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My Life With Sjogren's Syndrome
Published July 12, 2014
by Rachael O'Halloran
Disclaimer: This article is not to be considered medical advice. It is about my personal experience with Sjogren's Syndrome, my symptoms and medications. What is working for me medically doesn't apply to all patients with this disease. Please consult your medical care provider before taking any advice you read on the internet.
Sjogren's Syndrome
Sjogren's is pronounced as "SHOW-grins"
Some of you who follow awordlover on HubPages may have read her hub on Sjogren's Syndrome with its unique screening quiz, which I hope you'll check out. It is a useful tool for those who have mysterious symptoms and no diagnosis yet.
In the comments of her hub, I shared that I was diagnosed with Sjogren's Syndrome in 2008 and that I am managed pretty well with medication. Since my search took quite a few years with a lot of bumps along the way, I thought I'd share my experience with you.
My Sjogren's Is Not Your Sjogren's
By the time we are diagnosed with an autoimmune disease, we have picked up all kinds of medical and mental baggage. It often takes years to get a correct diagnosis. At least, it did for me. Some readers may be able to identify with that.
While it is not true for everyone, medical experts say that people who have one autoimmune disease will often contract another before their lives are over. So it is not unusual to have two or more autoimmune diseases cohabiting in your body at the same time.
I have a pretty specific treatment that works for me and it might not work for everyone else. I know it is tempting to compare because I did it too. I had to remind myself that not everyone with Sjogren's has every symptom on the list and that we all experience symptoms at different levels of intensity.
The Good News And The Bad News
If you have someone in your family with Sjogren's, you're at a higher risk of getting it.
If you have a first or second generation family member with an autoimmune disease, you are at a higher risk of getting some kind of autoimmune disease too, but not necessarily the same one as your relative.
The Sjogren's Syndrome Foundation says there are about 4 million Americans who have Sjogren's. It mostly affects women who are 40 or more years of age and are usually menopausal or post-menopausal. This number has not been updated since 2000 (14 years ago) so you can be sure it is much higher than that now. I think the age should also be lowered because I started out younger than 40 with symptoms.
If you already have your diagnosis, there is always more to learn about this insidious disease and how you can go about treating it with over the counter and prescription medications. It is one of those diseases that can change at the drop of a dime, or it can stay the same for years. It all depends on the person, their lifestyle, their medication plan and what else is going on with them medically.
I'll spare you the origins and history of this disease, who it is named for and all of that. You can find that on any other hub or webpage about Sjogren's because they all go into great detail. This article will address the process of getting my diagnosis and how I now treat my Sjogren's.
Researchers are learning more about Sjogren's all the time.
"Sjögren's syndrome is the main culprit behind dry, irritated eyes, mouth, throat, skin and nose. It is a painful condition that takes an average of 6.5 years to diagnose and can be difficult to treat. Georgia Health Sciences University researchers say learning more about how it develops should improve diagnosis and treatment."
--Georgia Health Sciences University November, 2011
Two Types of Sjogren's Syndrome
1. If you have Sjogren's and no other autoimmune disease, then you have what is called Primary Sjogren's Syndrome.
- Primary Sjogren's is more aggressive and can cause severe dysfunction in the salivary glands, stiffness and swelling, joint pain, rashes, fatigue, dry cough and vaginal dryness.
2. If you do have another autoimmune disease that was diagnosed before or after your Sjogren's, then you have what is called Secondary Sjogren's Syndrome. It doesn't matter which autoimmune disease came first; what matters is the fact that you have more than one.
- Secondary Sjogren's comes with less severe symptoms of dryness of mouth and eyes but it has to fight with other autoimmune symptoms in the body.
- When a patient has two or more autoimmune diseases, it is very difficult for a doctor to diagnose Sjogren's because the symptoms are masked to look like so many other diseases, delaying diagnosis confirmation.
The presence of other medical conditions determines how well a patient gets along with Sjogren's and with their treatment plan.
You don't have to have every symptom on the chart
How many symptoms do you have from the above Sjogren's Syndrome symptom list?
My General Health
Except for the 1990s when I was in the best of health due to being misdiagnosed a couple of times, I have always been pretty healthy. I've tried to take good care of myself, eat right, get plenty of exercise, and I've always drank lots of water.
Since 2009, most of the time I don't even think about having Sjogren's Syndrome. I don't give it a second thought, except for the couple of minutes I spend taking my medication or using eye drops each time. As soon as I'm done, it is out of my mind. I consider myself lucky that my symptoms are well taken care of with prescription and over the counter medication, exercise, diet, common sense and lots of rest.
I do wish I had been diagnosed sooner though, because it was a very rough road to get to diagnosis and treatment.
Looking back in hindsight, my symptoms were almost right out of the textbook, yet it took years to finally label my disease as Sjogren's. I was given several other diagnoses - Multiple Sclerosis, Lupus, Fibromyalgia - before I was definitely diagnosed with Primary Sjogren's Syndrome.
It was a wonder the doctors didn't kill me with all the medications they gave me for diseases I didn't have.
Autoimmune Diseases
Have you been diagnosed with an autoimmune diseases?
Restasis vs Artificial Tears
Dry irritated eyes
A Lot Of Misdiagnosis Along The Way
In 1985, I met awordlover (Anne DiGeorge) when we both had our babies in the same Philadelphia hospital. I had just given birth to my last child at age 38. Anne was a little younger, in her early 30's and had her last baby as well. She already had Multiple Sclerosis by that time, for about ten years. Over the two day hospitalization, we complained to each other about how tired we always were and we laughed at our terrible memory and concentration problems.
When she saw me putting eye drops in my eyes many times during those two days, she questioned if I had seen any kind of specialist. I didn't recognize my dryness, fatigue and concentration problems as symptoms of any disease, except being a "dead on her feet Mom" of five kids.
She said it might actually be something more than "busy Mom syndrome." For almost ten years, I all but ignored my symptoms because of taking care of my family, moving around the United States, and running with my children to their activities.
1990 - Moving from Philadelphia to California
By 1990, my oldest son was 23 and my youngest was 5. Usually we rented a house whenever we moved because my husband worked as a consultant for special projects with the federal government. Most of his assignments didn't last more than five years so we moved a lot over the years.
But this time, after one year of renting, we bought a house in California because we loved it there. After everyone was acclimated to new schools and jobs, I went back to work as a nurse at a Los Angeles hospital, working three 12 hour shifts per weekend.
Our health insurance also drastically changed with the move from the East Coast to the West Coast. We'd always had to pay for our family's medical insurance with Aetna or Blue Cross because Joe wasn't directly employed by the US government and we didn't get the great benefits other government employees did.
When I went back to work in late 1990, my health insurance at the hospital was free. But it was also an HMO, something very new to us (and to the rest of the US), requiring referrals for tests and to go to specialists.
Although for years my symptoms were dry eyes, dry mouth and monster-sized mouth ulcers, it was never really much to run to doctors about. Over-the-counter eye drops, a bottle of liquid Anbesol for mouth ulcers and drinking a lot of fluids usually took care of symptoms. In no time at all after we bought our house, I was exhausted because of house hunting, juggling job and taking care of family that it aggravated my symptoms.
Remember me saying that except for the 1990s, I wasn't in the best of health? Actually, I wanted to forget the 1990s altogether.
In 1991, when I was 44, I had a "routine" hysterectomy because of fibroid tumors and I developed a blood clotting problem after surgery that my doctors didn't catch in time so that I had a very small stroke. My brain MRI showed some fuzzy gray spots, but physically I was very lucky because I didn't suffer any outward ill effects.
Menopause kicked in full storm a couple of days after the surgery. I had no idea hot flashes were that hot! I started hormone replacement therapy. I went back to work in three months only to find myself exhausted more than ever and blaming it on going back to work too soon.
I had fatigue and dry eye symptoms and I was having more than the usual type of memory issues - at work, at home, in the store ... everywhere. Actually, I just thought I was feeling my age especially when my joint stiffness worsened. My family doctor thought it was residual from the small stroke. I was in a fix; my old neurologist no longer took my HMO insurance, so I had to find one I liked from their provider list.
Each new neurologist consult repeated old tests and the doctors either gave no diagnosis or a radically different diagnosis from each other - from Lupus to Multiple Sclerosis to Wegener's Granulomatosis, or Fibromyaligia. After doing some research at the library (pre-internet days!), I didn't think any of them matched what was going on with me.
Each doctor put me on steroids for short periods, which took care of some of my symptoms but as soon as the prescription was gone, everything came back again. I was recognizing the signs with each new appointment ... these doctors thought I was a quack patient and that all my symptoms were in my head.
1992 - You Have Lupus
Finally in 1992 at age 45, a Neurologist and a Rheumatologist agreed on one diagnosis -they said my test results all pointed to SLE, Systemic Lupus Erythematosus - Lupus. I wasn't totally convinced because when I compared myself to others, I knew I didn't look like other patients who had Lupus.
On top of a high dose of oral steroids, I was prescribed immunosuppressive and anti-inflammatory medications. After a month, I was switched off prednisone to methotrexate (a stronger steroid) for the joint stiffness and other medications for fatigue and dryness symptoms. I also needed medications for the side effects of all the medications.
Methotrexate is nasty and even though it helped a little, after three years, I stopped taking it because not only had I gained 30 pounds (a side effect of steroids) but my white blood cell count was becoming suspiciously compromised because of the immunosuppressive drugs.
1995 - Michigan and You Have Multiple Sclerosis
In 1995, we moved again, this time to frigid Michigan. We put our California house up for rent because Joe and I thought it would be a good place to live once the last child was out on his own. We still had three living at home, so we rented a house in Michigan for Joe's five year assignment there.
Oh how I wished we had never moved from California. I got worse with the drastic change in weather - dry skin, dry eyes, dry mouth ... dry everything. Prescription eye drops weren't covered on my Michigan HMO and besides, I really didn't see much difference between them and over the counter Visine or Murine eye drops. I couldn't buy enough moisturizer to keep my skin from breaking down and how my joints ached with the cold.
When we got settled in our rented house, I pulled myself up by my bootstraps and applied for a job as a nurse in Detroit. With a new HMO health insurance a month later and my medical records forwarded, I was assigned new specialists who renewed my prescriptions for me. After a few years, either they dropped my plan or I got rid of them. With new neurologists and rheumatologists came new MRI's, spinal taps and blood studies to make sure they were treating me for the right disease.
I really "looked" terrible. In late 1999, added to my fatigue were symptoms of blurry vision, balance problems and occasional foot drop. My dry mouth caused even more swallowing problems and mouth sores than before. I couldn't trust my memory at work to remember simple two and three step duties. I passed off my vision problems as turning 48, holding reading material an arm's length away to be able to see it, and needing reading glasses.
After being treated for Lupus for more than seven years, two more "second opinion" specialists said I didn't have Lupus at all.
I had Multiple Sclerosis. They both said my brain MRI and spinal tap were conclusive. My ANA blood test was positive at 1:280 and the other blood studies jived in. I wanted to make sure they understood that I was told the fuzzy gray spots on my brain MRI were from a small stroke, but they were convinced the spots were from Multiple Sclerosis.
June 2000 - DMD's - Disease Modifying Drugs
In June of 2000, I began the daily injections of DMD's, which my HMO didn't cover. The monthly cost would have bankrupted a Rockefeller. For the first time in my life I had to ask for financial assistance to help pay the $11,000 a month price tag for the medication. My copay was $2,500 per month and the grant from the drug company took care of the rest.
I only got somewhat better on the medication, and I had to take a lot of other drugs for the side effects of the DMD's. My bloodwork was carefully monitored and the drug company and insurance required a lot of MRI's for documentation.
Besides the patients I had in my care, I only knew two people personally that had MS - a nursing co-worker named Jane from California and Anne DiGeorge in Philadelphia. One was confined to a wheelchair and the other one was fired from her job when she couldn't perform her duties any more.
Depression doesn't begin to describe my mental condition. I was 53 years old and worried about how long I'd continue to be employable.
Before (L) and After (R) Treatment For Dry Mouth (Sicca)
Glossary of My Former Autoimmune Medications & Side Effects
In no particular order:
Methotrexate - can be oral or injected. Nausea or vomiting and abnormalities in liver function tests; mouth sores, rash, diarrhea, and abnormalities in blood counts; lung problems, persistent cough or unexplained shortness of breath, slow hair loss, sensitivity of the skin to sunlight
Betaseron - Injected. Flu symptoms after injection, lessens over time; allergic reactions, depression, liver abnormalities, low white blood cells, injection site reactions. No known long term reactions.
Copaxone - Injected. Chest pain, injection site reaction, shortness of breath, palpitations, deep full body flushing (a big hot flash) lasting 15 to 30 minutes and then it passes without treatment. No known long term reactions.
Rebif - Injected. Gives flu symptoms which lessen over time. Injection site reactions, liver abnormalities, depression, allergic reactions, very low red and white blood cell counts.
From the website: (They tell you this at the very bottom of the page after they scared you to death with the side effects of each medication!)
- All of these medications have been shown to reduce the frequency of MS relapses and the development of new lesions. In individual clinical trials comparing a drug versus an inactive placebo treatment, MS attacks were reduced by 28–68 percent by different agents. In the clinical trials, most people were also found to have fewer, smaller, or no new lesions developing within their central nervous system as visible in MRI scans. Some of these medications have also been shown to delay the progression of disability.
October 2000 - The World Wide Web, Massachusetts and Delaware
In October of 2000, we moved from Troy Michigan to Boston Massachusetts and then something wonderful happened.
We got connected to the internet and my life just changed overnight. It is amazing how much the internet has impacted all of our lives now, but in 2000, it was just getting off the ground and becoming available in homes. There weren't thousands of websites yet, much less medical websites but I swear I couldn't stay off my second hand computer.
In November of 2000, I answered an online ad for clerical work on a medical website that turned out to be managed by Anne DiGeorge. I started to work for her part time doing research for medical queries sent to her via email, in addition to working weekends at a Boston hospital. During one of our first phone calls, I mentioned to Anne that I had been mistakenly diagnosed with Lupus in 1992, that it was changed to Multiple Sclerosis in 1995, then I told her what my symptoms were.
Because of her knowledge of autoimmune diseases and herself having Multiple Sclerosis, she said my list of symptoms and test results sure sounded like MS to her. So I stayed on the injections, even though I only felt marginally better. I was able to keep working, and thought maybe it was the drugs helping me to do that.
By June 2005, I had been on DMD drugs for five years. My DMD drug protocol had been changed many times - from Avonex to Betaseron to Copaxone to Rebif. It seemed that every time the drug reps pedaled a new drug to doctors offices, patients were changed over to the new drug. Although the cost was getting a little lower, they still were not affordable for the average person. With the special assistance from the drug company, in Boston I had a copay of $2,000 a month toward the $9,000 monthly bill.
In July 2005, we moved from Massachusetts to New Castle Delaware because Joe accepted a short three year assignment. It was one assignment that he would never complete. I was hired with the Dupont medical network in Wilmington, again with free HMO medical insurance.
The Day My World Changed
At 2AM on January 1, 2007, my husband was hit head on by a driver going in the wrong direction on the Interstate. Two other drivers were killed. Joe had a very severe spinal injury with crushed cervical and lumbar vertebrae and two broken legs. He was comatose and on a ventilator for nearly three months in Intensive Care. I was there night and day when I wasn't working. When he finally came around and was weaned off the ventilator, only then did doctors see the extent of his spinal damage. He was completely paralyzed on his right side, partially on his left side, and unable to speak or swallow even liquids.
In April 2007, my $500,000 HMO hospital benefits had run out and my $250,000 nursing home coverage took over so Joe could be accepted to one of the best spinal injury rehabs in the country in Morris Plains, New Jersey, almost 200 miles from our home in Delaware.
We were dependent on my one income and this rehab had $50 a day copay. I was still paying my medication copay of $2,000 a month. My Delaware HMO said after the $250,000 nursing home benefits ran out, if he remained an inpatient in New Jersey, we were on our own. Because of our income level, savings and retirement accounts, we didn't qualify for any financial assistance for the remainder of the huge medical bills. I was commuting from Delaware to New Jersey every day to be with Joe, still working my 36 hour weekends, working part time for Anne and trying to bring enough money in to keep up with the bills.
By October 2007, we ran through both our savings and retirement fund. I moved our belongings from Southern Delaware to a house rental in Northern New Jersey so I could make a shorter commute to the rehab center. I was able to get hired with a former employer in South Jersey and with my new HMO, all our benefits were reset so Joe could be taken care of without high medical bills. My four oldest children lived in California, Colorado and Michigan. I wanted nothing more than to pack up and go back to California when Joe got better.
2008 - New Jersey, Philadelphia and Sjogren's Syndrome
In January of 2008 my husband was discharged from rehab to come home to live with me in North Jersey. It had been just over a year since his accident. He still required a lot of care and got very frustrated very quickly. To say I was exhausted was an understatement. We still had one son living at home to help out and my HMO kicked in for home care benefits so Joe qualified for nursing assistants three days a week with our $10 a visit copay. Things were getting back to normal at home, but I was starting to come apart at the seams.
I was taking more power naps to address my fatigue in between running for appointments to an Ophthalmologist for dry, gritty eyes, an Ear, Nose and Throat doctor and a Speech Therapist because of my swallowing problems. I sucked on Peppermint Lifesavers a lot when I wasn't drowning my throat with gallons of water.
For someone who was always in good health, I sure was taking a lot of medication and going to a lot of doctors.
Living near Philadelphia, I saw Anne more often now and I still worked for her about 25 hours a week. When Anne and I got together for lunch one day, the look on her face confirmed to me how bad I looked to others. After listening to my schedule of appointments, she said I was defeating myself by doctor hopping because no one doctor got to see me when I was at my best - or at my worse. She said my symptoms were being addressed separately with consults instead of being viewed as part of a larger picture.
She said, "If you say you don't feel any better after all this time on the DMD meds, it doesn't take a brain surgeon to figure it out - it sounds like the diagnosis is wrong."
It was exactly what I had been thinking. I should have talked to her sooner, like way back in 2002 or 2003.
The Facts About Dry Eye
"It Looks Like Sjogren's"
She didn't think I had MS at all and said that what I had, looked like Sjogren's Syndrome. Although I had read about it in passing, I didn't have a lot of the symptoms listed on the charts and so I had dismissed it. I never brought it up to my doctors and they never mentioned it to me. They were too busy looking for all the "regular" diseases. But you know, after being told I had Lupus and then MS, her words weren't that hard to hear.
"But the fuzzy spots on my MRI, they insisted it was MS" I told her.
"Rache, your little CVA is probably where the brain lesions came from. Any doctor you go to now will say you have MS because they are looking at your records, not at you. I'm telling you, these guys look no further than the previous doctor's notes, consults, lab reports and your medication list."
I couldn't believe this. What if she was right? Could I be injecting all that poison in my body for all the wrong reasons?
Between rent, gasoline, copays for Joe's home care and the copay of the MS drugs that I probably didn't even need, I was really stressed financially. When it was time to refill my prescriptions at the end of the month, I convinced myself that I was doing the right thing when I told my neurologist I was going to stop the DMD's.
Okay, so it was a very bad idea, but once I was over the withdrawal part, I knew I would never take those injections again. After reading volumes of information Anne sent me in emails, I agreed with her. I was now 95% sure I had been misdiagnosed first with Lupus, and then with Multiple Sclerosis.
She suggested I change from a Neurologist to a micro-specialist called Rheumatologist-Neurologist, with a sub-specialty in Immunology. I soon learned it was a specialty that had very few doctors and none were listed on my HMO plan. She steered me to Thomas Jefferson Hospital in Philadelphia, and gave me one doctor's name to read up on before making an appointment. I had to be a self pay patient but I didn't care at that point. I needed a doctor who knew what he was doing.
2008 - Finally Finding The Right Doctors ... For Both Of Us
I gave my new doctor a copy of my medical records, including all the reports from previous doctors. He took his time going over everything and giving me a thorough exam. He shook his head, saying he was sorry that I had been at this for so long, going from doctor to doctor all over the country..
Of course he had to order his own tests, more MRI's, and blood work. After two visits, he said he was sure that I had Primary Sjogren's Syndrome, but he still wanted to do a few more tests to make sure I didn't have a second autoimmune disease. I didn't. He started me on medications and within a couple of weeks, I was doing very well.
2009 - Home To California
I loved my new doctor, but in 2009, we were to move again, this time back to our home in California. We gave the tenants living in our house 90 days notice so we could move back in around May. Joe was referred to a visiting German neurologist at Cedars Sinai Hospital in Los Angeles who had great surgical success with his particular spinal injury and agreed to evaluate him. All I had to do was get HMO insurance at a job there, our coverage would be reset and all Joe's care would be paid for again. There was no decision to be made, of course we would move. But I told Joe I wasn't going to California doctors and I wanted to fly back to make my appointments in Philadelphia. We traded off the expense of my old DMD monthly drugs for airfare!
Twenty years of dealing with symptoms
Since 2009, I have been flying back to Philadelphia twice a year for my specialist appointments. After twenty years of doctor shopping, I wasn't giving up this one for the world. Three of our children had moved to the various cities on the East Coast in 2011, so my doctor's appointments in Philadelphia became pleasure trips.
Since starting treatment for Sjogren's, I have had several tweaks of medication but I have to say, I'm doing pretty good. My symptoms are troublesome when I am not following the rules -- an almost gluten free diet, moderate exercise, medication and making time to rest when I need it.
I take Vitamin D3 to protect my bones from the steroids, Glucosamine Chondroitin for joint health, Vitamin A for vision and eye health, Nexium for GERDS, a Disease-Modifying Anti-Rheumatic Drugs (called DMARDs) named Plaquenil, an antidepressant named Prozac, quinine for restless limbs, Vitamin E for dry skin issues, Restasis drops several times a day for the eye grit problem, a monthly steroid infusion as needed and Bayer aspirin for occasional pain and joint discomfort. I stopped taking Rituxan infusions mostly because of the hype about the leukemia and lymphoma side effects.
My bloodwork is right on par now for any active woman of 67 years old. I still have Sjogren's. I just don't dwell on it. I haven't felt this good in years.
My husband met with his new specialist and had successful spinal surgery in December 2009, followed by nearly six months of outpatient rehab which gave him back some mobility. He uses two canes to get around and rests frequently. Since leaving the New Jersey rehab, he takes a special joy in letting people know his brain has always been fully intact and that he doesn't appreciate being treated like an idiot.
Although he gets Social Security Disability, in 2011 Joe went back to work for three months or so. In May 2014, we decided to sell our house in California and move to Alexandria Virginia to be closer to our East Coast children and grandchildren. It was great timing because just when I decided I had worked long enough and to take my Social Security, Joe was asked to work on a special project in Virginia for a few months. We now split our time between Virginia and a little house we bought in a Florida retirement community.
Since 2009, things have been going very well. I have much to be thankful for.
Below is a list of tests that are typically done for Sjogren's Syndrome, although not all the tests are done for each patient. Doctors have their favorites and of course, a patient's symptoms determines which tests are needed.
How long to get diagnosis?
It sometimes takes going to a lot of doctors to get a diagnosis. How many doctors did you see before one said you had Sjogren's?
Sjogren's Means Daily Medication
Rose Bengal Test
In No Particular Order, Tests That Can Be Done For Sjogren's Syndrome
1. ANA - Antinuclear Antibodies Test
In most cases another blood test is done first called ELISA which stands for enzyme linked immunosorbent assay and looks for ANA's in the blood. Once found, the ANA test looks for "auto-antibodies" in the blood serum to detect autoimmune diseases for example: SLE - systemic lupus erythematousus, Sjogren's Syndrome, scleroderma, polymyositis, autoimmune hepatitis, psoriatic arthritis, Multiple Sclerosis, Rheumatoid Arthritis, cirrhosis, discoid lupus, juvenile arthritis, and some cancers.
This blood test is done to evaluate patients with signs of connective tissue disease ONLY when the Antinuclear Antibodies test (ANA) is positive, and especially if the patient has symptoms of Sjogren's Syndrome, Systemic Rheumatic Disease or Lupus Erythematosus.(LE)
- It takes about 1 day of laboratory time at the most for your doctor to get the results. It can be a stat order if necessary - usually ordered if a patient is in a flare up.
SS-A/Ro antibodies are mostly seen with connective tissue diseases including Sjogren's, childhood Lupus, neonatal Lupus, rheumatoid arthritis, and with congenital heart block in infants born to mothers with Lupus. This test measures the level of specific Sjogren's syndrome antibodies in the blood and is almost always Sjogren's when it comes out positive.
SS-B/La antibodies are usually seen in about 60 percent of patients with Sjogren's Syndrome and about 15 percent of those with Lupus Erythematosus (LE).
SS-B/La antibodies are usually not detected if there were no SS-A/Ro antibodies found.
- A positive result for SS-A/Ro or SS-B/La antibodies usually is indicative of connective tissue disease, including lupus erythematosus (LE), Sjogren's Syndrome, or rheumatoid arthritis.
3. Salivary gland biopsy
This is a biopsy of the minor salivary gland which is just under the inside of your bottom lip. Sometimes you'll feel them when you run your tongue inside your lip and feel little bumps there. The doctor numbs your bottom lip and makes a small incision on both sides. He takes a sampling of the glands and then sews up the incision. When I had mine, I was sore for a day or so, but that numbing didn't wear off for over a month. This test is for Sjogren's, sarcoidosis and lymphoma, and is best done when you are having symptoms so the doctor can get an idea from the results of how bad your disease is.
4. Schirmer's test
This test with a special dye is used for either dry eyes or very watery eyes to see whether your eyes make enough tears to keep them moist. A negative result here is considered a normal result. A score of 3 or higher is positive for Sjogren's. Most authorities agree that two out of three of the above tests must have a positive result to be Sjogren's Syndrome.
5. Fluorescent eye drop test
This is also a special dye test. The idea is to flush out the dye through the ducts in your nose in two minutes and if it takes longer, it is an abnormal test result.
6. Vitamin A Deficiency
This is a blood test looking for a cause of eye and vision difficulties.
7. Salivary Isotope Test (Parotid Gland Scintigraphy)
This is a nuclear medicine test where a radioactive tracer called technetium 99 is injected into your vein and you sit in front of a camera type scan so it can trace how much and how fast the isotope gets to your salivary glands (which are just under the jaw on both sides of your neck). This first scan is considered a baseline scan to measure against the next part.
About 30 to 45 minutes into the scan, you suck on a sourball or lemon candy so it can get your salivary glands to start watering. The technician takes another scan to compare it to the first part. A radiologist evaluates the results and usually within 24 hours your doctor has the report.
8. Rose Bengal Staining Test
This is an eye test done with a purple stain that looks for damaged epithelial cells as a reason for your lack of tears. Each eye is numbed with anesthetic, then one drop of one percent rose bengal solution is put in the corner of each eye in conjunctival sac. If your doctor thinks you have Conjunctivitis or Keratoconjunctivitis, this is a good diagnostic test. It is also part of the Sjogren's list because it can show the difference between them and Sjogren's. (Photo in sidebar).
If you are taking any kind of hormone therapy, your symptoms will be primarily inactive. Lack of estrogen, on the other hand, can make your symptoms look worse and can skew your test results greatly.
Links For Further Reading
- Sjögren's syndrome - Wikipedia, the free encyclopedia
The history, symptoms, tests, diagnosis and treatment of Sjogren's.
- 13 Types of Sjogren's Fatigue
13 types of fatigue presented by the Sjögren's Foundation
Sjogren's Syndrome Foundation, Inc.
6707 Democracy Blvd
Suite 325
Bethesda, MD 20817
Tel: (301)530-4420
Fax: (301)530-4415
Tel: (800)475-6473
Email: email@example.com
Internet: http://www.sjogrens.org
American Autoimmune Related Diseases Association, Inc.
22100 Gratiot Ave.
Eastpointe, MI 48021
Tel: (586)776-3900
Fax: (586)776-3903
Tel: (800)598-4668
Email: firstname.lastname@example.com
Internet: http://www.aarda.org/
National Sjogren's Syndrome
Box 147
Svedala, 233 23
Tel: 046255925
Email: email@example.com
Internet: http://www.sjogrensyndrom.se
Sjögren's Syndrome Association
3155 Rue Hochelaga, Suite 001
Quebec, H1W 1G4
Tel: 5149343666
Fax: 5149341241
Tel: 8779343666
Email: email@example.com
Internet: http://www.sjogrens.ca/
Lupus Society of Alberta
Suite 200, 1301 - 8 St. SW
Calgary Alberta, T2R 1B7
Tel: 4032287956
Fax: 4032287853
Tel: 8882429182
Email: email@example.com
Internet: http://www.lupus.ab.ca
Center for Peripheral Neuropathy
University of Chicago
5841 South Maryland Ave, MC 2030
Chicago, IL 60637
Tel: (773)702-5659
Fax: (773)702-5577
Internet: http://peripheralneuropathycenter.uchicago.edu/
Autoimmune Information Network, Inc.
PO Box 4121
Brick, NJ 08723
Fax: (732)543-7285
Email: email@example.com
European Society for Immunodeficiencies
1-3 rue de Chantepoulet
Geneva, CH 1211
Tel: 410229080484
Fax: 41229069140
Email: firstname.lastname@example.com
Internet: http://www.esid.org
AutoImmunity Community
Email: email@example.com
Internet: http://www.autoimmunitycommunity.org
Cogan's Contact Network
PO Box 145
Freehold, NJ 07728-0145
Tel: (732)409-1031
Internet: http://www.coganssyndrome.info/
This content is accurate and true to the best of the author's knowledge and is not meant to substitute for formal and individualized advice from a qualified professional.
© 2014 Rachael O'Halloran
This is a great, well-researched hub. Thanks for sharing your experiences with Sjogren's.
Wow! What a wonderful, in-depth article. Thank you so much for sharing your personal experience and opening up on a topic not many people know about!
Dear Rachael,
I don't know if you'll get this comment, so long after your article was posted, but I just wanted to tell you how moving and how genuinely helpful it was to read. I'm currently in the process of seeing various doctors in hopes of a diagnosis for my dry eyes and dry mouth (and a few other mysterious symptoms). Although I am desperately hoping that it's something other than Sjogren's Syndrome -- something temporary and not chronic -- I feel more and more certain that it is, in fact, Sjogren's. (My blood tests have been negative and I have not had a lip biopsy, but the doctors have offered no other explanation for my symptoms.)
My doctors reassure me that, even if it's Sjogren's, it can be well-managed. But at this point, I've read so many online posts about different people's experiences with Sjogren's, and so many of them are the worst-case scenario. These accounts have me terrified that I'm going to be immobile with pain and fatigue, useless as a parent, a burden to my young daughter -- with all my teeth rotting away, my brain shrinking and my organs failing.
So it was incredibly reassuring to read your account, as harrowing as some of it was. You have managed to make it seem like living with Sjogren's doesn't always have to be slow torture; you've made it seem like something that can be managed. For someone like me, who has been filled with terror and dread for weeks worrying about my future, this was an incredible gift. I am so grateful that you wrote this. You must be an incredibly strong and resilient person to have gone through all of this and to have emerged with such a positive attitude and so much empathy and compassion for others.
I have never heard of this before, you have gone through so much and have come out of it all. Thank you for sharing so much information on this, take care. Wishing you a Merry Christmas and many, many years of health, happiness, peace and lots of blessings from God. Take care.
Wow, what a lot of treatment you went through before finally learning that you had Sjogren's. Hope you are doing well now.
RachaelOhalloran; This piece has blown me away! Kudos to you for taking time to research and provide this very valuable information. I have been tested for Sjogren's MANY times over the years because I have a positive ANA - low, but positive...and when I saw my rheumatologist this year for dry mouth, he said my glands were swollen. But all he does is a blood test which turns out negative every time. So would that mean I do NOT have it? He has mentioned the biopsy from the gum on occasion, and my oral surgeon cannot do it without his order...but nothing else has ever been done except the blood test.
I am VERY familiar with the autoimmune information, and I DO get frustrated because blood tests are ALL normal...yet sometimes my face is very red for no reason...and I guess we all tend to have aches and pains. I do have osteoarthritis too.
This being said I cannot BELIEVE all you have been through for such a very long time. You are not only a trooper, and I so admire your stamina...but your taking the time to research this is so very admirable on your part. This hub will benefit many...you should submit it to some magazines also. God bless and thank you. Sparklea :)
Very interesting;well informed and will benfit many I am sure.
You've covered this so well. I'm sorry to hear about all that you've been through. Thankfully, your husband survived the accident. At least you know what you're dealing with now. I wish you and your husband well.
This is the first I have heard of this syndrome. I can see how many people would not realize they had it. Your sharing from personal experience is going to bring this to a higher awareness and help others. Vote up++
They do help!! When I got them, I was having to pry my eyelids open every morning and one time had to to go the emergency room to get my eyelids opened. I got my implants the next week. I have had them for years and although I still use drops now and then, it is now and then instead of constantly.
Very good article!! I have tear duct implants due to Sjogren's though I was only put on medication once, then taken off due to adverse reaction.
Thank you for sharing your journey so others can learn about coping with doctors and the medical system, and for sharing what you have learned for the benefit of other patients and their families.
If for no other reason, documenting experiences as you have here helped you keep up with what was happening in the difficult circumstances you faced but doing so and posting the record is invaluable to people who are struggling to get to the bottom of health problems they face.
You're welcome. I'm glad you're both doing well.
This was an absolutely fascinating read. You are remarkable! How on earth some people put a brave face on such misfortune I don't know! Most people would have crumpled under such strains, I think.
Your comprehensive information is so useful for other sufferers or for those who suspect they have been misdiagnosed. It could save others years of taking the wrong medication.
I hope you and your husband continue to sustain your good days and that life treats you with more respect; you certainly deserve it!
My best wishes to both of you.
I am so sorry you had to go through such hell. Getting wrong diagnosis after wrong diagnosis does not surprise me at all. I say trust your gut. No one knows your body better than you, so if something is telling you that what you are being told feels "off", it probably is. I am happy to hear that you and your husband are going great. Voted up, useful, interesting and awesome.
Wow what a story. I have never heard of this Sjogren's Syndrome. Many thanks for sharing.
A lot of people can benefit from this hub, Rachael. I'm glad that you found a doctor who can help you cope. Good fortune.
Rachael, it's unlikely we crossed paths, but it's still interesting to me. We moved from CA to PA in 1963, then to Philly 2 or three years later. Moved to Jersey in 1971 and I moved to Florida in 1976.
I'll keep my eyes out for other symptoms. So far, at age 57 I'm not on any kind of medication. My main problem is I've gotten fat. And I don't like that!
Wow, Rachael, you and your husband have been thru the medical red tape wringer! I've never heard of Sjogrens Syndrome. Several years ago I was diagnosed with dry eye. My eye doctor prescribed Restasis and I hated it. It made my eyes redder than they already were. Red whites next to blue irises is not a pretty picture! I ended up giving the unused tubes to a co-worker. I've since found an over-the-counter eye drop that works wonders. It's called Rohto (the last o is raised above the other letters). I don't have to keep in in the fridge to avoid the initial burning sensation that Visine and Murine gave me. I put one drop in each eye every morning after my shower and sometimes again later in the day if my eyes feel irritated. I love it!
I find it interesting that our lives have crossed the country in so many like places. We lived in California when my mom divorced my father. I was 6. We moved to York, PA where my mom had some family (she's one of ten). There she met my dad and we moved to Philly, which is where he's from. My sister was born in Lankanau hospital. Just before I entered high school we moved to South Jersey. Now we're in Florida, although my family is in South Florida and I'm in Central Florida.
I'm glad you're feeling better. I just wish it hadn't taken years of misdiagnoses and thousands of dollars to finally get the right treatment. You're a very strong woman, my friend!
Thanks for sharing your journey with this awful disease. I too was diagnosed with a rare disease early last year called Trigeminal Neuralgia. Fortunately, I was able to have an invasive "brain surgery" that fixed the problem, hopefully for good, but my time suffering with the disease and medicines before was just horrible. I plan also to write a hub on my experience in hope to help others. This is a well-written, very informative hub and I am sure you are helping others with Sjogren's Syndrome.
What a journey you have been on to reach the eventual diagnosis. I am impressed that you didn't give up. The medications can be challenging too especially when they are prescribed for another disorder. All this plus the stress of moving and your husband's accident. Racheal, I'm so pleased to read of your eventual correct diagnosis and all is now under control. I admit I had never heard of this disorder until you presented this. Thank you
I'm so sorry that you had to endure such horrible problems for so long, Rachel. It's wonderful that you've found a doctor that helps you, but it would have been great if it had happened much sooner! I'm sure that your hub will be very useful for a lot of people.
Interesting and informative. You did such a wonderful lay out on this hub. A great way to let one know about Sjogren's Syndrome.
Well this was a new one for me. I have never heard of this. I love that you are writing about it. Raising awareness is a huge step in de-mystifying it, and articles like this one help others and lessen their concerns. Well done my friend.


text:
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subset: commoncrawl


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Stories of Faith: Bob Hope Finds Real Hope in Jesus
By Diane Howard, Contributing Writer
Bob Hope brought laughter and joy to troops from World War II to the Persian Gulf War.
However, while bringing laughs to audiences everywhere, he kept his philanthropy and faith quiet, according to an obit in the Catholic Register in 2003.
Father Maurice Chase, who tells of Bob Hope's ministry to the homeless for decades, says "He helped many thousands of people here on skid row in Los Angeles."
Cardinal Roger Mahony of Los Angeles recognized that "the Hopes have contributed to the faith life of our Catholic community through donations to. . . many Catholic causes, often quietly and without public notice."
Bob Hope would say of his wife, Dolores, a lifelong Catholic and daily communicant, "My wife, Dolores, does enough praying to take care of both of us." However, eventually Dolores' prayers were answered, and Bob was baptized into the church.
The Catholic Register in 2011 gives an overview of Hope's life and says he was "the most honored entertainer ever, according to the Guinness Book of World Records, for his achievements in theater, radio, film, TV, philanthropy, and business, and an extraordinary record of service to country, with 199 USO shows around the globe." The Catholic Register in 2011 then begins to detail Bob Hope's life, service and faith journey.
Bob Hope was born Leslie Townes Hope on May 29, 1903, in Eltham, England, as the fifth of seven boys. Hope gave credit to his mother for his success. Hope telling of his mother in "Have Tux, Will Travel: Bob Hope's Own Story" says, "Mom. . . after making sure we were clean and uncomfortably dressed. . . sent us off to Sunday school at the Euclid Avenue Presbyterian — a church dad had helped build." As a child, Hope was rescued by his brother, when he got pinned under a pier and nearly drowned, but he was ultimately rescued by his mother, who, a singer herself, encouraged her young son's theatrical talent. After winning a Charlie Chaplin contest in 1914, he headed for the theater, believing that being "on stage" was his true calling.
By 1929, now "Bob Hope," he was becoming a well-known and liked comedian. He landed parts on Broadway. From there, his career took off in radio, film, and TV. In NYC he met and fell in love with a beautiful singer named Dolores Reade. They wed a few months later, which led to 69 years of marriage and a family of four adopted children: Linda, Anthony, Eleanora Avis "Nora," and Kelly.
Starting in World War II, Hope began donating entertainment to cheer up the troops and then expanded his generous charity work to many other causes.
However, Bob Hope was a womanizer, which often left Dolores in tears.
"I'm no angel. I've known very few angels," Hope wrote in "Have Tux, Will Travel."
Ironically, Bob Hope's signature song, "Thanks for the Memory" is about a couple contemplating divorce, and then they begin to reminisce about the wonderful times they've had, and decide to stay together. Dolores hung in there, knowing infidelity was Bob's weakness.
Father Groeschel said, "Dolores. . . faithfully, prayerfully, patiently, and with a certain amount of suffering" endured these trials. Father Goreschel said the reason she was able to persevere was that "Dolores Hope was a great Christian," and, through it all, she was praying for him.
Cardinal Theodore McCarrick observed, "Basically, the agent of his conversion was his wife." She was a daily communicant and prayed for him with a deep faith, asking others to pray for him as well. Longtime friend Virginia Zamboni said, "She took very good care of him."
Father Groeschel told how the Hopes were both very friendly people, opening their large but comfortable home to guests. Groeschel said that from time to time Bob loved to tell a story to priests who visited, sometimes for retreats Dolores hosted, about a big Catholic event he attended where the priest who was introducing him told jokes. Then Bob got up, looked at the crowd " as if warming up to tell his own set of jokes" and said, "Let us pray." Father Groeschel said that was the real Bob Hope.
In Bob Hope's last book, "My Life in Jokes," he said, "I was offering time and laughs — the men and women fighting the war were offering up their lives. They taught me what sacrifice was all about." It was during World War II, according to Cardinal McCarrick, that Bob became "very close" to New York Cardinal Francis Spellman. "They made all those rounds visiting the troops. And I really think that Bob was impressed by the faith of the men and women in the service he met."
Hope had severe trouble with his eyes and often had to rest in a dark room after surgery, once for three weeks. Those periods gave Hope time for reflection. In his last 10 years, he finally settled down and began enjoying life with Dolores, attending church regularly with her.
Bob Hope died July 27, 2003, at the age of 100 at home near North Hollywood surrounded by his family. His wife of more than 69 years, Dolores, and a priest were at his bedside. After an early morning memorial service attended by the family at the Hopes' parish church, St. Charles Borromeo Church in North Hollywood, Hope was buried at San Fernando Mission cemetery near Los Angeles. Largely due to the prayers and devotion of his wife, Bob Hope died with eternal hope.
Note: Diane Howard has a Ph.D. in Performance Studies, and can be reached at dianehoward.com.
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Revista de Salud Pública
Print version ISSN 0124-0064
CARDENAS-BUSTAMANTE, Omayda et al. Bogotá paint-industry workers exposure to organic solvents and genotoxic effects. Rev. salud pública [online]. 2007, vol.9, n.2, pp.275-288. ISSN 0124-0064.
Objective Investigating the degree of exposure to organic solvents and related genotoxic consequences in paint-factory workers by using cytogenetic monitoring and determining micronuclei frequency in lymphocytes and DNA damage as assessed by comet assays. Methodology Excretion of phenol and hippuric and methylhippuric acids in urine was investigated as biomarkers for benzene, toluene and xylene exposure. Urine samples were taken in two paint-factories in Bogotá and in a non-exposed control group. Benzene, toluene and xylene concentrations in air were measured in the work setting. Micronuclei and simple DNA chain breakage frequency were evaluated in peripheral blood sample mononuclear cells to assess early genetic effects. Results Hippuric acid concentration was found to be within normal values; by contrast, phenol and methylhippuric acid sample concentrations were above normal values by 3,3 % and 50,8 %, respectively. Benzene concentration in air was above permissible limits in one of the factories. There were no statistical differences regarding genetic biomarkers between exposed and non-exposed workers. Conclusions Organic solvent levels in the samples were apparently low, which is consistent with the absence of genotoxicity in cells. This study represents a step forward in research in occupational health surveillance.
Keywords : Paint; exposure; micronucleus tests; comet assay.


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Hi, This is Syed Saad Ali , Founder of oraclesolutions.pk
Capitalizing my interest in both Business & IT, I had chosen to navigate my career towards Enterprise Solutions that has enabled me to excel in the combination of both.
I have worked for different industries including banking, manufacturing, distribution, services sectors.
Providing Oracle Consultancy & Operations on call 24/7 Support, Troubleshooting, Tuning and Maintaining highly available IT infrastructures on various platforms (Oracle Enterprise Linux, Red Hat Linux, Sun/Oracle Solaris, Windows) support for Oracle Apps (11 and 12) and Oracle Databases (9i to 11gR2), including E-Business Suite (ERP), Real Application Cluster (RAC), Data Guard, Automatic Storage Management (ASM).
Extensive experience in Installing, Upgrading, Configuration, Administration, Cloning, Patching, Migrating, Support, Maintenance, Monitoring, Tuning and capacity planning, User Management, Backup/Recovery Management, SR Management, Monitoring Applications.
Comprehensive knowledge in directing, exercising and coordinating with concerned authority for planning, organization, control and successful completions. Proficient at solving customer issues by understanding and analyzing the issue, gaining key insights on the customer requirements in order to gain 360 degree view of customer requirements and preferences. Effectively able to communicate with customers, vendors and management.


text:
"Pentecost," Matthew Nelson. Used by permission from the artist.
Image © by Matthew Nelson. Artwork held in the Luther Seminary Fine Arts Collection, St. Paul, Minn.
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Day of Pentecost
John 14:8-17, [25-27] Commentary
by Barbara Lundblad
Joseph is in love with Maria.
| Bible Text
Acts 2:1-21 Commentary
by Matt Skinner
If a roomful of people given the ability to speak foreign languages sounds electrifying, try imagining a churchful of prophets.1
Psalm 104:24-34, 35b Commentary
by Jerome Creach
Psalm 104 presents a glorious picture of God as creator and a sweeping view of the world God made.1
Romans 8:14-17 Commentary
by Cynthia Briggs Kittredge
These four verses come midway in the ecstatic account of post baptismal Christian life that runs from Romans 8:1 through Romans 8:39.
Spirit Focus
by Karoline Lewis
May 15, 2016
Happy Pentecost, Dear Working Preachers! At the risk of sounding like the proverbial broken record, are you ready for preaching this Sunday that celebrates the Spirit?
One strategy ...
SB483 - Day of Pentecost
Discussion on texts for Day of Pentecost (May 15, 2016): (Gospel) John 14:8-17, [25-27];(First Reading) Acts 2:1-21; Psalm 104:24-34, 35b; (Second Reading) Romans 8:14-17.


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Rebuild Foundation and Stony Island Arts Bank are honored to host, in collaboration with HotHouse and Casa OSPAAAL, Tricontinental '66 and Other Acts of Liberation. This exhibition and accompanying program examine acts of liberation from imperialism/s and colonialism/s through multiple avenues of creative expression both contemporary and from the revolutionary era of the 1960's and '70's.
In 1966, many of the world's non-aligned movements came together to challenge empire in the 1966 Tricontinental Conference in Havana, Cuba. Amilcar Cabral speech at the Tricontinental inspired Cuba's subsequent military involvement in S.W. Africa and ultimately led to the defeat of the apartheid regime in Pretoria and the liberation of Angola and Namibia. The significance of these events have been popularized in people's cultural expression and are here reemphasized and contextualized anew through film, music, discussions and the graphic arts.
The project features a rare exhibition of posters produced by and with the cooperation of Cuba's Casa OSPAAAL (Organización de Solidaridad con los Pueblos de Asia, África y América Latina). The display of the original posters and original copies of the Tricontinental Journals (which were contributed to the exhibit from CASA OSPAAAL ) continues to give amplification and inspiration to aspirations of third world liberation movements and similar campaigns within in the US.
The exhibition opens October 4 and runs through January 6, 2019. The October program at the Stony Island Arts Bank is listed below. All events are free and open to the public. Do not miss this fascinating exploration of art, propaganda, and global liberation movements which still resonate today.
Tricontinental '66 Opening, October 4 – 6-8pm
Music by Bata ECA
Friday, Oct 5 | 7:30pm – 9:30pm
Film Screening: SAMBIZANGA
Opening remarks by Arif Smith.
Saturday, Oct 6 | 2:00pm – 4:00pm
Reading and Discussion with Anne Garland Maher
Saturday, Oct 6 | 5:00pm – 7:00pm
Chicago-Guantanamo Blues Exchange Fundraiser for Santiago de Cuba Music School with Ben LaMar, Shanta Nurullah, Jaime Garza, Fred Jackson, and Others.
Friday, Oct 12 | 7:30pm – 9:30pm
Film Screening: PAN AFRICAN FESTIVAL OF ALGIERS
Thursday, Oct 18 | 6:00pm – 8:00pm
Ayana Contreras: Sounds of the Tricontinental
Friday, October 19 | 7:30 – 9:30pm
Film Screening: MAMA AFRICA
Friday, October 26 | 6:30 – 9:30
Film Screening: BATTLE OF ALGIERS with remarks by Peter Kuttner
Performance by Iré Elese Abure, preceding film screening


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Share session between http and https
I have a web application with user login. after login the user is in https and he can browse in some categories and select a product. when he select a product he goes inside product detail that must be in http because this page has a iframe that call an external url and this url enable additional informations about that product. but it works only if the referrer is in http and not in https, so we must redirect in http where the user is in product detail.
but if we do that, the user lose his session because he passes from https to http (in other words he is logged out).
We useglassfish 2.
how can we avoid this problem?
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I finally did it... Joined the Y and love all the new equipment. I am hoping someone wants a partner to get in shape with! I live fairly close to Mcnabb and hoping someone can pick me up and bring me home after. I will gladly pay gas money. I am in the pine allard area.
I have walked there, but dam it gets cold sometimes and I hate cold!!
I would like to go late morning if anyone is interested please give me a pm. thanks


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Reactions in Vietnam after death of national war hero General GiapComments
Vietnamese people mourned the death of legendary General Vo Nguyen Giap, who died on Friday aged 102.
A national hero, self-taught Giap enjoyed a legacy second only to that of his mentor, founding president and independence leader Ho Chi Minh
Critics saw him as ruthless: willing to accept immense losses among his own forces. His defenders said his strategic ability and astute tactics won wars against enemies whose resources dwarfed those of a peasant army.
"Surrender" is not a word in my vocabulary, he once said. In Giap's words, any army fighting for freedom "had the creative energy to achieve things its adversary can never expect or imagine."
Giap defeated French forces in 1954 helping end French colonial rule in the Indochina region.
He defeated the US-backed South Vietnam government in 1975, reuniting a country that had been split into communist and non-communist states.
When neigbouring China invaded in 1978, Giap helped organise the
defence, driving back the Chinese with heavy losses.
Truong Quoc Dinh, veteran of the war against the US told euronews:
"The moment I heard about the news, I rushed here to get a newspaper. I couldn't believe it but it's true that he's gone. I'm waiting for more information when I can go and pay tribute to our great general," he said.
In a 2004 interview with Reuters, Giap recalled that on a visit to the United Nations in Geneva, he was handed a book to sign. "I wrote…and signed Vo Nguyen Giap, General of Peace."
Giap died of natural causes after several years in a Hanoi military hospital.


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(Last Updated On: November 29, 2013)
Independent filmmaker, Charles Irving, will soon celebrate the grand opening of Irving Films, one of the area's first African-American film production studios in Fort Bend County.
The new studio will allow Irving to film scenes from upcoming movies inside of his new location which includes a state-of-the-art green screen. The studio's backlot also will provide a setting for onsite production shoots. Irving is currently filming his latest independent film, "Never Give Up."
For more information, visit http://.irvingfilms.com.


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"Social media is an on-going concern that impacts everybody everywhere"
Social Media is one of the most buzzed terms used in today's dynamic and challenging environment. The term is coined few years back and has truly changed the way businesses use to work. It has changed the traditional marketing and gave novel and cost-effective methods of knowing the expectations of existing customers and reaching the new customers.
What is Social Media?
The term social media often confuses people about what exactly it means. According to Wikipedia, social media is
"Web- and mobile-based technologies which are used to turn communication into interactive dialogue among organizations, communities, and individuals. When the technologies are in place, social media is ubiquitously accessible, and enabled by scalable communication techniques".
It is an umbrella term that encompasses wide variety of activities such as:
- Social Networks
- Blogs/Forums
- Audio/Video sharing
- Image Sharing
- Podcasts
- RSS Feeds
- Social Bookmarking
Briefly speaking, any website that presents information and allows interaction among visitors comes under the category of social media.
Social Media Bridges the Gap:
Social media tends to bridge the gap between the target market and the media by encouraging user participation and feedback. It allows users to comment freely and vote for their preferred products. It provides businesses insight about what exactly their customers are looking for.
The most appealing aspect of social media is interactivity. It allows interaction among users and with businesses. With social media presence, people with common interests can form communities and promote their interests by generating and sharing valuable content.
Social Media is a great connector that links information and resources between different sites. By social bookmarking or tagging, it directs people to their required information.
Examples of Social Media Websites:
Here are some of the examples of social media websites:
- Social Networking: Facebook, Hi5, Myspace
- Professional Networking: Linkedin
- Photo and Video Sharing: Flickr, Youtube
- Content Sharing: Digg, Stumbleupon
- News Sharing: Reddit, Twitter, Wikipedia
All these social media websites allows easy and quick information sharing (photos/videos/content) among internet users. It holds promising benefits for users as well as for businesses. It educates users about their rights.
Social Media Stats:
The buzz of social media can be well estimated by the following statistics:
- 3 out of 4 Americans use social technologies (Forrester, The growth of social technology adoption, 2008)
- 2/3 of the global internet population visit social networks (Neilsen, Global Faces & Networked Places, 2009)
- The time spent at social networking sites is growing by 3x (Neilsen, Global Faces & Networked Places, 2009)
- 13 million articles available on Wikipedia
- 100 million videos on youtube
- 110 million blogs
- 123 million Facebook users
- 3 million tweets per day on twitter
How these statistics impact businesses can be estimated by the fact that about 93% of the social media users believe that companies should have their social media presence (Cone, Business in social media study, September 2008). The important point here is 93% of the social media users do not need irrelevant social media presence, but relevant and informative content that can positively impact their lives.


text:
E-mail: email@example.com
Region: Tbilisi
Tamar Oniani has been working as a Strategic Litigation Lawyer of GYLA since August 2018.
In 2018, Tamar has undergone six months internship at the Analytical Department of the Ministry of Justice of Georgia;
In 2017-2018, she was a vice president for academic activities at the European Law Students' Association;
From 2017 until now - she is a scientific assistant at David Batonishvili Institute of Law;
In 2017, she was assistant of a criminal lawyer at Georgian Young Lawyers' Association;
In 2016, she has undergone internship at the Human Rights Center;
In regard to the European Court of Human Rights and litigation in the Court, Tamar is representative of the case Zurab Japaridze versus Georgia (2018);
Tamar has participated in the following training seminars:
- Winter School of Justice (2019);
- Summer Schools on Constitutional and Human Rights Law (2017-2018);
- Summer Course "The European System of Human Rights Protection" (2018, Frankfurt);
- 2nd Training Session of René-Cassin Foundation in International Criminal Law (2018);
- Winter School "International Criminal Law Challenges and Georgia" (2018);
- European Compliance Conference (2017, Brussels);
- Summer School "Freedom of Religion in the practice of Constitutional Court of Georgia, Supreme Court of the United States and European Court of Human Rights" (2017);
Tamar is the author of six conference works and translations. She is also the author and organizer of the idea of up to 10 student's projects in the field of legal education.
Tamar Oniani graduated from Iv. Javakhishvili Tbilisi State University in 2018 with a bachelor's degree in Law (Cum Laude). Now she is studying at English language master's program of international law at the Georgian Institute of Public Affairs (GIPA).


text:
March 12, 2014
The Honorable Larry Bucshon
Subcommittee on Research and Technology
House Committee on Science, Space, and Technology
1005 Longworth House Office Building
Washington, DC 20515
The Honorable Lamar Smith
House Committee on Science, Space, and Technology
2321 Rayburn House Office Building
Washington, DC 20515
Dear Chairmen Bucshon and Smith:
The United States is at a critical juncture in ensuring that a solid foundation of basic science research is built to spur the science and technology developments of the future. The America COMPETES Acts of 2007 and 2010 provided necessary building blocks, and now is the time for Congress to lay the groundwork for the next several years.
The undersigned organizations write to express our serious concerns with H.R. 4186, the Frontiers in Research, Science, Technology (FIRST) Act of 2014. In our opinion, the bill, in its present form, would benefit from addressing the following:
We respectfully request that the bill incorporate the Guiding Principles as outlined in the attached. We remain committed to working with the House Science, Space and Technology Committee to pass a reauthorization bill for the nation's science agencies.
The Following Endorsing Organizations (as of March 12, 2014}:
American Anthropological Association
American Association for the Advancement of Science
American Association of Physics Teachers
American Astronomical Society
American Chemical Society
American Educational Research Association
American Geophysical Union
American Geosciences Institute
American Institute of Biological Sciences
American Mathematical Society
American Physiological Society
American Political Science Association
American Psychological Association
American Society for Biochemistry and Molecular Biology
American Society for Microbiology
American Society of Agronomy
American Society of Civil Engineers
American Society of Plant Biologists
American Sociological Association
American Statistical Association
Association for Applied Psychophysiology and Biofeedback
Association for Behavior Analysis International
Association for Psychological Science
Association for Women in Science
Association of American Geographers
Association of American Medical Colleges
Association of American Universities
Association of Environmental & Engineering Geologists
Association of Independent Research Institutes
Association of Population Centers
Association of Public and Land-grant Universities
Association of Research Libraries
Biophysical Society
Cognitive Science Society
Columbia University
Consortium of Social Science Associations
Council on Undergraduate Research
Crop Science Society of America
Duke University
Ecological Society of America
Entomological Society of America
Federation of Associations in Behavioral and Brain Sciences
Geological Society of America
Human Factors and Ergonomics Society
Incorporated Research Institutions for Seismology
Linguistic Society of America
Michigan State University
National Association of Marine Laboratories
National Communication Association
National Ecological Observatory Network (NEON), Inc.
National Ground Water Association
Population Association of America
Society for Industrial and Applied Mathematics
Society for Neuroscience
Society for Personality and Social Psychology
Society for Psychophysiological Research
Society of Experimental Social Psychology
Society of Multivariate Experimental Psychology
Soil Science Society of America
SPIE-The International Society for Optics and Photonics
Psychonomic Society
State University of New York
University of California System
University Corporation for Atmospheric Research
University of California, Davis
University of California, Irvine
University of California, Riverside
University of Maryland
University of New Mexico
University of North Carolina at Chapel Hill
University of Virginia
University of Washington
Vanderbilt University
Woods Hole Oceanographic Institution
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We took out the apricot tree this weekend – or rather Jim and Chip did, since it
was Chip's chainsaw and there was really only room for two in the work area. I weeded instead, but stayed close to stand witness.
This was a heartbreaking job for us. The apricot (a Tilton) was the second tree Jim and I planted after moving in to this house. Unlike the apple, which has always struggled, the apricot took to our hot, dry little yard as if it had been designed for it. It grew up with flattering speed and with the most minimal pruning took on a lovely broad-crowned shape.
We always knew spring was coming for real when the apricot started flowering. Mind you, that flowering was often early, the fruit buds getting killed off by the frost, but even so a few covert blossoms would sneak through and give us some amazingly sweet fruit.
In those years the apricot tree did produce fruit, the end result was amazing. One year there was so much fruit that the tree looked as if some garden god with an odd sense of humor had been out with crazy glue and lined the branches without rhyme or reason.
But gradually this fecundity began to ebb and the tree looked tired. Leaves curled. We found little holes in branches and trunk, did some research and discovered that in this area stone fruit (the class to which apricots, peaches, and plums all belong) are susceptible to borers.
This year the apricot tree didn't even flower. When spring came, two limbs didn't come back. A third made a valiant effort before succumbing. We trimmed these and hoped the rest of the tree would make it, that the unusually cold winter would have slowed the borers. No such luck. We realized we could watch the tree slowly die for the next couple of years or give in.
We gave in.
Most of the job went smoothly. The tree had been slowly dying for several years and didn't seem to have much fight left in it. Limb after limb dropped away under the chainsaw's touch. Even the trunk wasn't too hard to reduce to a couple of tidy logs. Almost no sap was running through what had seemed to be living wood, another indication of how bad the damage was.
Then we got down to the roots. If the rest of the tree had given up, the roots had not. Some of them were as big around as my arm. Others were only finger wide, but wiry and tenacious. Even the hair-fine ones were spread in a wide halo, grabbing every bit of moisture.
We've taken down the tree, but getting out those roots is going to take longer. Since we want to put another tree in the same area, we're going to avoid chemicals, so the process will involve hard work with a variety of tools.
Meantime, I'm thinking a lot about roots, about how many times as I've written these wanderings I've found myself going back to years gone by, to when I was very small, to high school, to college. It seems that, like the apricot tree, I'm supported and inspired by invisible cables I'm not even aware of most of the time.
And like the apricot tree, there are new roots forming all the time, drawing in moisture, perhaps making for stories I haven't yet formed. My heart's breaking for that little tree that put down such deep roots but still couldn't make it.
Yet I'm glad to know that despite having been planted in unkind earth, the apricot tree had such grand roots. I'm thankful for having this opportunity to dig down and realize how many and varied are my own.


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Full Moon Features, how I do love them.
I still remember my first encounter with Full Moon, I was in my local Blockbusters and was rummaging through a sale box and I picked up a VHS of "Puppet Master" and being intrigued by the cover and the plot outline.
I begged my Mum to buy it for me and luckily she agreed to do so, who knew that that small purchase would end up being a life changing moment for me.
After watching that video I was hooked, I started hunting down the rest of the series, this was pre-internet so I had to do it the old fashioned way of trawling through boxes of videos and getting that rush of excitement when I'd find one (I do miss those days).
It was also a time when I started taking notice of studio companies and the films they released, I started listing every film I could find out about and I would take that list out with me on my hunts.
This was how I discovered films such as "Dollman", "Head Of The Family", "Demonic Toys", "Hideous!" and many more, this wasn't an easy task though. Living in a small town in the UK I had to search and search.
Doing this built a love for this company and I became severely obsessed, so much so that I remember shedding a tear when I found out that I had missed the "Puppet Master" comics and would cost a fortune to buy now they were out of print.
I'd try and get my friends to watch these films but most of them just flat out refused, I recall one friend letting me put "Puppet Master" on and even though they did enjoy it, it became known as "that puppet film" and was never rewatched.
Then came the birth of social media and I found out I wasn't alone and that there were in fact many other like minded people out there and I was able to discuss my love for this company and it's films.
Ever since those days I've always had a soft spot for Full Moon and even though my tastes have grown and changed over the years my love for this company has never changed and I always tried to keep up to date with what they're doing.
Then came the day that I was contacted by Full Moon and was told they had seen my blog and liked what they saw and was asked to help in promoting and reviewing some of their stuff, I can't begin to tell you how happy that made me.
Full Moon still thrive today and I still will watch anything that they release, also the "Puppet Master" franchise is still going strong (thankfully). I never did get those old "Puppet Master" comics though...


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By Miriam Toews (McSweeney's)
This sad and improbably witty novel is about two loving sisters: one who wants to live, the other who wants to die. Toews mines the frustration of caring for someone set on self-destruction, offering a nuanced look at the wrenching questions about the end of life. — Ron Charles
By Dinaw Mengestu (Knopf)
Mengestu, who left his native Ethiopia as a child and now teaches at Georgetown, tells the mournful, mysterious story of an African man who comes to the Midwest on a student visa. He captures beautifully the conflicted emotions of someone who has survived the loss of his family, his country and his identity. — R.C.
By Anthony Doerr (Scribner)
At the center of this enthralling novel, a National Book Award finalist, are two children: a blind French girl who flees to the countryside when her father disappears from Nazi-occupied Paris and a whiz-kid German orphan whose science skills gain him entry into the Hitler Youth. — Amanda Vaill
By Hilary Mantel (Henry Holt)
Mantel wins the deliberate-provocation sweepstakes with the title story, which imagines the attempted murder of the former prime minister. It's one fine example in a collection that evokes a shadowy region where boundaries blur and alternate realities seem possible.
— Wendy Smith
By Siri Hustvedt (Simon & Schuster)
This electrifying work stars an enraged artist bent on exposing sexism and other prejudices in the art world. Her tactic: to have three male artists exhibit her installations as their own. — W.S.
By Helen Oyeyemi (Riverhead)
In this whimsical reimagining of "Snow White" moved to 1950s Massachusetts, Oyeyemi explores the alchemy of racism and the weird ways in which identity can be transmuted in an instant — from beauty to beast, or vice versa. — R.C.
By Cristina Henríquez (Knopf)
After she is severely injured in an accident, a teenager and her family emigrate from Mexico to Delaware. Quiet and unassuming, Henríquez's novel ravels slowly and surprisingly, and without an iota of sentiment, delivers an original coming-to-America tale. — Marie Arana
By Ian McEwan (Talese/Doubleday)
This svelte tale tells the story of a British High Court judge facing an especially challenging case: a teen refusing life-saving medical treatment. McEwan focuses not only on the conflict between faith and science, but on the way a woman's well-ordered life is shaken by a confluence of youthful passion and old betrayal. — R.C.
By Lisa See (Random House)
Set in San Francisco in the late 1930s, this affecting novel tells the story of three distinctive women who meet as dancers at a Chinese nightclub. The women endure precarious careers, roller-coaster romances and personal conflicts, but their precarious bond is put to the test when the United States declares war on Japan. — Eugenia Zukerman
By Chris Bohjalian (Doubleday)
Narrated by a 16-year-old girl in Vermont, Bohjalian's suspenseful and provocative novel pushes some hot buttons — child homelessness, mental illness, nuclear energy — while creating one of the most memorable teenage protagonists in recent fiction. — Elizabeth Hand
By Haruki Murakami; translated by Philip Gabriel (Knopf)
Murakami's thought-provoking novel centers on an engineer haunted by a shattering experience in his adolescence. His pilgrimage to find answers is not only a coming-of-age story, but also a suspense tale with deft twists and bright jolts of psychological insight. — M.A.
By Derek Howe Smith(Locked Room International)
Smith's stories, set in 1950s England, are works of subtle, highly imaginative intricacy. They test our skill as readers, employing every form of misdirection in their cluing, yet at their best leave us satisfied that, had we been a little shrewder, we might have grasped the truth before the final pages. — Michael Dirda
By Yvonne Adhiambo Owuor (Knopf)
"Dust"opens in 2007 with a panicked chase through the streets of Nairobi and moves between the lamentation of a single family and the corruption of national politics swirling around one young man's death, creating a vortex of grief that draws in generations of deceit and Kenya's tumultuous modern history. — R.C.
By Lily King (Atlantic Monthly)
This atmospheric novel reimagines a brief collaboration in New Guinea in the early 1930s involving the anthropologist Margaret Mead, her husband and future husband. It is the winner of the first Kirkus Prize for fiction. — R.C.
By Emma Donoghue (Little, Brown)
Set in San Francisco in the summer of 1876, Donoghue's novel is based on the real-life shooting of a cocky cross-dresser who supported herself by supplying restaurants with frog legs. This atmospheric tale unfolds as a full-throated murder mystery, as the victim's friend, a celebrated showgirl, tries to track down the killer before he gets her first. — R.C.
By Scott Cheshire (Henry Holt)
Cheshire, a former Jehovah's Witness, draws on his own experience in this tender novel about a child preacher who eventually leaves the church but is forced to face its teachings again as he cares for his maniacally devout father. — R.C.
By Antonio Muñoz Molina; translated by Edith Grossman (Houghton Mifflin Harcourt)
A labyrinthine and spellbinding novel of love and war, this story of a Spanish architect who falls passionately for a woman who is not his wife is an elaborate, complicated maze, peppered with historical facts and faces — and one of the most eloquent monuments to the Spanish Civil War ever to be raised in fiction. — M.A.
By Howard Jacobson (Hogarth)
This chilling novel, a finalist for the Man Booker prize, imagines an anti-Semitic future where wit and irony, along with jazz and literary fiction, have evaporated in the heat of a second Holocaust sometime in the 21st century. — R.C.
By Denis Johnson (Farrar, Straus and Giroux)
Set in post-9/11 West Africa, this high-suspense tale offers a more convincing portrait of amoral intelligence agents and the havoc they wreak than almost any journalistic account of Third World skullduggery.
— Michael Mewshaw
By Marilynne Robinson (Farrar, Straus and Giroux)
The Pulitzer Prize-winning author of "Gilead" and "Home" returns to the town of Gilead to complete a trilogy on spiritual redemption. In this National Book Award finalist, Robinson captures clearly and without a trace of condescension the mind of an uneducated woman struggling to comprehend why things happen. — R.C.
By Roberto Bolaño, translated by Natasha Wimmer (New Directions)
Published in Spanish a few months before Bolaño's death in 2003, this short novel about the struggles of an orphaned young woman is a gripping chronicle about urban youth, anomie, sex and crime. — M.A.
By Amy Greene (Knopf)
This literary thriller unfolds over three dramatic days in the summer of 1936 as a mother searches for her missing 3-year-old daughter in a depressed Tennessee town threatened by a flood. — R.C.
By Ayelet Waldman (Knopf)
Waldman's multigenerational novel centers on a historical event largely faded from memory: the Nazi-run Hungarian Gold Train, which carried a trove of goods stolen from the Jews in World War II. Tracing the fate of one iconic jewel from that collection through Budapest, Salzburg and Maine, Waldman demonstrates the curious and tragic ways that history binds us together. — R.C.
By Francine Prose (Harper)
Inspired by a Brassaï photo of Violette Morris, a celebrated French athlete who later betrayed her country to Hitler, this saga of Paris at war offers ribald humor, sexual transgression and military intrigue. — R.C.
By Amy Bloom (Random House)
Set in World War II and taking place from Ohio to Hollywood and Brooklyn, the novel centers on two motherless half-sisters who take it upon themselves to reverse their sorry fortunes. — M.A.
By Dan Rhodes (Europa)
In 80 or so very short — usually one-page — stories, Rhodes runs through a variety of Seinfeldian routines focused on love, marriage, infidelity, divorce and death. While his imagination runs riot, he addresses some of life's greatest joys and worst traumas in a voice that's deadpan, unflappable and understated. — M.D.
By Tony Earley (Little, Brown)
This collection of engaging stories is topped by a novella-length tale that's a rollicking experimentalist riff on "Jack and the Beanstalk" — featuring a contemptuous talking dog, a pair of post-feminist maidens and an equally forlorn Tom Dooley, who laments that his famous murder ballad "ain't done much good since Burl Ives died." — Michael Lindgren
By Colm Tóibín (Scribner)
Set in the early 1970s in Tóibín's hometown in County Wexford, Ireland, this autobiographical novel follows the story of a 44-year-old widow and mother of four. Across pages that never succumb to a single melodramatic or sentimental phrase, Nora quietly manages her grief and figures out how to carry on with her life. — R.C.
By Edward D. Hoch (Crippen & Landru)
Structured like those classic radio dramas during which Dr. Watson would sip Petri Wine and relate an adventure of Sherlock Holmes, the stories here — mysteries set in New England during the 1930s— offer glimpses of bygone small-town life.— M.D.
By Chang-rae Lee (Riverhead)
Lee's dystopian novel opens on a wasted landscape where the remnants of civilization survive in stratified compounds walled off from the lawless scrap heap of North America. In some ways, it's a familiar tale: a lone radical's picaresque journey through a repressive society ripe for revolution. But at every turn, Lee thwarts our expectations.
By Richard Powers (W. W. Norton)
A fascinating novel about the allure and power of music, "Orfeo" centers on an avant-garde composer in his 70s who lives alone in a Pennsylvania college town. He has taken up an alarming hobby: DIY genetic engineering. — R.C.
By Yelena Akhtiorskaya (Riverhead)
Equal parts borscht soup and Borscht Belt of upstate New York, this first novel replaces the inspirational hype of the great immigrant story with broad comedy about a menagerie of Ukrainian emigres making their way in Brighton Beach, Brooklyn. — R.C.
By William Gibson (Putnam)
No one writes better about the near future than Gibson, and in this surprisingly optimistic novel, he vaults us forward into two futures, one near and recognizable, the other more distant. As the two imagined realities make contact, forces large and malevolent converge. — Robin Sloan
By Phil Klay (Penguin Press)
In this story collection, a National Book Award winner, Klay draws on his experience as a U.S. Marine captain to give us one of the most compelling depictions of the Iraq war written. He explores what it really means not only to train young men to kill strangers, but to encourage those young men to shout with glee and high-five one another upon doing so. — Jeff Turrentine
By Stephen King (Scribner)
Spanning five decades, King's sweeping tale is narrated by a man whose life is profoundly affected by a chance meeting with a preacher when he was a boy in rural New England. — E.H.
By Susan Scarf Merrell (Blue Rider)
A tribute to horror-story master Shirley Jackson, this novel weaves events from the writer's life into a hypnotic story that will please Jackson fans as well as anyone in search of a solidly written literary thriller.
— Carol Memmott
By Jane Smiley (Knopf)
In this engaging first volume of her planned trilogy — a sweeping story that spans three decades, three continents and a generation of children on an Iowa farm — Smiley delivers a wry, old-fashioned tale of rural family life in changing times. — Valerie
By Sebastian Barry (Viking)
Jack McNulty, a beleaguered Irish soldier, has just returned from World War II. Cutting back and forth in time, he recounts the highs and lows of his life in a narrative as heartbreaking as an Irish ballad. — M.A.
By Elizabeth McCracken (Dial)
The calm, terrifying stories in "Thunderstruck" have the jittery emotional valence of fairy tales, where to name dangers — the wicked witch, the hungry wolf — is somehow to subdue them. The result is like some set of forgotten Brothers Grimm tales translated into the jolting anomie of modern life. — M.L.
By Nick Harkaway (Knopf)
Like a Marvel Comics mad scientist, Harkaway has crossed strains of a modern-day environmental crisis with the sweet story of a veteran of the Afghan war trying to adopt a little boy on a doomed island. — R.C.
By Joshua Ferris (Little, Brown)
This finalist for the Man Booker prize stars a Red Sox-loving, misanthropic dentist in a midlife crisis. Ferris spins a witty story that chews on Internet scams, relationship killers, crackpot theology, baseball mania and the desperate loneliness of modern life. — R.C.
By Amy Rowland (Algonquin)
Set at a newspaper that resembles the New York Times, this first novel by a former transcriptionist there, stars, fittingly, a shy transcriptionist, who, in unraveling the mystery of a puzzling death, is forced to step out of her shell and form a tentative engagement with the city around her. — M.L.
By Nancy Horan (Ballantine)
From the author of "Loving Frank," this novel reimagines the story of Robert Louis Stevenson and his American wife, Fanny Van de Grift Osbourne. Horan infuses both of these portraits with color, passion and intellectual spark, creating an operatic tale that is dead-on in its portrayal of pre-feminism-era women and their limited opportunities. — C.M.
By Rabih Alameddine (Grove)
The erudite narrator of this novel, a National Book Award finalist, unfolds her personal story within the 20th-century history of her beloved Beirut. With her, Alameddine has given us a marvelously cranky heroine, gruffly vulnerable and engagingly self-mocking. — W.S.
AN UNTAMED STATEBy Roxane Gay (Black Cat)
Gay considers questions of class, parental responsibility and sex as a weapon of terror in a fantastically exciting story about a lawyer kidnapped while visiting her rich parents in Port-au-Prince, Haiti. — R.C.
By David Nicholls (Harper)
Nicholls's dark comedy sets a crumbling family on a European tour, dangling the possibility that the trip might solve the problems of its middle-aged narrator, his artist wife and their challenging teenage son. As the family teeters on the verge of breakdown, Nicholls offers a poignant consideration of how a marriage ages, how parents mess up and what survives despite those challenges. — R.C.
By Emma Straub (Riverhead)
A dysfunctional family tries — and fails — to find joy on a summer vacation in Straub's wise and funny novel. Set on an island in the Mediterranean Sea, much of the comedy springs from the tension between being required to have the best time in the world and wanting to stab someone with an ice pick. — R.C.
By Karen Joy Fowler (Marian Wood/Putnam)
Fowler has conjured a set-up that's unusual in the extreme: a family of five in which the youngest daughter is a chimp. The novel, winner of the PEN/Faulkner Award and shortlisted for the Man Booker prize, tells an unsettling, emotionally complex story that plumbs the mystery of our relationship with the animal kingdom — relatives included. — R.C.
By Matthew Thomas (Simon & Schuster)
At the center of this multigenerational novel is Eileen Leary, who cares for her alcoholic mother, falls in love with an eccentric neuroscientist, raises a son and works a demanding nursing career before Alzheimer's threatens her husband — and her family's very fabric. — Alice LaPlante
By Kenneth Mackenzie (Text Classics)
First published in Australia in 1937, this novel, a beautiful depiction of school life, loneliness and sexual yearning, is one to set beside Joyce's "A Portrait of the Artist as a Young Man."— M.D.
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Finalist for the 2019 Auckland Architecture Awards
Category: Housing - Multi Unit
Project address:
The Buckley Design Guidelines and Framework Plan prescribed the units (on this superlot) along Hobsonville Point Rd
127-161 Hobsonville Pt Rd (between Rarahu Rd and Ponga St),
Hobsonville, Auckland
Client name: Universal Homes Ltd
Project description
The Buckley Design Guidelines and Framework Plan prescribed the units (on this superlot) along Hobsonville Point Rd provide either retail, commercial or 'work-from home' office activities at ground floor (3.2m ceiling heights), a maximum building setback of 1.5m off the road boundary and a mandatory 3 and 2+1 (third level to be a half storey) storey height requirement. Two identical blocks (9 units each), comprising of a 3- or 4-bedroom unit paired with a 2-bedroom unit (with provision for the homeowner to extend into the third storey attic space) have their northern boundary fronting Hobsonville Point road.
The Framework's parameters were not completely in line with our client's feasibility or development brief meaning the design had to account for and accommodate both (eg the framework plan required a maximum building setback of 1m on Hobsonville Point Rd). The primary building is pushed back 3m to allow a northern elevated courtyard (0.9m above pavement level) with planting used to control privacy – a non-complying activity under the framework plan due to the 3m setback. To mitigate this, 1.2m deep balconies were expressed up the triple height façade articulated through fine-grained vertical balustrading and an elegant structural frame which extends the building's bulk and a nod to the Framework plan's intent. The units are also served by a rear outdoor court accessed via the open plan living spaces. A clear mandate in designing out internal or membrane gutters drove the resulting roofscape - A repeating pattern of paired units (designed to read like a larger single unit due to the length of the street elevation) broken by vertical negative bands, arrayed 9 times over the 2 blocks. An elegantly robust rhythm of rich red brick and painted concrete gabled forms providing a strong urban edge appurtenant to its context.
Sustainability statement
Brick veneer and painted insitu concrete were chosen for durability and their relatively low maintenance nature. Large North facing glazing, with either a terrace or horizontal timber battens provide effective solar control; allowing the winter sun in whilst providing shade from the harsh summer sun. The solid concrete walls provide thermal massing maintaining a temperate internal environment. All units have either 2 or 3m3 water tanks used to collect and reticulate grey water (from the roofs) for use in flushing toilets, laundry and irrigation. Heat pump hotwater cylinders and gasfor cooking are some examples of energy saving initiatives.
Project Author Responsible for the design: Madushin Amarasekera


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mental/emotional issues
Business Name: Leah Davida Krecu
About: Leah Davida Krecu has been in private practice since 1997 in Encinitas, California as a licensed acupunturist. She is a graduate of Pacific College of Oriental Medicine in San Diego where she received a Master's Degree in Traditional Oriental Medicine, certified by the National Certification Commission of Acupuncture and Oriental Medicine (NCCAOM).
Category: California, Encinitas