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Use Arimidex as directed by your doctor.
- Take Arimidex by mouth with or without food.
- If you miss a dose of Arimidex, take it as soon as possible. If it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not take 2 doses at once. If more than one dose is missed, contact your doctor or pharmacist.
Ask your health care provider any questions you may have about how to use Arimidex.
Store Arimidex at room temperature, between 68 and 77 degrees F (20 and 25 degrees C) in a tightly closed container. Store away from heat, moisture, and light. Do not store in the bathroom. Keep Arimidex out of the reach of children and away from pets.
Active Ingredient: Anastrozole.
Do NOT use Arimidex if:
- you are allergic to any ingredient in Arimidex
- you have not gone through menopause
- you are pregnant
- you are taking estrogen (eg, birth control pills, hormone replacement therapy) or tamoxifen.
Contact your doctor or health care provider right away if any of these apply to you.
Some medical conditions may interact with Arimidex. Tell your doctor or pharmacist if you have any medical conditions, especially if any of the following apply to you:
- if you are pregnant, planning to become pregnant, or are breast-feeding
- if you are taking any prescription or nonprescription medicine, herbal preparation, or dietary supplement
- if you have allergies to medicines, foods, or other substances
- if you have liver problems, osteoporosis (weak bones), heart problems, or high cholesterol or lipid levels.
Some medicines may interact with Arimidex. Tell your health care provider if you are taking any other medicines, especially any of the following:
- Estrogen (eg, birth control pills, hormone replacement therapy) or tamoxifen because they may decrease Arimidex's effectiveness.
This may not be a complete list of all interactions that may occur. Ask your health care provider if Arimidex may interact with other medicines that you take. Check with your health care provider before you start, stop, or change the dose of any medicine.
Important safety information:
- Arimidex may cause dizziness. This effect may be worse if you take it with alcohol or certain medicines. Use Arimidex with caution. Do not drive or perform other possible unsafe tasks until you know how you react to it.
- Lab tests, including blood cholesterol or bone mineral density, may be performed while you use Arimidex. These tests may be used to monitor your condition or check for side effects. Be sure to keep all doctor and lab appointments.
- Arimidex should be used with extreme caution in children; safety and effectiveness in children have not been confirmed.
- Pregnancy and breast-feeding: Arimidex has been shown to cause harm to the fetus. If you think you may be pregnant, contact your doctor. You will need to discuss the benefits and risks of using Arimidex while you are pregnant. It is not known if Arimidex is found in breast milk. If you are or will be breast-feeding while you use Arimidex, check with your doctor. Discuss any possible risks to your baby.
All medicines may cause side effects, but many people have no, or minor, side effects.
Check with your doctor if any of these most common side effects persist or become bothersome:
Anxiety; back, bone, breast, joint, or pelvic pain; constipation; cough; diarrhea; dizziness; flu-like symptoms (eg, muscle aches, tiredness); headache; hot flashes; loss of appetite; nausea; sore throat; stomach pain or upset; sweating; tingling or burning sensation; trouble sleeping; vaginal dryness; vomiting; weakness; weight gain.
Seek medical attention right away if any of these severe side effects occur:
Severe allergic reactions (rash; hives; itching; difficulty breathing or swallowing; tightness in the chest; swelling of the mouth, face, lips, or tongue; unusual hoarseness); calf pain, swelling, or tenderness; chest pain; dark urine; depression; fainting; fever, chills, or persistent sore throat; frequent or painful urination; mental or mood changes; numbness of an arm or leg; one-sided weakness; red, swollen, blistered, or peeling skin; severe or persistent bone pain; severe or persistent dizziness or headache; severe or persistent nausea, vomiting, or stomach pain; severe or persistent tiredness or weakness; shortness of breath; speech problems; sudden, severe headache; swelling of the arms or legs; swollen lymph nodes; vaginal bleeding or unusual discharge; vision changes; yellowing of the skin or eyes.
This is not a complete list of all side effects that may occur. If you have questions about side effects, contact your health care provider.
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Ginny's Essential Family Pan with Lid
Additional Information
Product Details
Make family-sized one-pot meals in this jumbo pan! Aluminum construction gives quick, even heating, and the colored ceramic nonstick cooking surface wipes clean with ease. Bakelite handles, including a helper handle that makes it easy to lift. Includes 5-qt. (12") family-sized pan and lid with stainless steel rim and steam vent. Hand wash. Oven safe.
Additional Information
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Ginny's Essential Family Pan with Lid is rated out of 5 by 104.
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The Districts 'A Flourish and a Spoil' (album stream)
Published Feb 02, 2015Philadelphia indie rockers the Districts are set to drop their debut full-length A Flourish and a Spoil next week, but you can give it a full preview on Exclaim.ca right now.
The up-and-coming band of 19- and 20-year-olds inject their youthful energy into the 10-track collection, but frontman Rob Grote's gravelly, whiskey-soaked vocals definitely give off an older air. Grote and the gang met during high school in Lancaster, PA, though on tracks like "Suburban Smell," they're leaving behind their small town childhood sentimentality in favour of nights that turn into "6 AM."
The lineup is rounded out by founding members Connor Jacobus (bass) and Braden Lawrence (percussion), with Pat Cassidy as a new addition on guitar.
The record was recorded at Seedy Underbelly Studio in Cannon Falls, MN, with John Congleton (St. Vincent, Angel Olsen, Swans) producing, engineering and mixing the album.
Having shared the stage with acts like Deer Tick, White Denim, Dr. Dog and Temples, the Districts are ready to embark on a headlining tour this spring. You can see the full details, including stops in Toronto and Vancouver, listed below.
Scroll past the upcoming gigs to listen to A Flourish and a Spoil, which officially arrives on February 10 via Fat Possum.
Tour dates:
02/10 New York, NY– Bowery Ballroom
02/12 Cambridge, MA – The Sinclair
02/13 Lancaster, PA – Chameleon
02/14 Philadelphia, PA – Union Transfer
02/17 Pittsburgh, PA – Club Café
02/18 Toronto, ON – Horseshoe Tavern
02/20 Chicago, IL – Lincoln Hall
02/21 Madison, WI – High Noon Saloon
02/22 Minneapolis, MN – 7th St Entry
02/24 St. Louis, MO – Off Broadway
02/25 Kansas City, MO – Record Bar
02/27 Denver, CO – Larimer Lounge
02/28 Salt Lake City, UT – Kilby Court
03/02 Portland, OR – Doug Fir
03/03 Vancouver, BC– Fortune
03/04 Seattle, WA – Tractor Tavern
03/06 San Francisco, CA – The Independent
03/07 Los Angeles, CA – Troubadour
03/08 San Diego, CA – The Casbah
03/10 Phoenix, AZ – Last Exit
03/11 Tuscon, AZ – Club Congress
03/13 Dallas, TX – The Loft
03/14 Houston, TX – Fitzgerald's
03/15 New Orleans, LA – Gasa Gasa
03/16 Oxford, MS – Proud Larry's
03/22 Birmginham, AL – The Bottletree
03/23 Atlanta, GA – Aisle 5
03/24 Asheville, NC – The Grey Eagle
03/26 Chapel Hill, NC – Local 506
03/27 Washington, DC – Rock N Roll Hotel


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Find out more about how this website uses cookies to enhance your browsing experience.
Join us for free seminars, advice and Q&A session
Find out more about your fertility treatment options and get your questions answered by the experts at our free fertility open days. Whatever your situation – single or in a relationship, we have a range of seminars if you're considering starting a family now or in the future.
If you can't make it to our Open Days, we would love to see you at our other events across the country. See what's in your area.
Our speakers
While there will be an opportunity to meet and talk to many of our staff on the days, our main speakers are as follows:
Mr Michael Summers, Consultant in Reproductive Medicine
A graduate of King's College, Cambridge Mr Summers completed his medical training at the University of Pennsylvania School of Medicine followed by a Clinical Fellowship in Reproductive Endocrinology and Infertility at the Brigham and Women's Hospital, Harvard Medical School. He is certified by both the American College of Obstetrics and Gynaecology (ACOG) as well as on the GMC Specialist Register as a Consultant in Reproductive Medicine. His special interests include IVF, embryo culture, embryo implantation and preimplantation genetic diagnostics, areas of research in which he has published extensively.
Professor Nick Macklon, Medical Director
Professor Macklon is a world-renowned expert in reproductive medicine. He has held professorships at the University of Utrecht in the Netherlands, the University of Southampton and the University of Copenhagen - where he is currently based. He is co-founder of the Complete Fertility Centre clinic in Southampton, and a member of the Executive Committee of the European Society of Human Reproduction.
Mimi Arian Schad, Director of Nursing and HFEA Person Responsible
Mimi has been with the LWC since 2005 and is the Director of Nursing and Person Responsible to the HFEA for the LWC Harley Street. Mimi completed her nursing qualifications at Guy's Hospital and is qualified as an operating theatre and fertility nurse specialist. She is a member of the LWC's clinical governance team.
Mr Alvan Priddy, Consultant Gynaecologist
Mr Alvan Priddy, MBChB, FRCOG, MD, is a Consultant Gynaecologist and the Lead for infertility at North West London Hospitals NHS Trust since 1995. He has wide experience in Gynaecology, having trained in Manchester, Leeds and London under Professor Lord Robert Winston at the Hammersmith Hospital. He has a long list of scientific publications and guest lectures. Mr Priddy has been in private practice in London since 1995. He is a well recognised expert in the field of Gynaecology, including infertility and keyhole surgery. He performs both Laparoscopic and Hysteroscopic surgery for fibroids, endometriosis, ovarian cysts, polycystic ovaries, ectopic pregnancies, removal of damaged tubes, adhesions and polyps. He has a special expertise in Tubal surgery including reversal of sterilisation and the surgical treatment of large fibroids by Myomectomy.
Dr Mohar Goswami, Consultant Gynaecologist and Specialist in Reproductive Medicine
Dr Mohar Goswami is a Consultant Gynaecologist and Sub Specialist in Reproductive Medicine, having trained and done research at the Centre for Life in Newcastle, then the Chelsea and Westminster hospital in London. Before joining LWC, Mohar worked as Consultant Gynaecologist and Subspecialist in Reproductive Medicine at the James Cook Hospital. Her specialisms include investigations and treatments to sub-fertile couples, including treatment of anovulation, IVF and ICSI treatments, treatment with donor gametes, gynaecological endocrinology. She has keen interest in fertility research and ethics and has published papers and presented in various conferences.
Fertility treatments we offer
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The 10th Salon d'Hiver is coming up — an exhibition with OSA members.
Saturday and Sunday, November 2 and 3, 2019, 10am to 4:30pm.
57 Lewis Street (One way north from Eastern Avenue)
As always, visual and edible goodies from
Kim Atkins, Anthony Batten, Heidi Burkhardt, Kat Palmer and Maurice Snelgrove


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Property name Kronoslätt 1:11
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North Shore Kids Parade Revived After Over 20 Years
SYRACUSE — A 4th of July kids parade along the north shore of Lake Wawasee was revived yesterday morning, July 4. Residents, family members and friends gathered at Bob Fanning's home on Lake Wawasee to begin a parade down to the Needler home and back again.
Previously an annual event, it was originally run by Col. Jack Feighner and Master Sgt. Bill Beemer beginning in the mid 1980s and ending in the early 1990s. Jack's son, John Feighner, had been pushing to bring back the tradition. After meeting with Bob Fanning and Rick Winter, the parade was able to fall into place.
Beginning at 11 a.m. kids gathered to begin the parade. Those wishing to participate were invited to bring tin pots and wooden spoons to bang on, snare drums, flutes or any other traditional Revolutionary War instrument. They were also encouraged to wear either festive, July 4th apparel or traditional Revolutionary War garb and soldier accessories.
Rick Winter and his son-in-law, Chris Shellgren, marched in front carrying a flag. Directly after Winter's grandson, Graham Shellgren, 4, led the rest of the parade participants.
Approximately 60 to 70 people showed up to participate in the parade with many other residents waiting outside to cheer on the kids as they passed by. The kids who participated were also rewarded with a treat and juice box after returning to the Fanning residence.


text:
Dharma Talk by Ven. Shikai Zuiko O-sensei
Dainen-ji, February 8th, 1997
[The Sensei sings softly:] "Ring around a rosy, a pocket full of posies. Achoo, achoo, we all fall down."
Listen, can you hear that?
[Singing again more loudly:] "Ring around a rosy, a pocket full of posies. Achoo, achoo, we all fall down"
"Ring around a rosy, a pocket full of posies. Achoo, achoo, we all fall down"
[The Sensei imitates children's voices in the distance] "No, it's my turn now, let it be my turn"
For six hundred years, English speaking children have been singing this little ditty as they play. You can hear them: Little girls and boys singing. You can picture them: Perhaps at a birthday party, perhaps in the summertime, outdoors. Sunshine falling on their variously coloured little heads.
"Ring around a rosy, a pocket full of posies", isn't that sweet? And aren't they having such a good time. Singing their little song about death. Because that's what that little song is about. We're told it's a nursery rhyme, a little game for children to play. They hold their little hands, go around in a little circle, around a person who's in the middle, and when "we all fall down", well we all fell down. The last person to fall down went into the middle and we began the game again.
The 'rosy' of the rhyme "Ring around the rosy" originally referred to the red bumps or pustules that would form on the faces of people who had contracted the plague. "A pocket full of posies" was about the pomanders (some of which were oranges with cloves inserted into the peel), and the bunches of lavender or other sweet smelling flowers and herbs that were carried around in pockets or in 'nosegays', particularly the nobility. The aristocrats held their sweet smelling nosegays in front of their noses as they went about their daily business through the corpse ridden, putrid streets of London.
"Achoo, achoo"? Sneezing. Sneezing, a sign, yet another sign of approaching death. If you were sneezing and you had the 'rosies' on your body, well, the next thing was that you were going to fall down. Fall down. Go boom. Dead.
Our children's stories and songs have come down through the ages by word of mouth. Their original meaning has been changed or even lost over time. This one "Ring around a rosy" is a sign of , a remnant of, a deception that has been going on for as long, I'm sure, as human beings have been going on.
The deception begins early in our lives. It's part of our human attempt to deal with the reluctance, the recoil, the reactivity, that we all seem to have about birth and death, and life.
I'm dying.
You're dying.
We're all dying
All of us were born without asking, without being asked, without our knowledge or consent. We were all born. Most of us don't remember much about our birth because we didn't 'know' it. Not as we know this moment. Not as we can know the feeling of the breath as it breathes in, fans the ribs, causes the shoulders to lift ever so slightly. Not as we can know the seeing of the wall. Not as we can know the hearing of our neighbor's breathing. Not as we can know the feeling of the left hand cradled in the palm of the right hand, the feeling of the thumbs touching. We can know our life. So we can understand how, in a sense, we weren't really present for our birth. We weren't aware of it, as we are aware of this moment. Birth and death arise together. They're inseparable. They arise within and as life.
The day before yesterday, which was my birthday, the Roshi and I were talking about death because of my preparing for this Dharma talk. I had said: "life and death arise together. They are inseparable." And the Roshi wrote the following on my page to make it very, very clear how reality is, "Death is part of how life lives. Death and life are not opposites or even equals. Death is part of how life lives."
Life never dies. You will and I will and everyone else will, but life never dies.
So here you sit facing the wall, eyes open. Breathing out you breathe out. The breath, the life that was you dies and is gone forever. As you breathe in the nostrils widen, the rib cage expands, the spine lengthens. You can feel your heart beat. The heart muscle pumps blood through the lungs, the oxygen you have just breathed in passes into your bloodstream and is pumped to your brain, your internal organs, to your eyes, your ears, your fingers and toes, to the skin inside your elbows, to your tongue. Right now you are alive. You can know that. You breathe out. You don't know if there will be another breath. So fragile, so tender, trembling and teetering on the brink of...
One day there will be that final wisp of breath leaving the bodymind. I'll be dead. One day there will be that final wisp of breath leaving the bodymind. You will be dead. And you will be dead, and you will be dead.
What is it? What dies? Who dies? Life doesn't die. What a shame it would be to die without being aware of it. What a shame it is to live without being aware of it. But you're here and you're alive and you're aware of it. You know it. Not as a concept, which is usually how we tend to view it before we begin to practise. Not as the things you did in the little movie you remember of what was going on in your life before you got to the zafu. Not as the little movie that plays itself on and on about the things that you will do after you get out of here, after you get off the zafu. But when you practise, you are practising this very moment, this life that is living you.
So there you sit, being breathed in and out. The skull, the spine, the hands, the fingers, the space around the fingers, the beating of your heart: That is your life. And you can know it: When you're practicing. And isn't it amazing, here you are practicing. How did this happen? What did you do that afforded you this priceless opportunity to practise and study your life? To look into, moment to moment, how you are. To find out who you are.
In "Living With This Breath", a Dharma Assembly on Death and Dying, Zen Master Anzan Hoshin said:
When we are intimate with our experience as a whole, with our life as a whole, when we are completely embraced by life, we can begin to come to grips with death. When we can attend to what is, without creating another, then we can begin to look into this issue of death without falling into reactivity. Without trying to console our selves with mystical promises, and without viewing it as some kind of void. Then we can begin to understand death as part of what life does, as part of the activity of life.
Death, the one thing in your life you can be sure of. And most of the time you, but not just you, nearly everybody, wants to pretend that it's not happening. Gosh, you know, our finger and toenails are made up of dead cells. Our hair, that hair upon which some of us spend and have spent so much time and money, is made up of dead cells.
"Timor Mortis": fear of death, is something as old as human history. Fear of death is fear of something which is the inevitable lot of each and every sentient being, of each and every one of us. We don't like to talk about death in any real terms and yet every day we're surrounded by information telling us in various ways of the deaths of untold numbers of beings, real and fictional. It flickers in front of our eyes. It rings against our eardrums. We pass a newsstand, "278 died today". Well we know that's not true. Far more died today than the 278 in that one plane crash. We watch the evening news, and turn it off with a sigh of relief. Television news watching has become a ritual now, a kind of ritual of affirmation. If we're sitting here watching the news we know that we didn't die on this day because we're watching the body count. FFFEWH! "Made it through another one". Can go to bed safely, be tucked in and hopefully fall quickly into a deep deathlike sleep.
I find it curious that there are no little undertaker kits for kids. We have little carpenter kits, little baking kits, little sewing kits, but there are no little undertaker kits. There are no little 'divine outfits' for Barbie, for going to the funeral. Yet kids want to know about death. They want to know what happened to Sam the hamster lying there at the bottom of his cage. And they want to be told what's going on. The quest for the answer to the questions "what is death?" and "will I die?" and "why do we die?" does begin when we're very young. The answers we get? Embarrassing fabrications and fairy tales such as being lifted up into the blue sky in some sort of loose white night gown and popped on to a white fluffy cloud to play a stringed instrument for eternity. Other responses can be: "Don't ask, just don't ask. We don't talk about it." Or children are told not to worry about, 'you're not going to die for a long, long time."
Death, from the point of view of many scientists and lay folk, in a kind of basic materialist view, is bleak beyond despair and a cause for great anxiety. In practice, in this practice, we're all familiar with the term self-image: views that we have of our self, and how we are, and how the world is. Views, which if they are fed into, distort this moment of experiencing, distort our life. Self-image spends its whole life acquiring things: Story lines, beliefs, objects, money, love, costumes, masks and it does this in a vain effort to prove that it exists. That it is special, enviable, immortal perhaps. Considering how reactive self-image is to being questioned about anything for fear of losing what it doesn't really possess (as I'm sure you all know from your own experience) and considering how anxious you become when you lose a key, or some money, a job, your looks, it's not surprising that the fear of death, of losing everything including your 'self', is so pervasive.
Sometimes our fear is the subject of humour. As Woody Allen said: "I'm not afraid to die, I just don't want to be there." It is widely considered to be in very bad taste to joke or speak lightly about death. In earlier times there seems to have been a much lighter touch. In pioneer days, in the colonies in Canada and the United States, tombstones were often blunt in the stories they told. And in this bluntness there was often a touching humour. This, from the gravestone of a child: "If I am so early done for, what on earth was I begun for?" And on the gravestone of a 24-year old woman, inscribed in 1792, was this: "Molly, though pleasant in her day was suddenly seized and went away. How soon she's ripe, how soon she's rotten, laid in her grave and soon forgotten."
Death; something everybody does but no one wants to talk about , especially if it's actually going on in the immediate vicinity. Anger is a fairly common feeling expressed to thanatologists, those who study death and the process of dying. It's fairly common for people who are dying of a terminal illness such as cancer, to have a lot of anger at: guess who? The loved ones, the nearest and dearest, who either make the dying person feel bad and guilty by crying and carrying on: "Don't leave me! What will I do without you? Oh no how terrible!" Or the more optimistic type who insists on making plans for the cruise, for the adventure, the things we will do together "when you're better darling". The patient, the soon to be dearly departed, knows that they are the soon to be dearly departed, and what is being ignored makes them very angry. They are being ignored. Reality is being ignored. But then, that is what we human beings seem to like to do.
Students have asked very practical questions such as what they can do when they are with someone who is dying. What can they do to make it easier for the person that they are with. Practise, that's what all of you can do. That is what you must do. When you can see your story lines, when you can see where a feeling is turning into a feeling-tone, when you are contracting around self-pity which has nothing to do with the person you are with, the dying person, you can practise that and release it. Breathe with the person, touch them if they give your permission, hold their hand, wet their lips with ice or water. Just be there and practise. Give them the room they need to do what they must do.
What about if you're at a wake or a funeral? Practise; feel your breath moving in and out of the body, recognize, through having recognized your own capacity for getting into states, the states that people are in, and then perhaps you can be useful. Perhaps there is someone who needs to be looked after, or a Kleenex or a cup of coffee to be brought to someone. Practise. Find out how your loved ones want to spend the period of time up until their death, if they have a warning of it. Help them do what they want to do.
When you start to fall into your own story lines, your own states of fear about death and dying, the movies about "Oh how sorry they'll be when I'm gone" or "No, I don't want to go. No, not me. Please, please, not me." At that moment of seeing the movement of attention towards the thought, feel your breath rising and falling in the body, see the seeing, hear the hearing, practise this moment of your life.
The Roshi says, in "Living With This Breath":
Looking into birth and death means looking into our life and looking at our tendency to self-deception in regards to almost everything that we experience, allowing ourselves to be honest enough with that we have some opportunity for really answering it. But the kind of questioning that's involved here, the kind of answering that's involved here, has to be something that we do with our experiencing as a whole; with our whole body.
Dying is not like being asked to dance. You can't refuse. You don't have a choice. But you do have a choice in this moment. Practise this moment.
As a group, the human race often tries to pretend that it's actually possible for us to live forever. Maybe that's what will happen if we buy enough life insurance. Or at least it may possible for us to live for a really long time, looking good and maybe, as if we're only eighteen. It's all nonsense. We were all born and we are all going to die. And, you don't know when it's going to happen so feel the breath, see the colours, hear the sounds, practise this moment, practise your life.
Thank you for listening.
Hum hum, hum hum hum
Hum hum, hum hum hum
Hum hum, hum hum
Hum hum hum ...
[The Sensei hums the nursery rhyme and then strikes the floor with her shippei]


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Note that Msgr. Maurice Monier was appointed PRO-Dean. That means that Pinto is not necessarily retired. As a matter of fact it looks like Pinto is staying in place, according to a well-placed friend. So, BOTH Pinto and Monier will be wheeling in that chair at the circular table.
On the other hand, Catholic Hierarchy lists him as Dean Emeritus.
____ Originally Published on: Dec 12, 2016 @ 11:32
A while back Msgr. Vito Pinto – then-Dean of the Roman Rota – made disparaging remarks about the Four Cardinals of the Five Dubia on Amoris laetitia. At the time I observed that Pinto was 75 (aka retirement age).
Today I observe at L'Osservatore Romano that a new pro-Dean of the Rota has been appointed: Msgr. Maurice Monier of the Diocese of Le Puy-en-Velay.
It is tempting to conclude that the timing of the appointment has something to do with Pinto's explosive gaffe in his talk. However, I'm pretty sure that that is not what happened. It was time for Pinto to be retired anyway. Pintos exploded after all.


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Karen Stock
Karen is a certified exercise physiologist with a BEd degree and a double major in Physical Education and Health [UofR] and Home Economics [UBC}. She loves to motivate and educate clients on healthy eating practices and active living. Karen also believes that if you are doing it, you should achieve maximum results for your effort and time. Today, Karen volunteers for the Youth Justice Society, the CIBC Run for the Cure and is engaged in Long Term Athlete Development for Ringette Alberta.


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It's the Holiday Card Time of Year
Around here we just love this time of the year for countless reasons. One big one is this year's batch of holiday cards in all their glory. There is something untouchable about sending/receiving a tangible object to display rather than checking out someone's Facebook to see their latest family photos.
Dawn does a heck of a job each year coming up with a photo idea and executing. She lets me write the not-so-witty caption and then we pour over design after design. If Dawn has not lost her mind trying to get the photo, she usually does by this point. But, they always end up turning out just right. Something we are proud to show to you.
You'll have to check your mailbox for this years version, but I thought it would be fun to display all the years past.
Which one is your favorite? I lean towards the 2008, Dawn goes with 2011. Happy Holidays, everyone!


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This article was scientifically reviewed by Aishwarya Arjunan
We take the information we share seriously. Review our Editorial Policy Here.
A list of references is also included at the bottom of this article.
Cystic fibrosis, CF, is a genetic condition that causes a build-up of thick, sticky mucus that can be harmful and damage many of the body's organs
What's in this Guide?
- What Is Cystic Fibrosis?
- How Common is Cystic Fibrosis?
- What Are the Symptoms of Cystic Fibrosis?
- How is Cystic Fibrosis diagnosed?
- How is cystic fibrosis treated?
- What is the life expectancy of an individual with cystic fibrosis?
- How Is Cystic Fibrosis Inherited?
- Genetic testing for cystic fibrosis
- DNA Testing for Cystic Fibrosis: Benefits and Limitations
Disclaimer: Before You Read
It is important to know that your genes are not your destiny. There are various environmental and genetic factors working together to shape you. No matter your genetic makeup, maintain ideal blood pressure and glucose levels, avoid harmful alcohol intake, exercise regularly, get regular sleep. And for goodness sake, don't smoke.
Genetics is a quickly changing topic. Read More...
CF is a chronic condition that worsens over time but thanks to improved treatments, the average life expectancy for an individual with CF is 40 years of age.
Early identification and treatment can help improve the quality of life for individuals with CF.
What Is Cystic Fibrosis?
Cystic fibrosis is a genetic condition that results in the production of thick, sticky mucus, mainly in the lung and digestive system.
While some amount of mucus is necessary to line various organs in the body for protection and lubrication, individuals with cystic fibrosis produce mucus that is very sticky and thick which can clog and obstruct organs throughout the body 1 2.
Cystic fibrosis is caused by mutations in the CFTR gene which is responsible for creating a channel that helps transport chloride ions in and out of cells 3.
Chloride is a vital component of sodium chloride (also known as salt, NaCl) that is found in sweat.
The movement of chloride in the cells helps control the movement of water in tissues which is needed to create thin, free flowing mucus 4.
Mutations in CFTR disrupt this process resulting in the thick and sticky mucus that is characteristic of cystic fibrosis.
Over 1,700 disease causing mutations have been identified in the CFTR gene 5. These mutations can be divided into classic and non-classic mutations.
Individuals with two classic mutations are at risk for a more severe presentation of the condition that includes issues with the pancreas.
Individuals with one classic and one non-classic mutation or even two non-classic mutations are likely to have a milder presentation of the condition and may not experience any issues with the pancreas.
Two of the primary systems that are affected in individuals with cystic fibrosis are the respiratory and digestive systems 6 7.
The reproductive system is also affected in most males and some females.
How Common is Cystic Fibrosis?
While cystic fibrosis can be seen in individuals of all ethnic backgrounds, males and females, it is the most common autosomal recessive genetic condition in the Northern European population.
In the United State, 1 in every 3,200 newborns is affected by cystic fibrosis and 1 in every 35 Americans may be a carrier of the condition 8 9.
Currently, there are approximately 30,000 people with cystic fibrosis in the United States 10.
The condition is also more common in the Ashkenazi Jewish population with 1 in every 29 individuals identified as a carrier of the condition.
It occurs with a lower frequency in other ethnic groups. Approximately 1 in 61 African Americans and 1 in 118 Asian Americans are observed to be a carrier of cystic fibrosis 11.
Typically, the condition is diagnosed shortly after birth as all newborns in the United States are screened for this condition along with a number of others within a few days of birth.
However, there are cases of some individuals with the milder form of the condition that may not get diagnosed until later in life.
What Are the Symptoms of Cystic Fibrosis?
The severity of the symptoms of cystic fibrosis varies from person to person. A hallmark feature of cystic fibrosis is salty sweat.
Individuals with cystic fibrosis have 2-5x the expected amount of salt or sodium chloride (NaCl) in their sweat.
The primary systems impacted in individuals with cystic fibrosis are the digestive and respiratory systems.
Respiratory System Symptoms 12 13:
Mucus can clog the airways which can lead to severe problems with breathing. Infections in the lungs can cause coughing, wheezing, and inflammation.
The recurrent infections and buildup of mucus can cause permanent lung damage.
Additional respiratory symptoms an individual can exhibit include:
- Wheezing
- Shortness of breath (emphysema)
- Stuffy nose or Inflamed nasal passages or nasal polyps
- Frequent lung infections
- Chronic cough that produces thick mucus (sputum)
- Exercise Intolerance
Digestive System Symptoms 14 15:
The pancreas is responsible for producing insulin, a hormone that helps control blood sugar levels, and other digestive enzymes.
When mucus builds up in the pancreas, it damages the ability to produce the necessary insulin and digestive enzymes the body needs.
This can lead to diarrhea, malnutrition, poor growth, and weight loss.
In some individuals, the impaired ability to produce insulin can result in a form of diabetes that is called cystic fibrosis-related diabetes (CFRD)
Additional digestive system symptoms include:
- Pancreatic insufficiency
- Pancreatitis (inflammation of the pancreas)
- Inability to absorb nutrients
- Intestinal blockages (meconium ileus)– especially in newborns
- Greasy stools that smell foul
- Chronic, severe constipation
- Poor growth and weight gain despite a large appetite
- Gallstones
- Liver disease
- Rectal prolapse
Newborns who don't pass their first stool, (meconium ileus), may be held in the hospital longer, at least until they do.
Meconium ileus is a characteristic finding in babies with cystic fibrosis.
Because CF causes mucus to become thicker, it increases the chance that the meconium will get stuck in the ileum.
Approximately 1 in 5 babies with cystic fibrosis is born with meconium ileus 16.
In approximately 20% of children with cystic fibrosis, chronic coughing or constipation can cause rectal prolapse 17.
Reproductive System Symptoms:
Most males (~95%) with cystic fibrosis have congenital bilateral absence of the vas deferens (CBAVD) 18.
CBAVD is caused when the vas deferens (tubes that carry sperm) are blocked by mucus and do not develop properly and leads to infertility.
While most females with cystic fibrosis have normal fertility, some may experience infertility due to abnormal cervical mucus.
Other Symptoms:
There are additional systems that are also impacted in individuals with cystic fibrosis.
Cystic fibrosis can also cause clubbing (widening and rounding of fingertips and toes) and osteoporosis (low bone density) 19.
Due to the increase of salt in the sweat of individuals, individuals are at risk for electrolyte imbalances and dehydration 20.
This can lead to other symptoms, such as:
- Weakness
- Fatigue
- Low blood pressure
- Increased heart rate
- Heat stroke
How is Cystic Fibrosis diagnosed?
In the United States, diagnosis of cystic fibrosis will generally come via newborn screening from a physician, generally a pediatrician or medical geneticist.
Every state's newborn screening program for cystic fibrosis involves a blood test from the baby to check the levels of immunoreactive trypsinogen (IRT) which is made by the pancreas.
Elevated levels of IRT can trigger a positive newborn screen. Some states also include DNA screen along with the IRT test to look for a subset of mutations that are seen in individuals with cystic fibrosis.
Both of these tests are screens and are not diagnostic but these screens will help identify babies that are at increased risk of having cystic fibrosis and alert the pediatrician that additional diagnostic testing is necessary.
While most individuals with cystic fibrosis are diagnosed by the age of two, some individuals are diagnosed later in life.
This is because there is a variability in the severity of the condition and some may not be identified via newborn screening.
Sweat Test
The gold standard for diagnosing cystic fibrosis is a sweat test.
A sweat test measures the amount of chloride excreted in the sweat.
Sweat is collected by applying a chemical called pilocarpine alongside some electrical stimulation that helps induce sweat to a small area of the patient's skin.
The collected sweat is then sent for analysis and the results of the sweat test are generally available within a few hours.
Sweat chloride levels are not expected to change as an individual gets older.
If an individual has cystic fibrosis, the sweat chloride test will show that the individual has a high chloride level.
Individuals will generally receive one of three results from a sweat chloride test. If a chloride level is:
- Less than or equal to 29 mmol/L = CF is unlikely
- Between 30 - 59 mmol/L = CF is possible and additional testing is needed
- Greater than or equal to 60 mmol/L = CF is likely
The test is generally repeated if the chloride level falls in the 30-59 mmol/L range.
For individuals with possible or likely CF sweat chloride results, additional DNA testing is also performed to identify the specific genetic mutations an individual carriers.
Genetic Testing
Genetic testing for cystic fibrosis is completed by obtaining a blood sample from the patient and sending for CFTR analysis.
The test will look to see if there are any disease causing mutations in the CFTR gene.
The presence of two disease causing mutations will help confirm the diagnosis of cystic fibrosis.
There will be a subset of individuals who received sweat test results in the intermediate range and are identified to have no or one disease causing mutation.
These individuals are diagnosed as having CF-related metabolic syndrome or CRMS.
How is cystic fibrosis treated?
While there is no cure for cystic fibrosis, management involves treatment of the various symptoms that are present in an individual.
Each treatment plan is tailored to each individual and their symptoms. To a point, yes, the symptoms of the disorder are treatable.
The disorder will last a person's lifetime, and eventually be responsible for their death.
There are different types of treatments including medicine, surgery, rehab and physical therapy.
The treatment plan a doctor prescribes is based on the severity of the symptoms and the person's current quality of life.
As part of their daily routine, individuals with cystic fibrosis go through a combination of the therapies mentioned below 21 22:
- Airway clearance- done with the aid of a caregiver, this helps loosen up the mucus that builds up in the lungs
- Inhaled medicines – this type of medication helps with removing mucus from airways, making it easier for the patient to cough it up, improving their overall lung function.
- Antibiotics – included in the inhaled medicines mentioned above, antibiotics are commonly prescribed for individuals who develop chronic infections due to recurrent mucus buildup.
- Pancreatic enzyme supplements – these supplements aid in the absorption of vital nutrients the body needs to thrive.
- CFTR modulator therapies - these medications are designed to correct the malformed protein that is produced by the CFTR gene. Three CFTR modulators have been developed so far (Kalydeco®, Orkambi®, and Symdeko®) and these modulators are only effective in individuals with particular mutations.
Rehabilitation and Physical Therapy
Pulmonary rehabilitation and physical therapy are extremely beneficial to a patient with cystic fibrosis.
Chest physical therapy involves the individual using gravity to drain mucus from the lungs.
It may also involve vest therapy or having a caregiver or partner clapping on the back of the chest to help move mucus out of the airways.
Pulmonary rehabilitation is used to address chronic breathing problems.
It addresses exercise training, nutritional counseling, breathing strategies, and techniques to conserve energy.
In some instances, surgery may be necessary to address certain complications associated with the condition. These include:
- Nasal polyp removal
- Bowel surgery
- Feeding tube insertion
- Endoscopy
- Lung transplant
What is the life expectancy of an individual with cystic fibrosis?
Currently there is no cure for the condition but the life expectancy of individuals with cystic fibrosis has increased drastically over the last two decades.
For individuals born with CF between 2013 and 2017, the life expectancy is predicted to be 44 years 23.
It is important to remember that individuals with cystic fibrosis experience a variety of different symptoms with some having a more severe disease progression than others so the prognosis can be quite different depending on the severity of the condition.
Improvements in treatment options have helped improve the quality of life for individuals with the condition but some individuals still face challenges such as frequent hospitalizations and time-consuming treatment plans.
How Is Cystic Fibrosis Inherited?
Cystic fibrosis is inherited in an autosomal recessive pattern. This means that people with cystic fibrosis have inherited two copies of the defective (or mutated) CF gene, one copy from each parent.
We have 46 chromosomes in each cell of our bodies. These chromosomes can be organized into 23 pairs.
One of each pair of chromosomes is inherited from each parent. Our genetic information, or our genes, is carried on the chromosomes.
Genes are instructions telling our bodies how to grow and develop.
While each person has two working copies of each gene, parents of children with cystic fibrosis will have one copy that has a mutation and one copy that is working without any problems.
Because they have one working copy of the gene, they do not have any signs or symptoms of CF.
This is called "autosomal recessive inheritance". Parents who have one copy with a gene mutation are called "carriers".
CF occurs when an individual inherits two mutations in the CFTR gene.
When two carrier parents have a child who inherits both copies with a gene mutation, one from each parent, the child will have CF.
What are the chances that I will pass cystic fibrosis to my child?
- If neither parent has a disease causing gene mutation; that is, neither parent is a carrier, then it is highly unlikely that cystic fibrosis will be passed down.
- If only one parent has a mutation, is a carrier for CF, and the other parent has two normal working copies of the CFTR gene, the children of that couple will each have a 50 percent chance (1/2) of being an unaffected carrier of CF.
- If both parents are carriers of CF, then there is a 1 in 4 or 25% chance in each pregnancy to have a child with CF. This also means that there is a 3 in 4 or 75% chance in each pregnancy to not have a child with CF.
Genetic testing for cystic fibrosis
While blood testing and looking for disease causing mutations in the CFTR gene can help establish a diagnosis of cystic fibrosis, a sweat chloride test is considered the gold standard for diagnosing cystic fibrosis.
Speak with your health care provider if you wish to learn more about genetic testing for cystic fibrosis.
A referral to a genetic counselor can be helpful to discuss the various testing options for you and your family.
Is prenatal testing available?
Genetics play a very critical part in whether a person develops the disorder, or even if they are a carrier who can pass it onto their children.
If parents want to know their risk of having a child with cystic fibrosis then they can consider getting carrier screening prior to or in the early stages of pregnancy.
Carrier screening will help identify whether an individual or couple are both carriers for cystic fibrosis and thus at risk of having a child with the condition.
If a couple is identified to both be carriers for cystic fibrosis, then prenatal diagnosis via chorionic villus sampling (CVS) or amniocentesis can help determine whether the fetus is affected.
If carrier screening is done prior to pregnancy and a couple is identified to both be carriers for cystic fibrosis then that couple can explore other options such as pre-implantation genetic testing with IVF, using an egg or sperm donor, or adoption.
Speaking with a genetic counselor can help determine if this testing is right for you.
Where can I go to get genetic testing?
There are a variety of options available for cystic fibrosis genetic testing
Genetic testing is generally ordered by a healthcare provider though there are now a few options available for you to get testing directly from a testing company.
When considering any form of genetic testing, it can be helpful to speak with your healthcare provider to learn about the benefits and limitations of testing and testing options.
It is always advised to complete diagnostic testing under the guidance of a healthcare provider. Testing completed through your doctor's office will usually involve a blood sample.
Companies like 23andMe and Helix offer genetic testing that can help identify carriers.
It is important to compare these screens to testing that would be ordered by your provider to confirm whether they are as comprehensive.
Some direct to consumer tests may not offer as comprehensive of a screen compared to the one that you may get from your healthcare provider.
These direct to consumer tests typically involve a saliva or buccal sample.
You'll be able to view your results online within 4-8 weeks.
It is important to note that results from at-home kits may not provide a complete answer.
DNA Testing for Cystic Fibrosis: Benefits and Limitations
Genetic testing can a mix of benefits and limitations. There is no possibility of physical harm or any biological risk in getting tested aside from the general risk of a blood draw if a blood draw is completed.
Although deciding on testing is entirely voluntary, it can prove to be a complex decision that may raise new health concerns or anxieties.
For this reason, it's best to seek genetic counseling to help discuss the emotional and social aspects of genetic testing, as well as get an educated interpretation of the results.
With that in mind, here is a short list of the strengths and limitations:
Benefits of Genetic Testing:
- Relief from any uncertainty about whether or not CF is the appropriate diagnosis.
- In-depth understanding about the disease and how it impacts you and your health.
- You will be in a position to educate your family about the potential risk of passing down the condition or help diagnose other family members who may also have CF.
- Knowing you are a carrier can help you make future family-planning decisions.
Limitations of DNA Testing:
- Your new knowledge will not lead to a cure, but will help empower you to make decisions about your health and future
- You may not be able to get a conclusive answer after genetic testing which may then lead to a feeling of uncertainty about the diagnosis and family planning.
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Referenced Sources
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- Cystic Fibrosis Foundation. Retrieved online August 2019.
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- Ong T, Marshall SG, Karczeski BA, et al. Cystic Fibrosis and Congenital Absence of the Vas Deferens. 2001 Mar 26 ,Updated 2017 Feb 2. In: Adam MP, Ardinger HH, Pagon RA, et al., editors. GeneReviews® Internet. Seattle (WA): University of Washington, Seattle; 1993-2019.
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