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What Is Herpes Outbreak
Herpes outbreaks occur due to an attack by the herpes simplex 1 and herpes simplex 2 viruses. Both are highly contagious. The virus can spread from one person to another person from close contact. Herpes simplex, also known as HSV, is an infection that causes herpes. Herpes can appear in various parts of the body, most commonly on the genitals and mouth. Herpes simplex virus type 1 is transmitted through contact with the infected person for instance (kissing, eating from the same utensils or sharing personal items). It is associated with infections of the mouth, lips and face. On the other hand, herpes simplex virus 2 is sexually transmitted disease and associated with genital sores or ulcers. You can pass this virus to other people even when you don't have visible sores. Herpes outbreaks are characterized by fever blisters, mouth sores, and enlarged lymph nodes. According to studies during your first outbreak of herpes, you may have the fever. After an outbreak, the virus tends to be a retreat to the nervous system. It can become active again due to triggers like stress, illness, certain foods, hormonal changes and a compromised immune system.
Causes Of Herpes
- Kissing
- Unprotected anal or vaginal sex
- Sharing personal items
- Using same sex toys
- Blisters and sores in the mouth or genitals
- Pain during urination
- Itching
- Blisters on lip and mouth (in oral herpes)
- Difficulty in speaking, eating and swallowing (in oral herpes)
- Swollen lymph nodes in the groin area
- Fever (in oral herpes)
- A sore throat (in oral herpes)
- Drooling (in children)
While there is no cure for herpes simplex virus infections, there are few treatment options available for herpes. These medications can be used in both oral and genital herpes.
There are 3 antiviral medications that are approved for the treatment of herpes.
This is the oldest medicine to treat herpes. It is available since 1982 in topical form (as ointment form) and sold since 1985 in the pill form. Acyclovir has been proved to be safe in persons who have used it continuously for as long as 10 years.
This is the new drug and it slows the growth and spreading of the herpes virus. This antiviral helps your body to fight infection. Valacyclovir is used to treat infections caused by herpes viruses including genital herpes, cold sores, and shingles. This antiviral will not cure herpes and will not prevent you from spreading the virus to others.
Famciclovir is used to treat certain types of viruses. It treats shingles caused by herpes zoster. It also treats herpes outbreaks that cause cold sores around mouth and genitals. In people with frequent outbreaks of genital herpes, this antiviral is used to reduce the number of future episodes.
Antiviral medications are commonly prescribed for patients having a first episode of genital or oral herpes. But they can be used for recurrent episodes as well. But using these antivirals is not safe enough because it can give you side effects. And side effects can make your situation from bad to worse. These antivirals just lesson the effects of herpes virus and they do not work properly on your symptoms. On the other hand, herbal remedies work properly and cure your symptoms much effectively than antivirals. Herbal remedies are safe and affordable.
Above mentioned treatment option for herpes can erase herpes fast and safe.
Some of the herbal remedies to cure herpes symptoms are –
Aloe Vera Gel For Herpes
Aloe vera is clinically tested and approved to cure herpes symptoms. A person can have different ways to use aloe Aloe Vera for herpes including direct applications on the affected parts. Aloe Vera contains almost seven different antioxidants and reduces inflammation. The natural salicylates in aloe help in reducing the pain. Aloe vera gel is effective as well as affordable. You can use aloe vera to treat numerous health problems and it will not give you any side effects. According to studies, aloe vera is one of the best ways to stop genital and oral herpes outbreaks. To apply aloe vera gel you can use packed gel or juice. Or if you want you can use the fresh leaf of aloe vera plant.
Apple Cider Vinegar
ACV (apple cider vinegar) contains natural acids and it has antiviral, antibacterial and anti-fungal properties. Additionally, apple cider vinegar also contains minerals, vitamins, and enzymes which can make us healthy and reduce the future outbreaks. Always use unfiltered and raw varieties of apple cider vinegar to treat herpes. Dip a cotton ball in apple cider vinegar and apply this on your affected area three or more times in a day for three or four days.
Lemon Balm
Lemon balm is an effective remedy for herpes. According to studies, lemon balm contains a host of antiviral constituents including rosmarinic acid, flavonoids, and phenolic acid. This herb is also used to reduce symptoms of herpes outbreaks. Lemon balm is useful in reducing the intensity of herpes outbreaks. It also contains a compound called eugenol which works as a natural pain reliever. Drink lemon balm tea several times daily for a few days until the symptoms subside. You can also apply lemon balm tea bags on the affected area three or four times in a day. By visiting this site you will get the broad information about can lemon balm oil cure herpes and to what extent it is beneficial in curing herpes infection.
Black Coffee
Herpes virus infects not only genital parts but also lips and mouth. Black coffee is one of the ways to treat herpes outbreaks. Blisters in the mouth can cause pain and to treat them you have made black coffee. Let it cool down and take a sip hold it in the mouth for some time.
If you want to get rid of herpes symptoms naturally and fast, you can use Dr. Sebi Herpes Cure.
These are very effective and best ways to cure herpes symptoms. When herpes infection gets very severe, it becomes more difficult to cure its symptoms at your home with herbal remedies. If you feel that your condition is out of control, you have to consult with your doctor. You can use herbal remedies after consulting your doctor.


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subset: commoncrawl


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Need a general help with purchasing cars on CarGurus
I'm a beginner, and I would like to get a car, but I have no idea how does this
purchase system work. Do I use my own credit card in order to pay for car
monthly? Or is there another way?
1 Answer
Cargurus is a listing site. So dealers or individual sellers post a vehicle up on this site. Find a car you like, then on the vehicle page message the seller for more info. They will give you their location and you will test drive, inspect and work out a price at there lot as you do for any other vehicle. If a dealer they can most times offer financing. You can go to your bank or credit union before hand to find out how much you can afford. Get pre approval so to speak. I would stay away from the buy here, pay now lots.
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Katherine Marie Heigl is an American Emmy-winning and Golden Globe-nominated hollywood actress best known for her roles in Roswell, Grey's Anatomy, Knocked Up and 27 Dresses. Heigl was born in Washington, D.C.to Nancy, a personal manager, and Paul Heigl, a financial executive/accountant. She is the youngest of four children, in addition to siblings Meg, Jason, and Holt.
Heigl was once in a relationship with Jason Behr but that relationship ended soon. In June 2006, she became engaged to singer Josh Kelley, whom she met on the set of his music video for "Only You." They were married on December 23, 2007 in Park City, utah. Heigl is now a strong proponent of organ donation.
Birth name: Katherine Marie Heigl
Birth date: 24-11-1978
Birth place: Washington, D.C., USA
Spouse(s): Josh Kelley (2007-present)
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Apartment On Nevsky Prospekt 3
On Nevsky Prospekt 3 apartment is located around 1500 meters away from Mikhailovskiy Castle Historical Museum and 1450 meters from Monument to Catherine the Great . The apartment provides airport transfer, laundry and ironing service.
The property lies 10 minutes walking distance from Saint Petersburg city center. Serving a wide range of dishes, Bushe and Levin can be reached within 5 minutes' walk.
The apartment provides rooms featuring cable TV with on-demand movies, pay television, a writing table, a trouser press and high ceiling. Offering free toiletries, bath sheets and dressing gowns, a bathroom comes with a bathtub and a shower.
This property offers a microwave, an electric kettle, coffee/tea makers, a fridge and a stove for guests' use.
20 km to Pulkovo airport.
Guests will benefit from a balcony.


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I'm a 37-year old Seattle girl who was bitten by the travel bug on my first tour of Europe in 2004. This personal blog follows my attempts to visit as many countries as I can, as often as my budget will allow. Since starting this blog in 2007, I've also worked as a freelance copywriter for an online travel publication. This only served to add even more must-see locations to my already extended list.
Help me plan an itinerary!
From the pen of Lisa at 16:59
Labels: Austria, Czech Republic, Germany
1 comment:
- Brit' Gal Sarah said...
Looks like we all think the same!
- Tuesday, 21 October, 2008
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Editor's Note: TheStreet ratings do not represent the views of TheStreet's staff or its contributors. Ratings are established by computer based on metrics for performance (which includes growth, stock performance, efficiency and valuation) and risk (volatility and solvency). Companies with poor cash flow or high debt levels tend to earn lower ratings in our model. Calpine ( CPN) pushed the Utilities sector higher today making it today's featured utilities winner. The sector as a whole closed the day down 0.2%. By the end of trading, Calpine rose 21 cents (1.2%) to $17.45 on average volume. Throughout the day, 3.2 million shares of Calpine exchanged hands as compared to its average daily volume of 3.3 million shares. The stock ranged in a price between $17.25-$17.60 after having opened the day at $17.30 as compared to the previous trading day's close of $17.24. Other companies within the Utilities sector that increased today were: American DG Energy ( ADGE), up 5.3%, Huaneng Power International ( HNP), up 3.5%, EQT ( EQT), up 3.3%, and Empresa Distribuidora y Comercializadora No ( EDN), up 2.3%.
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Hypergrand Maverick Silver Silver Classic Black
The Hypergrand Maverick Silver Silver Classic Black features a surgical grade stainless steel casing and hands, a stainless steel face with contrasting black disk in the centre, white, black and grey detail and a classic black leather strap.
The Hypergrand Maverick Silver Silver Classic Black is a bold and unmistakable watch paired with the superior craftsmanship and elegance that makes a Hypergrand watch the go to choice for the discerning watch lover, you've found a timepiece that will fit easily within your collection for years to come.
Hypergrand is a brand designed out of Singapore by owner and ex engineer Leroy Xavier Zhong. Leroy recognised that the industry was lacking a range that could be versatile, priced competitively and frankly just damn cool. With this in mind Leroy had a vision for a Hypergrand Watch to become an everyday essential in your wardrobe with changeable Nato and Classic Straps allowing each owner to customise their watch with the season, the occasion or even simply just your mood.
- 44mm Polished stainless steel case
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1. We think the judge was in error in holding that Exhibit II required to be registered. The document only evidences an agreement to vary the terms of tenancy with reference to the amount of rent to be paid. As such it cannot be held to relate to an interest in immovable property and, therefore, did not require registration, Satyesh Chunder Sircar v. Dhunpul Singh I. L. R., 24 C., 20.
2. It was next contended that this document Exhibit II should be held to be binding on the plaintiff inasmuch as rent which up to then was payable only in respect of such lands as were cultivated thereby was made payable in respect of the entire holding whether cultivated or not. If up to the date of this document the defendant was not bound to pay for other than cultivated lands, the agreement on the part of the defendant to pay for lands whether cultivated or not would have made the agreement binding not only on the late Zemindar, but also upon the plaintiff, his successor, and no question would have arisen under the proviso to Section 11, Rent Recovery Act; but in the lower Courts the defendant did not allege that prior to this document he was entitled to remission as a matter of right. We cannot, therefore, say that the Judge was wrong in holding that the remissions prior to it were mere concessions Exhibit VII to which our attention has been drawn is not consistent with the contention that the remissions were a matter of right, nor does the language of Exhibit II itself support that view. That Exhibit II does not grant reduction of rent otherwise properly payable in respect of the land is quite clear, and unless such reduction is granted for any of the purposes set out in the proviso to S 11, already referred to, the arrangement must be held not to be binding upon the plaintiff. The finding of the Judge is that the reduction was not agreed to for any such purposes. The mere fact that the defendant has made some improvement since the execution of Exhibit II cannot bring the case within the exception to this proviso.
3. For these reasons, we must hold that the decree of the lower appellate Court is right, and dismiss the second appeal with costs.


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- "Everyone agrees they're no smarter than mice."
- —About scavengers
Vulture is an old male SandWing who is first seen in Darkness of Dragons. He is the grandfather to Qibli, Rattlesnake, and Sirocco, and father to Cobra. He is the leader of the Talons of Power, a cult/group of SandWings that wants to overthrow Queen Thorn. The Talons of Power have been setting bombs with Dragonflame Cactus plants off across the SandWing kingdom, and he blames the MudWings, bribing a MudWing named Bog (also known as Chameleon) to lie for him and say the MudWings caused the explosions with the promise of lots of treasure and stones. Vulture did this to gain trust from the SandWing subjects to originally allow Onyx onto the throne to overthrow Queen Thorn so he could be the power behind the throne, controlling Onyx's every move. However, once Vulture found out that Darkstalker had become the new king of the NightWings, he thought it wouldn't be such a bad idea for Vulture to rule the SandWings as a king instead, to be the direct power on the throne instead of Onyx. Vulture planned to dispose of Onyx once he got what he wanted before his plan was ultimately ruined by Qibli.
Appearance Edit
Vulture has pale yellow scales, with dragon skull tattoos all over his body, signifying that he has killed many dragons, supposedly making him look like a leopard from a distance. He has a hooked snout, likely a source of his name, and his black eyes look like bottomless voids, according to Qibli, and have gold rings in them, much like the Eye of Onyx itself. His gaze is often calculating and cold. He is a sly, cunning dragon. His barb, talons, and claws are dipped in gold leaf, and he wears several accessories, including enormous black and gold spider-shaped earrings, a black cape lined with gold, and draped gold chains all along his wings. He is obviously very wealthy and very powerful, and is said by Darkstalker to have not had "one happy day in his life." He looked like a dangerous dragon and he was one.
Biography Edit
Moon Rising Edit
Moonwatcher has a vision about Qibli fighting Rattlesnake and Sirocco, with Vulture glowering at him as well. Qibli was shouting "Where is she?" into the sneering faces of his siblings. He was referring to Cobra, not Ostrich or Moon herself.
Darkness of Dragons Edit
Vulture appears in Darkness of Dragons, working with Onyx. He keeps Ostrich as a hostage so he and Onyx can get to Six-Claws, Thorn's highest ranking and trusted general in the army, and then overthrow Thorn herself. He imprisons Qibli, Cobra, Winter, and Ostrich together, then tries to force Qibli to write down all of Thorn's secrets on a scroll. Qibli stalls, writing nonsense to distract him, and in this time the four of them escape and head to Thorn's Palace.
Later, Vulture bombs the SandWing Stronghold, and steals the Eye of Onyx. However, Queen Thorn has the real one, and the Eye he stole was fake; otherwise, he most likely would have been killed by the Eye. His plan unfolds when Onyx appears behind the queen, attempting to kill her. She was saved by a warning called from Qibli before Onyx could get to Thorn. Afterwards, Thorn suggests a royal challenge instead of a covert assasination, since all the past challengers have come this way. Onyx accepts, and both she and Vulture believe she's worthy due to royal blood. Afraid Onyx will be chosen, Qibli summons a sandstorm with Princess Anemone's weather bracelets, and in the choas of the storm Vulture disappears from the stronghold completely with no warning or sign.
Across the book, Qibli always had a suspicion that Vulture would end up working for Darkstalker and become a juggernaut, taking over the world. That suspicion proved to be true later on, where Vulture is seen in The Lost City of Night, bargaining and talking with Darkstalker about their alliance.
Near the end of the book, when Darkstalker is trying to convince Qibli to become an animus and work with him, he uses his power to teleport Vulture in front of him. Darkstalker then enchanted Vulture many times, including to make him act like a hatchling, make him feel guilt for everything bad he had done, and make him be the best grandfather for Qibli.
Quotes Edit
"Urple." -When Darkstalker enchanted Vulture to act like a hatchling.
"Oubliette. Ooooooooubliette. It sounds much friendlier than it is, like you should be able to eat it at parties."
"Everyone agrees they're no smarter than mice." -About scavengers.
"Qibli. Just the dragon I've been waiting for."
Trivia Edit
- In Darkness of Dragons, he says "Great snakes", which is a famous expression Tintin uses in his movie. (Tintin is a person from another book/movie series entirely, not a dragon)
- Each of Vulture's skull tattoos represents a dragon he's killed. This gruesome display was also taken up by two of his grandchildren, Rattlesnake and Sirocco. It is rumored they have the tattoos for the same purpose and not just for show and bragging rights.
- A vulture is a bird of prey that is known for eating rotting animals.
- Vulture is the name of Upper Egypt, as Cobra is the name of Lower Egypt.
Family Tree Edit
Gallery Edit
Present: Queen Thorn • Queen Oasis
Blaze • Blister • Burn • Char • Scald • Singe • Smolder • Sunny
|Jade Mountain
|Other Dragons
Addax • Agave • Armadillo • Camel • Capybara • Cobra • Dune • Horizon • Jerboa • Jerboa (DoD) • Kindle • Meerkat • Needle • Ocotillo • Ostrich (Deserter) • Palm • Parch • Prickle • Quicksand • Rattlesnake • Saguaro • Sandstorm • Sirocco • Six-Claws • Tawny • Torch • Viper • Vulture
Blaze's Fortress • Blister's Hideout • Great Five-Tail River • Possibility • Queen Oasis' Grave • Queen Thorn's Stronghold • Scorpion Den


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TO: ALL Boys over the age of 30I'm finally at the latter stage of my cold. The great news is that I'm almost fully recovered AND sound much better. I literally do sound better. Mainly, because this memorandum is to advise to you all that I have my sexy phlegm voice. Now is your chance to call me if you want to hear. If you hesitate now, your next chance will most likely be next Winter. Hurry soon before it's too late! This voice is only temporary. You know the number...so call NOW!
DATE: March 2, 2009
Warning: Please hang up if I start to yak a yucky cough. Remember, I'm still phlegmy.


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Future of Caregiving at the hands of Robots
Let's face it… Fewer people are having babies nowadays. I respect that, and honestly I completely understand why they are taking this decision. I am a mother of two and I love my children with all my heart; however it is no secret that they will be exposed to so many man-made atrocities. As parents, we do not want to see our children suffer which explains why, among many other reasons, young adults do not want to have any kids. It is inevitable though. The fewer children that are born the fastest we are going to run out of caregivers.
Disney movie Big Hero 6, recently winning an Oscar for Best Animated Feature Film, gives us an idea of what the future of caregiving will be (without the superheroes, flying, and adventurous parts of course) as Japan has presented their new caregiver prototype robot called: Robear. This cute guy features a sweet polar bear face with big round eyes. Robear is strong enough to carefully and easily lift and transfer elderly patients of those in need of the assistance to and from the bed, chair or bath. Robear has been designed to provide stability and strength to the patient as well as kindness and cleanliness.
"We voted for this design among options presented by our designer. We hope to commercialise the robot in the not-too distant future," Toshiharu Mukai, research leader, said.
Japan has always been reluctant in the topic of immigrations. This is another reason why it the need for robots to do hard physical work is growing more and more.
The same phenomenon is happening with the caregiving sector. The population of Japan keeps aging with less children to take on the task. Robear comes to fill in that vacancy. The creators of this friendly robot are hoping to improve and commercialize many like him in the next few years.


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ABSTRACT: Many individuals with advanced malignancy continue to suffer from pain and, consequently, impaired quality of life. The clinical scenarios in advanced cancer pain are complex, and successful management may require a more sophisticated and individualized approach than suggested by the World Health Organization guidelines. In patients referred to the Harry R. Horvitz Center for Palliative Medicine in Cleveland, numerous commonly occurring errors in opioid use have been noted. This article describes these errors and offers strategies with which to improve outcomes for patients suffering with cancer pain.
The classic approach to analgesia in cancer patients is both opioid and adjuvant medication prescribed in a stepladder fashion, as established by the World Health Organization (WHO). Since its inception, these guidelines have been validated and are now applied worldwide.[ 1] Given that over 80% of patients living with advanced cancer experience pain, it is one of the most common and severe problems in this population.[2,3] Oncologists must therefore be familiar with the effective use of analgesics. Many individuals with advanced malignant disease continue to suffer with pain and, consequently, impaired quality of life.[4-6] Why do those who complain of pain to their physician and receive treatment still suffer? In reviewing the literature and observing physician management decisions in patients referred to us in a tertiary care hospital, we have noted numerous gaps between theory and practice.[7]
In practice, clinical scenarios involving pain in advanced cancer are complex and require more sophisticated individualized approaches than those addressed by the WHO guidelines. Proper opioid management takes into account the quality and severity of pain as well as the time course-whether pain is constant, incident, or breakthrough in nature. Medically sound strategies for initiating opioids are based on the pharmacokinetic and pharmacodynamic properties of these agents, in addition to general prescribing principles.
Finding the right opioid for an individual requires trial and error. Reassessment for response may identify problems with the current opioid regimen. Even with dose titration, an opioid may not control the pain or cause persistent adverse effects. Assuming a sufficient trial of the original regimen has been attempted, this may require rotation to a new opioid or a new route of administration. To rotate opioids effectively, the physician must have an understanding of equianalgesic dosing for different opioids and routes. Appropriate prescribing, coupled with frequent reassessment and rotation if necessary, will provide effective analgesia for most patients with advanced cancer pain.
In patients referred to us for the management of cancer pain, we have recognized several commonly occurring errors in opioid use prior to the referral. As reported here, these observations are based on collective and collaborative clinical experience at our dedicated palliative medicine inpatient unit, as well as the inpatient and outpatient consulting services. The errors may be grouped into three categories: (1) errors in strategy, (2) errors in titration, and (3) errors in conversion.
In this article, we describe these errors, why each may occur, and the consequences. In accordance with the basic principles of opioid management that guide our practice, we also offer strategies to avoid these errors and improve outcomes for patients suffering with cancer pain. Morphine sulfate is the opioid of first choice in our practice.[3] For illustrative purposes in this report, we will use morphine sulfate as the model opioid.
Strategic Errors
Error #1: Rescue or As-Needed Prescribing for Constant Pain
Given constant pain, it is appropriate to start regular repeated doses of opioids. It is inadequate to leave a patient on rescue, or as-needed (prn), dosing alone. If only rescue dosing is employed, patients will be continuously trying to catch up with their pain. As a result, life revolves around not only the pain but also frequent medication. Rescue dosing for continuous pain at 3- to 4-hour intervals will also disturb sleep, as individuals will awaken during the night with pain and to take medication.
• Correction—This situation first requires a careful assessment of the temporal pain patterns. A general rule is that continuous pain needs continuous analgesia. This may be accomplished with (1) oral sustained-release (SR) medications, (2) transdermal medication, (3) parenteral continuous infusion, or (4) oral immediaterelease (IR) medications scheduled around-the-clock (ATC). The option of choice is an oral SR medication, which is easily prescribed in the outpatient setting.
If pain is severe, requiring rapid dose titration, then continuous parenteral (subcutaneous or intravenous) infusion- usually in the inpatient setting-is recommended to establish quick control. Although used less often since the development of SR opioids, regularly scheduled IR opioids are an alternative. A double-dose of the IR medication at bedtime is safe and can usually avoid the need to wake for dosing during sleep.
Error #2: Scheduled Prescribing Without Rescue Dosing
While continuous pain calls for ATC medication, pain levels vary. Breakthrough pain is an unpredictable exacerbation of baseline pain.[8-10] Failure to identify breakthrough pain causes inappropriate management. Individuals not given IR rescue opioids to take as needed may have significant pain before their next scheduled ATC dose. They will mistakenly believe their SR medication is ineffective. In response, physicians may increase SR dosing, producing adverse effects such as delirium, nausea, and sedation. Patients may also use or be given SR opioids to take as needed but, given the delayed analgesic onset, find them ineffective.
• Correction—Always prescribe a prn rescue opioid dose when initiating SR opioid therapy. The rescue dose should be an IR preparation, usually the same opioid as the sustained- release drug. SR medications should never be dosed prn. If rescue medication is required more than four times in 24 hours, the SR dose may be increased in an effort to prevent the breakthrough pain. An example of this process follows.
Mr. T. is taking 60 mg of SR morphine sulfate every 12 hours. He has required eight 15-mg doses of IR morphine for breakthrough pain, with good relief and no side effects. Over 24 hours, he used an additional 120 mg of IR morphine. His SR dose is increased by 120 mg, for a new total daily SR morphine dose of 240 mg, or 120 mg every 12 hours. Because his rescue dose has been effective, it is not changed.
Error #3: Not Using Prophylactic Rescue Dosing for Incident Pain
Incident pain is brought about by a specific action or event, which may be voluntary (moving, walking, eating) or involuntary (cough, defecation). Specific identification of incident pain is important, as it limits activity and creates a high probability of suboptimal pain control. Incident pain will not be effectively managed by SR medications alone, and oral rescue doses may not take effect rapidly enough for adequate control.
• Correction—As incident pain, by definition, is usually predictable, it is more effective to give rescue dosing before a known precipitating event. The rescue dose should be enough to control the incident pain and may often be larger than that required for breakthrough pain. Parenteral administration is sometimes needed for quick action. Buccal fentanyl (Actiq) is an alternative in this situation.[11,12]
Error #4: Use of Multiple Opioids and/or Formulations
We commonly encounter simultaneous use of both transdermal fentanyl (Duragesic) and SR morphine sulfate for continuous pain, and both IR oxycodone and IR morphine for breakthrough pain. That is, instead of titrating the initial SR opioid dose to pain relief, a second opioid was added. Multiple opioids complicate a regimen and risk confusing patients and caregivers. Usually neither medication is being given at adequate doses.
• Correction—Only one extendedrelease opioid should be used and increased until either adequate pain control or toxicity occurs. Whenever possible, the same opioid should be used for the IR dosing (ie, SR and IR morphine sulfate or SR and IR oxycodone). If a new opioid is required- for example, in the setting of unacceptable side effects-an equianalgesic dose of the new opioid is calculated. The original opioid is discontinued, and the new medication initiated and titrated until analgesia achieved.
Error #5: Not Prescribing Adjuvant Analgesics
The WHO guidelines recommend the addition of adjuvant analgesics at each step on the ladder if needed to achieve adequate analgesia, yet this is often not done. Common adjuvants include nonsteroidal anti-inflammatory drugs (NSAIDs), acetaminophen, tricyclic antidepressants, anticonvulsants, corticosteroids, and antiarrhythmics. Adjuvants may be particularly helpful for neuropathic pain, which is often incompletely controlled with opioids alone.
• Correction—The appropriate use of adjuvant analgesics requires a careful pain assessment. Typically, NSAIDs or corticosteroids are used in bone pain and antidepressants or anticonvulsants in neuropathic pain. Whether opioids or nonopioids are used as the primary analgesic, an adjuvant medication may contribute to improved pain control. If opioid toxicity occurs with titration, the addition of an adjuvant medication may improve pain control enough to allow an opioid dose reduction and elimination of the unacceptable side effect.
1. Ventafridda V, Tamburini M, Caraceni
A, et al: A validation study of the WHO method
for cancer pain relief. Cancer 59:850-856,
2. Daut RL, Cleeland CS: The prevalence
and severity of pain in cancer. Cancer 50:1913-
1918, 1982.
3. Donnelly S, Davis MP, Walsh D, et al:
Morphine in cancer pain management: A practical
guide. Support Care Cancer 10:13-35,
4. Ripamonti C, Dickerson ED: Strategies
for the treatment of cancer pain in the new
millennium. Drugs 61: 955-977, 2001.
5. Cleeland CS, Gonin R, Hatfield AK, et
al: Pain and its treatment in outpatients with
metastatic cancer. N Engl J Med 330:592-596,
6. Larue F, Colleau SM, Brasseur L, et al:
Multicentre study of cancer pain and its treatment
in France. BMJ 310:1034-1037, 1995.
7. Walsh D: Oral morphine in chronic pain.
Pain 18:1-11, 1984.
8. Portenoy RK, Payne D, Jacobsen P:
Breakthrough pain: Characteristics and impact
in patients with cancer pain. Pain 81:129-
134, 1999.
9. Bruera E, Macmillan K, Kuehn N, et al:
Circadian distribution of extra doses of narcotic
analgesics in patients with cancer pain:
A preliminary report. Pain 49:311-314, 1992.
10. Sarhill N, Walsh D, Davis MP: Intermittent
pain in advanced cancer: Incident and
breakthrough. Presented at the 7th Congress of
the European Association for Palliative Care
(EAPC); Palermo, Italy; April 2001.
11. Portenoy RK, Payne R, Coluzzi P, et al:
Oral transmucosal fentanyl citrate (OFTC) for
the treatment of breakthrough pain in cancer
patients; a controlled dose titration study. Pain
79:303-312, 1999.
12. Zeppetella G: Sublingual fentanyl citrate
for cancer-related breakthrough pain: A
pilot study. Palliat Med 15:323-328, 2001.
13. Walsh D: Pharmacological management
of cancer pain. Semin Oncol 27:45-63, 2000.
14. Jaffe JH: Opioid analgesics and antagonists,
in Gilman AG, Goodman LS, Rall TW, et
al (eds): Goodman and Gilman's The Pharmacological
Basis of Therapeutics, 7th ed, pp 494-
534. New York, Macmillan, 1985.
15. Davis M, Wilcock A: Modified release
opioids. Eur J Palliative Care 8:142-146,
16. Warfield CA: Controlled-release morphine
tablets in patients with chronic cancer
pain: A narrative review of controlled clinical
trials. Cancer 82:2299-2306, 1998.
17. Pereira J, Lawlor P, Vigano A, et al:
Equianalgesic dose ratios for opioids. A critical
review and proposals for long-term dosing.
J Pain Symptom Manage 22:672-687,
18. Indelicato RA, Portenoy RK: Opioid rotation
in the management of refractory cancer
pain. J Clin Oncol 20:348-352, 2002.
19. Cherny N, Ripamonti C, Pereira I, et al:
Strategies to manage adverse effects of oral
morphine: An evidence-based report. J Clin
Oncol 19:2542-554, 2001.


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Zoes Kitchen Greenville Sc Lovely Bojangles Spotlights Biscuits In New Prototype
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Sunday, September 07, 2008
Worlds colliding.
Back from the US of A. A long trip, with so many good things it is going to be hard to mention them all. We took stock in san francisco prior to aiming the rental barge to the marin headlands. With nick's cove as a base (in point reyes national park) we wandered, rode and sea kayaked ourselves into a state of relaxation, with the help of xcellent oysters, red wine and lagunitas IPA at the 'cove's rstaurant. The cabin we stayed in was amazing, with several shower heads and a seat in the shower wet room, and a bed which would keep a princess happy.
All too soon, it was time to head to napa for the singlespeed worlds. No doubt there will be acres of words dedicated to a fine event orchestrated by curtis inglis. The course was hard, the sun hot, the dust thick and the beer flowing. We stayed in a motel with the aussies, canadians, and some of the brits. A great and relatively chilled time was had.
At the compo for next years race, max pulled it out the bag for durango, so im off to order a hyperbaric tent...
3 comments:
no need for a hyperbaric tent!!
Just hold your breath for a minute at maximum exertion every training ride a time or two. This beautifully simulates the gasping for air etc.
oh wait. You're gonna try to up yr hematocrit?
One word: EPO.
SO much easier! And: the maker sponsors the Tour of California!!
- adjustablecrumpet said...
heh - i'm just planning on going a month early. ctr, anyone? ;o)
- dRjON said...
the ctr sounds proper hard....you'll love it jenn!
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Chronic Illness Awareness Svg #spoonie Svg Spoonique AF Svg Invisible Illness Svg Spoonie Support Svg Autoimmune Disease T-Shirt Unique AF To Show You CARE!More Spoonie Items in the Bundle:https://www.etsystudio.com/listing/605963513/awareness-svg-files-bundle-chronicAll proceeds go on charity in my local community. Support Each Other! Be Brave & Be Kind!All the Items in this section include Commercial Use License, so you can make a stickers to sale on Donation and Charity Events For your Local CI Awareness Organization.I do it because I fight Rheumatoid Poly-arthritis. You have my hand, the hand of a spoonie warrior for years.PLEASE NOTE!This item is a digital file ONLY - NO physical product. NO shipping provided.Please note it before you place an order.Browse other nice fonts and frames here in my store OR feel free to inquire about a custom design for your crafts and ideas.♥♥♥♥♥♥♥♥♥♥♥♥♥♥♥♥♥♥♥♥♥♥♥♥♥♥♥♥♥♥♥♥♥♥♥♥♥♥♥♥♥♥♥♥♥♥♥♥♥♥♥♥♥♥FORMATS AND COMPATIBILITY♥♥♥♥♥♥♥♥♥♥♥♥♥♥♥♥♥♥♥♥♥♥♥♥♥♥♥♥♥♥♥♥♥♥♥♥♥♥♥♥♥♥♥♥♥♥♥♥♥♥♥♥♥♥SVG DXF EPS PDF PNG JPG compatible with all kinds of graphic editing software and printing devices (Silhouette Studio, Adobe Illustrator, CorelDraw, Cricut Explore, SCAL, electronic cutting machines, vinyl cutters, portrait achines, screen-printing or die cut machines).♥♥♥♥♥♥♥♥♥♥♥♥♥♥♥♥♥♥♥♥♥♥♥♥♥♥♥♥♥♥♥♥♥♥♥♥♥♥♥♥♥♥♥♥♥♥♥♥♥♥♥♥♥♥POSSIBLE WAYS OF USE♥♥♥♥♥♥♥♥♥♥♥♥♥♥♥♥♥♥♥♥♥♥♥♥♥♥♥♥♥♥♥♥♥♥♥♥♥♥♥♥♥♥♥♥♥♥♥♥♥♥♥♥♥♥- CUTTING on any materials you have (in accordance with the features of your cutting machine). Filesready for laser cutting, vinyl cutting, programmed milling cutting etc.- REGULAR OR HEAT TRANSFER- SCREEN PRINTINGPhotos are provided in the EXAMPLES OF USE section. ♥♥♥♥♥♥♥♥♥♥♥♥♥♥♥♥♥♥♥♥♥♥♥♥♥♥♥♥♥♥♥♥♥♥♥♥♥♥♥♥♥♥♥♥♥♥♥♥♥♥♥♥♥♥COPYRIGHT♥♥♥♥♥♥♥♥♥♥♥♥♥♥♥♥♥♥♥♥♥♥♥♥♥♥♥♥♥♥♥♥♥♥♥♥♥♥♥♥♥♥♥♥♥♥♥♥♥♥♥♥♥♥These files are for personal and small business commercial use only, i.e. it is prohibited to re-sell, re-package, re-distribute or share them in any way. You may not claim any items in this zip folder as your own.♥♥♥♥♥♥♥♥♥♥♥♥♥♥♥♥♥♥♥♥♥♥♥♥♥♥♥♥♥♥♥♥♥♥♥♥♥♥♥♥♥♥♥♥♥♥♥♥♥♥♥♥♥♥REFUND♥♥♥♥♥♥♥♥♥♥♥♥♥♥♥♥♥♥♥♥♥♥♥♥♥♥♥♥♥♥♥♥♥♥♥♥♥♥♥♥♥♥♥♥♥♥♥♥♥♥♥♥♥♥PLEASE NOTE: I offer no refunds due to the digital nature of the product.Please do not hesitate to contact me with any problems you or questions you might have while purchasing or using these files.Cheers!


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UPS Capital makes international supply chains work for businesses like yours. From loans secured by foreign-based inventory, to risk reduction and fast conversion of payments into cash, we have the willingness and expertise to work with any size business engaged in international trade.
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UPS Capital Business Credit is located at 425 Day Hill Rd, Windsor, CT. This business specializes in Legal & Financial.
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Cruel Logic – The Evolutionary Right to Kill
Posted by Mats on 20/02/2009
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NETHERLANDS ISSUE 661 Sep 2017
Blupace Amsterdam photographers
Blu and Pace are two digital nomads who have been exploring, documenting and gaining inspiration from different cultures around the globe since 2007.
Their photographic style is a minimalistic blend of documentary photography with fashion and portraiture - a perspective which allows them to produce bodies of work with an underlining social message.
Blupace Photography provides an array of photographic services to clients within the fashion, art, documentary, editorial and travel industries, specialising in producing bespoke bodies of work on location within Europe, Asia and the Americas.
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Matt Adams
Matt Adams – Character – Perseverance
Ask For Rain 2016
Friday Evening – Kayle Mumby
AFR 2016 – Friday Evening – Kayle Mumby
Saturday Morning – Christelle Baldovinos
AFR 2016 – Saturday Morning – Christelle Baldovinos
Saturday Evening – Antonio Baldovinos
AFR 2016 – Saturday Evening – Antonio Baldovinos
Sunday Morning – Antonio & Christelle Baldovinos
AFR 2016 – Sunday Morning – Antonio & Christelle Baldovinos
Foundations of Christian Character – Honesty & Integrity
That was the sermon topic for this past Sunday. If you were unable to be with us at Celebration on Sunday I would encourage you to listen to the sermon on our website. The story of Daniel is so fascinating and true. Find your bible and read Daniel 6 today.
As you are reading it, ask the Holy Spirit to guide you into what the scripture passage is saying. The main thrust of Daniel 6 for Sunday's story is how much Daniel's integrity spoke to King Darius. The King of one of the largest empires to ever exist on earth is completely drawn into the life of one of his captives. Read each verse that speaks about Daniel's interaction with King Darius a few times. Daniel was a child of God that lived out his life before a king, but always lived his live fully for the King of Kings.
Honesty is stating something we truly believe.
Integrity is living what we truly believe.
'Integrity is the glue that holds our way of life together. We must constantly strive to keep our integrity intact. When wealth is lost, nothing is lost; when health is lost, something is lost; when character is lost, all is lost.'
-Billy Graham
'Image is what people think we are: integrity is what we really are.'
-John Maxwell
'Integrity is doing the right thing, even when no one is watching.'
-C.S. Lewis
How will we live our lives today when we know that God is the only one watching?
In the words of Red Green – 'Remember we are all in this together.'
Your fellow brother in Christ,
Cory Illingworth
Character – Integrity
Cory Illingworth
Cory Illingworth – Character – Honesty/Integrity
Due to technical difficulty, week 1 of the Character series – "Forgiveness" – was not recorded.
First of all I want to thank everyone that expressed how much they appreciated the message on the weekend. It was different this time. Most weekends there are people that say thanks for sharing a good message, but this weekend there was a genuine expression from many people indicating why this sermon was important to them. There has been Facebook messages, emails, text messages and actual, real, face-to-face words of gratitude.
I mention this because I struggled all week with this message. Not with the content or the imagery, but with the structure and form of delivery. You see, I tend to be a people pleaser. It's a blessing and a hinderance. One of the struggles I had was how blunt to be with the need (commandment) to forgive others, and how firm to be with recognizing the struggle some of us (me included) have with receiving forgiveness for ourselves. So the struggle was between God and me. His word and His commands over my desire to present a message that was easy to hear and didn't make me feel like I was, well, preaching. It sounds like God won. Nice. Because when that happens we all win.
The other struggle I had was what aspects of forgiveness to cover and how deep to go. As we talk about foundational aspects of Christian character the subjects we are discussing are not superficial. They are not subjects that can be fully unpacked in a morning message. In most cases, we will all want to spend some time, on our own, discussing them with God. Some aspects of character you may have already worked out. Others aspects God may want to work on with you. But, what He wants to work on in my life may be different than what He wants to work on in your life.
That's why your personal time, alone with God, is so vitally important. Let Him work with you on character. Let Him remind you how much He loves you. And let Him encourage you as you become more like Him. To help, I've included below a few scriptures and also a couple of books – either completely dedicated to the concept of forgiveness, or that have sections in them related to forgiveness. I encourage you to pray through the scriptures, and if God leads you, pick-up a book and it read prayerfully.
God Loves You. Love Yourself. Pass It On.
Fred Hill
February 22, 2016
Scriptures related to forgiveness:
1 John 1:8-9 – He is faithful and just to forgive us.
Leviticus 26:13 – Walk with your head held high.
1 Chronicles 21:8 – Confession and repentance are key aspects of forgiveness
2 Chronicles 7:14 – A great model of forgiveness in action: Move from Pride to Humility. Move from confession to repentance. Move from forgiveness to restoration.
Psalm 51:1-7 – my rebellion haunts me day and night
Psalm 32 – How great is the life of the forgiven.
John 8:11 – Christ does not condemn you.
Luke 23:34 – Father forgive them, for they don't know what they are doing.
Acts 2:14 "Then Peter stepped forward…" Peter moved from denying Christ, to being forgiven by Christ, to be used by Christ.
Matthew 6:9-15 – The Lord's Prayer – Forgive us as we forgive others
Mark 12:25 – When you are praying… forgive anyone you hold a grudge against
Matthew 18:21 – How often should I forgive?
Matthew 5:43-48 – Love your enemies … act as children of God.
1 John 2:2 – He is the sacrifice for the sins of the whole world.
Romans 12:17-21 – Bless those that curse you.
2 Samuel 12:14 – Forgiveness does not eliminate the consequences of sin.
Ephesians 4:30-32 – Forgive one-another …God has forgiven you
The Peace Maker, Ken Sandee, Baker Books, Jan 1, 2004
Bold Love, Dan B. Alexander and Tremper Longman, NavPress, 1992
The Book of Forgiving, Desmond Tutu and Mpho Tutu, HarperOne, 2014
Rising Strong, Brené Brown, Spiegel & Grau, 2015
The Supernatural Power of Forgiveness, Kris & Jason Vallotton, Regal, 2011
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text: tag:blogger.com,1999:blog-8033507129556624427.post663496420257555728..comments2018-04-16T06:08:40.668-04:00Comments on life from here: a letter to the churchKarrie Shew email@example.com:blogger.com,1999:blog-8033507129556624427.post-56629266215471810862013-10-29T13:07:28.099-04:002013-10-29T13:07:28.099-04:00This is my favorite quote -- so powerful and convi...This is my favorite quote -- so powerful and convicting: "Stop looking in the bible for your answers and start living your life with the Bible as the answer." You can preach His Word, girl!Jen Fergusonhttps://firstname.lastname@example.com:blogger.com,1999:blog-8033507129556624427.post-66125866506591276822013-10-29T09:03:07.126-04:002013-10-29T09:03:07.126-04:00We have developed a dangerous view of the church a...We have developed a dangerous view of the church as our country club, a place to gather and socialize, rather than His house of worship. I fear that many who believe that they are doing enough by just showing up will have a sad day of reckoning. Staciehttps://firstname.lastname@example.com:blogger.com,1999:blog-8033507129556624427.post-2210255479952433332013-10-28T18:38:52.945-04:002013-10-28T18:38:52.945-04:00"Because that is where we fail, when we make ..."Because that is where we fail, when we make it about us and not about Him." amen, sister.Kendal Privettehttps://email@example.com


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Monday, July 11, 2016
Blueberry Buckle
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Would like suggestions from people who have had both and which they liked better and why. Confused on which way to go.
Would like suggestions from people who have had both and which they liked better and why. Confused on which way to go.
Effectively they are the same. You either have to add the chlorine manually every day or the SWG "makes" the chlorine from the salt in the water. The SWG is usually a little less work as you are not having to haul bleach, and easier to go on vacation, but costs more upfront. Although in the long term the costs are pretty comparable either way.
Jason, TFP Moderator
18k IG pebblesheen pool, Hayward ProLogic P4 w/ T-15 SWG, Pentair 1HP 2-speed Superflo, Hayward 6020 DE filter
500 sqft Heliocol solar panels, ThePoolCleaner, TF-100 test kit w/ SpeedStir
Pool School + Test Kit + PoolMath = A TROUBLE FREE POOL
If you found TFP helpful and we saved you money ... Become a TFP Supporter!
Unless there's a specific reason in your scenario not to get a SWCG, get one! A valid reason might be using a very soft stone for coping.
18'x38' Rectangle (3'-8 1/2' deep w/ diving board) - 27K gal. w/ gray plaster
Hayward equipment (cartridge filter, 2-speed pump, SWCG, automation) View Our Build
Coverstar automatic pool cover | StoneMakers concrete retaining wall and decking | Merlin SmartMesh winter safety cover
Spring 2013 Build | Dolphin Active 20 robot cleaner | Support TFP!
I agree with Jason above. I imagine the costs equal each other in the long run. I love having an SWG So I don't have to test and dose daily. With the SWG, once I get my balance in the summer I can pretty much count on weekly testing and adjusting SWG with summer sun and heat. With my pool not being right out the back door and a 1/2 story below the house and down a walkway and then through the fence........I'd fail at daily testing and dosing until I could train the kids.
18*36*23 true "L" vinyl IG 29,000 gallons. SWG. TF-100 test kit.
18'x38' Rectangle (3'-8 1/2' deep w/ diving board) - 27K gal. w/ gray plaster
Hayward equipment (cartridge filter, 2-speed pump, SWCG, automation) View Our Build
Coverstar automatic pool cover | StoneMakers concrete retaining wall and decking | Merlin SmartMesh winter safety cover
Spring 2013 Build | Dolphin Active 20 robot cleaner | Support TFP!
This is my .02 but I have a friend that builds 160 to 180 pools a yr and now days he builds 30% SWG. 10 yrs ago it was the other way around he said. He also owns a reg chlorine pool for his own reasons.
Uh-oh, that is a lot of upcoming swampy pool threads with high CYA.
The problem is everyone thinks they can use pucks to chlorinate their pool. Easy just throw pucks in the chlorinator every now and then. And the CYA builds up week by week until it is 100+ and the pool turns green because there is not enough chlorine for the CYA level.
You'll not find many (any?) people here with saltwater pools who are unhappy with saltwater. There are also quite a few liquid chlorine/bleach users, some who dose manually and some with Stenner or Liquidator automatic chlorine dosing systems. They all seem happy too, with the occasional grumble about having to buy and haul LC and pour it into their dosing tank.
TFP Moderator
If TFP helped you or saved you money - Become a TFP Supporter! <--Click here
2012 build and pics, 20k gal gunite, black onyx pebblesheen, OK flagstone, IntellifoVS, cart filter w/Pleatco, IC40 SWG, Solartouch, 5 12'x4' solar panels, HP50HA heat pump, 8mil solar cover, borates, TF-100 test kit, SONOS, Doheny's Discovery Robot, hot tub on bleach
I also debated between chlorine and SWG. After the first month when I could not use salt with a new pool and chemicals were crazy, I couldn't have been more happy to switch over to the salt. The only time I have had to mess with chlorine pucks was when my SWG had died (it does have a life span)...and during the winter when pool temps get below mid 50's.
Love my SWG!
28,000 IG, gunite, IntelliChlor IC40 SWG with SPA,
Intellichlor/VS Pentair
Norman, OK
Will NEVER go back to a chlorine pool. My vote is for SWG hands down! My experience has been with smaller pools but even there I upgraded filters and pumps and messed with chemicals everyday. My last SWG pool was crystal clear and properly balanced the entire time. I just checked chemical levels to confirm what I already knew... it was perfect! Very little effort to keep balanced water once you have the SWG dialed in. We break ground this week on new IG pool - there was no question it was going to be salt.
2015 Pool Build --> HERE IG 19'x47' w/ 7'x7' in pool spa; 3'6"-8' deep.
Pentair 520 Filter, IntelliFlow VS XF Pump, IntelliChlor IC60 SWG, IntelliBrite/GloBrite LEDs, IntelliTouch w/Screenlogic2. 400K BTU heater. A&A G4V in-floor cleaning system. WetEdge Prism Matrix Pebble finish. TechoBloc Pavers and Coping.
Test kits - Taylor K-2006 FAS/DPD, K-1766 Salt, SpeedStir
36 x 16 IG, SWG, FAFCO Solar Heating System, WetEdge Primera Stone Sky Blue Treasure, 8.5' - 3.5' depth, 6' S.R. Smith Flyte-Deck II Dive Stand, Interfab X-Stream slide, 27k gallons, doggy tanning ledge w/ 2 bubblers, 2.75 Hayward Tristar pump, Hayward 425 cart filter, Hayward T-15 Salt Cell, Hayward ColorLogic 4.0 light, Dolphin Z5
We have had both and I would not go without a SWG again. It makes life much much easier in my opinion.
18k: IG: Black Granite Liner: Aspen: 16x33.5: SWG: Polaris 280
My pool build new-pool-build-in-nh-t60957.html
Interesting read:
Salt water systems corrode the pool equipment.
The Facts - The salt itself has issues of attacking the cement in the plaster and deck materials. This is a relatively slow process when the salt levels are low. The salt also can kill any landscaping in or around the pool as well as in the backwash area.
If the sodium hypochlorite levels are too high, the corrosion is caused by the chlorine being produced by the electrolytic cell. Chlorine can bleach the test reagents, giving you a "false negative", and people can grossly over-chlorinate their pool damaging equipment, the pool surface, lighting fixtures, and ladders. Over time the salt will attack any area the water evaporates at.
A common problem is corrosion at the ladder. The deck anchors are usually cast aluminum and the ladder should be stainless steel. The salt water will corrode the anchors overtime and a "safety event" will be pending.
Buyers should be aware that if you have salt water above 2800 ppm, (often 4000 to 5000 ppm), you will need to reseal your coping every year, especially if it is a porous stone like limestone or travertine. Otherwise, the salt will dry and start to etch the coping. Besides sealing the stone, it is also advisable and an added precaution to hose down the coping at the end of any swim day with fresh water. Although the salt water in the pool may not be corrosive at levels of 3000-3500 ppm, when that water hits the coping and evaporates, it leaves pure salt behind. The pure salt is corrosive and is the main cause of the corroding coping. Most autocover manufacturers now void their track warranty if a salt system is used.
Some pool builders are now refusing to build any salt water pools with cream limestone or taupe coping. Any customer that wants either coping for a salt water rock or gunnite pool must usually sign a release form. Pool builders have said that they have had to replace a significant amount of both these types of coping this past year. Cantilever designs simply disappear as the stone dissolves away.
Salt water systems require chemicals almost every week.
The obvious weekly use of muriatic acid is combined with the not so obvious need to use cyanuric acid to guarantee your salt chlorine generator can achieve 1-3 ppm chlorine residual in your pool. Since salt water pools produce chlorine, the sanitizing effectiveness of the system is impacted by changes in temperature, bather load, sunlight and rainfall. CYANIDE based, the CYANURIC acid is euphemistically referred to as conditioner or stabilizer and must be maintained between 35 and 85 ppm. Stabilized levels over 100 are harmful to children, pets, older swimmers, the pool itself and of course the environment.
Occasional algaecide, clarifier, stain and scale control and shock will be needed with a salt chlorine pool (maybe slightly more than a stabilized "puck" pool) and only the handling of the solid chlorine is avoided. Numerous other sanitation devices will cut overall chemical use, a salt system may not.
Salt water systems require cell replacement every 2 to 3 years at a cost of $500-$800.
With over 40 manufacturers in the salt water generator business the cell warranty ranges from 1 to 3 years and the replacement costs are from $500 self-installed to $800 installed by a dealer. Assuming the owner gets to the fourth year with the cell, salt can be one of the most expensive methods to sanitize the pool. If the cell does not make it through the third year, salt becomes the most expensive system in terms of operating cost.
You must worry about the pH with a salt system and do regular maintenance or you will destroy the pool and have zero recourse.
The Fact - When the pH and alkalinity get out of balance, the chlorine is much less effective. The pH should be 7.4-7.6. Chlorinating with a salt water chlorinator is similar to chlorinating with liquid chlorine-- they both have a high pH (11.7). One common problem is that homeowners tend not to test their pools' pH and alkalinity enough. Unfortunately, too many builders and retailers sell these systems as a "set it and forget it" solution. Most people with salt systems will run their pH from 7.8-8.0. This is bad for two reasons: 1) the pool is in a scaling mode, and 2) the chlorine is locked up by the basisity of the higher pH. It is best to run between 7.4-7.6 when using chlorine. Lack of pH management can ruin the cell in less than 90 days, scaling up the swimming pool as well as the cell. "Improper chemical use" will void any warranty, a system employed by portable spa manufacturers on delaminated shells and first year heater failure.
Salt systems are more harmful to human health than conventional chlorine, bromine or bioguanide chemicals.
With a salt system your skin will absorb sodium, salt, AND chlorine, versus just the halogen with a chemical sanitizer such as chlorine or bromine. Sodium absorption through the skin has long been known to present health risks at levels far below the 3000-5000 ppm levels salt chlorine generators require. For nearly 20 years people with high blood pressure, stroke history or other circulatory system issues have been asked to stop using their water softeners (at 200-400 ppm sodium in the water for just ten minutes in the shower) to avoid the heart mortality risks. The chlorine level and skin absorption of the chlorine is still based on the same 1-3 ppm chlorine residuals found, dioxin forms (as do chloramines) and the backwash water contains 3000 ppm or more chlorides.
Salt systems are damaging to the environment and have been banned on all pools in areas such as Los Angeles County.
While the "Ban the Brine" movement may have not picked up much steam in recent years, individual counties banning chloride discharge such as Livingston County, Michigan or specific bans on salt water chlorine generators in Los Angeles County, California have gotten regional attention. Those existing Los Angeles area salt water generators when the ordinance was passed are NOT "grandfathered" in.
One size does not fit all and salt generators use both high voltage AND high amperage outputs.
The Facts - It is essential when selecting a salt chlorinator to oversize the unit for your pool. You are better off having a chlorinator too large for your pool, one that is undersized is a complete waste of money. A chlorinator too large can be turned back or run for less time each day, making the cell last longer. A unit too small will mean algae problems later on if you don't run it for longer periods each day or add extra chlorine on a regular basis. The high amperage output of the cell will add between 500 to 1000 watts per day or 1.0 KW to 1.5 KW to your electric demand and monthly bill, at .11¢ per watt, this is $5 to $11 every month. Electric rates range from .11¢ to .19¢ per KW and will not likely decrease in price.
There is no maintenance on a salt water pool.
Fact - All salt water generator cells require cleaning every 90 days. This must be carried out before the calcium build up within the cell housing becomes one big block. If not cleaned for six months, four expensive things occur, (even with the unit turned off the scale still forms):
•The cell housing breaks when you attempt to clean it.
•The cell life shortens as the high voltage/amperage cannot penetrate the scale on the plates.
•The pool becomes a swamp when the cell scales up.
•The electronic box blows - due to scale on the cell or salt ppm above 5000 in the pool.
It is also very important to watch the salt level in the pool. A low salt level (less than 2000 ppm) will cause oxygen production and damage the platinum group metals on the cell anode, therefore, shortening the life of the cell. It is recommended that you try to keep the salt level at the higher end of the manufacturer's scale, for your specific model.
With a salt water pool, the owner MUST maintain a proper pH or the pool will scale, stain brown and destroy the cell. Also cyanuric acid levels must be maintained or the chlorine will quickly dissipate out of the pool.
Before you buy a device and throw 200 to 500lbs of salt in your pool, remember an old term - "Salting the Earth", 2000 years ago mankind knew bette
Paris, where did you get that information? You should always cite your source.
And now that I have started reading it ... there is SO much bad information there.
Edit2: and as I keep reading. Nearly every statement is wrong.
Jason, TFP Moderator
18k IG pebblesheen pool, Hayward ProLogic P4 w/ T-15 SWG, Pentair 1HP 2-speed Superflo, Hayward 6020 DE filter
500 sqft Heliocol solar panels, ThePoolCleaner, TF-100 test kit w/ SpeedStir
Pool School + Test Kit + PoolMath = A TROUBLE FREE POOL
If you found TFP helpful and we saved you money ... Become a TFP Supporter!
There are so many SWG people on this forum it's nice to see the other point of view. I am just about to start my pool build and we are going straight chlorine due to large amount of moss rock and flagstone coping.
That post contains blatant misrepresentations. It is so pathetic it almost comes across as a bad attempt at humor?
16x24 shotcrete pool with plaster; ~ 11,000 gallons; Hayward MaxFlo XL 1 hp pump; Hayward Pro-Series Top Mount Sand Filter; Hayward Turbocell SWG; Hayward ColorLogic LED light; Hayward AquaPlus Automation Panel; TF 100 Kit
Hello Mod -
Look it up online. It's public knowledge. Don't quote me on it but I do research things every now an then.
I am happy for whoever builds whatever. I just see +'s and -'s on both sides of the fence.
Glad to see responses to that post. We have heard a few negative things about it being hard on equipment but if there were serious health conditions it wouldn't be allowed I'm sure.
Jason, TFP Moderator
18k IG pebblesheen pool, Hayward ProLogic P4 w/ T-15 SWG, Pentair 1HP 2-speed Superflo, Hayward 6020 DE filter
500 sqft Heliocol solar panels, ThePoolCleaner, TF-100 test kit w/ SpeedStir
Pool School + Test Kit + PoolMath = A TROUBLE FREE POOL
If you found TFP helpful and we saved you money ... Become a TFP Supporter!
Paris, do you think you are the first person to copy and paste directly from that ECOsmart page? The problem is that on their page it can be disected as the (factually flawed) sales literature it is. Posting it here without a source and writing "interesting read" is usually a way to try to make it sound like it is coming from an impartial 3rd party. It is not, it was written by a company trying to sell a product and should be viewed as such.
As with all sales literature, it must be taken with a grain of salt. Pun intended.
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JD - 28' Round Above Ground Pool, 17,000 Gallons.
Dual speed Jacuzzi pump with cartridge filter.Dual speed 1 HP pump, Hayward S210T sand filter
Pool School - PoolMath - HIGHLY Recommended Test Kits


text:
But is it really cool.
Maybe I am the only person that hasn't seen this...
Monday, June 25, 2012
But is it really cool.
4 comments:
that was awesome! but i have to admit it kinda freaked out when i saw the piano dropping : /ReplyDelete
so cool! i want to build something like that right now. i don't know how successful i would be though ha ha.ReplyDelete
I could watch that over and over. So cool!ReplyDelete
I could probably set up a short row of dominoes... but that's about all I could figure out...ReplyDelete
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