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gayle forman
EllE, OctObEr 2001
Once a month you suffer. Now you can medicate those physical and psychological pains away—but at what personal cost? Gayle Forman reports on the highs of feeling low.
My first inkling that it’s coming is a fluttering in or paralyze me with nausea, as it does some my abdomen, little wings thumping against the women. Mostly it makes me melancholy and raw. walls of my insides. Somehow, I’m surprised by And that rawness is precisely why I cherish my the feeling, though it happens every month. Then PMS days. Other people take weekly trips to the it intensifies: a fist in my stomach, a turmoil in therapist’s couch to dredge up buried unhappi- ness and dissatisfaction. I don’t need to dig. PMS throws my emotions right in my face. Earlier this Only when the tears come at seeing an old man year, I lost four friends in a car accident. The grief struggle onto a bus, at catching thirty cornball was explosive, but I dealt with this inconceivable seconds of Touched by an Angel , do I realized tragedy by making plans, organizing wakes- being that my blues are the result of PMS, the condition in my head instead of in my heart. After the that affects up to 75 percent of menstruating funeral, I obsessed about the crash, replaying it women with a range of maladies, from bloating to in my mind, but I was unable to digest what had fatigue to insomnia to anger to despondency.
happened and unable to really grieve.
As ubiquitous as PMS may be, it’s a scientific Then my hormones kicked in, and one night while mystery. Doctors and researchers know that I was reading a magazine alone in my apartment, fluctuating levels of reproductive hormones I heard a siren. For two hours, I sobbed, screamed, trigger changes in neurotransmitters, such as threw pillows, and kicked furniture. Later, I serotonin, which regulates mood, among other felt horrible, yet relieved. PMS has become a things. But scientists still aren’t clear as to why monthly catalyst for my catharsis; each time the one woman’s sore breasts are another woman’s tsunami passes, I am more at peace. Of course, wrath. Of those who get PMS, between a quarter not everyone relishes her lunar lunacy. And in and a half (depending on which study you believe) the latest offensive against excessive emotion, experience extreme symptoms, which medical pharmaceutical giant Eli Lilly has remarketed literature vaguely defines as those that “disrupt Prozac to fight mood swings and testiness. The wonder drug, rechristened with the soft-focus- Is my case severe? PMS definitely drops my life sounding “Sarafem,” is now an FDA-approved with a thud, but it doesn’t inflame me with fury treatment for PMDD, or premenstrual dysphoric gayle forman
disorder. PMDD is the clinical twin of PMS, the board, we’re heading back to Victorian times, except that the former is an actual psychiatric when “hysterical” ladies stricken with the “curse” diagnosis- its existence codified in the Diagnostic and Statistical Manual of Mental Disorders - and its psychological symptoms are more I don’t care to be shushed. The malaise, the severe. Instead of the blues, women might suffer pimples, the swollen breast so tender that I wear depression or contemplate suicide; instead of a sports bra to bed- these I could do without. But crankiness, the could experience dizzying mood when PMS hits, I enter a slightly skewed reality swings or out-of-nowhere rages. As with many in which I see and feel things that are invisible psychiatric syndromes, however, there is no line to me the other twenty-odd days of the month. clearly demarcating where an extreme case of This makes me a better friend to tell your troubles PMS graduates to PMDD. It’s a subjective call for to. As a journalist, I am more able to empathize with my subjects and translate their experiences into words. When I’m in a full-on fit of mopey, I know that the estimated 3 to 5 percent of dewy-eyed mania, I live life the way I did before I women afflicted with PMDD are different from became a mature, even-keeled, sensibly sensitive me- the feel their hormones hijack their lives- and adult. I’m the girl I was when life was set to tragic I’m thankful the medical establishment is doing poems and euphoric songs, when I would fall in something to give them relief. But while Lilly’s love just like that (a single soulful conversation official line about Sarafem is that it’s intended for could do it), and be mortally wounded just like PMDD, the company’s Web site (www.sarafem.
that (by the cut of an unkind word). When I was com) and its advertisements suggest otherwise. that girl at nineteen, the dissolution of a friend- The drug is mostly touted as a treatment for the ship so devastated me that the only relief I could more prosaic ills of sadness, bloating and crab- imagine was to fly away. So I emptied my bank biness. Lilly won’t divulge its sales numbers, but account and headed to Greece for three months.
one spokesperson did tell me that Sarafem was most commonly prescribed for women complain- It was exhausting to ride that roller coaster. I couldn’t be that way and have what I have today: a husband, a career, a home, stability, sanity. But Eli Lilly hails Sarafem as a great step forward there are times when I question what I forfeited for women. (It’s also great for the company’s to be this contented woman. Am I somehow bottom line. Lilly’s patents on Prozac expired leading a dishonest life now that the painful in August, and strong Sarafem sales could help edges- and blissed-out highs- have been dulled? offset the inevitable losses of no longer having a Then, with my monthly emotional rush, I get a monopoly on the drug.) But if you ask me, it’s also reprieve from the relentless steadiness, and I a step back. Not for those who truly suffer from realized I really haven’t given up so much. Under PMDD, or even those whose PMS is borderline the influence of PMS, I can strip away decades of harrowing, but for millions of less severely experience, layers of justification, thickening, and afflicted women who are implicitly told that their politicking, and evaluate my life with renewed monthly emotional bouts should be quashed. I clarity. Two years ago at a party, I had a run-in worry that by medicating these outbursts across with a hideously rude lawyer who alternately gayle forman
bragged about his wealth, berated artists, and proclaimed that dating women over thirty was a sign of defeat. I usually write off such idiots, but because I was in PMS mode, my annoyance deepened into existential angst. I started to dwell on other things that were upsetting me- from abstract notions about our overly consumerist culture to personal worries about how hollow my work had become. I even talked to my husband about moving to Spain. But then the PMS lifted, taking with it the compulsion to flee and leaving me to mull the real issue: how to make my life more honest and meaningful.
Sometimes my PMS acumen wreaks havoc. I’ve quit jobs- walking out of a lucrative waitressing gig because the manager sniped at me- and compromised my credibility by losing my cool in front of colleagues. I’ve strained friendships and alienated lovers. My husband can chart my menstrual cycle by my “there’s something wrong with you” tantrums, but he knows my outbursts are like summer storms, inevitably best just weathered until they pass.
That said, I’m aware my emotional surges dent his life, and those of my friends and family. It doesn’t surprise me, although it still bothers me, when I hear patients and doctors explain why so many women are seeking PMS treatment: They are concerned with how their altered state affects those around them. Maybe PMS is so reviled by our culture because it forces women- who are meant to be nurturers- to go inward, to look after themselves. A wife who’s exiled herself to a dark room might not want to organize dinner or be the family cheerleader. Reveling in my menstrual sensitivity may be selfish, but it’s also necessary. PMS connects me to a part of myself that I would be lost without.

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