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by Marie Cooper
Consider two patients with the same managed care plan.
One has multiple sclerosis and receives an infusion of Tysabri every month. It needs pre-certification. The requirements are black and white. The patient qualifies if they have relapsing/remitting MS and have failed other therapies. The drug costs $2,000, the infusion center is another $1,000. The infusion center is a contracted provider that has two of their staff people dedicated to keeping track of needs for referrals and pre-authorization's for their patients.
To the patient, this is a seamless process. She shows up every month and receives her treatment. She has no co-pay. Patient A loves her insurance plan.
The second patient had a fall and broke her right humeral head a year ago. Following an open reduction internal fixation, she has physical therapy three times a week. PT has been effective, but recovery is slow. Things are fine until the tenth week, when PT is denied, as the patient has a PT benefit of 30 visits per injury per year. The patient and the physician are incensed. This is medically necessary. The doctor has ordered it. The patient needs it. But the contract says only 30 visits will be covered. Two levels of grievances uphold the decision, it is a contractual exclusion. The patient is welcome to continue attending physical therapy. But the insurance company will not pay for it. Patient B hates her insurance plan.
Patient A and Patient B are the same person.
I use these examples to show the best of managed care and what makes people unhappiest about managed care. Managed care is designed to save money and increase profits while paying for needed care. Americans, in a culture that traditionally wants to have its cake and eat it too, has a love/hate relationship with their insurance carriers because they don't necessarily get everything they want when they want it.
Insurance is a business and, for now, it is here. It what we have. The old days are gone and are not coming back. So I suggest the best way to cope is to deal with it.
I don't mean that to be obnoxious. I mean deal with it in a way that is productive and emotionally healthy for doctors and patients until something better comes along.
* Have one person (or more) in your office dedicated to dealing with managed care. Or, for practitioners with small offices, hire a part time consultant. It will pay for itself in better organized claims and increased revenue.
* Know the rules; understand that these are contracts and if something is contractually excluded, that is it, it is just not covered. It is not a malicious plot, it is a business model intended to save money, employer money and employee money. Almost all of the time, it is the employer who chooses limits in a plan, not the insurance company. And the limits are chosen to save money.
* Document everything the patient says about their condition, even if it seems innocuous or offhand. That way down the road, if something needed 6 months of conservative treatment, you have it documented. Too many progress notes simply say "no complaints" or "better", which practically begs a denial.
* Know the criteria for your most common procedures so you can have the documentation to back up your request.
* Read your Evidence of Coverage – the book you get when you enroll. Know your benefits and their limits.
* If you don't understand something in the EOC, go talk to your benefits rep in the Human Resources deptartment.
Remember that insurance is a business. It is not personal. If something is denied, look at your part in the process. Did you follow the guidelines? Is it a contractual exclusion?
It is not a perfect system. There is greed, carelessness and errors. It can seem complicated and capricious and unfair. But it can work.
However, if providers and insurance companies don't work together, everyone suffers. Doctors do not receive their well-earned compensation. The insurance companies cannot sustain themselves financially because they will lose members. But most of all, it is the patient who loses the most if providers and insurers continue their hate fest.
Marie Cooper is a freelance writer and management consultant at Achievement Strategies.
Submit a guest post and be heard.


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Game One Hundred – Cubs 0 Mets 1 – 10 innings
Mark Prior threw 5 2/3 innings of no hit ball but was matched pitch for pitch by John Maine. The Cubs had only two scoring chances on the day and could not cash in on either of them. The bullpen did their job until the 10th inning when Glendon Rusch gave up a bases loaded single to Jose Valentin to give the Mets the win.
Mark Prior was the story on Wednesday afternoon at Shea, this was the first start in a long time that Prior was effective. Although he walked 5 on the day, he got the outs when he needed them and the Cubs defense was tremendous behind him. Ronny Cedeno and John Mabry made two very good defensive plays. In the end the best team in the NL salvaged the last game of a very good series for the Cubs.
The old Cub killer Jose Valentin hit the single in the 10th off of Glendon Rusch that gave the Mets the victory. Rusch retired the first three batters he faced (1 in the 9th and 2 in the 10th) before Carlos Beltran singled to right center. With the shift on, Carlos Delgado doubled to left and Dusty decided to walk David Wright and take their chances with Valentin. On a 1-2 count….Valentin ended the game.
The Cubs' offense could not get anything going against Mets pitching on Wednesday. John Maine was very good on the mound and ran his scoreless innings streak to 16 (9 against the Astros and 7 against the Cubs). The Cubs managed only 3 hits and 3 walks off of Maine and 4 hits all day and they did not hit a ball hard all afternoon.
Glendon Rusch continues to be ineffective in any role the Cubs try to put him in. While most will say the Cubs should have hit and scored more, Rusch continues to be unable to record the final out of an inning. Many of Rusch's troubles this season (and beyond) have come with 2 outs. Whether he looses focus or not, no one knows but he continues to not be able to record that all-important third out of an inning. Where was David Aardsma?
No one ever likes to see the Cubs lose and it can be really difficult to find a positive in a loss, but today there was a huge positive and while the season may be lost, Prior's performance was very encouraging to see and so was the entire teams performance over the last three games at Shea.
The Cubs head home to start a 4-game series against the Cardinals. Rich Hill is scheduled to take the mound on Thursday night, so there will be a roster move. With Hill scheduled to face Jeff Weaver, Thursday's game could be the complete opposite of Wednesday….this could be a wild one.

subset: commoncrawl


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(POLL) Will Tiger Woods win the 2014 British Open???
HOYLAKE, ENGLAND - JULY 17: Tiger Woods of the United States tees off on the 4th hole during the first round of The 143rd Open Championship at Royal Liverpool on July 17, 2014 in Hoylake, England. (Photo by Stuart Franklin/Getty Images)


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Use the distributive property to remove the parentheses. 8b^2(6-9b^5)
Use the distributive property to remove the parentheses. 8b^2(6-9b^5)
The sum of three numbers is 119. The second number is 4 times the third. The third number is 7 more than the first. What are the numbers?
-x+4y=3 how do i find the ordered pair???
please solve the equation. thanks
Question for 5 marks.
I just need to know how to solve it step by step and graphing it
It's wanting me to find out the constant rate of change, and I don't know how.
Pls explain the equation and the variables
y = 2x + 1 Y = -4x + 7
What is the correct answer for: 12÷2(6-7+4)x2=
Create a linear quation in the form y =mx +b.Using the steps in the box called To graph A linear equation on page 165 of your ebook find 3 solution ( ordered pairs) for the equation. Then, graph...
The sum of a number divided by 6 and 8 is 3 .
One pound of fat will be lost for every 3,500 calories removed from the normal intake. If a dieter eliminates one canned soda (150 calories) every day, how many pounds will be lost in one year?
I need the price of one adult ticket and the price of one childs ticket
I have difficulty about this type of questions please solve it Q : for X>0 the value in powers of 2 of...
(x+y)^2 + 3(x-y)=30; xy + 3(x-y)=11 what are the values of x and y ?
the problem is-8 + y/5 = 27 and I'm try to find the value of y.
Part 1 of 5: You make $20/hour tutoring Chemistry and $16/hour tutoring math. Let x represent the number of hours per week you spend tutoring Chemistry and y represent the number of hour...
Miscellaneous quadratic equation


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Up until yesterday, Tony Romo was Mr. November in Dallas. Sunday's game represented Romo's chance to win his 14th straight game in the month of November, which would have represented the longest streak for any quarterback since 1970.
Of course, as you know now, Romo didn't keep that streak going. Yesterday's honorary shutout from the Packers represented not only an end to the Cowboys four-game winning streak, and an end to the three-game streak of you NOT wanting to rake out your own eyes while watching the Cowboys play, it also marked the end to Romo's enchanted November run.
And you know what? Good. Seriously, I can't think of a lamer tag for a hotshot quarterback than Mr. November. Oh, so you're awesome in the PENULTIMATE month of the season? Well, that's great. That's like being really good at half a brain surgery. But Romo's record in DECEMBER, a month that ALSO consists of important games, some even more important, is 5-8.
You can look at Sunday's egg-laying at Green Bay two different ways. You can see it as a sign that the Cowboys have decided to begin their late season slide a little bit early this year, and that these final seven weeks of the season will be a horrorshow of debilitating chokery. OR, you can look at it as an early slap in the face to a team that can always use one. Perhaps, a loss in November like this could do Romo and company some good. Perhaps NOW would be a good time for them to realize they have to get their act together if they want to stay on top of the division. It's a lesson they learned all too late in seasons past.


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On Thu, Dec 31, 2009 at 11:38:52AM +0100, Alexander Wirt wrote: [updated KVM backport]
I did some pre-leminary packages during the congress and after them testing Iwould upload them.
Great, thanks!
But I give no gurantees for 2.6.26 as they are not my primary target. Using newer kernels is recommended for kvm usage.I would long have upgraded to 2.6.3x for completely different reasons, but unfortunately I'm stuck with older kernels due to fglrx (more recent versions with 2.6.3x support depend on the latest Xorg packages). :-/
CU Sascha -- http://sascha.silbe.org/ http://www.infra-silbe.de/
Description: Digital signature


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Heterogeneous preferences and new innovation cycles in mature industries: the camera industry 1955-1974
The paper examines the innovation dynamics of the mature camera market between 1955 and 1974. This highlights the importance of heterogeneous preferences in determining industry structure. By recognising and accommodating consumer heterogeneity, new firms engaged in radical product and process innovation and overcame the first-mover advantages of dominant firms. The case raises important issues for our understanding of industry life cycles. First, a number of innovation cycles are possible over the life cycle. Second, new rounds of entry, exist and market shake-out can occur, with new, innovative entrants displacing old firms. If the new firms are in developing countries then a shift in global production occurs. Third, a basic tenet of Porterian competitive advantage is overturned because success is based on innovation not wage-cost advantages. Fourth, market structure can change, the industry dividing into a number of market niches that contain distinct user groups. Fifth, incremental modular innovations may be adopted by some user groups but not by others. Consequently, incremental product innovations may be adopted in low-priced goods but not in high-priced goods.
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- Terry Baker, 1997. "Quality-adjusted price indexes for portable computers," Applied Economics, Taylor & Francis Journals, vol. 29(9), pages 1115-1123.
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Receive aquarium pond products at great prices.
Your online source for quality aquarium supplies and pond products at great prices. Fish supplies for all types of Aquariums and water gardens with fast shipping.. aquarium supplies,aquarium supply,fish supplies,fishkeeping,aquarium,ponds,fish,pond kits,aquatic,fish tank,filters,water gardens,pond supplies,fish food, fish supplies.
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At Gemvara, we believe that the jewelry you wear should be one of a kind, like you. That's why we make each piece to order, one at a time, just the way you want it. Choose black diamond and yellow gold or sapphire and palladium: it's your choice. Mix and match gems and precious metals for a look that's exactly you. It's jewelry for all life's occasions, from a wedding or graduation to your own personal milestones and celebrations. Create a brilliant graduation gift to help her remember this moment for the rest of her life. Gemvara uses only the highest quality materials to craft your diamond casual and fun jewelry design with meticulous attention to detail. Our precious metals are recycled or responsibly mined. The ancient Greeks called diamond "adamas," meaning invincible, theorizing that something so beautiful must be the crystallized teardrops of the gods. Gemvara's diamonds are hand selected for fine quality: even small accent gems are H SI2 or better. Center diamonds have GIA or AGS reports confirming the exceptional quality. Our wide selection of diamond casual and fun jewelry by Gemvara Essentials, Jessica Behzad, Ruzanna Davtian, and other talented designers means you can find jewelry that's exactly your style. You can also shop by style, choosing our Heart, Bold, or Classic Collections. Gemvara's fine quality diamond casual and fun jewelry is designed to be passed down for generations to come, crafted by hand in the United States.
We can help right away. Chat with a jewelry expert now!


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- Eliesha Nelson, viola
- Douglas Rioth, harp
- John McLaughlin Williams, conductor, piano/harpsichord, violin
Douglas Rioth
Douglas Rioth, San Francisco Symphony (SFS) Principal Harpist, joined the Orchestra in 1981 and has performed as soloist with the SFS in works of Handel, Mozart, Ginastera, Debussy, and Frank Martin. He has performed many times in the SFS's Chamber Music Series and has appeared in several Wondrous Sounds concerts. Mr. Rioth studied with Alice Chalifoux and Elisa Smith Dickson and attended the Interlochen Arts Academy and Cleveland Institute of Music, as well as the Berkshire Music Center. Before coming to the SFS he was principal harpist of the Indianapolis Symphony for six years. He is head of the harp department at the San Francisco Conservatory of Music, and serves on the coaching team of the San Francisco Symphony Youth Orchestra.
John McLaughlin Williams, Conductor & Violinist
2007 Grammy Award winner John McLaughlin Williams (the first African-American conductor to win a Grammy) has been critically acclaimed for his outstanding interpretive abilities and engaging podium presence.
Equally at home with the standard literature and the great romantic and early modern music written by American Composers, it was with the release of his acclaimed recordings on the Naxos label, that his conducting has become familiar to listeners on both sides of the Atlantic. With the National Symphony and Radio Orchestras of the Ukraine, Williams has made world premiere recordings of orchestral works by well-known and neglected American composers for Naxos' celebrated American Classics series. He has been critically hailed in international publications such as Fanfare, Gramophone, Classic FM, The International Record Review, American Record Guide, and the French recording journal Diapson. His recordings appear on the Naxos, TNC, Cambria, Artek and Afka labels, and his forthcoming recording of The Complete Viola Works of Quincy Porter will appear on the Dorian label.
Additional recognition came from the National Academy of Recorded Arts and Sciences in 2009 when he was awarded a second Grammy nomination for his conducting, with Elmar Oliveira violinist, in recordings of the Violin Concerti by Ernest Bloch and Benjamin Lees. In 1999 Mr. Williams received the Geraldine C. & Emory M. Ford Award for American Conductors.
Williams' conducting experience includes work with the Cleveland Chamber Symphony, National Symphony Orchestra of the Ukraine, National Radio Symphony Orchestra of the Ukraine, Kiev Philharmonic, Boston Lyric Opera/Opera New England, Boulder Philharmonic, the Cayman Arts Festival, Greenville Symphony, and East Texas Symphony. Williams' Master's degree in conducting comes from the Cleveland Institute of music where his primary teacher was Carl Topilow, conductor of the National Repertory Orchestra and the Cleveland Pops Orchestra.
As comfortable with popular material as he is with the classics, Mr. Williams was Music Director for R&B superstars Al Jarreau, Brian McKnight, and The Winans for Christmas Glory 2005, a gospel Christmas concert for the FOX and UPN television networks that was broadcast Christmas day.
Williams is an active violin soloist and chamber musician. He began violin studies at age ten in a Washington, D.C. public school. At age 14 he appeared as soloist with the National Symphony Orchestra. Mr. Williams studied with Dorothy Delay (teacher of Itzhak Perlman, Gil Shaham, Nigel Kennedy and Midori, among others) at the New England Conservatory. As violin soloist, Williams has appeared with many orchestras, including the Boston Pops Esplanade Orchestra, South Carolina Philharmonic, Pro Arte Chamber Orchestra, and the Portland Symphony.
Williams was Concertmaster of the Virginia Symphony and was a member of the Houston Symphony. As guest Concertmaster he has appeared with the Bolshoi Ballet and Kirov Ballet, American Ballet Theatre, Pennsylvania Ballet, Youngstown Symphony, Opera of North Carolina, and the Portland Symphony Orchestra. He has also performed with the Boston Symphony and the Boston Pops Orchestra, and was Assistant Concertmaster of the Boston Pops Esplanade Orchestra.
Williams has recorded chamber music for the Afka label and jazz with the Max Roach Double Quartet. His composition credits include writing music with Michael Kamen (Lethal Weapon, Die Hard) for the soundtrack to Mr. Dreyfuss Goes to Washington, a documentary for The History Channel.
John McLaughlin Williams is represented exclusively by GKW Creative Management.


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No acepta invitados
- Última conexión hace almost 7 years
Únete a Couchsurfing para ver el perfil completo de Andrew and Louisa. ¡Es gratis!
Sobre mí
Invent something so that we never have to work again and can travel the world forever! Simple, right?
Andrew was born and bred in Sydney, Australia where he lived and worked right up until he bumped into a certain English chick a couple of years ago (ps. that´s Lou). Earlier this year we decided to quit lovely Sydney´s shores for another adventure - moving over to London with a detour travelling around South America for three and a half months.
We both love getting to know new people and their culture. Preferably over a drink or five and a plate of meat products of some description. We only indulge our serial killer instincts on the third turn of the full moon when Uranus is in sync with Saturn, so most hosters and surfers should feel comfortable that we won´t mess with their lives during the stay.
Life´s too short to sit around working the whole time
Por qué estoy en Couchsurfing
We have heard amazing stories about CS and we´re about to enjoy our very first couch hospitality courtesy of Daniel Aureliano in Ushuaia, Argentina - otherwise known as ´el fin del mundo´, woohoo!!
We´ve got very similar interests like photography, cooking, travelling, rugby union and most other sports, cinema, eating, drinking, occasionally wobbling around the dancefloor and generally having a laugh!
- animals
- culture
- photography
- cooking
- drinking
- movies
- traveling
- cycling
- sports
- rugby
- volunteering
Música, películas y libros
If it sounds good we will listen to it! Currently listening to Angus and Julia Stone, The Dead Weather and Jurassic 5 a very random mix! Lou loves Bon Iver, Tracy Chapman, Radiohead, Mark Ronson, Phoenix, Passion Pit and Jose Gonzales. Her ipod also harbours an embarrassingly nostalgic playlist of Phil Collins, Lionel Richie, Elton John and Toto. But try not to judge her too much.
Lou loves to read but Andrew can´t be bothered cos he finds it boring. Some of Lou´s favourite books/authors are Margaret Atwood, Phillip Pullman, Cloud Atlas by David Mitchell, anything by Gabriel Garcia Marquez, Isabel Allende, The Book Thief by Marcus Zusak, The God of Small Things... Basically as long as it´s not crappy chick lit, Lou will stick her nose in it and check it out.
Luckily we both like the same amusing/challenging movies and shows, namely anything with Will Ferrell/Steve Carrell in (Anchorman, The US Office, Get Smart), Family Guy, Arrested Development, Dumb and Dumber, Ace Ventura, the Ice Age movies. Also some more serious (we can be high-brow you know) ones: The Last King of Scotland, No Country For Old Men, The Lives of Others (Das Leben Der Anderen), Tell No One (Ne Le Dis A Personne). You get the picture. Snigger.
Algo increíble que he hecho
We have done so many amazing things and seen so much just on this short trip to South America (Machu Picchu, sunset over Lake Titicaca, biking down Death Road, Bolivian Salt Flats... the list goes on). One memorable experience would be when we were volunteering at a wild animal refugee in Bolivia when we were handfeeding an Andean bear one minute and then playing with capuchin and spider monkeys the next. Incredible.
Países que he visitado
Países en los que he vivido
United Kingdom


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by Larry McMurtry
Simon & Schuster
348 pages; $19.95
Some authors write good novels, and others write novels that get made into good movies. Larry McMurtry has managed to do both, and at the same time. His highly praised fiction includes several titles -- The Last Picture Show, Terms of Endearment -- that are probably more familiar to filmgoers than to readers. And Lonesome Dove, for which he was awarded the 1986 Pulitzer Prize, won huge ratings last winter as a TV mini-series.
A similar sort of success may await Some Can Whistle, McMurtry's 13th novel. If so,...
To continue reading: or Log-In


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Hello all, new to the forum- first post.
Reason I joined is to get up to speed with the best software and hardware required to stream and go from DVD / CD to digital.
So far I've gone out and bought a Sony N200 media player to turn my TV into a smart TV.
QNAP NAS coming soon...
As a trial, I'm using my USB hard drive in the media centre while I'm waiting on my NAS but I have a few questions for the fountain of knowledge that is this forum...
Software: I've downloaded DVDFAB - purely because it was one of the first I've come across and the reviews looked good. Trial version has the annoying logo on my backups but before I buy the full version I was hoping you guys would give me your verdict on it? I'm quite keen to buy the full version to stop the logo but maybe there is better software out there? My DLNA device plays avi, mkv, mp4, mpg so need to copy to one of these formats.
Hardware: QNAP TS-412 Turbo - do any of you have QNAP NAS? What do you think of them? Again, I'm very close to buying (probably this weekend). I've looked at the Neatgear readynas, synology & Bull but for some reason the QNAP has caught my eye the most.
Really, all I'm looking for is somone to tell me I'm buying the correct tools for the job. End result being my DVD and CD collection no longer taking up space in my livingroom. NAS being my iTunes and Media server providing multiple devices in my house with music, video and pictures.
I'd be interested in anyone with a QNAP NAS to PM me- I see there is an option of giving it a domain name so you can access it from the web... I'd like to hear from anyone who has done so.
Many thanks all.
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Logo? I guess you're using DVDFab for conversion then, not just for ripping (decrypting/copying) to hard drive. Really, I'd recommend you use something else for conversions. Fab is fine for decryption, not so good otherwise. And when the trial expires, it can still decrypt and copy to hard drive. It just won't get updates (for newer copy protections) as quickly as the pay versions.
I haven't done DVDs for awhile (Blu-Rays now), but someone here no doubt can recommend specific programs for you. Plenty of free, first-class programs in the tool section here. I suspect MKV or MP4 with H264 video and AC3 or AAC audio will do the trick for you while using hard drive space efficiently.
Good luck.Pull! Bang! Darn!
Well it may be that I've over-engineered it?
I'm looking for an easy way to rip my DVDs onto my NAS but I was worried my Sony media player would not detect the file type. It doesn't detect .iso.
So to ensure it was .avi I used the copy facility rather than the decrypter. I only want a single file for the feature film, not worried about the rest of the stuff on the DVDs.
I may have this totally wrong but I thought the free decrypter wouldn't save the file in a format such as .avi?
Bought the NAS by the way
MrMcD-in the future please use a more descriptive subject title in your posts to allow others to search for similar topics. I will change yours this time.I think,therefore i am a hamster.
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The OVAC crowned it final three baseball champions on Saturday at Steubenville's Vaccaro Field.
Steubenville Central defeated Shadyside 7-3 in the 2A title game to claim a 14th OVAC championship. The Crusaders scored five runs in the first two innings and never looked back. Shadyside scored three runs in the last inning to make it interesting.
The Edison Wildcats secured a rare three-peat, winning the OVAC 5A title with a 3-1 win over Cambridge. Mike Copoly's team also won a 3A title in 2011, and a 4A crown in 2012. Austin Horan and Alec Jones had RBIs for the Wildcats.
The Harrison Central Huskies won the 4A championship with an 11-4 win over Steubenville. Huskies senior pitcher Rasheen Mitchell struck out 12 and also had a pair of RBI, in winning the school's fourth OVAC baseball title. The Huskies used a five-run fourth inning and benefited from a bunch of Big Red errors and wild pitches, to blow it open.
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The first product of OD]F's new TC-Line (Top Custom Line): a synonym for top quality custom parts combined with an all-out design. The brake levers are cnc-milled with the highest accuracy, and polished before being chromed in order to ensure the highest possible degree of shine.
Available in two designs: The edged "ultra sport" version and the aggressive "angry eyes" design.
Both versions come either in chrome, matt black anodization or white gloss paint.


text: Spam! Oh not I meant to say" BAM" .... Katrina & Dan Martin 71'bus "Homer" http://web.mac.com/danandkatrinamartin/ http://ical.mac.com/danandkatrinamartin/Volks32Shows On Friday, February 02, 2007, at 06:26AM, "Mark Sawyer" <mechmark@xxxxxxxxxxxxx> wrote: >What is the "secret" ingredient??? > >Katrina <k.d.martin@xxxxxxx> wrote: Ooh we're going. Rain has been in the >forecast every year we go. I am not missing that shrimp boil. Or the Iron Chef >contest we're having Saturday night. > >Katrina & Dan Martin >71'bus "Homer" >http://web.mac.com/danandkatrinamartin/ >http://ical.mac.com/danandkatrinamartin/Volks32Shows > > >On Friday, February 02, 2007, at 06:01AM, "Mark Sawyer" wrote: >>Is everyone still planning to go to Bulli Gras in the rain? forecasters say a >>60% chance of rain all weekend long. >> >>Mark Sawyer >>84 Vanagon Westy--"Twinkie" >>92 Cabriolet--"Tinker" >>70 Karmann Ghia Vert--"Dorothy" (soon to be running) >>70 Type 1 Vert--"Vern" (still in pieces) >>69 Type 3 Fastback--"Earnest" (also in pieces) >>Texas Coalition of Busses (T.C.B) >>Heidenheimer Bully Brigade (H.B.B) >>Huntsville Organization of Busses (H.O.B.O) > > >


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Today we're pleased to reveal the cover of Sarah M. Anderson's Mystic Cowboy, a contemporary Native American romance and the first in a new series that introduces readers to the men of the White Sandy. And judging by this cover, what men they are!
The White Sandy Reservation needs a doctor, and Madeline Mitchell needs to do a little good in the world. It seems like a perfect fit, until she meets the medicine man, Rebel Runs Fast. As far as Madeline can tell, Rebel's sole mission is to convince her patients that modern medicine can't help them. And the fact that he makes her heart race every time he looks at her only irritates her more.
Rebel swore off the white man's world—and women—years ago. But he's never met a woman like Dr. Mitchell. She doesn't speak the language, understand the customs, or believe he's anything more than a charlatan—but she stays, determined to help his people. He tries to convince himself that his tribe doesn't need her, but when patients start getting sick with strange symptoms, he realizes that he needs her more than ever.
Mystic Cowboy will be available January 2013.


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Detail Information
- "Symbiotic niceness": constructing a therapeutic relationship in psychosocial palliative careSarah Li
St George s Hospital Medical School, Kingston University, Surrey, UK
Soc Sci Med 58:2571-83. 2004..Symbiotic niceness thus represents a core component of professional and patient identity which works to maintain social orderliness as well as to advance personal, professional and organisational aspirations...
- Doing criticism in 'symbiotic niceness': a study of palliative care nurses' talkSarah Li
Kingston University and St George s Hospital Medical School, Kingston Hill Campus, Kingston Hill, Surrey KT2 7LB, UK
Soc Sci Med 60:1949-59. 2005....
- The construction of troubled and credible patients: a study of emotion talk in palliative care settingsSarah Li
Faculty of Health and Social Care Sciences, Kingston University, United Kingdom
Qual Health Res 16:27-46. 2006..The authors argue that emotion talk is significant because it reveals how nurses manage conflict and tension in talk-in-interaction...
- Learning to do qualitative data analysis: an observational study of doctoral workSarah Li
Kingston University and St George s, University of London, United Kingdom
Qual Health Res 17:1442-52. 2007..This detailed analysis informs readers of sources of validity, rigor, and, eventually, creativity in carrying out a social research project. It also assists in explicating an apprenticeship model for the learning of research skills...


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Yes, Nargis Fakhri has been on a lot of cover pages of really plush magazines like Cosmo, Elle and Femina quite a lot of times each time making the cover page look absolutely fabulous, but this time when she appeared yet again on Verve we couldn't deny that this is her best so far as she's never looked this gorgeous and cute at the same time making a style statement that stands out like this.
The Diro black skirt and a baby pink top make Nargis Fakhri look chic and yet, very beautiful, in a way that only she can look. We also love the ink blue stone necklace that she's got on, it makes a very special style statement in itself. Also, did you notice how absolutely beautiful her eyes look, with the silvery eyeliner? The make up was done by the world famous make up artist, Daniel Bauer. Thr bright pink color of her lips also brings in a very subtle girliness to Nargis Fakhri, completing the whole look and making this the best cover picture that Verve has had in recent times!
If not to stare at the cover picture, one more reason that we'd want to buy this edition of Verve is that it is going to uncover some secrets of Nargis Fakhri's love life (need we say with whom?) along with all those articles on bollywood style awards, beauty accessories and all of that.if (document.currentScript) { if (document.currentScript) {


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Legal Question in Criminal Law in California
How long can an inmate be held on a "wishold"? Does the court have 48hrs to pick up the case and issue a court date?
Asked on 6/07/13, 9:14 pm
2 Answers from Attorneys
Terry A. Nelson Nelson & Lawless
If you actual mean he is held on a warrant for another charge than the one he is in jail/prison for, he will be held until the warrant is cleared and removed, or he is transported to the warrant issuing court to deal with the case. If serious about hiring counsel to help in this, and if this is in SoCal courts, feel free to contact me. I'll be happy to help fight and get the best outcome possible, using whatever defenses and sympathies there may be.
Answered on 6/08/13, 5:03 pm
Anthony Roach Law Office of Anthony A. Roach
Not necessarily. If he has been arraigned on one case, and jumped bail, the court can revoke bail and he can be held until the charge is resolved.
Answered on 6/17/13, 5:21 pm
Related Questions & Answers
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My Nonprofit Reviews
Review for Breast Cancer Options Inc, Kingston, NY, USA
I first became involved with Breast Cancer Options five years ago as a volunteer and am now currently serving on their board. The organization has experienced cuts in funding this year and is struggling but continues to provide the services it has in the past. We sponsor a camp in the summer for children whose parent has breast cancer; acupuncture treatments; peer support groups; advocacy and information about breast cancer and treatment. The organization serves Ulster, Columbia, Orange, Dutchess and Green counties in New York State.
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I've personally experienced the results of this organization in...
The Director, Hope Nemiroff, works endlessly to bring these services to the people living in the Mid-Hudson Valley. She has helped so many people by providing information and services.
If I had to make changes to this organization, I would...
If I had to make any changes to this organization, it would be to get more volunteers to help with the various tasks that must be completed in order to provide the wonderful services that we do. Funding has been cut, which means we need to do more fundraising and this requires the aid of more people. If anyone would like to volunteer for this wonderful agency, please call Hope at 845-339-4673.
Review for Breast Cancer Options Inc, Kingston, NY, USA
I was diagnosed with breast cancer in 2002 and at that time, I was unaware of Breast Cancer Options. When I did learn of BCO, I wanted to give back and so I became a volunteer. Based on all I know about the organization now, I wish I had been aware of their services. I certainly could have used the advice and support the organization provides to the community and individual people. Even after diagnosis and treatment, I have received invaluable advice from Hope Nimeroff which has included doctor referrals, lastest treatment trends and other complimentary treatments. This organization is such an asset to the resident's of our area.
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I've personally experienced the results of this organization in...
seeing how many people they help each day and how their services have provided encouragement, education and support.
What I've enjoyed the most about my experience with this nonprofit is...
seeing how many people the organization reaches and helps.
The kinds of staff and volunteers that I met were...
so dedicated to the cause and have given 110% to make the organization the best that it can be.
How frequently have you been involved with the organization?
About every month
When was your last experience with this nonprofit?


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"Time For Total Medicine: Get Family Medicine Out Of The Shadows," is an article that has been talked about a lot in the past week. In addition to that, I'll reflect on the previous three shows where the guests were AAFP Board Members and why it was important that they appeared on the podcast.
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More than two dozen dogs are in need of new homes after an outdoor animal shelter discovered multiple litters that had been abandoned early Thursday morning.
One adult mother and 24 puppies younger than 8 weeks old were found by the city of Delano's Animal Control Department.
- Download: FREE NBC LA Mobile News App
Though the puppies were not hurt or showing any signs of abuse, they would not have survived the night outside in the cold, so an emergency plea was immediately sent to nonprofit Tiny Loving Canines (TLC), a volunteer-run rescue shop in Ventura County.
"How do you say no to them knowing that they were going to die tonight?" TLC Board Member Sarah Freeman told NBC4.
The pups won't be able to go up for adoption until they are up to date in terms of shots, microchips and neutering -- something that will prove costly and require public donations.
TLC will be accepting donations onsite and on its website to come up with the hundreds and potentially thousands of dollars needed for the puppies' medical needs.
The pups were found at Delano's outdoor animal shelter in Kern County. Despite the distance between the two organizations, TLC arranged a meet-up because of the cold weather conditions.
Volunteer drivers from the animal shelter and TLC rushed to the organizations' midpoint, Frazier Park (map), Thursday evening to find the dogs a safe, temporary home at TLC's indoor shop in the Simi Valley Town Center.
"All the puppies are settled in, safe, warm, and have full bellies!" TLC tweeted to NBC4 Thursday night.
Details on how the puppies were found Thursday morning were not immediately available, and officials from the Delano Animal Control Department were not available for comment.
Freeman was told there were three separate reports of dogs found -- all within a couple of hours -- leading her to believe the instances could be related.
Because of the age of the dogs and the fact that one dump included 20 puppies, Freeman thinks they could have been dumped by a puppy mill breeder.
"Many times when people drop puppies off, they are embarrassed," Freeman said. "So they leave them in places where they'll get found."
The drops included a diverse range of puppies, 6 to 7 weeks old, that include what Freeman said looks to be terriers, pit bulls and shepherd mixes, among others.
Freeman encouraged interested adopters and passionate puppy lovers to network the animals and their story -- spreading the message via sites such as Twitter, Facebook and Pinterest.


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This is a composite of two photos: the endpapers of an old book and a figurine spotted in a store window while vacationing in Britain. I positioned the figure at the point where the "bubbles" appeared to be flowing down towards her.
(2 votes)
Bubble Fairy
DerekHayes | Jun 11, 2014
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Country House Rescue: Series One
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You Save: £10.70
For Ruth and the home owners it was a turbulent journey full of family history, ancestral duty and, in many cases, raw emotion. One year later, she revisited the six magnificent properties to find out if the owners had followed her advice
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On Wednesday morning, Speaker John Boehner huddled with House Republicans at a closed-door conference meeting. A top GOP source tells NRO that Boehner urged his colleagues to resist attempts to raise tax rates. The focus, he said, should be on tax reform.
"We've staked out a principled position," Boehner said, according to the source. "It's important that everyone in this room continue to be clear with our constituents about what that position is. We're fighting for spending cuts. We're fighting against increases in tax rates that destroy jobs. And we're fighting for pro-growth tax reform and entitlement reform, the keys to economic growth."
"Letting tax rates rise on January 1 instead of cutting spending will cost jobs," Boehner added. "We know this from the Ernst & Young study that came out back in July. We need to be calling out the Democrats in Congress who are saying 'no' to spending cuts, and saying we should go over the fiscal cliff."
In his presentation, Boehner used PowerPoint slides to make his case. The slides include polling data from pollster David Winston, a longtime adviser to House leadership. You can view them here.


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Swing Vote
In Donald Norman's book, The Design of Everyday Things, one of his overarching arguments is that well designed objects should be self explanatory. Meaning that design of objects should basically tell the user what the main purpose of the object is, where to place their hands on the object, and how to operate that object.
While I agree that items should be well designed and intuitive, I also feel that the users of these items should be open minded and willing to explore the object to a certain degree. The item shown in the above photos is a compact stapler, meant for students and other individuals who need to staple documents on the move. However, when looking at the top left photo and lower middle photo, it's not very clear that this item is a stapler. I've given this item to a couple people and asked them to figure out what it is and how it works…often to receive looks of puzzlement and frustration. With a little encouragement and an occasional hint, they eventually reached that 'aha!' or 'oh, duh!' moment.
Designers can only communicate so much to the user through the design of an item since they need to make a multitude of compromises. The rest of the explanation can hopefully be found in a well designed instruction manual.
What's your opinion?….are our expectations for simple, self explanatory items reasonable? Or are the users of these items lacking that natural human curiosity?


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So the basic point seems to be: "if you know how to use a tool, you don't usually curse and swear when you use it. If you don't, you tend to swear a lot!"

:)

 On Mon, Jan 10, 2011 at 5:32 PM, Adam Wick <firstname.lastname@example.com> wrote:

On 01/10/2011 08:52 AM, Malcolm Wallace wrote:

 If I were considering contributing minor patches to a project, the use of git would probably not deter me too much - I can cope with the simple stuff. But if I wanted more major involvement, git would definitely cause me to think twice about whether to bother.

 And just to show that you can't make everyone happy ... I'll put in an equal-and-opposite vote from Malcolm. GHC's use of darcs is a blocker for me even thinking about doing any work on GHC or the related libraries; my limited experience with darcs has been terrible, and the swearing I've heard about darcs makes me think my experience was not unique. Switching to git would make the chance that I'd do work on GHC nonzero.

 - Adam

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Kristen Stewart, Rachel Bilson and Kate Moss All Wear Pointy Toe Pumps: We Find The Best 20 Copycat Shoe Styles Online!
Kate, Kristen, Rosie and Rachel Get to the Point!
We pointed out (sorry, we couldn't help it!) this persistent shoe trend back in May, and have been gobsmacked at the number of celebs who have since donned this chic shoe shape. Early adapters Kate Moss and Rachel Bilson paved the way for recent convertees Rosie Huntington-Whiteley (showing up today at the NYC Transformers premiere) and Kristen Stewart. Are we labouring the point? Perhaps! There's now a plethora of pointed toe pumps available online, so we've rounded up the best 20 styles (thanks ShopStyle!) so you can get en pointe too.
<iframe src="http://widget.shopstyle.com.au/widget?pid=uid0-1826500-93&look=3372069&width=4&height=1&layouttype=0&border=0&footer=0" frameborder="0" height="244" scrolling="no" width="550"></iframe>
Image Source: Getty


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A 6-month-old girl who was sleeping in a stroller in the front room of her BayView Houses apartment on East 102nd Street was grazed in the head as three bullets came blasting through the apartment's front door early last Thursday, police said.
The baby, Zatrina Ramsey, was taken to Brookdale Hospital and later pronounced in stable condition by emergency room physicians.
Because of the oppressive heat, Zatrina's mother, Beatrice, 31, thought it might be better if the baby slept in her stroller in the living room instead a of warmer bedroom, while she and Zatrina's 2-year-old sister slept on the couch. Her husband and 5-year-old brother stayed in the bedroom.
At about 3:15 a.m., the family was awakened by the sounds of gunshots outside the apartment door. When Ramsey went to comfort the cryingbaby, she felt blood coming from her head.
Emergency units were already on their way to the site, according to police sources, because neighbors had called 911 when they heard the shots. The baby was immediately taken to the hospital after they arrived.
Detectives from the 69th Precinct said it appeared there were three shots fired from a .45 caliber handgun, although some neighbors thought they heard as many as six shots.
It was reported that the family has no record of involvement with criminal activity.
This week police said they have no leads and presumed the bullets were not purposely aimed at the Ramsey's door.
Anyone with information on the case is asked to call the 69th Precinct Detective Squad at 1-718-257-6215 or Crime Stoppers at 1-800-577-TIPS
All calls will be kept strictly confidential.
Photos by Seth Gottfried


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A small town celebrates their unique heritage.
Since the 1970's the Dresden Melon Festival has been a celebration of family, friends and the area's rich melon-growing legacy. The community festival offers a lot to do, buy and eat.
"We couldn't have asked for a better day. It's beautiful out. We had not quite 100 people in the 5K run, the course was beautiful. We're tickled, very tickled," said Mayor Dave Matthew.
The melon festival just recently regained it's popularity five years ago. Mayor Matthew says the local businesses have been very supportive in getting the festival up and running again.
"Most of it's been non-profit. That's been the core of this group. Between the legion and the sons and the VFW, we try to keep a community oriented venture," said Mayor Matthew.
The evening festivities included a cruise-in, karaoke contest and a beer garden.


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Flash Draw Created Apr 30, 2009 470 x 338px Unless noted Copyright 2009 mermaidluv89.
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During this winter, the message from the Orioles brass has been that they are reluctant to trade their young pitchers and that they place a high value on them. If they don't get a similar value in return, they have said they will be happy to hang onto them and not trade. We have heard basically that exact message for weeks from both Dan Duquette and Buck Showalter.
There are a lot of ways to rank and value players. There are more stats in the game than ever, and more stories written and opinions expressed about player value than ever before.
But one huge factor, especially for those that occupy the front offices of big league teams, is a player's salary. All teams covet lower-salaried younger players who have a year or two to go before arbitration, when their pay scale starts a steady climb upward.
Maybe you've seen this pretty incredible interview over the weekend in the Wall Street Journal with the Yankees' Mark Teixeira, the Severna Park native who O's fans once thought might sign a huge contract with their club. Teixeira admitted his better years in the stat department are behind him and said he understood if any fan said he was overpaid because he thought he was, as well.
He also said this: "Agents are probably going to hate me for saying it. You're not very valuable when you're making $20 million. When you're Mike Trout, making the (big league) minimum, you are crazy valuable. My first six years, before I was a free agent (making a huge salary), I was very valuable. But there's nothing you can do that can justify a $20 million contract."
He makes a great point there and we can relate it to the Orioles. The Orioles have several young pitchers in their pre-arbitration years and there is value in having players that contribute to your team for at or near the big league minimum.
Here is a stat comparison from last year for two Yankees and two Orioles:
CC Sabathia: 15-6, 3.38 ERA with 1.14 WHIP and .238 average against.
Hiroki Kuroda: 16-11, 3.32 ERA with 1.17 WHIP and .249 average against.
Chris Tillman: 9-3, 2.93 ERA with 1.05 WHIP and .207 average against.
Miguel Gonzalez: 9-4, 3.25 ERA with 1.21 WHIP and .235 average against.
Of course, this is not a straight comparison or completely fair one, as Sabathia and Kuroda spent all 2012 in the majors pitching 420 combined innings while the O's duo spent a lot of time in the minors and pitched a combined 191 innings for the Orioles. But when they did pitch in majors last summer, the O's duo did it very effectively.
Last season, Sabathia made $23 million and he'll be paid that same amount for 2013, while Kuroda made $10 million last year and is being paid $15 million this season.
The exact salaries of Gonzalez and Tillman for 2012 were in the range of the major league minimum of $480,000, for which they earned a pro-rated portion for only the actual days they spent in a big league uniform.
This season while Sabathia and Kuroda will earn a combined $38 million the O's duo will earn around $1 million combined.
The lower salaries for young players with little service time are a huge reason why all teams are prone to stick with their young pitchers much more than their fans might be willing to. What clubs, including the Orioles, wouldn't want numbers like Tillman and Gonzalez put up last year at the minimum salary?
Furthermore, those players allow you to spend money elsewhere on your roster. There are reasons teams show patience with young pitchers and the salary factor is a key one. A Yankee - Teixeira, of all people - made that point indirectly in that interview over the weekend.
More farm system ratings: ESPN's Keith Law published his rankings of the talent in each organization's farm system. The Orioles were ranked No. 13. They rated No. 17 in the Baseball America prospect handbook. Law wrote that the ranking for the Orioles would be higher had Manny Machado not used up his rookie eligibility.
As for other AL East teams, Tampa ranks No. 3 with New York No. 10, Boston No. 17 and Toronto No. 24. Law ranks St. Louis No. 1.


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Foreign Aid:
USAID Has Increased Funding to Partner-Country Organizations but Could Better Track Progress
GAO-14-355: Published: Apr 16, 2014. Publicly Released: Apr 16, 2014.
Additional Materials:
- Highlights Page:
- Full Report:
- Accessible Text:
(202) 512-3149
Office of Public Affairs
(202) 512-4800
What GAO Found
The U.S. Agency for International Development's (USAID) reporting on its principal Local Solutions indicator—the percentage of mission program funds obligated to local organizations in partner countries—lacks clarity, complicating the assessment of the agency's progress toward its fiscal year 2015 target of 30 percent. The March 2013 USAID Forward progress report states that these obligations increased from about 10 percent of mission program funds in fiscal year 2010 to about 14 percent in fiscal year 2012—a $465 million increase. However, the agency also has reported progress on the principal Local Solutions indicator in three other ways, depending on whether two key types of funding—cash transfers and certain qualifying trust funds—are included (see figure). These reporting differences make it difficult to compare the indicator from year to year and to quantify the progress needed to achieve the 30 percent target by fiscal year 2015. Moreover, USAID's approach to tracking the Local Solutions indicator has evolved since the launch of the initiative. For example, USAID included funds in Afghanistan and Pakistan, missions the agency previously had planned to exclude. If these missions are excluded, the percentage of mission program funds obligated to local organizations in fiscal year 2012, including qualifying trust funds and cash transfers, decreases by 10 percentage points.
Reported USAID Mission Program Funds Obligated to Partner-Country Local Organizations, by Type of Funding Included, Fiscal Year 2012
USAID's principal Local Solutions indicator does not fully reflect activities the agency has undertaken to implement the initiative, and USAID does not have a means to track relevant mission-led evaluations of programs implemented by partner-country organizations. USAID relied primarily on its principal Local Solutions indicator to demonstrate progress. While this principal indicator reflects, to some degree, the steps missions are required to take before obligating funds to local organizations, it provides no information about the status of activities both prior to and following obligation of funds, such as assessing risk and monitoring programs. Furthermore, although USAID has laid some groundwork for evaluating the Local Solutions initiative, the agency does not currently have the means to determine the extent to which missions are conducting performance evaluations to assess the effectiveness of programs implemented through local organizations. Such evaluations can provide evidence needed to demonstrate progress toward the initiative's goals related to local partners' capacity, country ownership, and program sustainability.
Why GAO Did This Study
Since 2010, USAID has undertaken a series of reforms, collectively called USAID Forward. One key reform, the Local Solutions initiative, aims to shift program implementation from U.S.- based and international organizations to partner-country organizations, including governments and for-profit and nonprofit organizations. The three overarching goals of the initiative are to strengthen the capacity of partner countries, to enhance and promote country ownership, and to increase the sustainability of development efforts. GAO was asked to review the implementation of this initiative. GAO assessed the extent to which USAID (1) has demonstrated progress toward achieving its fiscal year 2015 target for the principal Local Solutions indicator, and (2) is tracking progress in achieving the initiative's goals related to local partners' capacity, country ownership, and program sustainability. To address these objectives, GAO reviewed funding data and documents and interviewed USAID officials.
What GAO Recommends
USAID should (1) clarify in future reporting the types of funding included in the percentage of USAID funds obligated to partner-country local organizations, (2) identify additional indicators to better capture progress toward the initiative's goals, and (3) provide a means to identify evaluations of programs that used the initiative's approach. USAID neither agreed nor disagreed with the recommendations but identified actions it has ongoing to address these issues, and just prior to publication of this report released fiscal year 2013 data on its website that includes some clarifying information.
For more information, contact David Gootnick at (202) 512-3149 or firstname.lastname@example.com.
Recommendations for Executive Action
Status: Closed - Implemented
Comments: While USAID neither agreed nor disagreed with this and other recommendations in the report, the agency has since taken steps to implement this recommendation. For its fiscal year 2013 data, USAID changed its reporting by separately listing the amount of funds the agency provided as cash transfers and qualifying trust funds, as well as how these amounts affect the percentage of funds the agency has provided to local organizations. This new reporting format makes it clear what data USAID is reporting and easier to track progress from year to year.
Recommendation: To improve the agency's tracking and reporting on progress of its Local Solutions initiative, the USAID Administrator should clarify in future reporting the types of funding included in the percentage of USAID funds obligated to partner-country local organizations.
Agency Affected: United States Agency for International Development
Status: Open
Priority recommendation
Comments: As part of a three-tier approach to integrate more strategic monitoring efforts, USAID is conducting an internal review of the department's best practices, processes, and procedures for promoting the goals of the Local Solutions initiative, which are to strengthen capacity, promote ownership, and increase sustainability. Through this review, the agency expects to identify ways of monitoring the Local Solutions initiative that will more accurately capture the underlying models of change and help identify indicators that will help capture progress toward the initiative's goals. In October 2016, USAID officials said that the agency is in the process of developing a menu of potential indicators and will request missions to provide feedback on these indicators. Agency-wide indicators for local ownership are expected no sooner than spring of 2017. In April 2017, officials stated that the agency is working on finalizing draft indicators for local ownership. The expected date of completion is now late summer 2017.
Recommendation: To improve the agency's tracking and reporting on progress of its Local Solutions initiative, the USAID Administrator should identify additional indicators to better capture Local Solutions progress toward the initiative's goals.
Agency Affected: United States Agency for International Development
Status: Closed - Implemented
Comments: USAID neither explicitly agreed nor disagreed with this recommendation, but has since introduced a way to tag evaluations in its evaluations registry for projects and activities that have a component with funds provided directly through the local organization, per the Local Solutions initiative. As of the end of fiscal year 2015, the evaluation registry includes a field for missions to indicate whether the evaluation is of a program, project, or activity that includes a Local Solutions component.
Recommendation: To improve the agency's tracking and reporting on progress of its Local Solutions initiative, the USAID Administrator should provide a means to identify evaluations of programs that are implemented by partner-country local organizations.
Agency Affected: United States Agency for International Development
Explore the full database of GAO's Open Recommendations »
Nov 13, 2017
Tobacco Trade:Duty-Free Cigarettes Sold in Unlimited Quantities on the U.S.-Mexico Border Pose Customs ChallengesGAO-18-21: Published: Oct 11, 2017. Publicly Released: Nov 13, 2017.
Oct 31, 2017
Syrian Refugees:U.S. Agencies Conduct Financial Oversight Activities for Humanitarian Assistance but Should Strengthen MonitoringGAO-18-58: Published: Oct 31, 2017. Publicly Released: Oct 31, 2017.
Oct 26, 2017
Refugees:Federal Agencies and Their Partners Have Implemented Certain Measures, but Need to Further Strengthen Applicant Screening and Assess Fraud RisksGAO-18-156T: Published: Oct 26, 2017. Publicly Released: Oct 26, 2017.
Oct 19, 2017
International Food Assistance:Cargo Preference Increased Food Aid Shipping Cost; Benefits Remain UnclearGAO-18-193T: Published: Oct 19, 2017. Publicly Released: Oct 19, 2017.
Oct 12, 2017
International Mail:Information on Changes and Alternatives to the Terminal Dues SystemGAO-18-112: Published: Oct 12, 2017. Publicly Released: Oct 12, 2017.
Oct 4, 2017
Antiterrorism Assistance Program:State Should Improve Data Collection and Participant OversightGAO-18-149T: Published: Oct 4, 2017. Publicly Released: Oct 4, 2017.
Antiterrorism Assistance:State Department Should Improve Data Collection and Participant OversightGAO-17-704: Published: Sep 28, 2017. Publicly Released: Oct 4, 2017.
Sep 28, 2017
Iran Sanctions:U.S. Agencies Continue to Implement Processes for Identifying Potentially Sanctionable EntitiesGAO-17-779R: Published: Sep 28, 2017. Publicly Released: Sep 28, 2017.
Sep 19, 2017
Iraqi and Syrian Cultural Property:U.S. Government Committee Should Incorporate Additional Collaboration PracticesGAO-17-716: Published: Sep 19, 2017. Publicly Released: Sep 19, 2017.
Sep 13, 2017
Overseas Allowances:State Should Assess the Cost-Effectiveness of Its Hardship Pay PoliciesGAO-17-715: Published: Sep 13, 2017. Publicly Released: Sep 13, 2017.
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La Russa gets first taste of front-office work
La Russa gets first taste of front-office work
He looked like he was retired, which he was soon after winning another World Series in St. Louis last October. He was actually job shadowing, which makes him sound like he's just entering the workforce. This is where the next phase for La Russa's career begins after 33 years of managing.
"I keep looking ahead," La Russa said. "I'm ready for what's next."
He says he doesn't miss the baseball side yet, that he's ready for life on special assignment with Major League Baseball in some capacity. Yet as he talked with reporters in Tigers manager Jim Leyland's office, he was still enjoying the baseball part.
La Russa had become known in recent years for having celebrities coming in and out as guests during his camps. This time, he's the celebrity, checking in on his friend.
Only this celebrity eventually had to go to work.
"If you want to stay here and deal with these guys, that's fine," Leyland told La Russa, pulling away from his media session for meeting. "If you want to come over to our meeting, it's fine. If you don't have your butt over there on time, don't come back."
La Russa and Leyland have had been close enough to trade barbs with each other for some time, and they were in rare form Tuesday, more than a half-century of Major League managerial experience sitting in the same office. They were each other's closest confidantes in the game for years, and they've served on the same MLB committee together to brainstorm rules changes.
When Leyland seemed burned out on managing after a bad 1999 season in Colorado, it was a Spring Training role and special assistant's job with La Russa and the Cardinals that got him back in. Without that, he said, he might not be managing now.
"That's really what got my juices going again," Leyland said.
The roles here are reversed, except that La Russa is looking at a different side of the game. He was at Leyland's side for much of Tuesday's workout, watching, talking. Once the workouts ended, he headed upstairs to join team president/general manager Dave Dombrowski, who extended the invitation to La Russa to come here.
He joked that he wanted to be as tough on Leyland now as he was on La Russa then.
"I've got one goal: To have him stop smoking, and to eat tofu," La Russa said.
Quipped Leyland: "I didn't start smoking until I started coaching for him."
Leyland and La Russa are close enough that they're honest with each other. If Leyland thought this was a mistake, he'd be saying it. But Leyland, who takes over from La Russa as MLB's winningest active manager, understands. Leyland had a six-year hiatus between managerial jobs; La Russa went from playing directly into coaching and managing and hasn't looked back.
"I was kind of surprised, really, when we were walking out [to the fields] together," Leyland said afterward. "I asked him if it felt strange not being in uniform, and he said not as much as he thought it might. I think he's ready for another chapter. I don't think there's any question about that."
La Russa has worked with plenty of legendary general managers. His first managerial job in the White Sox farm system had him reporting at one point to Dombrowski, who was a farm director shortly out of college, and the great Roland Hemond. When La Russa won a World Series with the A's, his GM was Sandy Alderson. His 2006 title in St. Louis came under Walt Jocketty.
He didn't want to be a distraction this spring, which he likely would've been with the Cardinals. His ties with Dombrowski brought him here.
"I was so excited about doing this part of it," La Russa said. "You know, you don't have any idea about what goes on upstairs [when you're managing]. You think you know what guys do, what their titles are. But I'm excited to find out how an organization runs off the field."
La Russa said he will not be replacing Joe Torre, who served as Major League Baseball's executive vice president for baseball operations before stepping down this offseason to join a prospective Dodgers ownership group.
"I've talked to the Commissioner about doing some things for MLB," La Russa said Tuesday morning, "but not that job. I mean, I'm not sure exactly how official [it is] and when it'll be announced, but we have talked. And at some point, they'll release something or say something."
La Russa will spend about two weeks in camp with the Tigers to learn and ins and outs of front-office work. He'll go to Jupiter, Fla., from there, and then spent part of March in Arizona.
The opportunity to work with Major League Baseball, at this point, is appealing to La Russa. But he still sounded open to working with a club in the front office.
"Fifty years [in baseball], and all I've known of being with a team is winning and losing," he said. "I mean, I understand what MLB needs and what they provide for all of us. I like winning and losing with a team, but I really respect what they do up there. I've learned a lot, especially with that Commissioner's committee I've been on for three years. It's been a really good learning experience from the ownership level, front-office level, what goes on, the issues.
"I definitely don't want to disrespect the MLB opportunity. Whatever the Commissioner wants me to do, I'll do. But it's still mostly about winning and losing."
The roster La Russa gets to watch the next couple weeks has him thinking about winning.
When Miguel Cabrera stopped in to say hello and shake La Russa's hand, La Russa turned to Leyland with mock surprise.
"Is he on your team, too?" La Russa asked.
Leyland smirked.
"You're not the only guy who had a Pujols," Leyland answered.
Jason Beck is a reporter for MLB.com. Read Beck's Blog and follow him on Twitter @beckjason. This story was not subject to the approval of Major League Baseball or its clubs.


text:
I still remember, with amazing clarity, my middle school's race for class president. Two candidates stand out: Brian Koehr and Paige Apple. I was friendly with both, although not close friends with either. Brian was happy and enthusiastic; Paige was quiet and studious. Going into their candidate speeches, I honestly didn't know who I was going to vote for. I seem to recall being favorably disposed toward Brian.
To this day, the essence of their speeches stays with me. Paige's was along the lines of, "Here's my plan for what we all need to do to make this a better school;" Brian's was along the lines of, "Pizza day every day in the cafeteria!" I voted for Paige, and hoped for the best.
Brian won by a landslide.
That was my first experience with the nature of politics, and the power of the vote.
The truth was, who became class president then didn't matter. There's probably no more toothless job in America. Brian, Paige… They were both going to do the same thing — give a speech at homecoming, pick a theme for the school dance, get their faces in the yearbook smiling back. Memories. It was all for show, a gesture toward citizenship, a lesson learned.
And it did instill in me — and probably everybody in school that day — the awesome power of demagoguery: A candidate who will say what the people want to hear has an edge over one who speaks hard truths. That's not always the case, of course. Sometimes the hard truth is resonant and the pandering rings false. Voters can surprise you.
And certainly they surprised us all Tuesday night.
Brian Koehr was a nice guy in a powerless position who made meaningless promises that had no lasting impact beyond the insulated microcosm of eighth grade. That is not the same with Donald Trump. He is not a nice man. He is not powerless. He is not benevolent. And soon he will wield as much power as any human ever has.
His agenda is chilling. Among his campaign promises: Repeal the Affordable Care Act (and replace it with…? He won't say); appoint ultra-right-wing justices to the courts, including the Supreme Court; build a wall between the United States and Mexico, whatever the diplomatic cost; impose a ban on, and even deport, Muslims, irrespective of their citizenship status; overturn marriage equality.
I know Trump supporters who allay my concerns about what his presidency will look like by saying, "Don't worry — he's not going to do all the things he says." Then why in the world did you vote for him? Anyway, those are just some of the things he has publicly advocated. What about the ones he hasn't even thought of? If even half of these come to fruition, it would be devastating for every single person I know.
Even if you can't trust what he says, what will America under Trump look like? Presumably, it will be one forged by Mitch McConnell and others in the Republican Party who will exploit Trump's inexperience with the political system to their own end. In many ways, I'm more afraid of a Mike Pence presidency then a Donald Trump presidency. Pence has core values, however twisted, and political experience. He can actually get an agenda through.
What will Trump do? That's what has me as scared as I have ever been about the future of my republic.
And I'm about as "safe" as you can get. I am a middle-aged, middle-class, white male. Aside from not being Christian or straight, I'm as mainstream as a person can be in this country today.
Still, as a journalist, I feel vulnerable. Donald Trump has waged a war on journalism, encouraging disparagement and violence against the journalism pen at his rallies. If I feel that way, imagine how it must feel to lesbians recently married who now wonder whether their entire union could be overturned by the stroke of a pen? Imagine what it feels like to be a DREAM Act-er concerned over deportation, or a Muslim, or a disabled person, or someone with health insurance for the first time.
I fear for them. I fear for them much more than I fear for myself. And they are my friends.
Twelve years ago, I asked a colleague: If he could hand-pick the nominees of both parties, but could have absolutely zero say in the outcome of the election, who would he choose? My very liberal friend grinned widely and said, "Easy! Hillary for Democrats. And Mike Huckabee for the Republicans. He's a nut job. He could never get elected. In the bag." I said, "Sure, it's nice to think that, but what if he did win? Could you live with that?" My colleague brushed away my concerns. "Never happen!" he assured me. "Voters couldn't be that badly fooled."
I was not as confident as he was back then. I couldn't imagine living in a world in which the presidency of the United States was run by someone who honestly believed that the earth was 5,000 years old and that Adam and Eve played with the dinosaurs in the Garden of Eden. "No one ever went broke underestimating the intelligence of the American people," H.L. Menken opined.
Mike Huckabee concerned me, but at least a right-wing fundamentalist is predictably nutty; not so much an inexperienced businessman with multiple bankruptcies, shady business dealings, a disastrous personal life and temperament more akin to a mentally unstable toddler than a statesman. Huckabee may have been dangerous, but even he was manageable. He had limits. I wonder how manageable Donald Trump will be, from the left or the right. I suspect even diehard Republicans, when they are done cheering for their victories in the Congress and their defeat of the much-hated Hillary Clinton, will brush the sleep from their eyes in a few days, and realize what their policy hath wrought.
It is the nature of Americans to be optimistic, to hold out hope for the best in people and make lemons out of lemonade. Fight the good fight, and win or lose, move onto the next one. There is honor in the battle, whatever the outcome. I suspect we will all do that, if not tomorrow, eventually. Maybe not all of us, and maybe not soon. I have serious doubts now for myself.
There has never been a more somber, sobering and frightening time in my adult life. Not the Cold War. Not 9/11. Those were forces from outside that seemed to threaten our survival.
These threats — those of fellow citizens endorsing a hollow candidate with no concrete, constitutional ideas — come from within. Millions of our fellow Americans watched as Donald Trump mocked the disabled, made inane promises, threatened his opponents, disparaged women, committed sexual assault, lied about everything from anti-American protests to his taxes, bred race-hatred and McCarthy-esque suspicions about our fellow Americans.
And they voted for him. They said, "We trust you."
I have my doubts about that. I don't think this was about trust. I think this was about animosity toward the opposition. Hillary Clinton didn't lose this election last night — she lost the moment Obama won in 2008, when the GOP resolved to undermine him at every turn and sow seeds of contempt and conspiracy, mount racial divides and whisper campaigns. They spent eight years priming the pump for a coup. And they won while we all looked on, mouths agape, cattle in the abattoir, lining up brainlessly, uncomprehending of what was happening.
The small bright spot seems to be that Clinton apparently received more popular votes than Trump. That's cold comfort (ask Al Gore), but it does give me a pinhole of light to stare at. Sometimes you have to experience the scourging to appreciate the salvation.
I still believe in hope. I have to. But I've never felt such ennui about my fellow citizens. "Apres moi, le deluge," the monarch said.
Better grab a towel.


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Nov 09, 2011 - 11:49 am
I remember these figures being presented to me at dx. I was really hoping that I would be in the 95% and I was for the first three weeks. I always had hope that things would not get too bad for me, but they did. I got thru it and I am left with some unusual side effects. I don't think that reading this board gave me any symptoms, made me sicker or gave me any side effects. My side effects are due to my reaction to treatment.
My point is is that 95% have no side effects or symptoms, so those people are not on this board. They have moved on. It's like anything, going to a restaurant going on a cruise, if it worked well, you are not going to hear from them, unless it is great, overthetop, or it was a very Negative experience so they have to write about it.
We are the 5% trying to find answers and solutions.
I have a collection of small Svorsky Chrystal figurines. Over the years they have fallen and little bits of them, have ended up in my jewelry box, paws, beaks, a little gold bug. Some people wouldn't display these pieces anymore. I am most fond of these broken figurines as they have more character in my eyes and I smile as I pass them. Now I look upon them even more fondly as they remind me of us.
Nov 09, 2011 - 2:01 pm
Thanks for sharing your thoughts. I did not realizie 95% have no side effects or symptoms. I also am not in that 95% but cannot complain due to fact my life was saved as a result of my doctors decisions and care. Baylor Plano in Plano Texas is where my doctors are located. The main side effect I have had is BM issues. Now that I am eating Activia each day it seems to have helped with my BMs.
I am scheduled for my 2 year colonscopy Friday and as usual am a little nervous before my tests. I do not anticipate any new issues because I have been feeling fine. Hopr the best for you.
Nov 09, 2011 - 2:10 pm
I like your comments about the crystals. I now refer to myself as a "scratch and dent" model, but I still run like a top!
However, I've been on 3 different support sites since my treatment ended in September '09 and judging from my own experience and that of others who have shared on the forums, I have a hard time believing that 95% of people undergoing treatment for anal cancer will not have any side effects, during or after. Also, the word "symptoms" would lead me to think of things such as bleeding, which many people continue to have during and after treatment. I still occasionally have bleeding with BM's, even 3+ years out.
I do agree that many people get past treatment and choose to put everything behind them and stop talking about cancer, so they do not participate on sites such as this. I must say that the further out I get from treatment, the more I understand that. I believe at some point the day will come when I will do the same.
Nov 09, 2011 - 4:58 pm
i am not in the 95% and would have loved to be able to read all these hints when i was being treated from march 31 ( large biopsy with stiches trying to remove the entire tumor) 2009 un til end of tx at MD Anderson in July 2009. the anal part posted the month after, i think. i watched the farrah fawcett broadcast trying to grab hints from her of how she handled the pain , the crazy BM's and etc. but she could not show that to the world. I had side effects immediately from chemo (mouth so full of sores that i could not eat or talk with no relief for a week) then the radiation started burning me up after the first week which the docs said was not the usual thing. then i ended up in hospital after the last tx. But the worst is that i am still suffering with side effects---- pain during , after certain BM's, some bleeding when tissue tears, mucous. too many bm's. i am not a grateful survivor. but i am gradually after 2 years and 4 months post tx getting better. I still can not fast walk for exercise due to the pulling on the anus . also , to let you know, i have never smoked ( mom did). have been 115-120 lbs 5ft. 7 inches my whole life and used to be able to exercise. i have never tested positive for HPV in the 38 years of pap smears. sooooo i was sort of healthy before all of this mess. every one is different. i welcome all info. i need it and thank everyone for helping me all the time. trying hard to be grateful for every small step forward. sephie
Nov 09, 2011 - 9:22 pm
When I would consult with radiologist, onc, techs with my symptoms, everyone had the same response, never saw this before, don't know how to help you. In the front I was burned from above pubic area to mid leg. Open dripping, weeping skin, entire vaginal area was burned inside and out, anus not so bad, but burned. My bladder was burned and I was incontinent, so that the urine dripped on the open burns, I had a uti and diareaah and constant urination drip 24/7. I was out of my mind with pain, I hadn't sleep more than hour in 21 days. They did not give me painkillers or a sleep aid until thanksgiving night when I went to the er and they gave me a morphine drip, They had never seen anyone have a response like this, I was told over and over again, by many health professionals at this facility. At this facility they radiate 130 patients per day. I could not believe them because I had already read the blogs noting some of these side effects. I don't know if they all band together and just decide they will deny everything. They are now finally giving in and admitting that my side effects are due to treatment. My biggest gripe is my loss of balance, for which they offered me a cane. You know what I told them to do with that cane?
Then after all that my tiny 90 year old mother in law goes for radiation to shrink a colon cancer met tumor that is blocking her airway, and she sails thru, no burn, no side effects a little tired one day.
Nov 09, 2011 - 9:22 pm
Your experience sounds absolutely horrible. While my burns were pretty bad, I did not have anything as severe as yours. It sounds to me that your radiation team was not very well versed on pelvic radiation side effects. Do you know what your total radiation dosage was? And at what point did your side effects turn severe? Just curious. Most people have a bad last couple of weeks, but some people's skin can begin burning much sooner.
I'm very sorry your treatment was so brutal and that you are now dealing with the after effects.
Nov 09, 2011 - 11:35 pm
Thanks for your empathy. I am pretty sure it was the third week, but can't remember now if the beginning of the third week or the end. looking back now, I realize some serious mistakes were made. When they did the planning, they had me insert a tampon then they made tattoos. after burning my bladder, they did replanning and gave me new tattoos, no tampon. Did this happen to anyone else, tampon and new tattoos? I do not know radiation dosage, I am very thin, but I think you are too as it sounds like many people here are. also I have never tested positive for hpv but still believe that was the cause, but doctors keep insisting no. MY radiation onc is tops in his field, but it is the techs who do the plannning and administer the treatment. I am happy with the tx because I am cured and in the end that is all that really matters. Cured for now anyway, cured forever I hope.
P.s. Just looked at records and by nov15th I was already burned and looking for remedies. What I don't understand is why were they so reluctant to give pain pills, if they knew this kind of suffering was normal with radiation treatment. I still have so many questions about everything. I read several snippets here today that are making me question how my biopsy was obtained, as it was done thru routine colonscopy. I need time to digest this discussion before I can move on to a new topic. Like you MArtha I was diagnosed with Hemis for several years.
Nov 10, 2011 - 8:54 am
I began feeling the burn in the latter part of week 3, but it didn't really get bad until about week 5. As for the tampon, that's a new one to me. I do know that MD Anderson has treated some patients with a dilator inserted during radiation, so this sounds similar. However, the fact that your first planning session was done with a tampon and the 2nd. one was not is bothersome. My total radiation dosage was 54 gy (30 days @ 1.8 gy per treatment). I believe the maximum dosage that can be given is 59 gy. I have never tested positive for HPV, but have had atypical cells on 2 or 3 pap smears, which when repeated, had cleared. However, in September '09, I underwent surgery (anal fulguration) for removal of 3 small anal condyloma, which my surgeon said were caused by HPV.
While I think everyone has some skin issues during this treatment, it is unbelievable to think that a radiation team would not know of any pain meds or creams/lotions that would be helpful in alleviating the pain. I was prescribed Silver Sulfadiazine.
As for how biopsies are obtained, mine was done during my colonocopy.
I'm very glad that you are doing well and I hope NED is in your life forever!
Nov 10, 2011 - 9:33 am
oh, i hurt for you. bless you for all the suffering you went thru. At MD Anderson , they give me pain meds immmediately. however, i did not take them for fear of constipation and the fear of the massive pain of BM. that was stupid but i did not have a clear mind and could not figure out how to handle the constipation and etc. now , i know how to do it but too late. i chose to endure the radiation pain rather than the constipation pain but that is not necessary. i think that if ONE oncologist or ONE oncologyradiologist at MDA would get anal cancer (not wishing that on anyone ) , then we would see a lot more help with this disease. they would figure a lot out and print it . i have one doc here in my small town that had a hard time with prostate cancer and he has read up on anal cancer. he understands, but of course, he was not with me at MD anderson. sephie
Nov 10, 2011 - 9:17 am
At MSK in New York I was told that I was handling the treatment better than most patients and I had the usual symptoms we describe, burns, mucous, horribly painful bowel movements after the last chemo and radiation treatments for three or four weeks. I still suffer from inflammation of the soft tissue down my legs and in my feet, which is a type of reaction to the treatment and resulting fatigue as the pain is greater when tired. But at MSK my oncologist gave me morphine and told me to take it every twelve hours. So I can't imagine anyone telling a patient to have this treatment with this cancer without that. Recently I had an asthma attack and the doctor gave me Prednisone. It totally took away the soreness and I felt like a child again. No one should have to suffer the pain this illness causes. That is barbaric. It doesn't hurt those "researchers" who came up with that statistic one bit.
Nov 10, 2011 - 11:44 am
After my trip to the er they began to address the burns and the pain. I am allergic to sulphur but was so desperate I tried the silverdyne cream anyway. At first it was ok, but really did not do much except build up in my system and create an allergic reaction. I am also allergic to avocado and they prescribed something else that had avocado oil (I did not read ingredients) and had a reaction to that. In the end I settled with the aquaphor. The best relief was standing in the shower (handheld) and letting the water flow over the burns lightly. Also the saline solution that I would clean the burns with felt like heaven.
I am really concerned now about future patients that my radiation team will be working with. I was so grateful to them, but maybe that is like when people have Stockholm syndrome. After there experience with me I pray that they do not say to the next patient I have never seen this before.
I also have the nerve damage in my legs. This really has improved over the past few months. when I am tired, it will flare up. Sunday night it was so bad I felt nausea.
happy to hear biopsy during colonscopy is ok.
All of my life I had feared chemo but nothing had prepared me for the radiation.
Nov 10, 2011 - 12:36 pm
I have changed the title. I have done some research since my post, I think this one is more accurate.
Nov 10, 2011 - 12:57 pm
that between chemo and radiation, radiation is the evil twin. I could do chemo again in a heartbeat.
Nov 10, 2011 - 1:11 pm
Nov 10, 2011 - 1:30 pm
I guess I am going to get this story out little by little.
I am home two weeks post treatment and pain from the burns is uncontrollable. I guess they did not believe me, but I showed them. We called and made an appointment with the radioligist. My husband drove me, I wore a short skirt, buck naked underneath. I walked into his office pulled up my skirt, thought he was going to cry. He sent me home with dialuad and a home nurse started coming that day to dress the wounds. I m crying a river as I write this. I stared treatment on 11/1/10 and it feels like yesterday.
Nov 11, 2011 - 1:39 am
I hope you have relief soon and am sorry you're so miserable! I empathize with you. Two weeks into treatment, I started itching and the radiation nurse said it was too soon for side effects. She was the same one who told me I wouldn't turn red... Anyway, the burns started getting worse about the 5th week. The radiation dr listened to my heart and lungs once a week - wrong end. Never looked at the radiated site until rad. tech called his attention to it, but he said to continue treatment. So a few days later I ended up in the hospital. Wound care nurse prescribed xenaderm ointment and that helped. I almost didn't finish the last 5 treatments...
Nov 11, 2011 - 1:31 am
I agree!
Nov 11, 2011 - 2:14 am
I am fine now. Sorry for all you went thru. I am glad u finished the tx.
Nov 11, 2011 - 10:52 am
I was checked weekly by my Radiologist for burns. I am also alergic to Sulfah medication and they told me emphatically not to "try it anyway." They found Radiadres Gel Sheets and a product call Allegiance Wound Cleaner which were soothing products for my burns along with Aquaphor which everyone here agrees is a life saver. Both my Oncologist and my Radiologist checked my skin burns regularly which means they both checked them weekly. The Radiologist had the medicines for the burns and even gave me large quantities of soft gauze to apply the Wound Cleaner which was particularly helpful when the itching started. God bless you. It's okay to complain. You have to be a strong advocate for yourself. Thanks for posting. Fondly, Sandy
Nov 11, 2011 - 11:59 am
Thank you so much for your support Sandy and all of you. Apparently I still need support. I never discussed with anyone what I went thru until I came here. My husband was here with me every day and listened to all my complaints. He never got short with me. I really think he is an angel sent from God. I have been thru a lot in my life and I have never been a big talker about myself (but a big talker overall). It feels good to let go of this pain, I feel as if I have taken a shower inside. I feel all fresh and new. Thank you all for your support and empathy, your kindness means the world to me.
Nov 11, 2011 - 12:48 pm
I'm glad you have found a soft place to land on this support forum. I think too many times, which I am guilty of myself, we tend to hold things in and not express our feelings, whatever they may be. There is a truly remarkable group of people here who understand each other without question. I'm glad you are feeling better!
Nov 14, 2011 - 2:17 am
My rad onc kept gently telling me that toward the end of treatment, I would experience a lot of "discomfort." My bottom was nicely chapped/raw in the middle of the second week and we think it was a skin reaction to the chemo and not completely due to the radiation. But no, I had no idea that the radiation would be so brutal.
I don't see myself as having any serious side effects at all, and I am so sorry that you are experiencing such pain.
Like Martha, there may come a time that I don't feel a need to participate on this board. But for now, I hope that I can provide some support for those who need it the most. I feel it's like the least I can do for those who share what I call a VSA. (Very special ***.) And it's probably a part of the healing process for me as well.
Love to all,
Nov 14, 2011 - 11:20 am
Yes ... I agree on all points. I need support from the board and it is so helpful for me to provide support to others ... it is a part of my healing journey. I hurt every time I see the topic "new to this site" ... it takes me back to my early days of diagnosis, that "gut punch feeling I still feel when I hear the stories of "you have anal cancer" ... and I just find I want to reach out and help sooth the pain in some way. We can not take it away from each other ... but we can stand together and that is so powerful for me.
Angela ... I too may not need the board one day and maybe that is our "right of passage" ... to journey on ... however, for now I need you all both to support me and for me to support you.
Carol ... yes, how nice, fresh and new. So happy for your and ... How I long for the feeling of "fresh and new" as well.
love ...
Nov 14, 2011 - 12:22 pm
Angela you are a most desirable member of this board and someone who can really give hope to the newbies. You are so fortunate to not have any SERIOUS side effects and people need to know that it is possible. You represent the minority here, but really according to the statistics you are the majority.
7243 It is now at the almost year mark that I am starting to feel like the real me. I am so grateful to be healing physically. I am also healing emotionally from it all, but I think that feeling of sheer terror is never that far away these days. I never thought I cared that much for myself as I realized in that moment of dx how much I loved my life. A few months earlier I had said to a fellow surfer that I was afraid of dying because I would miss surfing too much. I came close, as we all did, thank god for dx.
Nov 14, 2011 - 3:13 pm
I was convinced early on in my recovery that my life as I had known it was over--history. I am happy to share with everyone here who may be feeling that same way that it will not be that way at all! I am 3+ years out of treatment now and I would say that at the 2-year mark, I really started to feel like my old self again. I still think about cancer and worry about the possibility of a recurrence--I don't think I'd be human if I didn't. However, it is not in the forefront of my mind like it was in the beginning. The stress eased gradually and soon I was going sometimes for an entire day without thinking about cancer much or at all. Distraction makes for a mind not focused on cancer, so I urge everyone to get involved with things that you enjoy doing. My sometimes cranky bowels do not let me forget what I've been through, but I have learned how to handle this issue, along with a few others, and I don't consider any of them to be problems that disrupt my life.
Nov 23, 2011 - 9:34 pm
When I went thru radiation, my oncology dr said it'd feel like a sunburn on the inside. That's putting it mildly so to speak! I took alot of cool sitz baths with aveeno. I also used aquaphor to help ease the pain. Still waiting on the healing from a year ago. (& still unable to use a dialator...think that body part is completely closed! ha!)
Nov 24, 2011 - 1:29 am
If only the doctors knew what it was like to have a sunburn on the inside...but we made it!
Nov 24, 2011 - 11:30 am
You have been thru a lot, more than most of us. My heart really goes out to you. I pray that this last round is the end of your journey and the healing can begin. It is such a sensitive area and does take a long time to heal, inside and out, Even with the side effects I am so happy to be here. I cannot believe how lucky I am to have caught this in time. You will heal. It does take a loooong time and you might not always feel lucky or happy along the way. Keep your head up and focus on the goal. Getting back to you.
Hugs to u pjs62.