What Is The Hushed Truth About Lyme Disease? A Recovery Story, Part 4.

One unit of alcohol is equivalent to half of a pint of beer or one
measure of spirits or 10 g of alcohol.What is Alcoholic Fatty Liver Disease?Alcoholic fatty liver disease or ALD is a condition in which there is a build-up of fat that occurs within
the liver cells of people who regularly drink alcohol heavily. When can we say that too much alcohol is consumed to cause development of alcoholic fatty liver? The threshold for men is more than 50 units of alcohol per week or about 25 pints of beer. The threshold for women is any amount beyond 35 units of alcohol per week or about 17 pints of beer. This threshold applies for any type of alcoholic beverage consumed.When a person drinks alcohol, it goes to the stomach and intestines and is absorbed into the bloodstream. Then, it passes through the liver before circulating around the whole body. In the liver, diseases of the nervous system; metabolize alcohol into other chemical substances. The disease with drinking too much alcohol is that the liver cells cannot cope with the volume of alcohol that should be metabolized, so the
level of alcohol in your bloodstream rises.As in Non Alcoholic Fatty Liver Disease, alcoholic fatty liver disease can occur in three forms:
Alcoholic Fatty liver. This is the simplest form and is not usually serious nor causes any symptoms. It
will usually reverse if you stop drinking heavily.Alcoholic Hepatitis. In some
people the fatty liver progresses and develops into hepatitis. Hepatitis means inflammation of the liver. It can be mild or severe. A very severe alcoholic hepatitis can
quickly lead to liver
failure. This can cause deep jaundice, blood clotting problems,
confusion, coma, bleeding into the guts, and is often fatal.Alcoholic Cirrhosis. This is a condition where normal liver tissue is replaced by scar
tissue or fibrosis. The damaged liver
cells die so the
liver gradually loses its ability to function normally. About 10% of heavy drinkers will eventually develop cirrhosis which tends
to occur only after 10 or more years of heavy drinking. Who are at risk of having ALD?Not all who drink alcohol develops ALD. What are the factors that contribute to the likelihood of developing
ALD? Here are the things that we need to consider:
Drinking Pattern – Those who drink daily are more susceptible than those who drink intermittently.  Non-continuous drinking allows the liver to recover. Those who drink regularly for longer periods of time are also more likely to have
ALD.
Gender – Women are more likely to develop alcoholic hepatitis and progress to cirrhosis even if they stop alcohol consumption. This is because blood ethanol levels following a standard
dose of alcohol are higher in women than men, which causes more damage to the liver. Genetic – Genetic factors may be important as statistics show that only 10-20% of heavy drinkers
develop cirrhosis, and 33% of heavy drinkers have no hepatic
consequences.
Nutrition – Alcohol increases requirements for some nutrients, therefore poor nutrition contributes to one’s likelihood of developing ALD. This is especially true for protein deficiency as this diminishes the available amino acids and enzymes that the liver needs for its metabolic processes. Coexistence of viral infections
like hepatitis B and C increases the seriousness of ALD.Alcoholic patients
may encounter non-specific digestive symptoms, such as
anorexia, morning nausea with dry retching, diarrhea, and vague right
upper quadrant abdominal pain with ALD. It is recommended that the patient undergo further testings to really know if the symptoms have anything to do with fatty liver disease.Some of the procedures that a patient may need to undergo are: Blood Tests to evaluate the patient’s alcohol intake like FBC (may reveal macrocytosis), LFTs, gamma GT (indicates possible alcohol abuse), abnormal ALT (reflects
hepatocellular damage) and an AST:ALT ratio (a value greater than 2
suggests alcoholic damage).Ultrasound scan may show that you have a damaged liver.Lliver biopsy where a small sample of the liver is taken to be studied under the microscope to reveal extent of liver damage and suggest prognosis.What should I do if I have ALD?Total abstinence from alcohol. Alcoholic fatty liver disease is usually reversible with cessation of alcohol consumption. Later on, the patient may be allowed to drink modestly as long as it can be controlled.
Alcoholic hepatitis patients, on the other hand, need medical attention aside from the lifelong abstinence from alcohol if he is to survive. The doctor may prescribe corticosteroid therapy, antibacterial therapy, vitamins, minerals and amino acid supplementation, as the case may need.
Cirrhosis is irreversible. It is actually considered as the 3rd or 4th commonest cause of death in adults in the USA. Treatment is directed at
its
complications and liver transplantation may be required.Get Counseling and Support. The difficulty in treating ALD lies in the difficulty of stopping alcohol consumption. If a patient cannot stop
drinking, he can seek counseling and support from a doctor, nurse, or counselor. Alcohol dependent patients may need to undergo ‘detoxification’ treatment.An Ounce of Prevention is Worth a Pound of CureHeed these word of advise if you wish to prevent contacting ALD.Limit your alcohol consumption. For men, it should be no more than 21 units of alcohol per
week (and no more than four units in any one day). For women, it should be no more than 14 units of alcohol per week
(and no more than three units in any one day). Pregnant women or those trying to get pregnant should not drink at all. If you do, it should be limited to 1-2 units once or twice a week.Feline Hepatic Lipidosis or Feline Fatty Liver Disease is most often caused by a cat going without eating for one reason or another. As a result, the cat’s liver begins to digest the stored fat and using that to make its fuel. Unfortunately, since a cat’s liver is not as efficient as most other mammals, some of the fat gets trapped in the liver which causes this disease. Although, even if you discover that the cat does in fact have feline hepatic lipidosis, you want to find out what caused his lack of appetite in the first place. Did you change food and he didn’t like the texture, taste, smell etc? Did you go on vacation and he got really upset? Is there something else ailing the cat that caused him not to have his normal appetite that needs to be treated? Regardless of the reason, the first step to treatment is taking him to the vet. Sudden weight loss
Low appetite
Excessive salivating
Vomiting
Become very lethargic
Become jaundice (yellowing of eyes or skin) The first symptom you will see is the sudden weight loss, you may also notice that your cat does not have its typical eating habits. For our cat, he refused to eat our new cat food, and began trying to scavenge for food on our counters. We then began hiding our own food, and that’s when we realized he was beginning to lose weight. We decided to switch food, and at first he was eating his new food, so we thought everything was okay.
Unfortunately, his liver had already been affected, and this made him not feel very well, so he slowly ate less and less. Because jaundice is often delayed it took a couple days for us to notice the yellowing, after he had already lost a significant amount of weight. We first noticed this in his ears where you could see the skin had a slight yellow hue. The first time I saw it, I thought it was the lighting, but then it was very evident. The whites of his eyes were yellow, his skin was yellow, even the inside of his mouth was yellow.
We never really noticed any excessive salivating, but he did throw up occasionally. This was not unusual for this cat, since we did nickname him pukey since he often would puke up hair balls, or his food due to excessive gorging. Unfortunately, our cat is also a very laid back cat. So to see him sleep all day and cuddle was not unusual. But in retrospect, we realized, he stopped http://www.doctorbittercom.charterly.com on top of the cupboards where he liked to go when he wanted to be alone. He also stopped attacking the other cat. This was one of his favorite pastimes, and our other cats least favorite pastime, but it was amusing. We felt bad we didn’t notice this, but his personality didn’t seem to change since he was already a very mellow cat. But this is a very serious disease, and should be checked out immediately if you suspect your cat has fatty liver disease. Your veterinarian will have a very good idea when he sees your cat. For instance, the moment I brought my cat in, all I said was, “We switched food, and he wouldn’t eat it, by the time we finally went back to his old food, he started losing weight. Today when I woke up, I noticed that his ears are very yellow.” He instantly knew, but he did a blood panel anyway. In some cases they would do a liver biopsy under light anesthesia, but in our case the blood panel was suffi

Disease – Wikipedia the free encyclopedia
Diseases amp Conditions CDC


What Is The Hushed Truth About Lyme Disease? A Recovery Story, Part 4.

One unit of alcohol is equivalent to half of a pint of beer or one
measure of spirits or 10 g of alcohol.What is Alcoholic Fatty Liver Disease?Alcoholic fatty liver disease or ALD is a condition in which there is a build-up of fat that occurs within
the liver cells of people who regularly drink alcohol heavily. When can we say that too much alcohol is consumed to cause development of alcoholic fatty liver? The threshold for men is more than 50 units of alcohol per week or about 25 pints of beer. The threshold for women is any amount beyond 35 units of alcohol per week or about 17 pints of beer. This threshold applies for any type of alcoholic beverage consumed.When a person drinks alcohol, it goes to the stomach and intestines and is absorbed into the bloodstream. http://www.doctorbittercom.charterly.com Then, it passes through the liver before circulating around the disease body. In the liver, enzymes metabolize alcohol into other chemical substances. The problem with drinking too much alcohol is that the liver cells cannot cope with the volume of alcohol that should be metabolized, so the
level of alcohol in your bloodstream rises.As in Non Alcoholic Fatty Liver Disease, alcoholic fatty liver disease can occur in three forms:
Alcoholic Fatty liver. This is the simplest form and is not usually serious nor causes any symptoms. It
will usually reverse if you stop drinking heavily.Alcoholic Hepatitis. In some
people the fatty liver progresses and develops into hepatitis. Hepatitis means inflammation of the liver. It can be mild or severe. A very severe alcoholic hepatitis can
quickly lead to liver
failure. This can cause deep jaundice, blood clotting problems,
confusion, coma, bleeding into the guts, and is often fatal.Alcoholic Cirrhosis. This is a condition where normal liver tissue is replaced by scar
tissue or fibrosis. The damaged liver
cells die so the
liver gradually loses its ability to function normally. About 10% of heavy drinkers will eventually develop cirrhosis which tends
to occur only after 10 or more years of heavy drinking. Who are at risk of having ALD?Not all who drink alcohol develops ALD. What are the factors that contribute to the likelihood of developing
ALD? Here are the things that we need to consider:
Drinking Pattern – Those who drink daily are more susceptible than those who drink intermittently.  Non-continuous drinking allows the liver to recover. Those who drink regularly for longer periods of time are also more likely to have
ALD.
Gender – Women are more likely to develop alcoholic hepatitis and progress to cirrhosis even if they stop alcohol consumption. This is because blood ethanol levels following a standard
dose of alcohol are higher in women than men, which causes more damage to the liver. Genetic – Genetic factors may be important as statistics show that only 10-20% of heavy drinkers
develop cirrhosis, and 33% of heavy drinkers have no hepatic diseases of the nervous system; Nutrition – Alcohol increases requirements for some nutrients, therefore poor nutrition contributes to one’s likelihood of developing ALD. This is especially true for protein deficiency as this diminishes the available amino acids and enzymes that the liver needs for its metabolic processes. Coexistence of viral infections
like hepatitis B and C increases the seriousness of ALD.Alcoholic patients
may encounter non-specific digestive symptoms, such as
anorexia, morning nausea with dry retching, diarrhea, and vague right
upper quadrant abdominal pain with ALD. It is recommended that the patient undergo further testings to really know if the symptoms have anything to do with fatty liver disease.Some of the procedures that a patient may need to undergo are: Blood Tests to evaluate the patient’s alcohol intake like FBC (may reveal macrocytosis), LFTs, gamma GT (indicates possible alcohol abuse), abnormal ALT (reflects
hepatocellular damage) and an AST:ALT ratio (a value greater than 2
suggests alcoholic damage).Ultrasound scan may show that you have a damaged liver.Lliver biopsy where a small sample of the liver is taken to be studied under the microscope to reveal extent of liver damage and suggest prognosis.What should I do if I have ALD?Total abstinence from alcohol. Alcoholic fatty liver disease is usually reversible with cessation of alcohol consumption. Later on, the patient may be allowed to drink modestly as long as it can be controlled.
Alcoholic hepatitis patients, on the other hand, need medical attention aside from the lifelong abstinence from alcohol if he is to survive. The doctor may prescribe corticosteroid therapy, antibacterial therapy, vitamins, minerals and amino acid supplementation, as the case may need.
Cirrhosis is irreversible. It is actually considered as the 3rd or 4th commonest cause of death in adults in the USA. Treatment is directed at
its
complications and liver transplantation may be required.Get Counseling and Support. The difficulty in treating ALD lies in the difficulty of stopping alcohol consumption. If a patient cannot stop
drinking, he can seek counseling and support from a doctor, nurse, or counselor. Alcohol dependent patients may need to undergo ‘detoxification’ treatment.An Ounce of Prevention is Worth a Pound of CureHeed these word of advise if you wish to prevent contacting ALD.Limit your alcohol consumption. For men, it should be no more than 21 units of alcohol per
week (and no more than four units in any one day). For women, it should be no more than 14 units of alcohol per week
(and no more than three units in any one day). Pregnant women or those trying to get pregnant should not drink at all. If you do, it should be limited to 1-2 units once or twice a week.Feline Hepatic Lipidosis or Feline Fatty Liver Disease is most often caused by a cat going without eating for one reason or another. As a result, the cat’s liver begins to digest the stored fat and using that to make its fuel. Unfortunately, since a cat’s liver is not as efficient as most other mammals, some of the fat gets trapped in the liver which causes this disease. Although, even if you discover that the cat does in fact have feline hepatic lipidosis, you want to find out what caused his lack of appetite in the first place. Did you change food and he didn’t like the texture, taste, smell etc? Did you go on vacation and he got really upset? Is there something else ailing the cat that caused him not to have his normal appetite that needs to be treated? Regardless of the reason, the first step to treatment is taking him to the vet. Sudden weight loss
Low appetite
Excessive salivating
Vomiting
Become very lethargic
Become jaundice (yellowing of eyes or skin) The first symptom you will see is the sudden weight loss, you may also notice that your cat does not have its typical eating habits. For our cat, he refused to eat our new cat food, and began trying to scavenge for food on our counters. We then began hiding our own food, and that’s when we realized he was beginning to lose weight. We decided to switch food, and at first he was eating his new food, so we thought everything was okay.
Unfortunately, his liver had already been affected, and this made him not feel very well, so he slowly ate less and less. Because jaundice is often delayed it took a couple days for us to notice the yellowing, after he had already lost a significant amount of weight. We first noticed this in his ears where you could see the skin had a slight yellow hue. The first time I saw it, I thought it was the lighting, but then it was very evident. The whites of his eyes were yellow, his skin was yellow, even the inside of his mouth was yellow.
We never really noticed any excessive salivating, but he did throw up occasionally. This was not unusual for this cat, since we did nickname him pukey since he often would puke up hair balls, or his food due to excessive gorging. Unfortunately, our cat is also a very laid back cat. So to see him sleep all day and cuddle was not unusual. But in retrospect, we realized, he stopped jumping on top of the cupboards where he liked to go when he wanted to be alone. He also stopped attacking the other cat. This was one of his favorite pastimes, and our other cats least favorite pastime, but it was amusing. We felt bad we didn’t notice this, but his personality didn’t seem to change since he was already a very mellow cat. But this is a very serious disease, and should be checked out immediately if you suspect your cat has fatty liver disease. Your veterinarian will have a very good idea when he sees your cat. For instance, the moment I brought my cat in, all I said was, “We switched food, and he wouldn’t eat it, by the time we finally went back to his old food, he started losing weight. Today when I woke up, I noticed that his ears are very yellow.” He instantly knew, but he did a blood panel anyway. In some cases they would do a liver biopsy under light anesthesia, but in our case the blood panel was suffi

Disease – Wikipedia the free encyclopedia
Diseases amp Conditions CDC


Top 10 Complementary and Alternative Medicine Therapies that work

Has this ever happened to you? Have you ever felt groggy, tired,
drowsy, and/or drained of energy when waking up in the morning to go to
work or anywhere else for that matter? Feeling this way can actually
affect the rest of your day and you might find that it is hard to
function and accomplish the necessary tasks ahead of you. There
is a way to battle these morning symptoms and to recharge yourself so
that you are filled with positive energy and are ready to take on the
day. What you have to do is practice what is known as the daily energy
routine that I have discovered in Donna Eden’s Energy
Medicine book. The daily energy routine consists of eight
easy-to-accomplish techniques and takes up less than ten minutes of your
time. It is great to practice this routine every morning after getting
out of bed, but it will only benefit you more if you do it more than
once a day. The daily energy routine consists of the following
techniques: The Three Thumps – this technique will “boost
and restore energy, increase strength and vitality, and strengthen the
immune system.”The Cross Crawl – this technique will “balance
and harmonize energy, improve coordination, and clear thinking.”The
Wayne Cook Posture – this technique will “focus the mind, allow you to
untangle inner chaos, see with better perspective, think more clearly
and learn more proficiently.”The Crown Pull – this technique
will “relieve mental congestion and headaches, clear and refresh the
mind, sharpen medicines and open the crown chakra to
higher inspiration.”Connecting Heaven and Earth – this
technique will “open the meridians, expel toxic energies, and stimulate
fresh energy to flow through the joints.”The Celtic Weave –
this technique will “pulse your auric energies outward
and strengthen them, and connect all your energies together so they
operate as a single web.”The Hook Up – this technique will
“get strange flows moving, strengthen auric field, leave you feeling
whole again. It will calm you and help you feel connected.”The
Zip Up – this technique will “boost confidence, clear your thoughts,
and protect you from negative energy that may be around you.”Step
1: Use several fingers to tap various points on your body.
While tapping make sure to breathe in through your nose and to breathe
out through your mouth. Step 2: Tap the K-27
points for about 15 seconds. To locate the K-27 points, place your
fingers on the collarbone and move them inward toward the U-shaped notch
at the top of your breastbone. Move your fingers to the bottom of the U
and then move down and out about an inch.Step 3: Tap
the Thymus for about 20 seconds. To do this place the fingers of one of
your hands in the center of your sternum at the thymus gland. Step

4: Tap the neurolymphatic spleen points for about 15 seconds.
They are located beneath the breasts and down one rib. Then tap the
spleen acupuncture points for about 15 seconds. They are located on the
side of the body, about four inches down from the arm pits. The Cross CrawlStep
1: While standing, lift your right arm and left leg at the
same time.Step 2: As you put them down,
raise your left arm and right leg.Step 3: Repeat
this again but this time exaggerate the lift of your leg and the swing
of your arm across the midline to the opposite side of the body. Try to
make the elbow touch the http://www.doctorbittercom.charterly.com kneeStep
4: Do this exaggeration for about one minute and make sure to
breathe deeply while doing it.Step
1: Place your thumbs at your temples and your fingertips
resting at the middle of your forehead.Step 2: Slowly,
with pressure, pull your fingers apart to the hairline stretching the
skin above your eyebrows.Step 3: Place your
fingers at the hairline and repeat the stretch.Step
4: Repeat this pattern starting at the top, center, and back
of your head. Continue all the way down until you reach the base of your
neck. Use pressure as you pull.Step 5: Move
down to your shoulders and push your fingers in and hold. Then pull
across your shoulders toward the front. Hold your hands there until it
feels right, then release and drop your hands/arms.Step
1: Sit with your spine straight. Place your left foot over
your right knee. Hold your left ankle with your right hand and the
bottom of your left foot with your left hand. Step 2:
Breathe in slowly through your nose, letting the breath lift
your body, while stretching your leg toward you. Exhale slowly through
your mouth, relaxing your body. Repeat four or five times.Step
3: Switch to the other foot and repeat the entire process.Step

4: Uncross your legs and “steeple” your fingertips, resting
your thumbs just above the bridge of your nose. Breathe slowly in
through your nose and out through your mouth three or four times. On
exhale, separate your thumb slowly stretching your skin on your
forehead. Slowly bring your hands down in front of you. Surrender into
your own breathing.Step 1: Start with your hands on your thighs,
fingers spread.Step 2: Inhale through your
nose, circle your arms out, and bring your hands together in prayer
position. Exhale through your mouth.Step 3: Inhaling
through your nose, stretch one arm up and one down, pushing with your
palms. Hold, exhale through your mouth, and return to the prayer
position. Repeat switching arms. Do this twice for each arm. Step
4: Drop arms down, fold your body forward at the waist, and
relax with your knees slightly bent. Take two deep breaths before slowly
returning to a standing position.Step 1: Stand tall, hands on thighs. Breathe deeply,
in through your nose and out through your mouth throughout. Step
2: Rub hands together, shake them off, face palms, and try to
feel the energy between them. Rub and shake again, place palms close to
ears and take a deep breath.Step 3: Inhale
and bring your elbows together. Exhale, cross your arms and swing them
out to the side.Step 4: Cross and swing them
out again. Bend forward, repeat and cross arms over upper legs. Step
5: Swing out again, in front of ankles. Bend knees, turn
palms, forward, scoop energy, stand, and pour that energy all over your
body.Step 1: Place your middle finger of one hand on the
“third eye”. The “third eye” is the spot between your eyebrows above the
bridge of the nose.Step 2: Place the middle
finger of the other hand in the navel.Step 3: Press
each finger into the skin and pull it upwards. Hold for about 30
seconds.Step 4: Do this until you start to yawn
or feel yourself having a deep sigh. This will mean that your energies
are hooked up.Step 1: Place your hand at the bottom of the central
meridian – at your pubic bone.Step 2: Take a
deep breath in as you move your hands, slowly and deliberately,
straight up the center of your body to your lower lip.Step
3: Continue upward, bringing your hands past your lips and
exuberantly raising them into the sky. Circle your arms back to your
pelvis. Step 4: Repeat this three times. This Daily Energy Routine is easy and fun. You can do it on your own or with a group of people (friends, family, etc.) It is effective in many ways and doing it on a regular basis definitely will help you. So, don’t hesitate to try it…Seasonality has become a fashion statement on the dining scene. However, eating seasonally has been exactly “what the doctor ordered” since antiquity.Food was the ‘drug of choice’ in all of the ancient medical systems in Europe, India and China. Whilst the medical theories in each differed, they shared a common philosophy: illness is the result of imbalances medicines company; the body and between the body and the environment. Man lives within nature and staying in harmony with nature’s rhythms is essential for good health. The word disease is literally “dis-ease” or physical disharmony. Diet plays a significant role in correcting imbalances and is an important factor in healing the body. Traditional Chinese Medicine (TCM) is based on the cosmic theory of Yin and Yang; and the laws of the Five Elements (wood, fire, earth, metal, and water). These elements correspond with organs in the body. Other groups of five such as five flavours, five seasons etc are also involved in TCM. The principles, development of which is credited to the Emperor Huang Di – also known as the Yellow Emperor (2698 – 2589 BCE) – are documented in the ancient Chinese medical classic Huang Di Nei Jing . It remains a respected reference source in TCM to this day. Indian medicine from around 800 BCE was based on the theory of bodily humours (fluids) which in the Hindu view were connected with cosmic factors. The approach also integrated concepts such as the thermal (hot/cold) qualities of foods and the five states of matter (earth; water; fire; air; and ether/space.) These concepts were codified in several major Indian medical texts, translations of which made their way around the world over the centuries. Humorial medicine was taught by the Spaniards as part of the medical

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Medicine – Wikipedia the free encyclopedia


Overview of Doctor Faustus by Christopher Marlowe

High on my list of things to do when I visited Beijing, China, was to have a check-up done by a TCM (Traditional Chinese Medicine) doctor. Is it possible to be diagnosed without taking off my clothes, without a blood test, and without x-rays? Yes, it is possible. It is also possible to enjoy a bit of a snicker when one man in my group gets his very disturbing but accurate diagnosis. The smirking and snickering didn’t last long because this man rose to his diagnosis like…well, like a real man. This is how it all happened:I signed up for a visit to a Traditional Chinese Medicine Hospital in Bejing. Along the way, nine other people joined me and the tour guide. The others were a couple from England, and seven engineers from India and Bangladesh, who were on a day outing sponsored by their corporate branch in China.Throughout our tour, our charming tour guide gave us a running commentary. She told us that a large part of the basis for TCM comes from Daoism. The Yellow Emperor composed the ‘Basic Questions of Internal Medicine’ during his reign from around 2696 to 2598 BC. At the TCM facility, staff members in white uniforms gave us a tour and a lecture. We were told two mutually dependent forces known as ying and yang represent the energy of the universe. The body is believed to be a microcosmic representation of ying and yang. Additionally, qi (pronounced chee), is the vital energy that flows through the body by way of a network of channels known as meridians. These meridians contain active points that are used first to diagnose – then to treat. We were then invited to visit doctors who would diagnose us through the use of pulse-taking and a tongue diagnosis. The ten of us went to a waiting room where the modalities were discussed. The treatment modalities of TCM include herbal medicine, acupuncture, massage and moxibustion. The nurses told us we would visit with the four doctors waiting for us. It was at this time our most charming tour guide told us what a real TCM doctor should look like.First, a TCM doctor should be much older as it takes years to study the practice. Next, she told us that gray hair is desirable as proof of age. The most interesting feature was the stomach – it should have a small pouch. A TCM doctor with a small stomach pouch proves that he knows how to breathe properly. For example, when you take a deep breath you should fill your stomach with air and that should be noticeable.I sat next to the young woman from Birmingham, England and she became panicky. She told me that she was sure the doctor was going to tell her that she drank way too much and at only 19 years of age she had a problem. Sure enough, when I caught up with her later, she told me her doctor said her liver was bad! She vowed to drink more water, and wait until she got back to England because there, medical care should she need it, would be free. Her partner, a young man of 20, bounced out from his checkup with an excellent bill of health. She told me, she wasn’t surprised because he is one of those people who may have a drink with a meal, exercises regularly and even eats properly. For some reason, this annoyed her.My turn came. It took less than five minutes for the doctor to diagnose me. First, he checked my pulse. The accompanying nurse told me that, historically, rich women had no intentions of taking off their clothes to be diagnosed – so doctors developed diagnostic skills based on external signs. I was asked to rest my wrists on a pad on the desk with palms facing up. I was told that unlike in Western medicine where only two fingers are used to take the pulse, in TCM, three fingers are used – the doctor middle and ring fingers. Gentle pressure is applied to different points on the wrist which correspond to the internal organs.Next, the doctor looked at my tongue which had a bit of cookie on it but that did not matter. The nurse explained that tongue diagnosis ranks second to the pulse diagnosis. Different parts of the tongue relates to different parts of the body. The root of the tongue relates to the kidney and bladder, the center relates to the stomach and spleen, the sides relate to the liver and gall bladder, and the very tip relates to the heart. Other issues are considered too, such as the color, if the tongue is cracked and for how long, and the person’s age.MY diagnosis? My doctor told me I had pain across my back and shoulders as well as a serious case of brain fog. This was true. In fact I have had a pain, particularly in my right shoulder, for so long that I no longer think about it. The pain comes and goes, is not debilitating, and I figured it came with carrying heavy shoulder bags and I’ve made an effort to not carry bags on the right shoulder. With the brain fog, I considered that part of being overworked as a teacher, traveling from S. Korea to China, and then a couple days later to New York City – and carrying around my laptop which was adding pressure to my shoulder. Nevertheless, I bought a two months supply of herbal medicine. The results? For the first time in many years, after taking the herbs, the shoulder pain, along with the brain fog, went away and hasn’t come back. That was two years ago.The fun diagnosis about the man, that had everyone snickering, happened when I came out of my doctor’s office; the incredibly good looking engineer in his 20’s was sitting, staring and smiling at his co-worker who was in his 40’s. I asked the tour guide what was up and with a smile she told me. It turns out that the diagnosis of the engineer in his 40’s was…you’ve waited for this…he was told that he was impotent, and could not satisfy his wife. But here’s where this man gets everyone’s respect. While a few of us waited, smirking around, for our herbal prescriptions – this included me, an amazing thing happened. We were so impressed that this impotent gentleman was handed two giant shopping bags with herbs. Yes, he doctor who season 8; bought a year’s supply – and he didn’t care if we knew it. He even asked a nurse if he should see another doctor in case there was something, anything else, he could do. One of his friends helped him carry his big shopping bags of herbs out to our bus. About those herbs. When I got to the U.S., before I took the herbs, I decided to do some research about the herbs used in my prescription. Herbs play a major role in TCM and are divided into three categories as follows:Upper Herbs – which includes ginseng root, cinnamon, sweet gum fruit, ginger, peony root, Sichuan pepper, and leaves and fruits.Middle Herbs – which are strong and may have side effects, and include clerodendrum, wormwood/mugwort, field mint, loquat, spindle fruit, and fossil bone.Lower Herbs – these herbs are toxic and should only be used under the guidance of a qualified practitioner. These herbs include opium poppy, persica, forsythia, evodia, Japanese honeysuckle, and ephedra (ma huang). The reason I highlighted ‘ephedra’ is because this toxic drug was placed on the market in dietary supplement form and sold to the general population. This should have never been. After doing much harm and even causing death, the supplement was pulled in 2004 by FDA recommendation. Note: TCM practices are not to be confused with herbs bought off the shelf at a vitamin shop. There is no relationship to a visit to a trained doctor who dispenses a formula that will most likely be from the ‘upper herbs’ category, to a manufacturer who can package a supplement and put it on the shelf with no oversight. Ephedra is from the ‘lower herb’ category – and should only be used under the supervision of a trained herbalist. Lower herbs are meant to treat serious disorders. The dietary supplement ephedra, often a synthetic version – as are many dietary supplements, was marketed as a weight loss supplement, and to increase energy, and enhance athletic performance.My perfectly safe herbal formula included ren shen, gui zhui, gan jiang, etc. In English, those translate to ginseng root, cinnamon, and ginger. I seem to remember licorice in there but all my herbs came from the ‘upper herb’ category http://www.doctorbittercom.charterly.com the way they were formulated – they worked!While our tour did later include a lecture on acupuncture (and we remembered the reference to 365 principal points or channels because it corresponded to how many days in the year), by this time we didn’t care at all because we were getting hungry and a little rowdy. We had to be fed as soon as possible. Then it was on to the Great Wall which was just astounding! Wow!For further information about the Great Wall, my visit to the jade factory to get a lucky bok choy, and other facts about my visit, and research, please see the links below.The fifth season of Doctor Who is the most momentous since its first. Everything is changing: it’s now being filmed in HD, we have a new showrunner in Steven Moffat, a new Doctor in Matt Smith, a new companion in Karen Gillan, a new interior for the Tardis and even a new sonic screwdriver (it

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With the increasing average age of Americans, more and more patients presenting for surgery and anesthesia are older or elderly. Some surgeries are elective and others will be emergencies.
Many people are living longer and are doing so with relatively good health. Modern medicine has also made it possible to extend life, even while being treated for serious health conditions.
There are normal changes in how the body works as we age. In addition, older people have more serious health issues. All of these things must be taken into account when administering an anesthetic.The overall effects of age on the heart lead to a more dramatic drop in blood pressure when anesthesia is induced. If the patient is also dehydrated or has very high or very low blood pressure to begin with, this drop can be even more pronounced and may become dangerous if not attended to and treated right away by the anesthesiologist. Care must be taken in drug selection and dosing for the induction of anesthesia, since the elderly patient’s ability to compensate for these changes may be limited or impaired.
The anesthesiologist must also be aware the the time it takes for blood to circulate in the body takes longer in older people, so medicines given in the IV will take longer to take effect.While the normal changes to the heart of aging are complex, the overall function of the heart may be fairly well preserved in the absence of heart disease. Surgery and anesthesia are a stress on the body, however, like moderate exercise. Under anesthesia, the effects of age on the heart may be more likely to be seen.
As we get older, we have a lower resting heart rate and a decreased ability to increase our heart http://www.doctorbittercom.charterly.com during physical or physiologic stress. This can become important during surgery and anesthesia. If we aren’t able to maintain our cardiac output (determined by the heart rate and the amount of blood pumped with the heart’s contraction), it makes it much more difficult for our body’s to compensate for the stress that may accompany surgery and anesthesia.
Of course, any preexisting cardiac disease further complicates this issue. The anesthesiologist must have a thorough understanding of cardiac physiology (both normal and abnormal) in order to plan the most effective–and safe–anesthetic possible in these situations.Because oxygen levels may be lower, it may be advisable to use higher concentrations of oxygen while under anesthesia.
Careful selection of ventilator settings can help reduce overdistention and collapse of small airways. Airway pressures should be monitored and adjusted to compensate for changes in the ability of the lungs and chest wall to expand and relax.
Postoperative oxygen may be needed and patient fusion; patients, but especially the elderly with preexisting lung disease, should be instructed to use an incentive spirometer (device to help reexpand the lungs by deep breathing). Walking early in the postoperative course also helps decrease pulmonary complications from anesthesia and surgery.The lungs have a natural elasticity to them. This gives them the ability to expand and then recoil appropriately with breathing and to adapt to changes in the depth and pattern of breathing.
As we get older, the elasticity of our lungs decreases. The overall effect is that smaller airways can collapse. Those collapsed areas are then not available to help absorb oxygen into the blood and get the carbon dioxide (waste gas) out. The body may take longer to respond to changes in oxygen levels, and overall oxygen levels may be lower.
The chest wall, itself, may also become more rigid and the muscles of breathing may weaken.
Pneumonia may be more likely in the postoperative period.Examination of the airway preoperatively is necessary to predict and prepare for any difficulties with intubation (placement of the breathing tube).
Precautions should be taken to prevent aspiration pneumonia.
Administration of antacids before anesthesia to high-risk patients.
Induction techniques that block acid from rising up from the stomach into the throat and then into the lungs (called “cricoid pressure or Sellinger maneuver- an assistant pushes on the hard cartilage on the front of the neck to push against the food pipe and close it off to keep acid down).
Ensure that airway reflexes have returned by removing the breathing tube only once the patient is fully conscious.
The airway is the passageway to get air with it’s vital oxygen to the inside of the body and get waste gas like carbon dioxide, out. The airway includes the mouth, nose, throat, voicebox (larynx) and windpipe. Related structures and the lungs may be included in this term, depending on the context.
In older people, there are changes in the airway that occur with normal aging. The jaw and neck may have limited mobility due to arthritis. This can make placement of the breathing tube more difficult.
In addition, reflexes like coughing and gagging may be impaired. If the upper airway cannot be cleared of secretions, then aspiration of these secretions into the lungs may be more of a potential complication. Aspiration pneumonia is a serious condition that may become life-threatening.Metabolism in general, slows as we age. The ability and speed with which the liver and kidneys clear toxins and medications from the body may be significantly different in the elderly.
Anesthesiologists must understand the changes that occur and how each drug administered to an elderly patient is handled by the body. Older patients may need less medication if the drug is cleared more slowly.
Electrolytes such as potassium are also regulated by the kidney. If there are risk factors that impair kidney function, electrolyte abnormalities may be more likely and can lead to problems during and after surgery. Abnormalities with heart rhythm and muscle weakness are examples of complications of electolyte disturbances.
Older patients are more prone to mental decline after surgery and anesthesia. While postoperative cognitive dysfunction was presumed to be the result of general anesthesia’s effects on the brain, studies have now shown that this decline can occur regardless of the type of anesthesia used. Current theories speculate that factors related to illness and the stress of surgery, along with changes that occur in a body trying to heal (inflammatory mediators and hormone changes) may contribute to this phenomenon.
The kidneys lie along the borders of the Psoas muscles and are therefore obliquely placed. The position of the liver causes the right Kidney to be lower than the left. The Adult Kidney weighs about 150g. The kidneys are supported by the perirenal fat (which is enclosed in the perirenal fascia), the renal vascular pedicle, abdominal muscle tone, and the general bulk of the abdominal viscera. Variations in these factors permit variations in the degree of the renal mobidity. The average descent on inspiration or on assuming the upright position is 4-5cm.The Adult Ureter is about 30cm long, varying in direct relation to the height of the individual. It follows a rather smooth S curve. Areas of relative narrowing are foundat the ureteropelvic junctionwhere the ureter crosses over the iliac vessels, and where it passes through the bladder wall.The Adult bladder normally has a capacity of 350ml-450ml. Where empty, the Adult bladder lies behind the pubic symphysis and is largely a pelvic organ.The Kidneys play a central role in the maintenance of a constant internal environment for body cells in response to cellular catabolism and wide variations of dietary intake. It achieves this by regulating extracellular fluid and solute concentrations by the excretion of salts, water, metabolic waste products and foreign substances. The process involves the production of a plasma Ultrafiltration of 180L per day. This passes down to about 2 million tubules from which essential solutes and water reasbsorbed into the blood and non-essential solutes secreted from the blood into the remaining fluid which becomes the final urine. The other functions of the kidney incude hormone production and the production of glucose by breaking down other non-carbohydrate substrates (gluconeogenesis).Main Urologic symptomsSystemic manifestations, local and referre pain (Kidney pain, Pseudorenal pain, ureteral pain, vesical pain, prostatic pain, testicular pain, epididymal pain, back and leg pain), gastrointestinal symptoms of urologic disease, symptoms related to the act of urination (frequency, nocturia and Urgency, burning sensation during urination, symptoms of prostatic obstruction, symptoms of urethral obstruction, incontinence, oliguria and anuria, Pneumaturia, cloudy urine, bloody urine, enuresis (an inability to control urination. Use of the term is usually limited to describing individuals old enough to be expected to exercise such control) ), other objective manifestations (Urethral discharge, skin lesions of the external genitalia, visible or palpable masses, edema, bloody patient

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One unit of alcohol is equivalent to half of a pint of beer or one
measure of spirits or 10 g of alcohol.What is Alcoholic Fatty Liver Disease?Alcoholic fatty liver disease or ALD is a condition in which there is a build-up of fat that occurs within
the liver cells of people who regularly drink alcohol heavily. When can we say that too much alcohol is consumed to cause development disease alcoholic fatty liver? The threshold for men is more than 50 units of alcohol per week or about 25 pints of beer. The threshold for women is any amount beyond 35 units of alcohol per week or about 17 pints of beer. This threshold applies for any type of alcoholic beverage consumed.When a person drinks alcohol, it goes to the stomach and intestines and is absorbed into the bloodstream. Then, it passes through the liver before circulating around the whole body. In the liver, enzymes metabolize alcohol into other chemical substances. The problem with drinking too much alcohol is that the liver cells cannot cope with the volume of alcohol that should be metabolized, so the
level of alcohol in your bloodstream rises.As in Non Alcoholic Fatty Liver Disease, alcoholic fatty liver disease can occur in three forms:
Alcoholic Fatty liver. diseases of the nervous system; is the simplest form and is not usually serious nor causes any symptoms. It
will usually reverse if you stop drinking heavily.Alcoholic Hepatitis. In some
people the fatty liver progresses and develops into hepatitis. Hepatitis means inflammation of the liver. It can be mild or severe. A very severe alcoholic hepatitis can
quickly lead to liver
failure. This can cause deep jaundice, blood clotting problems,
confusion, coma, bleeding into the guts, and is often fatal.Alcoholic Cirrhosis. This is a condition where normal liver tissue is replaced by scar
tissue or fibrosis. The damaged liver
cells die so the
liver gradually loses its ability to function normally. About 10% of heavy drinkers will eventually develop cirrhosis which tends
to occur only after 10 or more years of heavy drinking. Who are at risk of having ALD?Not all who drink alcohol develops ALD. What are the factors that contribute to the likelihood of developing
ALD? Here are the things that we need to consider:
Drinking Pattern – Those who drink daily are more susceptible than those who drink intermittently.  Non-continuous drinking allows the liver to recover. Those who drink regularly for longer periods of time are also more likely to have
ALD.
Gender – Women are more likely to develop alcoholic hepatitis and progress to cirrhosis even if they stop alcohol consumption. This is because blood ethanol levels following a standard
dose of alcohol are higher in women than men, which causes more damage to the liver. Genetic – Genetic factors may be important as statistics show that only 10-20% of heavy drinkers
develop cirrhosis, and 33% of heavy drinkers have no hepatic
consequences.
Nutrition – Alcohol increases requirements for some nutrients, therefore poor nutrition contributes to one’s likelihood of developing ALD. This is especially true for protein deficiency as this diminishes the available amino acids and enzymes that the liver needs for its metabolic processes. Coexistence of viral infections
like hepatitis B and C increases the seriousness of ALD.Alcoholic patients
may encounter non-specific digestive symptoms, such as
anorexia, morning nausea with dry retching, diarrhea, and vague right
upper quadrant abdominal pain with ALD. It is recommended that the patient undergo further testings to really know if the symptoms have anything to do with fatty liver disease.Some of the procedures that a patient may need to undergo are: Blood Tests to evaluate the patient’s alcohol intake like FBC (may reveal macrocytosis), LFTs, gamma GT (indicates possible alcohol abuse), abnormal ALT (reflects
hepatocellular damage) and an AST:ALT ratio (a value greater than 2
suggests alcoholic damage).Ultrasound scan may show that you have a damaged liver.Lliver biopsy where a small sample of the liver is taken to be studied under the microscope to reveal extent of liver damage and suggest prognosis.What should I do if I have ALD?Total abstinence from alcohol. Alcoholic fatty liver disease is usually reversible with cessation of alcohol consumption. Later on, the patient may be allowed to drink modestly as long as it can be controlled.
Alcoholic hepatitis patients, on the other hand, need medical attention aside from the lifelong abstinence from alcohol if he is to survive. The doctor may prescribe corticosteroid therapy, antibacterial therapy, vitamins, minerals and amino acid supplementation, as the case may need.
Cirrhosis is irreversible. It is actually considered as the 3rd or 4th commonest cause of death in adults in the USA. Treatment is directed at
its
complications and liver transplantation may be required.Get Counseling and Support. The difficulty in treating ALD lies in the difficulty of stopping alcohol consumption. If a patient cannot stop
drinking, he can seek counseling and support from a doctor, nurse, or counselor. Alcohol dependent patients may need to undergo ‘detoxification’ treatment.An Ounce of Prevention is Worth a Pound of CureHeed these word of advise if you wish to prevent contacting ALD.Limit your alcohol consumption. For men, it should be no more than 21 units of alcohol per
week (and no more than four units in any one day). For women, it should be no more than 14 units of alcohol per week
(and no more than three units in any one day). Pregnant women or those trying to get pregnant should not drink at all. If you do, it should be limited to 1-2 units once or twice a week.Feline Hepatic Lipidosis or Feline Fatty Liver Disease is most often caused by a cat going without eating for one reason or another. As a result, the cat’s liver begins to digest the stored fat and using that to make its fuel. Unfortunately, since a cat’s liver is not as efficient as most other mammals, some of the fat gets trapped in the liver which causes this disease. Although, even if you discover that the cat does in fact have feline hepatic lipidosis, you want to find out what caused his lack of appetite in the first place. Did you change food and he didn’t like the texture, taste, smell etc? Did you go on vacation and he got really upset? Is there something else ailing the cat that caused him not to have his normal appetite that needs to be treated? Regardless of the reason, the first step to treatment is taking him to the vet. Sudden weight loss
Low appetite
Excessive salivating
Vomiting
Become very lethargic
Become jaundice (yellowing of eyes or skin) The first symptom you will see is the sudden weight loss, you may also notice that your cat does not have its typical eating habits. For our cat, he refused to eat our new cat food, and began trying to scavenge for food on our counters. We then began hiding our own food, and that’s when we realized he was beginning to lose weight. We decided to switch food, and at first he was eating his new food, so we thought everything was okay.
Unfortunately, his liver had already been affected, and this made him not feel very well, so he slowly ate less and less. Because jaundice is often delayed it took a couple days for us to notice the yellowing, after he had already lost a significant amount of weight. We first noticed this in his ears where you could see the skin had a slight yellow hue. The first time I saw it, I thought it was the lighting, but then it was very evident. The whites of his eyes were yellow, his skin was yellow, even the inside of his mouth was yellow.
We never really noticed any excessive salivating, but he did throw up occasionally. This was not unusual for this cat, since we did nickname him pukey since he often would puke up hair balls, or his food due to excessive gorging. Unfortunately, our cat is also a very laid back cat. So to see him sleep all day and cuddle was not unusual. But in retrospect, we realized, he stopped jumping on top of the cupboards where he liked to go when he wanted to be alone. He also stopped attacking the other cat. This was one of his favorite pastimes, and our other cats least favorite pastime, but it was amusing. We felt bad we didn’t notice this, but his personality didn’t seem to change since he was already a very mellow cat. But this is a very serious disease, and should be checked out immediately if you suspect your cat has fatty liver disease. Your veterinarian will have a very good idea when he sees your cat. For instance, the moment I brought my cat in, all I said was, “We switched food, and he wouldn’t eat it, by the time we finally went back http://www.doctorbittercom.charterly.com his old food, he started losing weight. Today when I woke up, I noticed that his ears are very yellow.” He instantly knew, but he did a blood panel anyway. In some cases they would do a liver biopsy under light anesthesia, but in our case the blood panel was suffi

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People generally assume there is an infection when chills are accompanied by fever, but that’s not always the case. There is a long list of medical conditions which may manifest as chills without a fever. Each one is described in detail, below.When the body attempts to produce heat to increase its temperature from within, the muscles contract and relax rapidly. You can see goose bumps on the skin when it is cold and during times of stress. This is what happens when chills manifest.If the chills occur without a fever, it may indicate any of the following conditions:Bladder infections (aka cystitis or urinary tract infections) effect women much more than men. Most of these infections are caused by bacteria that enter the urethra and then the bladder and can spread to the kidneys if left unchecked. One in five women will get a bladder infection at some point and if she’s had one before, she’s more likely to have another. Men rarely get bladder infections, although the likelihood he will increases with age.
A bladder infection does not always cause chills as one of its symptoms but its symptoms may include:
chills (with or without a low grade fever)
increased urinary frequency,
the sensation of a full bladder even when you just emptied it,
strong-smelling, cloudy, or bloody urine,
cramping in abdomen, and
a burning sensation during urination,
If you experience any or all of these symptoms, you should consult a physician to determine the underlying cause. If it is a urinary tract infection, your doctor may prescribe antibiotics such as ampicillin, penicillin, or sulfisoxazole. The duration of treatment depends on the age and gender of the patient but lasts three days for most women. Male patients and children require longer duration of treatment, usually from seven to ten days. In some cases, the infection spreads to the kidneys or the patient may need to undergo a surgical procedure to address any problems that may have caused the infection.Certain prescription drugs may cause side effects like chills without fever. You may have a reaction to your medication, it may not mix well with another medication you’re taking, or perhaps the drug was incorrectly prescribed or you didn’t use it correctly. You may experience:
a series of bouts of chills without fever,
uncontrollable muscle spasms,
sleeplessness or drowsiness,
hypersensitivity,
nausea and/or vomiting, and
heart ailments.
There are numerous reasons the body might not get adequate nutrients.These include digestion and absorption issues, insufficient food or food that lacks proper nutrition, and secondary health conditions. General symptoms include:
chills without fever,
depression,
exhaustion,
lightheadedness,
and loss of weight.
The symptoms of malnutrition may come and go depending on the cause angina malnutrition. A doctor will assess the situation and make a prescription, depending upon the circumstances.Anemia http://www.doctorbittercom.charterly.com a deficiency of red blood cells or hemoglobin in the blood. Its symptoms include:
chills without fever,
cold hands and feet,
weakness and angina pectoris; skin,
depression,
angina (severe chest pain),
dizziness and/or difficult or labored breathing,
a fast or irregular heartbeat,
cognitive difficulties, and
headaches.
The cause of anemia determine how it will be treated. If an iron or nutrition deficiency is the cause, doctors may give supplements to be added to the patient’s daily dietary regimen. If it is caused by severe loss of blood, treatment may involve a blood transfusion. If it is an autoimmune condition, the physician may prescribe drugs to keep the immune system in check. Bone marrow problems may also cause anemia. This is managed with erythropoietin, a medication that acts to stimulate production of blood cells in the bone marrow.Hypoglycemia is a clinical syndrome that results from low blood sugar. Its symptoms come on quickly and include:
chills without fever,
vision problems,
confusion or delirium,
heart palpitations,
anxiousness,
weakness and/or trembling,
diaphoresis (sweating), and
intense hunger (perhaps to the point of nausea).
When hypoglycemia is the problem, intervention involves an immediate increase of blood sugar via intake of food with high sugar content. As soon as blood sugar levels have normalized, the next step is to determine what caused the patient to become hypoglycemic. Some causes include uncontrolled diabetes, excessive alcohol intake, side effect of medication, high levels of insulin, endocrine problems, and kidney or liver conditions. Once the underlying cause is determined, appropriate treatment can be rendered.The thyroid is a gland that releases metabolic hormones. Hypothyroidism occurs when the gland is underactive and does not generate adequate hormones to control the way your body uses energy. Its earliest symptoms may include:
chills without fever,
depression,
fatigue, weakness, or listlessness,
constipation,
heavy menstrual period,
aching joints and muscles,
pale skin,
weight gain,
fragile or thin hair or fingernails that break easily.
As the condition develops, other symptoms become apparent such as bloating in the face, feet, and hands, slow or hoarse speech, thickening of the skin and thinning eyebrows, and loss of taste and smell.
When your thyroid is sluggish, you’ll need to take hormones to replenish the deficiency. Medical management may involve Levothyroxine that the patient must sometimes continue taking even after symptoms are gone.What if you’re perfectly healthy but you still feel cold? If there is no underlying health problem causing the chills, they might be managed through certain natural solutions or remedies.
Adequate rest and enough hours of sleep without disturbance can alleviate chills. The recommended number is eight to nine hours of continuous, uninterrupted sleep.
Consume sufficient amounts of nutritious food without skipping meals. Make sure to keep healthy foods on hand in case hunger strikes, like fruits, energy bars, or other handy snacks.
Maintain a regular exercise regimen. It does not have to be rigorous. Morning walks or doing laps in the pool are recommended. Physical activity is great for keeping your blood circulating.
Vitamin B is highly beneficial to maintain homeostasis in the body. This vitamin can help alleviate chills and improve energy.
Taking sips of warm water is very relaxing for the body, aids in digestion, and reduces chills. It helps to keep the body hydrated and also helps maintain body heat.
A warm bath or shower can soothe and provide warmth to the body and reduce chills.
Rochester Cemetery has been a favorite of ghost hunters and Halloween thrill seekers since at least 1967. They come here hoping to see the infamous Albino Woman who roams the cemetery as well as the surrounding neighborhood, supposedly searching for her lost child. But Rochester Cemetery is much more than the home of a famous ghost. Perched on a bluff overlooking the Kaw River Valley near Topeka, Kansas, Rochester is possibly the capital city’s oldest cemetery. A sign at the side of Menninger Road proclaims it’s been there “since 1850″. But most any American history buff knows Kansas Territory wasn’t opened to white settlerment until 1854. Therefore, any burials before that date would have been pioneers from “the States” (as everytthing east of the Missouri border was then known), bound for New Mexico on the Santa Fe Trail. Covered wagons making this arduous journey had been passing nearby since 1821. The most charming aspect of Rochester is the abundance of trees, many uncommonly tall for the area. During spring and summer, it’s not hard to imagine that you’re in an ancient burial ground somewhere in the British Isles. Because the trees provide a nearly solid canopy of shade, better take a jacket on a summer day because the temperature can be twenty or more degrees cooler. AC comliments of Mother Nature. With so much of the sun blocked out, it’s also quite spooky, which only adds to its reputation for being haunted. But only when the trees are in full leaf does it
look like a place where one could meet a roaming spirit at any moment,
even during a daytime visit. When the trees are bare, as in the photo above, Rochester doesn’t seem spooky at all. Then it’s “just” a cemetery.I recently seized an opportunity to visit, looking forward
not only to a respite from the the day’s unseasonable heat, but also
the chance to connect with my British roots. Why I thought the trees in Rochester would have leaves when every other tree for miles around didn’t is beyond me. Wishful thinking probably. But there I was.
Determined the trip wouldn’t be a total waste, I followed the road round to the oldest section. Usually this is the least visited part of a cemetery because family members and friends who used to bring flowers on special days have died or moved away. Following the 19th century tradition that graves face the morning sun, Rochester’s is on a downhill slope on the east side.Since I didn’t get my Brit F

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In Shadowrun Returns, the hero is close to learning the truth about the Ripper. First, he must get the DNA sample to Johnny Clean and David Fry II. Johnny Clean will hack into the matrix and learn the truth about the DNA sample and the identity of the Ripper from the various information databases http://www.doctorbittercom.charterly.com the matrix. This will provide tactics for the hero as he confronts the Ripper and defeats him at the Mercy Mental Hospital.Johnny Clean is jacked into the matrix. This is a fairly linear section, where Johnny Clean will move from point A to point B to point C and defeat security drones along the way. The objective is to get to reach the information database and get the required information from the database.
Johnny Clean will have no problems with the drones and getting to the information database, as long as he stays behind cover each time and attacks the drones from behind cover, one at a time. Do not attack from wide open spaces. Remember to heal up when Johnny Clean’s IP points are down.After getting the required information from the databases, go discuss the information with Johnny Clean and David Fry II. Through the conversational options in the dialogue, work out the identity of the Ripper and then prepare to go to Mercy Hospital to force him to confess.
Again pick the most appropriate team of shadowrunners ”9speak to Mr Delilah) to come along with you. Remember that Shannon Half-Sky can be recruited for free.
At Mercy Hospital main entrance and lobby, Dr Holmes will take some time to answer the hero’s call. Take this opportunity to explore the asylum. The purpose of these extra quests is to get karma points to raise the hero’s primary attribute as much as possible, in preparation for the big fights that are to come in the game.
First, head down to the cafeteria area and speak to Lorraine. Lorraine will ask the hero to find her friend for her. Head hospital and then east down the corridor a room with mangled pieces of a corpse. Pick up the ring and return to Lorraine for some karma points.
Then, Dr Holmes answers his call. Through the window, throw the truth at Dr Holmes. He does not even deny the truth. A massive fight breaks out between the asylum’s security guards, crazy patients and the team of heroes. This series of fights will take place over three sections, with the final section being the final fight to take down Dr Holmes.
If the main hero is a mage, then the tactics will be the same as before.
In the first section, the key is to work your way down the corridor on the right to the exit on the top right half of the section. The way will be guarded by guards and crazy patients. Hide behind cover and defeat them all.In the second section or Halls of Disrepair, the key is to work your way down the corridor on the left to a room and area where a gate key is located. More crazy patients and security guards block the way there. Once the hero and his team get the gate key, go back to the center of the section. The previously locked gate will now be unlocked, and the hero can proceed through and then get to the exit to reach the final section. Of course, there is the small matter of some resistance from mobs and monsters along the way.Finally, Dr Holmes is within reach at the end of the third section. In the third and final section, Dr Holmes will command his Frankenstein monster, Pitezel to finish off the hero and his mates. The main tactics used here are –
Command the drone and the adept to move in first and tank / attack Pitezel.
Concentrate all attacks and use as much damage as possible on the Pitezel until he is down.
Remember to use Shannon Half-Sky to haste the adept.
Use the mage hero’s most powerful spells on the Pitezel.
When this monster is finished, attack Dr Holmes relentlessly until he is defeated.
Dr Holmes is defeated, and Sam Watts has been avenged, but the ultimate culprit pulling the strings for Dr Holmes is still out there. It’s time to unearth this culprit.
Return to the Seamstresses Union and stock up, and then go attend Sam’s funeral.I volunteer to drive vulnerable patients to their hospital appointments. I do this on behalf and to support the ambulance service. We use our own vehicles and do not get paid for our time. This is my second confession. This confessions of a hospital volunteer ambulance driver is about a forgetful priest.

We are sometimes given tight schedules to deliver our patients. We often have a full seat capacity of patients with multiple pick-ups and drops. Each patient is assisted and escorted. We are used efficiently, effectively and economically.

It wasn’t an unusual day. I was given a list of patients and, although a bit of a rush, I managed to let them all know my progress throughout the day. It was in the afternoon that I picked up a cancer patient for a drop some 50 miles into radiotherapy. The second patient was to go to an outpatient’s appointment. I phoned up both and discovered that the second one was to be picked up from a ward on route. I asked the nurse if there were special requirements and where the patient was to be escorted to. She didn’t know but agreed to have him ready.
Time was tight. I arrived at the hospital. The patient wasn’t ready. I reminded the nurse that we needed to leave. So, a nurses five minutes later… and we all know how long this! I introduced myself to the man in his room. I was trying to speed up the process and see what I could do to help. He looked a little confused. “Hello, Mr O’Ryan. I’m Sharon and I will taking you to your outpatients appointment.” An Irish accent returned with a little vagueness, “Ock, I thank you.” I helped him with his coat and we proceeded to the car. The nurse armed me with a thick folder of notes. I noticed on the header of the folder his name – he was a Father, so I thought it a good icebreaker and friendlily mentioned this. When we got to the car, I noticed a little hesitation. “Is everything alright, Father?” I asked. “Ock, yes, all is fine.” So I tucked him in the back seat with his seat belt and proceeded. “So, you are off to Longitude Hospital. Which outpatients clinic do you need to attend, Father?” I enquired. “Oh, for the life of me I can’t remember. It’s something the other Father’s had organised, I really can’t tell you.” I thought, my God, there are dozens of clinics at this major hospital; it is going to be like a needle in a haystack! “Do you have a letter at all?” I tentatively asked. “Um,” He thought deeply, “I think I left it on the side, before the accident.” Oh, so he was in an accident of some kind, I thought. Then I realised his hesitation when he encountered the car. “When was the last time you were in a car, Father?” I fished. “Well, it must have been,” he thought for a few moments, “when my car collided with that other one. Yes, be Jesus, so it was!” This poor man must have been caught in a smash up, knocked unconscious and suffering from memory loss. I hadn’t been prepared for this but as we come across all sorts of challenges helping people, it isn’t unusual to have to think on our feet as a volunteer. I felt that the Father would have been reliving past events in his mind, now there was an association with the car. It might have been that he had only just remembered. Taking this on board, hospital; realised how important it was to make this first journey good. Like riding a bike, if a child falls, the best way to help them move on is by getting him straight back on again. I decided to take a route that was limited in traffic, nice to look at and reliable in time. It was important to reassure and divert the attention from negative conflict with other cars, providing a smooth journey. This journey, therefore, was more than just taking someone to their appointment. This could have a marked affect on his recovery. Time was tight, but I wouldn’t let the pressure make me drive faster and affect the father.

During the journey, I reassured him not to worry about being late. All would be fine and I would find out when we got to the destination where we needed to be. I pointed out all the lovely spots and conversation points of interest to help keep him calm. It was a conversation that included all of us, including the cancer patient. I could see that my resources, however, was more needed with the Father than the patient going to radiotherapy, so I dropped him off first and escorted him to the right place. I gave him a pre-prepared note with my telephone number so as the receptionist to contact me and I could give her an idea how long he would be.

We reached Longitude Hospital, just about on time, but now the challenge – hunt the right outpatients department! It would have been fine if the control office knew where he was supposed to be, but they didn’t have a clue either! I went to department 1 – to no avail. They had no record on the computer system. I then

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