !!!

MTHFR

No, it's not an error, it is the DNA testing I had done this past February and thought I'd post the report on this blog. It's important to my family to have this information, and I was encouraged to 'spread the word' in case YOU might be afflicted.

MTHFR, DNA analysis
Result: A1298C/A1298C
Two copies of the same mutation identified.
Interpretation: (Methyltetrahydrofolate Reductase)
This patient's sample was analyzed for the MTHFR mutations C677T and A1298C. Two copies of the A1298C mutation were identified. Results for the C677T mutation were negative. Elevated homocysteine levels have not been reported when two copies of the A1298C mutation have been found. The diagnosis of hyperhomocysteinemia can not rely on DNA testing alone but should take into consideration clinical findings and other studies, such as homocysteine levels. Because MTHFR mutations and their associated risks are inherited, genetic counseling and testing of at-risk family members should be considered.
The MTHFR enzyme is responsible for creating the circulating form of folate. Folate is important in homocysteine regulation. Defects in the MTHFR enzyme can indirectly cause elevated homocysteine levels. The C677T mutation in the MTHFR gene can cause elevated homocysteine levels in individuals with insufficient folate, particularly when there are two mutations present. The A1298C mutation has not been associated with elevated homocysteine levels unless a C677T mutation is also present. Elevated serum homocysteine levels have been associated with an increased risk of cerebrovascular disease, coronary artery disease, myocardial infarction and venous thrombosis. In women, pregnancy complications and an increased risk of fetal open neural tube defects have also been reported. The relationship between these conditions and MTHFR mutations is controversial.
Additional information:
Dietary folic acid, B6 and B12 supplementation has been suggested to lower homocysteine levels in some people. Folic acid supplementation has been shown to reduce the recurrence of neural tube defects.

IT'S BEEN A GOOD DAY

"Therefore, having been justified by faith, we have peace with God through our Lord Jesus Christ, through whom also we have access by faith into this grace in which we stand, and rejoice in hope of the glory of God. And not only that, but we also glory in tribulations, knowing that tribulation produces perseverance; and perseverance, character; and character, hope. Now hope does not disappoint, because the love of God has been poured out in our hearts by the Holy Spirit who was given to us. " Romans 5:1-5

What a delightful day I had at work. I'm covering for Nell in the office while she has to be away. I love the girls I work with and Dr Mitra is probably the best employer anyone could ever have. I'm glad I have these few extra days to help out.
After 2 days of not even seeing Wendell, I got home tonite and he was resting in the recliner. He's in good spirits and says he's had a couple of good days too. He doesn't look haggard or stressed out- but more relaxed than anything. The guys at the park are truly looking out for him- urging him to rest and helping him do the things that are required.
Everyone understands the limitations and they seem happy to have him back.
I brought home grilled chicken salad for supper. It was supplied to me by a drug rep at the office today, but I'd eaten before I left, so I saved it for supper tonite. It was sooooo good!
Way too much for one person- Wendell and I split it and were quite satisfied.
He still doesn't have a schedule, but was told he'd be off this weekend. I will be working every day- Wednesday again for Nell, then Thursday for Remicade, and Fri, Sat, and Sunday at the hospital. I'll be ready for a day off on Monday. I've offered to fill in then too, but I think Nell will perhaps return by then.
Lots to do here..... I best get busy. Keep praying for us.. we appreciate it!

10:50 pm

What a lovely day it has been today. No glitches to keep us from worship, and though it was a tad chilly, the sun shown brightly. We were able to attend church this morning finally. It felt like being back home again.

I took a short walk today up to the garden to check the asparagus- the frost last night got them pretty good. All the stalks were a funny color and when I tried to snap them, they went to mush in my hand. There was a lot there to lose, but more will come in its place in a few days.

JJ and Keith dropped by for a visit, and to drop off our laundry. It's hard to know how to say thank you when someone looks out for you in this way.. but ..... thanks... you are so appreciated... and I'm glad we have time to chat.
Keep up the great work, Keith.. we are proud of you! You'll be a manager one day of your own shop- I feel sure of it.

I stopped over to see Becky the office manager and also a cousin today too. We had such a lovely visit. Lots to talk about.

Besides the normal chores that have to be done, I took the big trash can to the road for the first time tonite. It's heavy !! But it's done. I got Wendell's work clothes out for him and got little jars of fruit and sugar free pudding ready for his lunch tomorrow. It'll be his first day back.
I pray he'll do all right.

I am also scheduled to work tomorrow, but the odd shift 11am-7:30pm. It takes such a chunk out of the day. I asked to be downsized for that day or half a shift. They may not need me, and I'd be 'on call' for them, making time for me to get more done here. Spring cleaning has just begun, and already I'm looking for time to do it. With Nell going to Mississippi for the funeral, I am hoping to fill in for her on Tuesday and/or Wednesday this week + my Remicade day in the office. It'll be a crazy busy week.

Wendell is already in bed and probably sleeping.. I should do the same. So I 'll say goodnight to all my blogger buddies.. sleep tight and don't let the bedbugs bite!
Keep us in prayer please.......

NEW BEGINNINGS

In the beginning was the Word, and the Word was with God, and the Word was God. He was in the beginning with God. All things were made through Him, and without Him nothing was made that was made. In Him was life, and the life was the light of men.
John 1:1-4

I'm up early- it's a new day- you might say the first day of the rest of my life. These verses from John keep running through my head this morning.
We have a lot of 'beginnings' in our lives. Learning to walk, speak, drive, etc.. then new births, marriages, friends, and jobs.. All of these have one thing in common- in the beginning, they were the start of something new and special. God certainly is weaving a beautiful tapestry with our lives. He has given us so many new beginnings, and all things come from his wonderful hands.
Today I'll be at the hospital again- gainfully employed. It's my regular weekend off, but one of my co-workers was so kind to change days with me so I could be off yesterday to be with Mandy and John on their special new beginning. So I am fulfilling my obligation to my co-worker, and then be off again on the Sabbath.
We plan to be in church then, so ask that you all would uphold us in prayer again - that we would both be healthy and able to make the trip down to New Kensington. God has already provided new tires for my car, and a full tank of gas.
All is cleared on all sides for Wendell to return to work on Monday- 6 weeks post operatively.
He will be on light duty for 4 more weeks, and his boss says he'll have him do some painting for a while. He still has to be very careful- his sternum is just beginning to heal, and could snap easily if he isn't. He's moving around pretty well, and able to do some little things- like mowing grass on the lawn tractor.
I guess you could say it's a new beginning for him- new coronary vessels, and returning to work anew for this season.
New beginnings tend to make my heart joyful.. that's the way it should be.
Have a glorious new day, everyone... be thankful and pray without ceasing!

WEARY......

"Have you not known? Have you not heard? The everlasting God, the Lord, The Creator of the ends of the earth, Neither faints nor is weary. His understanding is unsearchable." Isaiah 40:28

I'm starting to feel weary. I'm so thankful that God doesn't and is able to keep me going. After 2 evenings at the hospital, and a 3rd one today, I do feel the effects. It doesn't seem to matter whether I'm overworked or have had 2 easy nights there (which I have). I've been the lone secretary on my unit that is usually tended by 2 secretaries. It hasn't been bad. Quite the opposite. But my body gets so tired from the regimented up at 8am and to bed at 1am the next day, with all the activity in between.
Wendell has gone to see the cardiologist- his first trip out by himself. It was sort of a force play in that if I got up at 6:30am to go with him, I'd not have had enough sleep to make it to midnight tonite. Hopefully all will be well physically with him. I see no reason for any other choice. He's done very well, and though he doesn't care to do his walking, he needs to do this to return to his job in another 8 weeks hopefully.
I have been in contact with a cousin from my mother's side of the family. He sent me some old pictures with identifications. This is such a delight to me. I haven't done much with the family history for quite a while. I'd been compiling photos to put on another blogsite,listed to the right of this posting- IMM BEST CONNECTION - when his e-mail arrived. I have been seriously considering posting my mother's journals online in yet another blog. It would be time consuming, but like the photos, I'd be doing only a little at a time.
I need to get moving on my day. It will be another long one. Enjoy the sunshine and keep praying !!!!

WHAT?! NO INSULIN???

It's another frustrating day where simple things become mountains.
Wendell used his last insulin this morning. I dutifully went to the pharmacy where we get all our medications, and found that they were out of his insulin- but they were expecting at least some by Monday.. What to do? Immediately , the gut starts to twist again, and the nausea appears. For the rest of the world who are not diabetic, it presents no problem, but for a diabetic who is getting regulated again post operatively, it's life threatening. I could only pray and trust that they could rectify the situation. It occurs to me that I am relying on God more and more all the time.. that's what He wants me to do, and if it takes one crisis after another, then so be it.
Of course it's Saturday and no doctors are in today, though there would be someone on call to talk to, but not his doctor- Not someone who KNOWS how he has been going up and down with his blood sugars over the past 4 weeks, and that he's just been in the normal range all day for 2 days now. It's really quite stressful.
The pharmacist finally called another local pharmacy at a grocery store, and was able to get one box of the filled pens with Wendell's type insulin. I was so relieved and went directly there for the medicine. They actually had 2 boxes left in their stock, but since I was not one of their 'regular' customers, they would only give me the one box. That's okay.. at least he'll have his insulin tonite for dinner, and we'll go for the 2nd box next week and thank the Lord for providing again. He goes through about 5 pens a week (one box).
That seems pretty odd to me that a drug company would run out of their supply of insulin. I mean, when you think of the millions of diabetics in the world, and the need for the drug to sustain life, you'd think that there would be a never ending supply... but there isn't.
Here is a site that is about diabetes. Wendell is a Type 2.

SHOWERS OF BLESSINGS....

"then I will give you rain in its season, the land shall yield its produce, and the trees of the field shall yield their fruit"
Leviticus 26:4

It's 3am. Why I awaken at this hour so many nights, I wonder. There is gentle rain falling in these wee hours of the morning- something that normally would put me to sleep soundly.
And yet, here I am.
We needed the rain that came yesterday afternoon and evening, and there is more to come today says the weatherman. Work day at the church had to be cancelled.
Yesterday afternoon Wendell was wrapped up in a fleece blanket with a heavy comforter and a flannel shirt. He was cold. It was nearly 80 degrees. I wouldn't have thought much of it, but he said he was chilling. I looked for a thermometer, but couldn't find one and had to leave for work- I was already pushing the clock pretty closely. I'd noticed he was pale at breakfast, but then he does look pale by times. I was feeling pretty shaken by this event, so I decided to buy a thermometer on my way to work and ask JJ to stop by the house on her way home and check him out. As a second thought, I decided to call her at work on my way and make sure she didn't leave before I got there, but the cell phone was disconnected- the bill came this Tuesday and I hadn't paid it yet, but there it was- no service. It would have been a minor annoyance normally, but with Wendell convalescing, he could still develop infection and need more hospitalization if that were the case- he could go down pretty rapidly. So my nerves were becoming a bit tattered in light of this fact and that if I had to wait to get to the hospital to see JJ, I might just miss her. Prayer is always the answer. And the various verses I have hid in my heart started coming to mind .. "I will not leave you nor forsake you", "Fear not", "Cast your cares on the Lord and He will sustain you".. and they go on. I don't remember much of the drive into the hospital- my stomach was in knots wondering "What next?".. but still hanging on to the promises. I told JJ what I needed and she quickly and cheerfully agreed to check her dad on her way home.. and then I asked her to call me to set my mind at ease- but to use the department phone as mine was not in service because of the bill. She assured me she'd call, and I gave her the new thermometer and headed up to my department.
I was chosen to mentor a new secretary. She's a delight and will be a good one for my unit. This was to be her last night of orientation, so I was able to sit back and just be there in case she had any questions and make sure she did the job correctly. God is merciful in that I wasn't sure I'd be able to think straight until I heard all was well at home- he provided another secretary to do the work while I sat, observed and made suggestions on how to do things in a more orderly manner. She asked me how my past week had gone since I'd been her mentor last Monday. I told her about the fire and how I thought I'd done well with all the joking that went on after. Then I told her about Wendell and how he'd been chilling, and she told me her father in law had open heart surgery 6 weeks ago, and has had the same thing! Well, now, maybe it isn't infection then.. maybe a quirk of post op recovery for open heart. She offered so much reassurance. By supper, we were laughing and giggling at silly mistakes we make when we transcribe and when we answer the phone. ("5Main- Unit specimen".. I'll never live that one down! ) JJ called shortly after supper to say all was well on the homefront, his temperature was 97 something, and that my cell phone works fine. I was happy and relieved to hear he was okay, but then , confused about the cell phone..... she said the bill was paid and service was restored. Well, what does one say but Thank You ... and then the tears start to well up..
I don't think I know anyone who has a family that is so supportive and comes together so much and so often when another member is having a hard time. It is only the hand of God who is making provision for us.
I have really experienced 'showers of blessings' yesterday. Prayer answered, Wendell is okay, the cell phone is in service, and He sent me Kelly for reassurance, and we are getting the rain we have needed. Who could ask for anything more?
Sometimes I just am so awestruck at the things that happen around me.... how God takes what I see as catastrophe and turns them into good. I can only see such a wee tiny piece of the tapestry He weaves. Sometimes I just don't understand why things happen, but I know that things are always under His control, and though I can't see it, there is purpose to it all- and He just keeps weaving.. adding new threads and removing others and making things perfect.