text:
Central Apartment with Wi-Fi
Size70 m²
Floor No.2(with elevator)
- Family/child friendly
- Internet/WiFi
- Kitchen
- Washer/dryer
- Disabled access
- Elevator in building
- Balcony/terrace
|Arfe, 41001 Sevilla, Spain
|Property type
|Property ID
|Acceptance rate
|Response time
|A few hours
|Calendar updated
A comfortable double bed and a chest of drawers are placed in the warmly decorated bedroom. Enter the living/dining room to find additional sleeping space in the form of a double sofa bed and a single bed. The fitted kitchen can be used to prepare home cooked meals.
Walk in 2 minutes to the Giralda, a former minaret that was converted to a bell tower for Seville Cathedral. Four hundred metres away lies the Alcázar of Seville, a UNESCO World Heritage Site and the oldest palace still in use in Europe.
Metro and bus stops in additional to a taxi rank are all within walking distance. Many restaurants, bars and shops are in close proximity.
|Check-in after
|On arrangement
|Check-in before
|On arrangement
|Check-out before
|On arrangement
|Cancellation Policy
Javier and his wife are very nice for breakfast, concerned that their guests enjoy their stay. Their apartment in the heart of Tirana is ideally located, everything can be done on foot. The rather popular area is very nice, tapas bars are small prices to appreciate with Seville at the Nuot fallen. The apartment itself was very nice, clean, comfortable beds, it lacks nothing (dishes, pillows, ...) and the gem, the roof terrace in the shade in the evening, perfect for taking a drink before exploring the city at night. Anyway, I highly recommend this apartment! Thank you to his wife and javier
Javier et sa femme sont des hotes très agréables, soucieux que leurs locataires passent un agréable séjour.
Leur appartement au coeur du quartier de Tirana est idéalement placé, tout peut se faire à pied. Le quartier plutot populaire, est très agréable, de bon bars à tapas à petits prix sont à apprécier avec les sévillans dès la nuot tombée.
L'appartement en soi est très bien, propre, literie confortable, on ne manque de rien (vaisselle, oreillers, ...); et le petit bijou, la terrasse sur le toit, à l'ombre en soirée, parfaite pour prendre l'apéro avant de découvrir la ville de nuit.
Bref je recommande vivement cet appartement!
Merci à javier et sa femme
- Quality assured accommodation
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text: I am facing some problem with the free version of the Avast. I have Windows XP professional installed on my computer and after installing that I found that the performance of the virtual machine slows down a lot. I am having the VMware Server 1. Can you tell me that what could be the problem with this? If I try by disabling the real time protection then the it is running the virtual machine without any problem but as I activate the protection then it shows me the same problem again. Please help me with this.

subset: commoncrawl


text:
The Physical Therapist Assistant Program at Penn State Hazleton.
The Physical Therapist Assistant Program at Penn State Hazleton was granted initial accreditation in 1983 with an enrollment of 20 students and was the first PTA Program offered within The Pennsylvania State University. Since then, the program has successfully prepared many Physical Therapist Assistants following the best traditions of excellence in education which are the trademark of The University. Today, the PTA Program employs four engaged full-time instructors and one full-time lab assistant who work closely with students to encourage professional and personal growth. The campus admits 54 students/class and has state-of-the art facilities that mirrors contemporary practice with over 900 agreements to support our clinical education curriculum. The Program's next accreditation is scheduled for June 2016.
The curriculum is a combination of general education, applied physical therapy sciences and three full-time clinical learning experiences. After successful completion of the didactic and clinical components of the PTA curriculum students will earn an Associate in Applied Science degree from Pennsylvania State University. PTA's must graduate from a CAPTE-accredited program and are required to obtain licensure in most states to work. Students seeking licensure as a PTA must apply to the licensing authority of the jurisdiction (state) in which the graduate is seeking licensure and then register for the National Physical Therapy Examination for PTA's administered by the Federation of State Boards of Physical Therapy.
**The Physical Therapist Assistant Program at The Pennsylvania State University, Hazleton Campus is accredited by the Commission on Accreditation in Physical Therapy Education (CAPTE), 1111 North Fairfax Street, Alexandria, Virginia 22314; telephone: 703-706-3245; email: email@example.com; website: http://www.capteonline.org.
Admission Information
Admission to the program is available to first-year, transfer students, re-enrollment applicants, and current Penn State students wishing to change major/campus. Students are admitted during the fall semester. Spring semester admission is possible for transfer students if they have taken anatomy; decisions will be made on an individual basis. The size of each class is limited to 54 students. This number allows for optimal academic, clinical and practical experiences while maintaining a high degree of individual attention for the students. The recommended deadline for application is November 30 of the year prior to the next fall admissions. Applications received after November 30 will be considered in a later pool of applicants.
The applicants will be selected based primarily on their prior GPA (grades in science courses are weighed heavily). Documented observations in physical therapy clinics amounting to at least 10 hours, will be reviewed favorably; this documentation must be sent directly to Dr. Rosemarie Petrilla, not University Park. For the PTA Observation Form click here.
Students currently in 2 PTA majors at another Penn State campus, who wish to change campuses and 2 PTA programs, will be considered based on availability of space. The direct approval of the program coordinator at the Hazleton campus will be required.
Articulation Agreement Between Penn State and Misericordia University
On September 2, 2009, Pennsylvania State University, through Penn State Hazleton, and Misericordia University entered into an agreement to transfer academic credits from Penn State's Associates in Science Degree in the Physical Therapist Assistant Program to the Doctor of Physical Therapy Degree program offered by Misericordia University. Graduates of the PTA Program can continue their education to earn a bachelors degree at Penn State that includes the prerequisites as per the agreement and must remain in good standing can apply to Misericorida University's Doctor of Physical Therapy degree program. Please contact the following individuals for information regarding this agreement.
Penn State Hazleton's representative:
Rosemarie Petrilla, PT, DPT
Address: 76 University Drive
Hazleton, PA 18202
E-mail: firstname.lastname@example.com
Phone: 570-450-3042
Misericordia University's representative:
Susan P. Barker, PT, PhD
Address: 301 Lake Street
Dallas, PA, 18612
E-mail: firstname.lastname@example.com
Phone: 570-674-8096
- PTA Program Information


text:
Rainbow of irises provides show in Norman
NORMAN — Red Foster says he grows irises rather than other flowers because their hardy nature and drought resistant qualities allow them to thrive under Oklahoma weather conditions.
Plus, he said, he just plain loves them.
"They get me up in the morning and keep me going all day," Foster said.
Foster is a longtime member and current vice president of the Oklahoma Iris Society, whose members participated in the Norman chapter's National Iris Society Show on Sunday at the Norman Public Library.
The name 'iris' comes from the Greek goddess of rainbows, and all shades of the rainbow were represented at the show.
Silverado irises with pearly-white petals stood alongside sherbet-orange Volunteer Pride irises. Some varieties, like the deep crimson Cranapple and the royal purple Daughter of Stars, represent variations on more traditional colors.
Others, like the chocolate-brown Huckleberry Fudge and translucent gray-green Ozone Alert, are unlike anything seen in a typical garden.
Foster says he has more than 1,000 irises growing at his home in Shawnee. One of his tricks, he says, is watering them with rainwater, spiked with just a pinch of artificial sweetener. The flowers seem to like it, he said.
More than three dozen flowers were submitted for this year's show. Irises were divided into category by variety, and first-, second- and third-place ribbons were awarded. The blue-ribbon winners moved on to what is called the Queen's Court, where they compete for the title of Queen.
This year's Queen was Night Skies Glowing, an iris grown by Cynthia Wade, of Oklahoma City. Wade is president of the Oklahoma Iris Society.
The contest is open to anyone who grows irises and can name the breed. In the artistic display category, entries were judged on the arrangement of the irises in decorative vases or alongside other flowers.
Louise Carson, a member of the Norman area society, served as show chairwoman. Two of her entries made it to the Queen's Court. Although not a judge in the Norman show, Carson is certified by the Iris Society and knows what traits please the judges.
"There are a lot of things we look for," she said.
"The condition of the flower, and of the stem, and the culture of the plant. What we really judge them against is not their neighbors, but against what others of its category are supposed to look like," Carson said.
The Norman chapter will hold sales to raise money for the society on June 22 and July 6. Both sales will be in conjunction with the Norman Farm Market at the Cleveland County Fairgrounds, 615 E Robinson St.
Many of the plants for sale will be the award-winning varieties represented in this year's show, Carson said.


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"Ciudad del Este" Top 5 Page for this destination Ciudad del Este by RudoElCojonudo
Ciudad del Este Travel Guide: 43 reviews and 84 photos
Ciudad del Este is in the Paragayan border, close to Brasil and Argentina, near Iguazu Falls, one of the biggest in the world.
Ciudad del Este is like a huge market, you can find everything here, from sport shoes to sun glasses, and everything perfectly falsified. Nothing has a fix price and everything is for sale.
There are some stores also, which are suposed to be more trustable, but not to much anyway.
The city is chaothic, people going up and down, cars and motorbikes everywhere going quick, and street vendors talking to you, everything is dirty and people drinking mate continiously.
They ofered us virgin girls for 60 reais and any kind of drug. *:-|
Coming back to Campinas y was the only one in the bus who wasn't a merchant. The bus was full of people with huge suitcases full of.... anything, going back their Brasilian cities where they would sell it more expensive. My eventual bus mate told me that he does this trip twice a week, more 60 hours by bus per week. Incredible!!
He told me that most of the shops and stores belong to chineese, Hong Kong and muslim people, and that it was comon to be a 3 or 4 deaths every night because of the mafias. It was frigtening!!
But it's normal, actually, if you go to Ciudad del Este by bus from Foz de iguazu there are no controls in the border. I coulden't belive that!!
The chaos in the eath exists and I have been there, people knows that like... Ciudad del Este.
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Don't forget you passport!! Remember that the argentinian and brasilian borders are really close, maybe you want to... more travel advice
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Ivy Tech Community College's State Board of Trustees has announced what it is calling the most substantial organizational changes in the system's 50-year history.
Some of the community college's regions will be consolidated, and Ivy Tech will operate with 11 regional chancellors, according to a news release. At one time, the college had 14 chancellors.
The consolidation includes Columbus/Franklin, which has been overseen by Chancellor John Hogan. He has been named associate vice president for student affairs within the Ivy Tech statewide system.
The Columbus region, which includes degree-granting locations of Columbus and Franklin, will be combined with the Southeast region, which includes locations in Batesville, Lawrenceburg and Madison, the release said. These locations will be overseen by a single chancellor.
Ivy Tech said an interim chancellor for the newly defined Columbus/Franklin region will be named in the coming weeks.
Other restructuring announced Tuesday includes:
Combination of the East Central region, which includes the degree-granting locations of Anderson, Marion, Muncie and New Castle, with the Richmond region, which includes the Richmond and Connersville locations. These locations will be led by current East Central Chancellor Andrew Bowne.
The Greencastle location, formerly part of the Wabash Valley region, now will be managed as part of the Central Indiana region.
The college first combined regions in April 2013 when Chancellor Thomas G. Coley was named to oversee both his current North Central region in addition to the Northwest region.
The changes will result in increased efficiencies and further focus on the various communities the community colleges serves, the release said.
"Ivy Tech is focused on being responsive to the local community needs and workforce development efforts. Regional consolidation ... will allow us to expand our outreach efforts and ensure that we are providing what our communities need," Ivy Tech President Thomas J. Snyder said in the news release.
"All of these changes are a part of our plan to align with the Indiana Career Council and Works Councils efforts," Snyder said. "Ivy Tech, in addition to its transfer mission, continues to be focused on job-skills development and career training. Our new structure will allow us to best assess existing skill gaps between available jobs and Indiana's workforce and partner with business and industry to fill those gaps."


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Product 3/12
Do your days seem to be spinning faster and faster? Do you often feel you can't possibly get everything done you want or need to do? Do you wish you could get off of the world for a while?
Decompress your life! You will feel the difference. Others will see the difference in you and how you react to them.
Through this powerful hypnosis and suggestion program, you will learn to unwind your mind and body from the tension brought on by the rigors of your day.


text: GoldenBearSports.com Petri Goes Through Hall Of Fame Festivities Former Water Polo Standout Formally Enshrined By Cal Athletics on Thu, October 24, 2013 Related Links Follow Cal Women's Water Polo on Twitter BERKELEY - After being voted into the Cal Athletic Hall of Fame in May, former women's water polo standout Heather Petri went through enshrinement festivities last weekend. Petri, the only four-time female Olympian in school history and the only athlete ever at Cal to win medals in four separate Olympic Games, joined seven other former Cal athletes at the annual Hall of Fame banquet at the Greek Orthodox Church Conference Center in Oakland last Friday. The class of 2013 also was honored at halftime of the Cal football game on Saturday. Petri helped Team USA to a gold medal in 2012, silver medals in 2000 and 2008 and a bronze medal in 2004. She starred for the Bears from 1997-99 and 2001; Petri took the 2000 season off to train with Team USA and prepare for the Olympics. Petri had her cap retired in a special ceremony before a home match last season. RECOMMENDED STORIES < Bears Place Eight On MPSF All-Academic Team Petri Named To Pac-12 All Century Team Carrega Named To All-MPSF First Team > OFFICIAL ONLINE STORE < Men's Nike Gray Cal Bears Team Stripe T-Shirt $25.95 Buy Now > Cal Bears Nike Navy Blue Medium Training Duffle Bag $60.00 Buy Now > > Left Promo SHOP NOW > Right Promo MORE INFO > Bears On Pac-12 Networks Full TV Schedule Get Pac-12 Networks


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Holliday aims to pick up where he left off
DENVER With all due respect to Peyton Manning and his trio of wide receivers, the most electrifying member of the Denver Broncos is 5-foot-5 speedster Trindon Holliday.
By now, fans know not to run to the fridge or to the concessions stands when Holliday's about to return a punt or a kick.
The former LSU track star had four TD returns last year but also fumbled five times. His make-or-break style was such a sore spot that a radio reporter asked coach John Fox before last year's playoffs if Holliday would be active on game day.
Was he ever.
Denver's diminutive returner raced right into history when he piled up a league-record 248 yards in returns against the Baltimore Ravens. He became the first NFL player ever to take back both a punt and a kickoff for TDs in a playoff game. And those touchdowns were the longest punt (90 yards) and kickoff (104 yards) returns for scores ever in the postseason.
Holliday's breakout, however, was relegated to a footnote when the Ravens outlasted the favored Broncos 38-35 in double overtime thanks to Jacoby Jones' game-tying 70-yard touchdown catch from Joe Flacco with 31 seconds left in regulation.
Otherwise, it might have been Holliday and not Jones putting his fingerprints on the Lombardi Trophy in New Orleans, appearing on Jimmy Kimmel's late show and prancing across the floor with Karina Smirnoff on "Dancing With The Stars" in the offseason.
"On the one hand for us, I thought we did a sub-par job on both of those plays, which is usually the case when balls go back all the way," Ravens coach John Harbaugh said as Baltimore prepared to kick off the new season at Denver on Thursday night. "It was an amazing turn of events for a divisional game to have two returns for touchdowns.
"So, from that standpoint, I guess I had reluctant admiration for what they accomplished and what he accomplished in such a big setting."
Holliday was a perfect 16-0 in the regular season last year. He started his season with the Houston Texans, but after their 5-0 start, they jettisoned the returner and the Broncos grabbed him off waivers, then won their next 11 games with Holliday leading the league with a 32.5-yard kick return average and a 10.8-yard punt return average from Week 6 on.
The sprinter was an eight-time All-American in track and field at LSU, winning the 2009 NCAA title by running the 100-meter dash in 10 seconds flat. But he really made himself a household name on Jan. 12 - until the Broncos blew their late lead and were sent packing by the eventual Super Bowl champs.
Holliday, who also returned a punt and a kickoff for touchdowns in consecutive games during the regular season, figures he can be even better in 2013 with a full offseason in Denver's system. He's also hoping to play more than a cameo role on offense after being used sparingly last season, when he caught a pair of passes from Manning.
The Broncos want to get the ball in his hands as much as possible.
"I'm glad I'm not kicking to him anymore and he's on our team now," teammate Matt Prater said. "He's a fun guy to watch because any time he touches the ball, it's exciting. He can score on any play."
He can also put it on the ground at any time, part of what led to the Texans giving up on him.
Holliday worked hard on ball security this offseason after making fans, teammates and coaches cringe as much as celebrate whenever he touched the ball and turned on those jets.


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text:
Dirty Hunch Punch
Dirty Hunch Punch
1 Liter Everclear
1 Liter Malibu Coconut Rum
1/2 Liter Vodka
2 Large Cans Pineapple Juice
1 Gallon Hawaiian Punch
Variety of Fruit — Cherries, Slices of Oranges, Tangerines, Pineapple etc.
Pour all ingredients into a large container in the order given
Stir well
You can add ice to this punch, but it will dilute it somewhat as it melts
just fill individual glasses with ice
Any size glass you want
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I give away a huge amount of free information on this site and I also promote some third party products. I will not recommend anything that I haven't used or needed or find to be of significant value. Yes - Sometimes I receive a commission when these products are purchased from this site. Once again, I do not or will not promote anything that is not useful or valuable.


text:
- Differential Diagnosis
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- Try building your search one term at a time, and be as specific as you can! Search term example: "chronic cough".
- Do not enter multiple findings such as "anemia, chronic cough, weight loss, vomiting" all at the same time.
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Differential Diagnosis For Microlab/Latex fix antigen test abnormal
Available only to registered users.
- Suggest
- 2 possible diagnoses found
- Infectious Disorders (Specific Agent)
- Staphylococcus aureus infection
- Staphylococcus aureus/CA-MRSA virulent PVL gene
- Synonyms
- Abnormal, Agglutination Test Latex, Agglutination Tests Latex, Fixation Test Latex, Fixation Tests Latex, LA, LA Latex agglutination, Latex agglutination, Latex agglutination assay, Latex agglutination test, Latex agglutination test (procedure), Latex Agglutination Tests, Latex Fixation Test, Latex Fixation Tests, latex particle agglutination test, Microbiology Lab, Test Latex Agglutination, Test Latex Fixation, Tests Latex Agglutination, Tests Latex Fixation
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text:
Curtis William Estep and Denise Coffman, both of Franklin
Brandon Alton Gunter and Cistinna Lynn Cathcart, both of Nineveh
Rogelio Urive-Garcia and Maria Dolores Briseno Cardenas, both of Greenwood
Joseph Cleeter Hardwick of Indianapolis and Mikaela Ann Thomas of Greenwood
Keith Lawrence Toombs of Greenwood and Charlotte Lynn Whitaker of Mooresville
Deanthony Lynell Knighten and Elizabeth Jay Streicher, both of Franklin
Jason Eugene Jones and Lisa Marie Adams, both of Franklin
John Robert Proctor and Julia Ann Schrelick, both of Edinburgh
Clarence Henry Chastain of Greenwood and Reva Joy Porter of
Zachariah James Campbell and Kimberly Anne Sanford, both of
Jonathan Randall Goode and Amanda Gayle Kindred, both of
Robert Nathaniel Curtis Foltz and Billie Jean Guldi, both of Bargersville
Kevin Bryan Kraus and Leslie Rene Kraus, both of Franklin
Daniel Ray Proctor of Greenwood and Amy Elaine Latkowski of Beech Grove
Christopher Lowell Haste and Anna Tsurkan, both of Trafalgar
Mark Anthony Howell and Alicia Ann Schaeffer, both of Franklin
Andrew Michael Myers and Anne Katherine Smith, both of Greenwood
Terry L. Cooper and Dawn Renee Taylor, both of Greenwood
Andrew Thomas Kahl and Misty Lee Murdoch, both of Franklin
Brendan Allen Murphy and Taylor Dawn Tucker, both of Greenwood
Paul Wayne Roberts and Kelli Jo Hall, both of Franklin
Isidro Alfonso-Guadalupe and Tiffany Marie Daniel, both of Greenwood
Cody James Beck and Brittany Maria Vanatta, both of Greenwood
Robert Liberty Peters and Christina Larraine Cooper, both of Prince's Lakes
Dalante Dontrel Hampton of Franklin and Amber Shanice Hurt of LaPorte
Matthew Paul Huggins and Katlin Sue Ten Zyck, both of Greenwood
Daniel Ray Ryle and Beth Ann Whitney, both of New Whiteland
Jamie Ray Higginbotham and Sylvia Leighann Cook, both of Franklin
Sean Alan Small and Lindsey Paige Higdon, both of Franklin
All content copyright ©2016 Daily Journal, a publication of AIM Media Indiana unless otherwise noted.
All rights reserved. Privacy policy.


text:
by Timothy Rutt
You're looking for a reason to get the kids in some air conditioning, aren't you? The Altadena Main Library will have an origami extravaganza this afternoon at 4:30.
Make Yoda and Darth Paper origami puppets from Tom Angleberger's popular Origami Yoda book series -- and they'll be raffling off copies of hew new book, The Secret of the Fortune Wookie.
It starts at 4:30 at the Altadena Main Library, 600 E. Mariposa St.


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I have one big problem after updated WP to version 2.7.
Well, my update was fine,after that I was able to login as admin but I had some problems with akismet plugin and that's where problem started.
I connected via ftp and put chmod666 to akismet folder (don't ask me why). After that, all of a sudden, akismet folder just disappeared.
I use Filezilla for ftp and don't know how to revert akismet folder.
I tried to overwrite akismet plugin with new one, but it always says 550 file exist, and permission denied.
I tried to delete whole plugin folder, it deleted all other plugins but at the end it shows message like folder is not empty, so I can't even delete plugin folder.
So, at the moment I can access to my blog only through ftp.
If I try with /wp-admin.php, after username and pass enter, the page just refresh without any messages (like wrong username or pass or stuff like that).
I think the problem started with this akismet (chmod 666) but maybe I am wrong. I googled and tried to find solution but without hope.
Anyone know how to solve this problem? I want to login to my blog as admin.
And how to get back that akismet folder with 666 permission??
I don't know what to write in ftp (tried with chmod 755 akismet, but nothing happens). Folder looks like hidden, I enabled in filezilla to show hidden files but it is still invisible.


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NewsOK Blogs / Alternate Crop
A Quick Preview
I've been editing pictures all morning. Last week I mentioned on our facebook account that I'd spent the day in Perry, Okla., photographing wrestlers for a story about the tradition and history of the sport in the small Oklahoma town.
I still have plenty of work to do, editing sound and putting together the slideshow, but here's a quick preview of the project. Look for Matt Patterson's story in the Sports section of Friday's newspaper and check back here for links to the online story, pictures and slideshow.
-John Clanton
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I have an application which contains some EL evaluation used for programmatic configuration. Given an EL expression I want to get what free variables it contains without actually evaluating it. The intention is to provide a UI where end users can bind values to free variables before pressing an "evaluate" button.
javax.el.ValueExpression does not provide this functionality, so I may need to use vendor-specific API. It is quite early in the development, so I have not yet fixed my choice of implementation. I have thought of MVEL, JUEL and SpEL, but of course whatever I chose should have the functionality I described above.


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Saturday, June 2, 2007
Pregnancy After A Preemie
50 comments:
- abby said...
This was a great post and we'll seekit outagain if and when we try to give hallie a sibling.
- June 3, 2007 at 10:23 AM
- Doc's Girl said...
Great post...I was reading in suspense...! :-D
- June 3, 2007 at 9:52 PM
- 20somethingmommy said...
I am so glad that somebody is talking about pregnancy after preemies...the idea of getting pregnant has so completely scared me that I will be candid here (you don't know me, after all ;) and tell you simply that my marital life has already been GREATLY affected by it. But for now that doesn't seem to bother either of us.
Anyway, thank you for this post. You have touched on some things in here and in previous posts that I honestly thought weren't felt or shared by anyone but me, until I read them here. And it makes me feel a little stronger every day. Maybe not so much because I'm "healing" from my preterm nightmare, but more because you have validated my feelings, and I know it's okay to be this way. At least for now. :)
- June 4, 2007 at 9:30 AM
- terri w/2 said...
Great post PE! Unlike you, I never did get the courage up to try again. With all the lifting of my daughter (who is in a wheelchair d/t CP caused by prematurity) I thought that this would be a huge detriment to carrying FT. Besides, one of my aunts had 2 sets of twins, and I just didn't want to take the chance of landing in hell (the NICU) again.
Has ANYone ANYwhere ever done research on how many preemies are born during allergy season? Both my friend and I delivered our preemies during the height of allergy season here in the upper midwest, and it has caused us to wonder of some type of systemic allergy trigger may have caused our PT delivery.
- June 4, 2007 at 11:15 AM
- The Preemie Experiment said...
Thank you all for the positive comments.
20something wrote: "You have touched on some things in here and in previous posts that I honestly thought weren't felt or shared by anyone but me, until I read them here. And it makes me feel a little stronger every day."
I'm glad I could help with validation. You'd be surprised at how many people share in the thoughts that I post. I get emails all of the time with supportive comments from preemie parents who feel guilty for their feelings. It's hard to separate the feelings of joy that your babies are alive with the ones of honest feelings. I'm thankful for my children but that doesn't take away from my true feelings.
On a side note... out of all of the emails that I get, this topic (pregnancy after preemie) is the most talked about. Parents are looking to me for the encouragement to try again. I cannot offer that.
Terriw/2 wrote: "Unlike you, I never did get the courage up to try again."
Oh no, no courage here. Quite the opposite. My son was a HUGE shock. Hubby and I were doing almost everything we could to NOT have another one. When I started having morning sickness, extreme emotional outbursts and low abdominal cramping I went out and got a pregnancy test. Both of them (different boxes) came out negative. I was convinced something else was wrong with me. I almost threw up when the nurse at the OB's office showed me the positive pregnancy stick.
We only had sex once that month (how's that for sharing my life to the world-told you my sex life was crap back then) and it was 5 days before I should have gotten my period. No where near ovulation time.
I never thought I would make it through pregnancy. I was supposed to be on bedrest but unfortunately Paige's care couldn't be put on hold. We still averaged a specialist a week (give or take) along with medical tests. It sucked.
I've had a few people give me grief for tying my tubes. But, there was no way I was going to have another surprise. My love for my son is so incredibly deep. I get teary, to this day, when I am with him. But, that doesn't mean I need to do it again! lol
- June 4, 2007 at 12:40 PM
- I am just the mother said...
What's wrong with tying your tubes?
- June 4, 2007 at 4:10 PM
- nancy said...
I want to know more about the rupture on the Uterus. I have never heard about it... I want to know if I am at risk....
- June 4, 2007 at 11:31 PM
- The Preemie Experiment said...
- This comment has been removed by the author.
- June 5, 2007 at 9:33 AM
- The Preemie Experiment said...
I am just the mother wrote: "PE,
What's wrong with tying your tubes?"
Boy oh boy did I catch crap for this one!
First, my family is Catholic (I no longer attend church-long story). Enough said there.
Religious friends told me that I was sinning. I received emails from people (that I didn't know-church members of friends) that were praying for me.
I cannot even begin to tell you how many people told me that I shouldn't have done it in case we wanted another one. I was and still am, very confident with my decision. I do NOT want to be pregnant any more. I am almost 39 years old. Every pregnancy would end with an early birth. No thank you. If I feel the intense need to add more kids to our family, I'll adopt.
Then there were the people who told me that I shouldn't do it in case one of my children got sick and I needed to have another baby to save them. I won't even comment on that one.
Then there were the people who told me that I would never feel normal, and may not even feel like a woman, again. Well, to those people... my sex life is 100% better now that my tubes are tied.
(to those who are going to email me and tell me that I still can get pregnant-I'm already aware of this)
- June 5, 2007 at 9:35 AM
- The Preemie Experiment said...
Nancy wrote: " want to know more about the rupture on the Uterus. I have never heard about it... I want to know if I am at risk.... "
Hi Nancy,
From what I understand, the risk changes based on the way you delivered in the past.
For me, I had a classical c-section.
I have also heard that it is less likely to happen in people who have gone full term with their prior pregnancies.
Buddhist Mamma... anything you can add here??
- June 5, 2007 at 10:04 AM
- I am just the mother said...
I know all about the abortion issue with the Catholics (am a disillusioned one myself) but didnt realize that tying of the tubes was a mortal sin. Please, people need to worry more about their own business and health issues. :)
- June 5, 2007 at 10:44 AM
- daedalus2u said...
Thank you for sharing your symptoms observations during your pregnancy. I need to read and think a lot more, but many of the symptoms associated with preterm birth seem to me to be related to low NO.
I think it is pretty clear that low NO is related to gestational diabetes, preeclampsia, and placental insufficiency and anemia.
I think it is also related to polyhydramnios, steroid abnormalities (they might not be measurable because it is local levels that "really matter", not what is in the blood) especially hyperandrogenic abnormities.
It might be related to PROM, PTL and risk of uterine rupture.
- June 5, 2007 at 5:10 PM
To Daedelus2u:
Most preterm labor and/or PROM (and a lot of what is attributed to "incompetent cervix") is associated with, or caused by, infection and inflammation. Somewhere between 60% to 80% of all very preterm births (before 33 weeks) are due to infection.
These infections can arise from elsewhere in the body. For example, gum disease, and the organisms associated with it, are implicated in preterm labor and delivery.
I'm guessing from what you've told us that vulnerability to infection may also involve NO imbalances?
- June 5, 2007 at 7:10 PM
- daedalus2u said...
Yes all of those infections do relate to NO. An important part of what regulates bacteria in the mouth is nitrate in saliva. Saliva concentrates nitrate (which is mostly from green leafy vegetables like lettuce) about 10x over plasma. There are bacteria on the tongue that reduce that nitrate to nitrite, which can reach about 2 mM/L in saliva. That is a lot. When that saliva is swallowed, the low pH in the stomach decomposes it and releases NO. That NO goes somewhere (the details are not known), eventually gets oxidized to nitrate and is then recycled in the saliva.
The standard treatment for bacterial vaginosis is metronidazole, which is an NO donor. Normal vaginal flora (the lactic acid bacteria) are extremely resistant to metronidazole (as are "my" bacteria) as well as other NO donors. One of the best known commensal vaginal lactic acid bacteria is Lactobacillus crispatus, which does make H2O2. The Lactic acid bacteria in yogurt are not necessarily the ones best adapted to be human commensals.
BV and premature delivery is usually characterized by higher vaginal pH, (normally it is less than 4.5 from lactic acid bacteria). The bacteria raise the pH by cleaving urea into ammonia. The combination of lactate, nitrite and hydrogen peroxide is ~100x more toxic to E coli than is any one alone.
I suspect that the "normal" vaginal flora does contain "my" bacteria, they simply have not been recognized yet. I suspect that the there is substantial synergy between the lactic acid bacteria and the nitrite producing bacteria. Lactic acid bacteria can produce some nitrite from nitrate, but "my" bacteria can produce orders of magnitude more. Normally, the low pH would actually inhibit them because they absorb ammonia as ammonia, and at low pH ammonia becomes ammonium and is unavailable. If there was an infection of bacteria that hydrolyzed urea to ammonia, it would create a local region of high pH where "my" bacteria would metabolize the ammonia into nitrite, lowering pH.
"My" bacteria are quite sensitive to alkyl-benzene sulfonate detergents which can kill them at ppm levels. Nonoxyl-9 may be quite toxic to them also.
- June 5, 2007 at 9:34 PM
Can you tell us more about your bacteria?
How did you find them in the first place? How do you "cultivate" them? How can they be identified? Has anyone else described them or carried out research using them? Anything published?
What antibiotics take them out? With what other bacteria do they happily co-exist?
How does one acquire them?
Do you recommend bacon and other cured meats as an NO source (in addition, of course, to green veggies as the *major* source)? I've heard that bacon, etc., can lead to stomach cancer.. is this true and, if so, how does one balance the risk/benefit?
I hope you are in touch with the March of Dimes about all of this.
- June 5, 2007 at 9:51 PM
- daedalus2u said...
Helen, "My" bacteria are quite common, being found in just about every soil, and every natural source of water including rivers, ground water and the ocean. They are responsible for the first step in the process of nitrification, the oxidation of ammonia into nitrite. Another type of bacteria takes the nitrite to nitrate.
They are very well known in soil chemistry and waste water treatment chemistry. The are obligate autotrophs, that is they are unable to metabolize organic compounds and use them for energy or to grow. Essentially all organic carbon they derive by fixing CO2 using the energy derived from oxidizing ammonia to nitrite. I think they are completely incapable of causing an "infection" because they don't have any enzymes to metabolize animal-derived compounds. They simply have no virulence factors.
I am the first to suggest that they might be commensal organisms, and I have found them on the surfaces of multiple organisms, including clams, mussels, lobsters, turtles, earthworms. They are probably commensal on most plants.
I figured out they were important when a friend asked me why her horse rolled in the dirt in March, before insects come out. I reasoned that it was to get the "right" bacteria on its skin before summer so that its sweat wouldn't peutrify. A major component of sweat is urea, bacteria can hydrolyze urea into ammonia which is bad, the bacteria in the soil that metabolize ammonia are the autotrophic ammonia oxidizing bacteria which eventually take it to nitrate which is benign. I reasoned that if getting the right bacteria on its skin was important enough for horses to evolve that behavior, it must be really important, and perhaps important for other mammals too. I looked in the literature, found nothing associated them with any organisms, isolated some from barnyard soil, reasoned that in the "wild", humans would be unable to prevent a biofilm of these bacteria from forming (humans in the "wild", never bathed in their entire lives).
So I decided to start my "science experiment", by putting some on me, establishing a biofilm of these bactera and then not bathe and "see what happened". That was 5 years ago (this month). My health has never been better. A lot of the life-long chronic disorders that I have had are now remarkably better.
The most striking changes have been in my mental health. I have Asperger's, and it is remarkably better, as is my depression, anxiety and PTSD.
I am not in contact with the March of Dimes, having Asperger's, it is really hard for me to do interpersonal stuff. What I have is pretty "far out", and people are simply not willing to spend the time to see if what I am saying makes sense or not. The NO research field is very complicated and very fragmented. There are a lot of misconceptions in it because some of the experimental work is quite challenging, and the NO pathways are so "coupled", that it is virtually impossible to perturb them artificially. I have made tremendous progress in getting to senior researchers at the highest levels, but getting funding to actually do stuff is quite another matter. I am not at an institution that has the capability of doing the kind of research that is necessary, or even of applying for grants to do it.
Research funding these days is so hard to come by, that most every granting agency has 10x or more proposals than they can fund. It is extremely difficult to fund one that is "far out" under those circumstances. It is perceived to be "high risk". What that means is that there is a "high risk" that the reviewers will appear to be foolish if the project fails.
I have been growing these bacteria in my basement for about 5 years now, using distilled water plus minerals plus ammonia. The only organic is from what they make themselves by fixing CO2. Not much else can live under the conditions I have them at.
If you get me your email I can send you some of what I have written. If you leave a comment on my blog with a return email, and then delete it, I will get the emailed comment but the spammers won't.
- June 6, 2007 at 9:46 AM
- The Preemie Experiment said...
I am just the mother said...
I know all about the abortion issue with the Catholics (am a disillusioned one myself) but didnt realize that tying of the tubes was a mortal sin. "
It's against the churches "rules" because it is a form of birth control.
- June 6, 2007 at 12:15 PM
- Katie said...
This post, and the one you linked to, are excellent posts. I wish I would have been able to read them several months ago.
My own preemie, 24 weeker who died after 98 days of life, was also born early due to PROM, the cause of which was not found. After his death, which had been preceded by a miscarriage and a stillbirth, I absolutely did not want to be pregnant again. No more babies (I have one daughter, a healthy 33 weeker, and an adopted son). The risk of another preemie was too high. My body and my heart couldn't take another months-long NICU stay, another loss...
I wanted my tubes tied. My husband was adamantly against it (he wanted more kids). I will echo what you said about if your partner and you are on different sides of this issue - get help. Hubby and I ended up separating for six months over this issue (and others, but this was the biggie) - eventually got back together but certainly not without help.
And then - surprise - I was pregnant. I felt like my world was crashing down around me again. I sat on the news for a few weeks, until my husband started suspecting. I did not want to be pregnant. I was devastated, and still grieving my lost son...but determined to come out of this pregnancy positively.
I also had the 17P shots, though I, too, had two bouts of pre-term labor. A couple months of bedrest later, and then the baby was *really* ready to come, nothing stopping this kid this time. I successfully completed a VBAC (which I hadn't expected to be even allowed to attempt) at 37 weeks, not quite my goal of 38 weeks but certainly good enough when it got me my healthy boy. And *this* time, this was absolutely my last pregnancy. In fact, the only downside of my VBAC was the loss of the opportunity of doing a tubal with the c-section I'd planned on.
In your post about your second pregnancy, you mentioned you did not want mag sulfate. May I ask why? It successfully stopped my PTL both times this recent pregnancy and I'm just curious.
- June 6, 2007 at 4:11 PM
To Daedalus2u:
My email is already pretty public, so:
I remember reading recently, I think it was in _Science News_, about a type of soil bacteria that could cure depression. I'm wondering if these could be your microbes?
Now, off to do some gardening!
- June 6, 2007 at 4:35 PM
- daedalus2u said...
I saw that article. No, those are not the bacteria I am working with. Those are Mycobacterium vaccae, which while nominally non-pathogenic, still can cause disease but mostly in immunocompromised individuals. They are mycobacteria, the same type of bacteria that cause leprosy and tuberculosis.
The mechanism by which these bacteria have effects is unknown. The acute immune system stimulation they induce with these bacteria is prompt, and likely involves induction of iNOS, and an increase in NO levels. Increased NO during septic shock does increase ATP levels in muscle, it likely would in the brain as well. What ever the agent is, it must pass through the blood-brain barrier. There are some immune system molecules that can do so.
The immunological effects on the nervous system that they observed are prompt effects. I suspect that the effects would not be effective in the long term. That is, I suspect they are an acute effect associated with an acute response to an immune system stimulation. You can't treat a chronic condition acutely. The antidepressant effects that I have observed with "my" bacteria are long term. I think the two effects are fundamentally different.
The bacteria I am working with, the autotrophic ammonia oxidizing bacteria have never been reported to cause any infection or disease and it is likely that they cannot do so because they don't have any virulence factors, they generate no toxins, and are unable to metabolize any animal derived organic compounds for either energy or growth. They are unable to grow on any media used to isolate pathogens. I think they cannot cause an infection, even in immunocompromised individuals.
My perspective is that "depression", is a generic aversive mental state brought about by diverse malfunctioning of multiple pathways. I think if you compromise brain metabolism, you will ultimately get some form of depression. It is an aversive mental state, to condition organisms to avoid stimuli that make them depressed. In the elderly, vascular depression is well known, depression that accompanies a decline in vascular activity in the brain. The selective serotonin uptake inhibitors (SSRIs) work by inhibiting the uptake of serotonin. Serotonin is synthesized, stored in granules and then released when that neuron fires. The serotonin is then both degraded and taken up to be used again. By inhibiting the uptake, the serotonin level remains higher for longer. Usually it takes some time for antidepressants to "work", and when one goes off them, there can be definite "withdrawal" symptoms. I suspect that what is happening is that whatever regulates the balance between serotonin release, and serotonin receptor activation is modified by the higher serotonin levels, and the number of serotonin receptors is reduced. This has the effect of reducing metabolic load on that neuron because fewer serotonin receptors need to be synthesized (at a cost of ATP), fewer serotonin receptors need to be transported out the axon to the synapse (at a cost of ATP), less serotonin needs to be synthesized (at a cost in ATP), and less serotonin needs to be uptaken (at a cost in ATP). The neuron can now work better because its metabolic demand is now better matched to its ATP supply (determined largely by NO).
My personal experience with antidepressants is that many of them did work for me, but they stopped after a while. My hypothesis is that many of the specific mechanisms are under feedback control, and that eventually that feedback brought my metabolism back to where I was depressed. Now, I think I have corrected the insufficient ATP on the front end, and so there isn't any metabolic disruption to "fix" pharmacologically. I have started tapering down my antidepressants and expect to eventually go off them. I have been on them for more than 20 years.
- June 6, 2007 at 9:21 PM
- Christie said...
oh goodness, i cried throughout your post. congratulations on your wonderful little boy! i had a 34 weeker last year and surprise! found out i was pregnant when he was 11 months old. was definitely not ready for that. I had actually had told my husband i didn't want to try again yet and probably wouldn't for a while, but he so was and i guess i kind of caved (even though it really was a surprise). i am scared to death,of course your experience was very different than mine, my water broke unexpectedly also. anyway, i start taking the shots next week but haven't really found any reason not to. thanks for writing about this. i truly believe we know our own bodies. i vow to go 41 weeks this time around-- fingers crossed! but i'll be praying the whole way.
- June 7, 2007 at 8:40 PM
FWIW, I was progesterone baby 60 years ago -- also a DES daughter-- and it turns out both drugs were unnecessary.
It was discovered, after mom had 4 term babies, 4 late miscarriages, and a hysterectomy, that she had a bicornuate uterus. If a baby implanted in the small side of her uterus, it miscarried; if it implanted on the other side, the baby went to term.
I went on to have one preemie (due to food poisoning from listeria) and one 41-weeker after a pregnancy complicated (at the very end) by PIH (no preeclampsia, however).
- June 7, 2007 at 10:20 PM
- Stacey said...
I think it's interesting that anyone would suggest that having another baby after having a preemie would be therapeutic. Sure. It might be..if you carried to term.
In my case, I had another preemie (my OB did the FFN tests, but the always came out negative). I had been *so* sure that I'd recognize the signs of preterm labor if it happened to me a second time, but it was totally different the second time around. I was absolutely devastated.
Although I made it to 31.5 weeks with my second, she was born with a 0 Apgar, her first few days were very uncertain and her long-term outcome pretty sketchy. I was very close to suicidal in the weeks after her birth. Talk about needing help! Thank goodness I got some!
Even now, I think about having another baby...just so I'd have a chance at a "normal" pregnancy. But I know it wouldn't be normal and I'm pretty sure another trip to the NICU would just kill me. I kinda want it...but for all the wrong reasons! I'm not sure I'd even survive 3 kids! : )
Stacey (the one with the 'e')
- June 8, 2007 at 12:54 AM
I may have another child but I won't carry it. I will have a surrogate or adopt. I never want to be pregnant again! My son was born at 23 weeks and died shortly after birth, my 2nd was a miscarriage and my 3rd a 24 weeker. She survived and came home after 125 days in the NICU. They can't figure out why I go into preterm labor. I've had all the tests with no results. Even if they promised me a full term baby I would never do it. Mentally I could never go through a pregnancy again, too many very bad memories. It would be a 9month panic attack.
I've been critized by this point of view (of course by friends and family with full term, healthy babies). The reason I hear most is that my daughter shouldn't be an only child, that she *needs* a sibling. So not only is there a stigma attached to children with disabilities, as I'm finding there is alson one to only children. You just cant win.
- June 8, 2007 at 7:09 AM
I'm hate that people who haven't been in our shoes would give all sorts of unwanted advice about future pregnancies. Some think it's wrong not to try, and others think it selfish to try again - you can't win.
There are times that I want to have another baby after having a 24 weeker. I still stare at women with their big pregnant bellies with longing and sadness. I am still in a lot of emotional pain, anxiety and sorrow. I still feel so much guilt at not being able to carry full term (and it's been over a year). I blame myself every time my daughter has to endure anything that a healthy full term baby wouldn't have to endure, even though I had excellent prenatal care blah blah blah. I hope I get over that guilt one day.
After being in the NICU for months, I know of too many ways a pregnancy can go horribly wrong - even at full term. It's too scary and emotionally painful to think of the many ways the pregnancy and delivery could go wrong. I can't wait for the time someone tries to judge me for my decisions because I'm going to go off. How dare they, having never walked in my shoes.
- June 9, 2007 at 1:30 AM
This is a great post... and I am happy for your success at carrying your son to 35-4.
But I am wondering, you often talk about your advocacy- and I am wondering, what is it for? I know you wish to educate the masses about the real side of prematurity, and I respect that, I do. But what end purpose is in sight? The awareness you deserve? The end to biased coverage of "miracles." Convincing parents not to resuscitate their preemies? You've mentioned Helen Harrison as a "Pioneer"- of what? Shouldn't the objective be preventing prematurity- and isn't that what the March of Dimes is for? And why(yes, I've read through everyting in your blog)- do you/your readers dislike the ambassador families w/ good outcomes.
Please don't take this post as a flame against you or your movement- it isn't. It's not that I disagree, it's that I don't understand.
I guess I just think the parents should have the final say in saving their preemie.
- June 9, 2007 at 11:54 PM
- terri w/2 said...
Anna said:
"But I am wondering, you often talk about your advocacy- and I am wondering, what is it for? I know you wish to educate the masses about the real side of prematurity, and I respect that, I do. But what end purpose is in sight? The awareness you deserve? The end to biased coverage of "miracles." Convincing parents not to resuscitate their preemies? You've mentioned Helen Harrison as a "Pioneer"- of what? Shouldn't the objective be preventing prematurity- and isn't that what the March of Dimes is for? And why(yes, I've read through everyting in your blog)- do you/your readers dislike the ambassador families w/ good outcomes."
For me personally, advocacy is desperately needed because prematurity is just not considered a serious issue in the eyes of the media. Everything is eroneously "miracle-based."
Our children are suffering - suffering through the NICU experience (one of my daughters had over 500 heel sticks and a surgery without anesthesia during her 5 months NICU stay). Our children are suffering after the NICU experience due to many varied disabilities - more often the case than not. .cerebral palsy, mental retardation, mental health disorders, blindness, seizures, etc etc.
Currently if the average person were stopped on the street and asked about 1 pound preemies, they would most likely think that everything being done is wondrous and that these babies survive and are normal. Most are not normal below 26 weeks gestation. Families are in desperate need of help in raising these impaired survivors. The divorce rate among families of disabled children hovers somewhere around 85%. Mothers of impaired preemies are forced from the workforce and often into near-poverty due to the necessity of caregiving of their child at home. What a huge unknown women's issue!
The March of Dimes - don't get me started! Ok, I'm started. . .back in the '90's, nearly everything generated by the MOD centered around mothers on drugs and smoking as the cause of prematurity. They even went so far as to publish pictures of baby footprints - one large, one tiny and the caption read "guess which mother smoked (or did drugs) while she was pregnant". .it was SO wrong to peg every mother of a preemie as a smoker or drug user when many preemies are born for reasons that are uncontrollable - twins, medical conditions, and nearly 50% are preterm for no known reason at all. Every woman should be made aware of the danger. The MOD has created a false sense of security among pregnant women as well as needless finger-pointing toward preemie mothers who are already dealing with such emotional pain. Then, there are the poster families, now called "ambassadors" . .carefully selected normal children of extreme prematurity who do not represent the true picture. Again, it tells the average person or pregnant woman - no need to worry here - technology that we support is saving babies who are now all leading perfectly ok lives, aren't we great!
The truth is far different. Because they are not telling the truth about our families, our families needs and most of all our children's needs are hidden from public view.
And yes, parents should have a choice in resuscitation of marginally viable infants. After all, it is us who are the ones providing for a lifetime of care.
- June 10, 2007 at 2:17 PM
- The Preemie Experiment said...
No offense taken. Actually the way you asked your questions is one of the nicest way I've ever been approached.
I am being pulled in quite a few directions but will be answering soon. I will be making a post out of your question and my reply.
Please check back.
- June 10, 2007 at 10:05 PM
Will do.
- June 10, 2007 at 11:51 PM
To Anna who said "You've mentioned Helen Harrison as a "Pioneer"- of what?"
Whether I am a "pioneer" or not is for others to decide, but I came to parent advocacy about 30 years ago after our son was born prematurely.
Alone, or with a few others, I did and said many things for first time, speaking from the vantage point of a parent of a prematurely-born child. Many other parents and professionals have helped along the way, most particularly my dear friend and mentor, the late Dr. William Silverman, the "father of neonatology."
I wrote _The Premature Baby Book_ for parents of premature babies (published in 1983 by St. Martin's Press) and was a founding member about the same time of "Parent Care," the first international support organization for parents of premature babies. during the next decade, I wrote for several parent publications (Twins magazine, for example) and published in several medical journals (NEJM, for example) on issues having to do with prematurity.
In 1992, with Dr. Jerold Lucey, editor of _Pediatrics_, I helped organize the first-of-its-kind conference between parents of prematurely born children and neonatal professionals.
As a result of this conference, the first-of-its kind article by a parent was published in the journal _Pediatrics_ [Harrison H. "The Principles for Family Centered Neonatal Care"_Pediatrics_1993;92:643-650]
Together with Jill Lawson, I was the first parent to speak out in a national publication against the widespread practice of unanesthetized surgery on preemies (see Rovner S, "Surgery without anesthesia: Can preemies feel pain?"_The Washington Post Healthtalk_pp7-8, August 12,1986.)
I was an early opponent of postnatal steroid therapy for preemies. I informed parents about steroid use and abuse in the NICU (and in high risk preganacy) on the Internet and in published articles and talks: (for example, "Preemies on Steroids? A New Iatrogenic Disaster?"_Birth_2001;28:57-59)
I am currently one of the moderators of the Internet group NAROF (Neonatology and the Rights of Families) and I am highly concerned about the apparent epidemic of brain damage/autism in our preemies. I am trying to interest autism advocacy groups in looking at the possible connections between autism and prematurity or prematurity-related treatments and toxicity (for example, use of steroids).
To my knowledge the March of Dimes has not been involved in any of these issues.
Briefly, what I advocate is this:
1)Open, honest and complete communication between parents and NICU professionals on medical and ethical issues.
2)Parental access to rounds discussions concerning their baby, access to their baby's chart, and more generally access to the same facts, and interpretation of those facts, as the staff, including knowledge about uncertainties, dangers, and alternatives to proposed treatments.
3)The right of fully informed parents to give or withhold consent for procedures in situations involving great uncertaintly, high mortality, morbidity, and extreme suffering.
4)Information on pregnancy outcomes as a part of prenatal care and the opportunity for expectant couples to compose advance directives stating what they want done (or not done) in the eventuality of an extremely preterm birth.
5) Acknowledgement and alleviation the pain of infants in intensive care.
6) An appropriate neuroprotective environment for babies in the NICU (i.e., developmental care).
7) Ensuring the safety and efficacy of neonatal treatment through randomized controlled trials of treatments and use of evidence-based medicine in the NICU.
8) Nursery policies and programs that promote parenting skills and encourage maximum involvement of families with their hospitalized infants-- particularly help with lactation.
9) Meaningful long-term follow-up for all high risk NICU survivors.
10)A public and professional understanding that critically ill newborns can be harmed by overtreatment as well as by undertreatment; laws and treatment policies based on compassion; An awareness of the needs of NICU survivors with disabilities with adequate public support for them and their families; a decrease in disability through universal prenatal care.
- June 11, 2007 at 1:09 PM
Thank you for enlightening about your mission. I admire your resolve in parental involvement and certainly agree with the things you listed. I had no idea a neo would perform an unmedicated surgery and am horrified by the thought.
I guess I consider myself moderately educated about the effects of prematurity--I cringed with horror when I heard about sextuplets recently born here in MN at 22w6d (today, in fact)--I read blogs, have done research on the health issues, etc. And I have considered a career in neonatology after nursing.
The many things you have advocated for that you shared with me--your efforts must be working b/c most parents whose blogs I read who have young preemies seem very involved in their care.
I, BTW, am a big bfing advocate. Again, thank you for opening my eyes. You are an amazing and determined woman.
- June 11, 2007 at 3:47 PM
To Anna,
One of the problems with pain control for preemies is that both the pain of NICU treatment, and, it appears, many common pain relievers, can cause brain damage to preemies.
It is hard to know how to negotiate these treacherous shoals, but at least most doctors now acknowledge that preemies *do* feel pain (perhaps even more than older individuals) and that they are permanently marked by it.
I wish you luck in your future medical career, and hope you will continue to consider neonatology.
I did not know about the sextuplets until I saw your post. At that almost impossible gestational age, my heart really goes out to them and their family.
And I am a big proponent of breastfeeding. It is the one major intervention that seems to improve the outcomes of preemies Though I realize the evidence is becoming somewhat mixed on this issue, I remain confident that one of the best family supportive measures any NICU professional can take is to encouraging lactation and breastfeeding and the wonderful physical, emotional and immunologic bonds that ensue.
Thank you for you kind words!
Best wishes,
- June 12, 2007 at 12:05 AM
Again, thanks for the info. I should probably mention that I didn't read through the comments when going thru the blog and didn't know you posted here-- I was referencing you as a a well-known far-off famous person- ya know? (although I obviously knew next to nothing about your mission) You are definitley well-known in the neo community! Some say you are negative, some say you are realistic, and some are like me and say you speak for what you believe-- I can't judge, I have no idea what its like to walk in your shoes.
I too am heartbroken for the sextuplet family here--even sadder for them was that another set was born in AZ today at 30w4d. The 23 wkers will likely die or have serious health issues, while the 30wkers (from what I know) will probably have a non-invasive 6 week stay and suffer only minor delays and no long-term problems. I am sure both women did everything "Right"--one's body handled the pg and one's didn't. Its stories like these that make me TERRIFIED to do IF treatments, even though I have PCOS (never fully dxed--but I just know) and cannot likely conceive on my own.
As far as my possible neo-career goes, I currently work on a L&D floor in a suburban hospital--where any mom in labor @ less than 36 wks is sent to children's hosp. in Minneapolis. We have a few preemies once in awhile (almost always 32+wkers) who transfer over once they are "grower's and feeders"--never w/ a cannula/CPAP/brain damage, over having A&B's. And I am to "junior" to handle them. But we are talking about building a NICU down the line to allow Children's to focus on cancer--what they do best. Who knows?
Wow--this was long:)
- June 12, 2007 at 1:16 AM
Thank you for sharing your story w/ me-- I can't imagine the horror you felt at finding our your dd had been operated w/out meds (although, Helen informed me that it can cause brain damage, I'm honestly not that educated on the subject).
You are right, the media is into "The doctor said he would be blind/deaf/paralyzed but he is a genius" type stories-- I guess I just don't believe them b/c I don't trust the media anyway (another LOOOONG story).
I've never been involved too mch w/ the MOD--like I said, prematurity is an abstract subject to me, as I don't have children. I can't imagine how a preemie mom would feel if she saw an ad like that.
It certainly would be more realistic if the media told the whole story , but of course they want to make moola off the rare, exciting stories. I've often wondered why Discovery Health Channel featured update on the quints born @ 32wks but not the quints born @ 24 wks. Is it b/c the kids have disabilities? Of course, I don't know, and to be fair, they did feature a triplet update in which 2 of the families had a child on the autism spectrum. Autism, for some odd reason gets ALOT of media attention (although they usually do not mention prematurity), probably b/c most cases are unknown causes and there are debates over vaxes, TV, etc.
I can't imagine the suffering of families who have kids w/ disabilities--the financial and emotional stress would certainly tear marriages apart.
- June 12, 2007 at 1:36 AM
Those blue eyes are so captivating...
Just a side note--If you want to, I would encourage you to add www.micropreemietwins.blogspot.com to your list. Holland and Eden were born at 24w3d and are almost 3. Both have CP--one very mild, one more severe, and one is deaf. Their mom is positive and inspiring but also frank and realistic about the effects of their early birth and their disabilities.
Just throwing that out there, of course.
- June 12, 2007 at 1:40 AM
- folliculitis said...
I've been through this since my wife and I had a premature baby and the fact the decision of a second child is not easy ... thanks for the aport is very rewarding
- June 26, 2010 at 12:12 AM
- support for parents of preemie babies said...
I read the article and I can say that it is a very well written article. I want to know more about this and I will keep visiting this blog.
- April 1, 2011 at 1:09 AM
thanks for a great post!
- June 27, 2011 at 12:39 PM
- Angela said...
- This comment has been removed by the author.
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- July 6, 2015 at 12:04 PM
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- September 24, 2015 at 6:55 AM
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- November 5, 2015 at 2:50 PM
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- December 2, 2015 at 1:06 AM
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- January 8, 2016 at 7:27 AM
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- April 11, 2016 at 11:26 PM


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Pointman (1994 TV Movie)
Plot Summary
Arbitrageur Constantine "Connie" Harper is sentenced to a maximum security prison for fraud and decking the DA at his trial. Upon his release, one of his cellmates asks him to bodyguard his sister Rosie, who is being threatened by a diamond broker over some diamonds. Connie becomes a reluctant bodyguard to Rosie. While in prison, his name got on "the list," a collection of people to go to when you've exhausted all other options.- Written by Jeff Cross <email@example.com>
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|BANK OF CANADA Patent applications
|Patent application number
|CLEAR MAGNETIC INTAGLIO PRINTING INK - The invention discloses an ink for the engraved steel die printing process, having a viscosity at 40° C. between 3 Pa.s to 15 Pa.s, preferably 5 to 10 Pa.s, and comprising a polymeric organic binder and magnetic pigment particle, characterized in that said magnetic pigment particles comprises a magnetic core material which is surrounded by at least one layer of another material. The surrounding layers, single or in combination, confer the pigment particle particular optical properties in the visible and/or in the near IR, chosen from high specular or diffuse reflectance, spectrally selective absorption or reflection, and angle-dependent absorption or reflection, and allow for the formulation of inks having a large gamut of color and other optical functionalities.
|SECURITY DEVICES, THEIR PRODUCTION AND USE - Security documents, such as passports, bank notes and credit cards, often incorporate security devices that are difficult to replicate by conventional printing or copying techniques. Disclosed herein are security devices and methods for their production. In selected embodiments, the security devices may be used with polymer core materials in such a way that they simulate the appearance of known security devices more traditionally used with paper core materials.
|INK OR TONER COMPOSITIONS, METHODS OF USE, AND PRODUCTS DERIVED THEREFROM - Magnetic ink and toner compositions traditionally comprise magnetic materials in fine particulate form, either as a dry composition or a liquid suspension. Often such materials are black or dark in colour. Disclosed herein are particles compositions suitable for use as inks or toners, that exhibit desirable magnetic properties, and furthermore which include particles coated so they appear white substantially white, or coloured. Such compositions present new opportunities for the production of corresponding magnetic layers, when the compositions are deposited in an appropriate manner to a substrate.