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Knoxville has 173,890 residents. It is located in Knox county.
For Tennessee residents, the average tuition for all Knoxville advertising schools for the 2009 - 2010 school year was $10,270.00. For non-residents, the average tuition for Knoxville advertising schools was $14,170.00.
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|Average Salary
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Did you hear that? That was the collective sound of TV fans across the country all brain-farting in unison. 'Lost' is back for its final season and I've gotta be honest -- I'm not really sure what to think about 'LA X.' In four or five months time, once the series has concluded, I'm positive I'll think differently about it. However, right now, 'LA X' was easily one of the most confusing hours of 'Lost' yet, and despite ABC's promos promising that "questions would be answered," all it gave us was a jumbo-jet (literally) chock full of new ones. Whatever ... I still loved every second of it.
We last left our favorite Losties as Juliet finally got Jughead to explode. The big question coming into the final season was whether or not the explosion would be the key to resetting events and allowing Oceanic 815 to land safely at LAX on 9/22/04. Well, we got our answer... sort of. The two hour premiere was split into two distinct threads, and as most fans predicted, one of them appears to be an alternate reality. (Lostpedia has already wisely dubbed this a "flashsideways.")
We saw events unfold on the island post-Jughead with no effects and we saw events on Oceanic 815 post-Jughead, but pre-island, with lots of changes. Of course, the question at this point is which side of the story is real? Did Jughead do what Faraday said it would? For argument's sake, and until we get some real answers, let's assume that the world in which Oceanic 815 lands safely is the alternate reality.
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Lincolnshire based Solicitors Sills & Betteridge are one of the leading law practices in the East Midlands. I produced marketing collateral for their flagship project Moving Forward Lincolnshire. This included branding, video production and print work.
As part of their moving forward campaign, Sills & Betteridge required a video covering the different areas of expertise within the firm. This video is made available on the Sills & Betteridge website, along with in DVD format and included in their information packs.


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Hotfrog Canada provides information regarding The Source in Cote Saint-Luc QC. The Source is located at 5800 Blvd Cavendish, Cote Saint-Luc QC and provides Retail services. Contact them on (514) 487-1853 or by visiting them on their website http://www.thesource.ca/.
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Students read a case study and debate the pros and cons of a Marine Protected Area (MPA) in the region. Then they select a Marine Protected Area and develop and present a management plan for it.
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rosieMy creepy wounded hand - holding ear plugs - at JINGLE BALL #mamasold
- joedrakenycHysterical
- canela__e@rosie What happened to your hand?
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- waytoocloseIs that from when you had the staph infection loooong ago @rosie?
- tonebutchHa.. loud much? ;)
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- shy_gyrlMan I can't believe how much damage you sustained from that fishing hook then staph infection. I was so afraid we were going to lose you or that you would lose your hand!!! I could have been so much worse. Tres cool ear plugs by the way.
- shy_gyrlIt could have been... Tired eyes.
- rosiesmomsuGetting old sucks 😦
- chrisclark182Wounded but alive. Stay strong. ✋✊✌👋👍👌
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- spedspedding@rosie I always steal about fifty of these got rehearsals at big shows. Hahaha
- allysonjaneHaha :)
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Five teachers recognized with 2016 Outstanding Teaching Awards
Please join us in congratulating the winners of this year's Outstanding Teaching Awards...
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Ph.D., University of Massachusetts-Amherst
M/W/R 11:45-1:00 and by appointment 445 LA
Sarah Finn is assistant teaching professor in the English department's Writing Program at Northeastern. She holds a B.A. in philosophy from Tufts University, where she began teaching and mentoring first-year students. She received an M.A. in English and a Ph.D. in composition and rhetoric studies from the University of Massachusetts at Amherst. Her research focuses on affect, social justice pedagogies, and the interconnections of student activism and classroom writing processes. Her work has been published in the Gustavus Myers Center for the Study of Bigotry and Human Rights: Multi-Diversity Myers Book Commentary, and she has also written and researched for an array of legal, governmental, and nonprofit groups. Sarah received the Walker Gibson Prize for best essay in composition and rhetoric from the UMass Amherst Department of English. She also received the Residential First-Year Experience Student Choice Award from UMass Amherst students for her teaching of first year writing.


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With Poor Immigrants to America
By (author) Stephen Graham
Format: Hardback
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With Poor Immigrants to America by Stephen Graham
Book DescriptionAn Englishman tries to experience the immigration process the way the poor of Russia and Europe do, traveling from NYC to Chicago (often on foot).
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Book DetailsISBN: 9781429005623
(236mm x 165mm x 31mm)
Imprint: Applewood Books
Publisher: Applewood Books
Publish Date: 1-Jan-2007
Country of Publication: United States
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Books By Author Stephen Graham
Vertical, Hardback (September 2016)
A revolutionary reimagining of the cities we live in, the air above us, and what goes on in the earth beneath our feet
Cities Under Siege, Paperback (November 2011)
How cities have become the new sites for military focus.
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The weather is starting to cool off, we officially have our first snow, and that means our winter tune up special is back! Bring us your bike and we will keep you rolling smoothly through the winter or get you ready to ride for next season. All services include a bike wash and protective polish!
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All business sales enquiries come directly to you, the business owner. You co-ordinate the sale of your business from handling enquiries, qualifying prospective buyers, conducting inspections, negotiating price and dealing with solicitors and accountants relating to contract requirements . This is specifically suited to a business owner/s who have the time and skills to manage the sale project, also suited to smaller businesses (up to $100,000 sales price) who do not need the additional se
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NaNoWriMo, PiBoIdMo and NaBloPoMo
Try saying the above three times (very quickly) after three glasses of wine. For all you Wrimos, whether you are a novel writer, children's picture book writer or blogger, there is something for everyone in November. NaNoWriMo The insanity of … Continue reading
Posted in All my posts, Art and writing events, Helen Ross writer, Helen Ross writes, NaBloPoMo, NaNoWriMo, National Blog Posting Month, National Novel Writing Month, PiBoldMo, Picture Book Month, Picture Book Writing Challenge Tagged NaBloPoMo, NaNoWriMo, National Blog Posting Month, National Novel Writing Month, PiBoIdMo, Picture Book Idea Month, Wrimos, Yeah Write 1 Comment


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Delaney & Bonnie On Tour with Eric Clapton (Live)
53 ratings
|List Price:
|You Save:
|$1.70 (10% Off)
Available: Usually ships in 1-3 business days
Format: CD
sku: ATCO 33326
Brand New
CD Details
- Released: February 1, 1992
- Originally Released: 1989
- Label: Atco
Entertainment Reviews:
Rolling Stone - 7/9/70, p.39"...Delaney & Bonnie & Friends with Eric Clapton put on a show that was a beautiful hybrid of southern funk and British rock..."
Mojo (Publisher) - p.1144 stars out of 5 -- "ON TOUR WITH ERIC CLAPTON remains one of the two Rosetta Stones of roots rock'n'roll."
- 1.Things Get Better
- 2.Poor Elijah-Tribute To Robert Johnson: Poor Elijah / Tribute
- 3.Only You Know And I Know
- 4.I Don't Want To Discuss It
- 5.That's What My Man Is For
- 6.The Where There's A Willre's A Way
- 7.Coming Home
- 8.Little Richard Medley: Tutti-Frutti / The Girl Can't Help It / Long Tall Sally / Jenny Jenny
Product Description:
Personnel: Delaney Bramlett (vocals, guitar); Bobby Whitlock (vocals, organ, keyboards); Rita Coolidge, Bonnie Bramlett (vocals); Dave Mason, Eric Clapton (guitar); Bobby Keys (saxophone); Jim Price (trumpet, trombone, horns); Jim Gordon (drums); Tex Johnson (congas, bongos).
Audio Mixer: Bill Halverson.
Recording information: England.
Photographers: Tom Wilkes ; Barry Feinstein.
Arranger: Delaney Bramlett.
In the late 60s and early '70s, Delaney and Bonnie Bramlett played a vibrant, country-tinged blues-rock that also owed a heavy debt to gritty Memphis R&B (it is no coincidence that their first album was released on Stax Records). And while their singing and playing were consistently top-notch, their profile was not weakened by their association with Eric Clapton, who toured with them between his stint in Blind Faith and the formation of Derek and the Dominos. In fact, when considering Clapton's musical evolution, it seems clear that the rootsy, downhome vibe of Delaney & Bonnie was a direct influence on the direction of his solo career.
This excellent live set showcases Delaney & Bonnie's superb vocal performances (note Bonnie's gospel-drenched take on "That's What My Man Is For"), and Clapton's superior playing. Whether on driving, Stax-style soul ("Things Get Better") or good old rock & roll (on the fierce, extended Little Richard medley), the band--which consists of some of the finest musicians of the day, many of whom went on to play with Clapton and other luminaries throughout the '70s--tears it up. But while the set teems with advanced musicianship, the overall vibe is one of straightforward fun and good times.
Eric ClaptonEric Clapton (Deluxe Ed.) (2-CD)
Delaney & BonnieD & B Together
Eric ClaptonEric Clapton's Rainbow Concert (Remastered)
$6.02 Super Savings
Ernest TubbGonna Shake This Shack Tonight: Thirty Days
$20.91 Super Savings
Delaney & BonnieHome
$9.05 Super Savings
Bonnie BramlettI'm Still the Same
Joe CockerMad Dogs & Englishmen (Live)
$11.84 Super Savings
D & B Together (CD)(8)
To Bonnie from Delaney (CD)(11)
$11.35 Super Savings
Home (CD)(7)
$9.05 Super Savings
Accept No Substitute (CD)
$11.12 Super Savings
Classic Soul Duets: Boy Meets Girl (CD)(13)
$5.98 on SALE
The Complete Stax / Volt Singles, Volume 2 (1968-1971)... (CD)(12)
Festival Express (DVD)(115)
On Tour With Eric Clapton (180GV) (LP)(61)
Out of PrintSave for Later
Accept No Substitute (CD)(13)
Out of PrintSave for Later
Music Lovers' Ratings & Reviews:
Customer Rating:
Based on 53 ratings.
Based on 53 ratings.
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Product Info
- Sales Rank: 18,920
- Shipping Weight: 0.25/lbs (approx)
- International Shipping: 1 item
The Very Best of The "5" Royales (CD)(9)
$12.98 on SALE
Nature Wonders 2 (3-CD)(11)
$4.98 on SALE
#1 Soul Hits of The 1980's (CD)
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God Bless America (CD)(3)
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$16.04 Super Savings
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Top ranking titles in the Pop / Rock genre:
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- Various Artists Best of Chicago Garage Bands - The Quill Records Story (CD) ~ 99¢ on SALE
- The Herd Very Best of I Can Fly (Featuring Peter Frampton) (CD) ~ 99¢ on SALE
- Various Artists History of Rock - JukeBox Giants, Volume 3 (CD) ~ 99¢ on SALE
- Various Artists WCBS FM101.1 - Motown, Soul & Great Rock 'N Roll: Rock 'N Roll (CD) ~ $4.98 on SALE
Top ranking CD:
- King Curtis Enjoy Records - The Best of King Curtis (CD) ~ 99¢ on SALE
- Johnny Cash Original Golden Hits, Volumes 1 & 2 (CD) ~ $6.98 on SALE
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Vintage WWII Premier Vacuum Cleaner Ad - 1945
"The Best is Always Worth Waiting For" - Waiting for her man to return home from the war (See framed photo of GI) a Premier Vacuum Cleaner will keep her happy! There are just not enough ..."to satisfy the "Pent-up demand"... don't be tempted to settle for just what's available, ..."always worth your while to wait for the best".
We are talking vacuum cleaners here, right? I just love how these WWII ads are so wonderfully scripted and illustrated.
Ladies' Home Journal - November, 1945
Scan Upgrade 2016-12-17: Ad, Appliance - Premier Vacuum Cleaner, Electric Vacuum Cleaner Co., Best is worth waiting for - Ladies Home Journal, 1945-11 - Artist- Schroeder.jpg
20,137 views
12 faves
4 comments
Taken in November 1945


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- You are here:
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Morrisons Spicy Piri Piri Houmous - 200g
Cals (per 100g): 277
Fat: 20g
Sat fat: 2g
Sugar: 2.7g
Salt: 1.1g
Price: 99p
Although higher in calories than the Sainsbury's Houmous on the previous slide, this Piri Piri version from Morrisons does have a higher fat content, so if it's fat over calories that you're watching then steer clear of this one!
Your comments
- Biscuits: The best and worst revealed
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NNCP (Node to Node copy) is a collection of utilities simplifying secure store-and-forward files and mail exchanging.
This utilities are intended to help build up small size (dozens of nodes) ad-hoc friend-to-friend (F2F) statically routed darknet networks for fire-and-forget secure reliable files, file requests and Internet mail transmission. All packets are integrity checked, end-to-end encrypted, explicitly authenticated by known participants public keys. Onion encryption is applied to relayed packets. Each node acts both as a client and server, can use push and poll behaviour model.
Out-of-box offline sneakernet/floppynet, dead drops and air-gapped computers support. But online TCP daemon with full-duplex resumable data transmission exists.
NNCP is copylefted free software licenced under GPLv3+. It should work on all POSIX-compatible systems. Easy integration with existing SMTP servers. Single YAML configuration file.
Why create yet another store-and-forward solution when UUCP, FTN and even SMTP exists? Look in comparison section! Simplicity, cryptographic security, sneakernet compatibility and easy integration with current SMTP servers are the reasons.
|• Comparison:
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|• News:
|• Installation:
|• Configuration:
|• Call configuration:
|• Integration with Postfix:
|• Commands:
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|• Spool directory:
|• Log format:
|• Packet format:
|• Sync protocol:
|• Thanks:
|• Contacts and feedback:
|• Copying conditions:


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Villa Unggul
Find Hotel Rates
Recent Searches
Wego searches multiple travel sites so you can find and compare the best rates.
Villa Unggul Hotel Reviews
Based on reviews from across the web.
Villa Unggul Hotel Details
- Highspeed Internet
- Restaurant
- Airconditioning
- Safe/Vault
- Restaurant
- Bicycle rentals
- Dry cleaning
- Internet services
- Safe deposit box
- Air conditioning
- Cable television
- Internet access
- Minibar
- Shower
Ideally located in the prime touristic area of Gili Trawangan, Villa Unggul promises a relaxing and wonderful visit. The hotel offers a wide range of amenities and perks to ensure you have a great time. To be found at the hotel are safety deposit boxes, bicycle rental, Wi-Fi in public areas, restaurant, laundry service/dry cleaning. The well-appointed guestrooms feature shower, mini bar, internet access – LAN, air conditioning, satellite/cable TV. Recuperate from a full day of sightseeing in the comfort of your room or take advantage of the hotel's recreational facilities, including outdoor pool. Convenience and comfort makes Villa Unggul the perfect choice for your stay in Lombok.


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Welcome to my page
feel free to ask me anything, you want to know I'm always happy to get to know new people
I'm a 20 year old Austrian girl who loves to paint.
Currently I'm trying to get back into art so you and I would love some constructive critiques on my pictures.
Right now I'm trying to do daily sketches, so you most likely wont see too many finished pictures here in the next time but I'll try to post a collection of my sketches on regular basis from now on^^
Icon Commissions are currently open.
|| Tumblr | Youtube ||


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false pdp {"scheme":"product1_cr"}
false pdp {"scheme":"product2_cr"}
Quilted Hammock is rated out of 5 by 2.
Rated 5 out of 5 by Mugsbgraham from Great Hammock
Date published: 2014-04-17
Rated 5 out of 5 by jjazz3 from relaxing by the river Excellent quality with superb construction exactly what I was looking for in a hammock.
Date published: 2013-08-09
Are the straps and pillow included, when I order the "Quilted Hammock"? Thanks!
Thank you for your interest in the Quilted Hammock. This hammock includes the hammock itself, the ropes, two chains, and tree hook hardware. The hammock stand and pillow are sold separately.
Date published: 2017-02-01
Product:103105-Quilted Hammock


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Troubleshooting Exceptions: System.Printing.PrintingCanceledException
Visual Studio 2010
A PrintingCanceledException exception occurs when code attempts to access a canceled print job.
If you are creating a Windows Presentation Foundation (WPF) application that includes printing functionality and allows print jobs to be canceled, be sure to correctly handle this exception. An unhandled exception of this type can cause a Windows Presentation Foundation application to stop responding.


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This note was uploaded on 05/05/2009 for the course STOC 2552 taught by Professor Pompper,donalyn during the Spring '09 term at Temple.
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Hotels in Marina di Montenero
Hotel reservation
Marina di Montenero
Hotel rooms in Marina di Montenero
There are not so many hotel rooms in Marina di Montenero, just 11, still everyone can find an offer to suit his choice. The most common offers in this city are 3 и 4 stars, they count 1 out of 11, and their prevalent location is central district. According to our practice, it is the most profitable to book a hotel in the south of Marina di Montenero, as it is the location of the hotels with optimal cost and quality offers along with the cheap hotels. Taking into account the small size of the city, there is no need to dwell hotel reservation on the location: the road to the city center would take less then half an hour, so one can book a hotel in any district of Marina di Montenero. The most populated with hotels district of Marina di Montenero is the center, 72% of cheap hotel rooms are concentrated here. However, even those who want to live in the south can choose from 1 variants of hotel rooms. Marina di Montenero is an ideal place for couple and family, such travellers rate hotels there 7.4 out of 10 on average. The view to pool from the hotel room can serve as a pleasant addition to the journey. Apart from all these, hotels in Marina di Montenero offer their customers swimming pool, low mobility guests welcome, parking and bar. The most appreciated amenities in Marina di Montenero hotels are beach and location. According to the visitors reviews, hotels in Marina di Montenero has beautiful beach, fantastic service and great location. Take a look at our selection of the cheap hotel rooms in Marina di Montenero to make a well-informed choice for your reservation!
Marina di Montenero cheap hotels
Marina di Montenero
Guest Houses
Marina di Montenero
All cheap hotels in Marina di Montenero
Best hotels in Marina di Montenero
Hotels in Marina di Montenero are spread around the city within the distance of 2.8 kilometers, while 8 hotels are located directly in the city center. Those who are keen on antique should definitely fall in love with
Hotel Strand
, the oldest hotel of Marina di Montenero, constructed in 1975. This hotel is located 0.6 km away from the city center. The most popular accommodations in Marina di Montenero is
Hotel Strand
, 3 stars hotel located in a 0.6 kilometers from the city center.
The best hotels are here and now. Try them!
All cities in Italy


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All Topics » Health Care » Health care programs » State-administered programs
State-administered programs (1 - 10 of 119 items) in Custom Date Range
Medicaid and CHIP: Considerations for Express Lane Eligibility
GAO-13-178R: Published: Dec 5, 2012. Publicly Released: Dec 21, 2012.
Four key considerations related to ELE's availability beyond 2013 include (1) the potential for administrative savings; (2) effects on enrollment of eligible, but not enrolled, children; (3) states' level of interest in using ELE particularly for implementing PPACA; and (4) uncertainty regarding the potential for erroneous excess payments for children enrolled through ELE.Available information reg...
Medicare Savings Programs: Implementation of Requirements Aimed at Increasing Enrollment
GAO-12-871: Published: Sep 14, 2012. Publicly Released: Sep 14, 2012.
The Social Security Administration (SSA) took a number of steps to implement the Medicare Improvements for Patients and Providers Act of 2008 (MIPPA) requirements aimed at eliminating barriers to Medicare Savings Program (MSP) enrollment and spent about $12 million in fiscal years 2009 through 2011 to do so. SSA reported transferring over 1.9 million Low-Income Subsidy (LIS) program applications t...
Pre-Existing Condition Insurance Plan: Comparison of Implementation and Early Enrollment with the Children's Health Insurance Program
GAO-12-62R: Published: Nov 10, 2011. Publicly Released: Dec 13, 2011.
The federal Pre-Existing Condition Insurance Plan (PCIP) was created in 2010 to provide access to insurance for individuals previously unable to acquire coverage due to pre-existing conditions. Eligibility is limited to those who have been uninsured for at least 6 months prior to application, thus focusing the program on those who have been locked out of the private insurance market. The Patient P...
Medicaid Program Integrity: Expanded Federal Role Presents Challenges to and Opportunities for Assisting States
GAO-12-288T: Published: Dec 7, 2011. Publicly Released: Dec 7, 2011.
The Centers for Medicare & Medicaid Services (CMS), the federal agency that oversees Medicaid, estimated that improper payments in the federal-state Medicaid program were $21.9 billion in fiscal year 2011. The Deficit Reduction Act of 2005 established the Medicaid Integrity Program and gave CMS an expanded role in assisting and improving the effectiveness of state activities to ensure proper payme...
Pre-Existing Condition Insurance Plans: Program Features, Early Enrollment and Spending Trends, and Federal Oversight Activities
GAO-11-662: Published: Jul 27, 2011. Publicly Released: Aug 26, 2011.
Individuals applying for health insurance are often denied coverage due to a pre-existing condition. The Patient Protection and Affordable Care Act appropriated $5 billion to create a temporary pool--known as the Pre- Existing Condition Insurance Plan (PCIP) program--to provide access to insurance for such individuals until new protections take effect in 2014. Twenty-seven states opted to run thei...
Medicaid and CHIP: Most Physicians Serve Covered Children but Have Difficulty Referring Them for Specialty Care
GAO-11-624: Published: Jun 30, 2011. Publicly Released: Jun 30, 2011.
Medicaid and the Children's Health Insurance Program (CHIP)--two joint federal-state health care programs for certain low-income individuals--play a critical role in addressing the health care needs of children. The Children's Health Insurance Program Reauthorization Act of 2009 required GAO to study children's access to care under Medicaid and CHIP, including information on physicians' willingnes...
Medicaid and CHIP: Reports for Monitoring Children's Health Care Services Need Improvement
GAO-11-293R: Published: Apr 5, 2011. Publicly Released: Apr 5, 2011.
Medicaid and the Children's Health Insurance Program (CHIP)--two joint federal-state health care programs for low-income families and children--play a critical role in addressing the health care needs of children. In 2008, more than 36 million children in the United States received health care coverage through Medicaid or CHIP. Like all children, children covered by Medicaid and CHIP may have heal...
Medicaid and CHIP: Given the Association between Parent and Child Insurance Status, New Expansions May Benefit Families
GAO-11-264: Published: Feb 4, 2011. Publicly Released: Feb 4, 2011.
The 2010 Patient Protection and Affordable Care Act (PPACA) expands health insurance to millions of individuals, including many parents. New insurance options for parents raise a question about whether providing health insurance to parents benefits their children. The Children's Health Insurance Program Reauthorization Act of 2009 (CHIPRA) asked GAO to assess (1) the extent a parent's health insur...
School-Based Health Centers: Available Information on Federal Funding
GAO-11-18R: Published: Oct 8, 2010. Publicly Released: Oct 8, 2010.
Many of our nation's children have difficulty accessing needed health care services. In 2008, the Robert Wood Johnson Foundation reported that about 25 percent of children with insurance and about 55 percent of uninsured children did not receive a recommended routine checkup within the previous year. According to the Department of Health and Human Services (HHS), children face growing risks from c...
Medicaid Managed Care: CMS's Oversight of States' Rate Setting Needs Improvement
GAO-10-810: Published: Aug 4, 2010. Publicly Released: Aug 4, 2010.
Medicaid managed care rates are required to be actuarially sound. A state is required to submit its rate-setting methodology, including a description of the data used, to the Department of Health and Human Services' (HHS) Centers for Medicare & Medicaid Services (CMS) for approval. The Children's Health Insurance Program Reauthorization Act of 2009 required GAO to examine the extent to which state...


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Creative Recreation Cesario Lo Woven
Product Information
- Go sleek and clean with the Cesario Lo Woven.
- Low profile sneaker features textured and woven canvas upper.
- Lace-up front with stitched eyelets.
- Signature Creative Recreation® instep strap.
- Textile lining with cushioned footbed.
- Rubber toe guard, 360º sidewall trim and Creative Recreation® heel patch.
- Vulcanized construction.
- Herringbone-pattern rubber outsole.
- Imported.


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Business, Business News, News & PoliticsFollow
|Business News
Stay informed of breaking news throughout your day with senior editor John Wordock of The Wall Street Journal. Listen to critical news and engaging interviews, featuring executives, economists and notable WSJ editors discuss business, markets, politics and more.
October 15th, 2015
Episode 110 of 1192 episodes
RealtyTrac's Ginny Walker discusses the state of home foreclosures, where it's happening, and why an increase in bank repossessions is a good thing.
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iPhone apps
Boost your Metabolism Fast
Looking for ways to boost your metabolism and lose that stubborn weight? Has your metabolism slowed down, and want to know ways to spark it back up?Let us help. Learn tips and tricks that can help jumpstart your metabolism again. Learn about Exercise….. Read more
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@Annerley, how are you? Have you had your D&C? Just want you to know that I'm thinking of you and hope you're doing ok. Big hugs
@Annerley, how are you? Have you had your D&C? Just want you to know that I'm thinking of you and hope you're doing ok. Big hugs
Annerley (26-08-2016),lotsathoughts (27-08-2016)
@Finchee me too! I've bled three times, went to hospital the second time and everything has been fine at my two scans. I've had brown spotting everyday since. I don't think it's uncommon. It definitely messes with your head though x
nattie84 (26-08-2016)
Hi @Gypsy37 yes all done thanks
I woke up feeling much better on Wednesday too so the bug is behind me finally.
The procedure went really well to be honest. I was a bit teary when I had to leave dh and go to the waiting room so the nice nurse called him back in to wait with me. They called me around and then the poor girl that was in before me (for a different surgery) had a huge complication so I went in 2hrs late. They wheeled me back around to be be with dh again.
It's strange as I was terrified of having the EPU as I've never had surgery before but this time I felt surprisingly calm. The wait probably helped as I was relieved when I finally went in. I don't even remember going under as I think the stuff they out in the drip must have zonked me out before the GA and I woke up easily. I've only had minor discomfort so overall it was less taxing physically than an EPU.
Emotionally/ mentally I've been much better than I expected I'd be. I teared up when one of the genea nurses stopped by to see me at the hospital before I went home and that's it. I'm not sure if it will suddenly hit me like a ton of bricks as partly it feels like all of this happened to someone else. I'm going to have an appointment with the clinic counsellor just in case- can't hurt! Besides that, dh and I have made some exciting future plans to look forward to and I've been really enjoying and appreciating DD- I haven't had to go to work at all this week so we've had plenty of time together. For now I'm at peace with it all, which feels so strange. It does feel weird to not have a real plan re: IVF. I feel like ive had a basic plan around when to do the fets since conceiving DD in 2013.
Sorry for the long post but it has helped me to put it all into words so thanks for asking after me.
Still thinking of all of you ladies xx
Last edited by Annerley; 26-08-2016 at 21:41.
I haven't really read back but just had a quick read of the last couple of posts. @lotsathoughts please take care of yourself. Sorry to hear that you are feeling unwell and I hope it isn't the same strain I had as I still have the runs and it's been a week. DD is only just over it today and hers started on the 16th. The vomiting is the worst. If you end up not being able to keep down water, please go to a hospital. Apparently I wasn't over-reacting when I went (I called 13health and they told me to get there within 4 hrs once I hadn't kept anything down for about 10-12hrs). Baby won't be affected but you need to be looked after and not risk dehydration. The drip made me feel heaps better temporarily.
@Annerley thanks for keeping us updated Hun. I'm glad to hear the procedure went well. I'm also really glad to hear you're coping ok emotionally/mentally. I do think it's a great idea that you see the counsellor, you're right it can't hurt and it's what they're there for.
Plans with DH sounds exciting it's always so nice to have something to look forward to.
You sound like one strong woman. xxx
Annerley (27-08-2016),lotsathoughts (27-08-2016)
@Annerley thank you so much for sharing. You sound extremely aware of your emotions and seem like you're riding the wave as it happens. What a brave person you are, you might not see it now but I'm sure later you'll look back and realize how much strength you've gained from this whole IVF process. The good/bad and ugly. So annoying tho, we don't want to be strong sometimes, we just want things to fall into place. I hope that time comes soon for you xx
I admire your courage and wish you continued peace and good fortune into the future, whatever your plans may be. I know all of us love hearing how you're going so always feel free to drop in here and share how what's happening in your life.
Last night when I couldn't keep down water and was getting lightheaded I thought of you and hospital and called home DH, who was out at the footy (I'd assured him id be fine.) When it continued I got scared and called him home. Today I've just woken and am a bit nervous to move around too much. Just trying to sip water as I'm sure I'm dehydrated. Thanks for your advice, if it continues I'm going straight to the hospital. Dehydration is serious biz.
Annerley (27-08-2016),Gypsy37 (27-08-2016),hopefull29 (27-08-2016)
@Annerley I am really glad the procedure is over and done with and you can move on to the next phase. I agree that the counsellor is s good idea, I see one every 2 weeks, because I think the psychological/emotional aspects of IVF are far more taxing than the physical aspects, and it's good to have someone impartial to speak to about everything. Wishing you all the best and can't wait to hear when you get your BFP, which I'm sure won't be too far away. Xxx
Ladies I think I am out.. Started spotting last night and then today a bit heavier with some clots.. No major cramps though which is weird. Hoping for a miracle but trying to be realistic.
@nattie84 so sorry to hear about the bleeding. There's a few ladies that have suffered bleeding on this thread and they're OK. Bleeding can be so common in early pregnancy apparently more so in an IVF pregnancy. I really really hope all is ok Hun. Is your next BT on Monday? No cramping is a really good sign too. xx
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HAL Sells 7th & Madison Medical Building for $100M
SEATTLE-HAL Real Estate Investments, a Seattle-based company, has landed a big payday with the sale 7th & Madison, a 205,000-square-foot medical office building on the First Hill neighborhood of Seattle.
Featured Content
Why So Many 1031 Investors Are Emerging
SAN DIEGO—Just like home buyers look to level up, we're also seeing a bit more fluidity in typically middle-market groups seeking more institutional deals and vice versa, Avison Young's Peter Sherman tells GlobeSt.com.
Challenges Community Business Banks Face
COSTA MESA, CA—A lot of the challenges facing community business banks—or all banks, for that matter—hinge on the interests of their investors, who in large part establish the culture of a bank, Blue Gate's Chris Walsh tells GlobeSt.com.
Event Coverage
Weak Productivity, Low Investment Plays Major Job Growth Role
SAN DIEGO—GlobeSt.com was in attendance for the opening session Sunday at MBA's CREF/Multifamily Housing Convention and Expo 2017 where speakers provided their insights about the economy and commercial and multifamily real estate finance.
LOS ANGELES and TOKYO—The agreement will mark the Japanese conglomerate's entry into US real estate asset management, although it has been active as an investor and developer here.


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Escape on a tropical journey of relaxing, cleansing, rejuvenating & healing rituals. Since ancient times Marama's (woman) of the villages have utilized Fiji's natural resources for both beautification and medicinal purposes.
Essence of Fiji produces skin & body care products made with locally harvested organic seaweed, pure coconut oil & papaya as their key ingredients.
Naturally based skincare containing beneficial sea minerals & plant extracts for all skin types & conditioning for both men & woman.
Our company prides itself in giving back to the community by establishing village enterprise through harvesting local extracts for our product manufacturing.
Soften & nourish your skin with enriched luxurious coconut milkAll skin types - Ideal for dry skin
Moisturize your skin with this lingering & exotic fragrance of the pacific. All skin types. Vitamin E Virgin Coconut Oil Almond Oil Frangipani Oil
/ Benefits Soothes and relieves Sunburnt & sensitive skin. Key Ingredients Papaya fruit extract, Aloe Vera, Cucumber How to use Apply on sunburnt or sensitive skin when required. Tips Keep refrigerated...
A soothing, purifying, antibacterial & rebalancing face mask.A great boost for dehydrated skin. All skin types - Ideal for dehydrated or sensitive or oily & problem skinExcellent for rosacea Seaweed...
Discover Fiji's 'bua' Frangipani flowers.
Indulge in their sweet floral scent, leaving your skin naturally perfumed.
1. Frangipani Body Lotion
2. Coconut Body Oil (Frangipani Infusion)
3. Bookmark with Frangipani Essence Vial
4. Handcrafted Coconut Oil Soap (Frangipani Infusion)
Essence of Fiji works closely with Tamasua Village in Yasawas, to produce virgin coconut oil & ground coconut shell for our product ranges, thus providing sustainable revenue for the village.
1. Coconut Body Scrub
2. Coconut Body Lotion
3. Coconut Body Oil
4. Handcrafted Coconut Oil Soap


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USER EDITORTesserT
In the season finale, Peggy and Ed try to escape.
Peggy and Ed follow their plan at the Motor Motel; Lou faces jurisdictional politics; and Hanzee reports to the Gerhardts.
Hanzee searches for Peggy and Ed while Dodd ends up in unfamiliar territory.
Floyd takes action and Charlie tries to prove himself. Peggy and Ed disagree about what to do next and Lou is sidelined during Ronald Reagan's campaign tour.
Floyd responds to Kansas City's proposal; Hanzee takes a road trip; and Lou comes to a realization.
The Gerhardts get an unexpected offer and two surprising murderers try to clean up their mess.
In the second season premiere, a surprising event at a diner disrupts the citizens of a small Minnesota town.
Molly takes the lead, while Gus follows a hunch. Lester takes control of a situation, and Malvo finds a new target.
Lester has an unexpected encounter. Meanwhile, Malvo changes course while a new investigation sends Molly down a familiar avenue.
Lester starts to feel like a new man while Molly is being compelled to close the case.
Malvo looks for answers as Lester wangles a number of his own. Molly and Gus endeavor to get past a delay in the investigation.
Molly makes an unorthodox decision after Lester has a close call.
Gus tries to fix a mistake. Meanwhile, Molly uncovers a promising lead.
Molly sets a trap. Meanwhile, Gus thinks about coming clean; and Lester returns to work.
Molly has her suspicions about Lester's involvement in the murders but the new Chief has her pursue a different direction. Malvo checks out a blackmail scheme against The Supermarket King.
A manipulative drifter preys upon a small-town insurance salesman in the opener of this adaptation of the 1996 Coen brothers film.
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Business, Education, Health, Self-HelpFollow
Awarded 'Best of iTunes', EOFire is a 7-day a week Podcast where John Lee Dumas chats with todays most successful Entrepreneurs. Pat Flynn, Seth Godin, Tim Ferriss, Tony Robbins and Gary Vaynerchuk are just 5 of the over 1400 interviews to date. EOFire was created for YOU, the Entrepreneur, Side-Preneur, Solo-Preneur and Small Business Owner. If you're looking for ACTIONABLE advice during your daily commute, workout, or 'me' time, JLD brings the HEAT. Each episode details the journey of a successful Entrepreneur who shares their WORST Entrepreneurial moment and lessons learned, an AH-HA moment and how they turned that idea into success, and much more. Each episode ends with THE LIGHTNING ROUND where JLD extracts golden nuggets, Internet resources and action steps for you, FIRE NATION!
June 28th, 2016
Episode 1426 of 1684 episodes
Taylor is the Author of The End of Jobs. Inc Magazine rated The End of Jobs one of the Top Three 'Start Your Own Business' Books of 2015 and a Top Business Book of 2015. A former Brazilian Super Bowl champion, Taylor has lived in Argentina, Brazil, Vietnam, and Thailand.
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Contamination by foodborne pathogens and mycotoxins was examined in 475 eggs and 20 feed samples collected from three egg layer farms, three egg-processing units, and five retail markets in Korea. Microbial contamination with Salmonella species, Escherichia coli, and Arcobacter species was examined by bacterial culture and multiplex polymerase chain… (More)
- Hyun Ee Ok, Fei Tian, Eun Young Hong, Ockjin Paek, Sheen-Hee Kim, Dongsul Kim +1 other
- Toxins
- 2016
An interlaboratory study was performed in eight laboratories to validate a liquid chromatography-tandem mass spectrometry (LC/MS/MS) method for the simultaneous determination of aflatoxins and sterigmatocystin (STC) in white rice and sorghum (Sorghum bicolor). Fortified samples (at three different levels) of white rice and sorghum were extracted, purified… (More)
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Nonfiction » Philosophy » Ethics & moral philosophy
American Theodicy: An Essay by Edward E. Rochon
Price: Free! Words: 1,840. Language: English. Published: August 28, 2014. Categories: Nonfiction » Religion and Spirituality » Ethics, Nonfiction » Philosophy » Ethics & moral philosophy(3.00 from 1 review)
Theodicy is justification of evil in the world reconciled to divine power. The essay takes issue with common assumptions and offers a true reconciliation of God's power with freedom of conscience and desire.
Controlling your anger by chen0096
Price: Free! Words: 770. Language: English. Published: August 21, 2014. Categories: Nonfiction » Philosophy » Mind & Body, Nonfiction » Philosophy » Ethics & moral philosophy
this is short book about anger, and the results of anger, you'll learn about the techniques to control your anger/temper. ideas are extracted from Confucius teachings. and please excuse any bad English, as my English isn't very good.
Любовь с точки зрения мужчины by Ришат Вахитов
Price: $3.99 USD. Words: 21,980. Language: Russian. Published: August 20, 2014 by izdat-knigu.ru. Categories: Nonfiction » Philosophy » Ethics & moral philosophy
Читатель! Ты знаешь, что мужчина и женщина любят по-разному? Ты знаешь, чем отличается любовь мужчины от любви женской? Ты видел математическую формулу любви? В этой книге есть на это ответы. В ней приведена та самая формула любви! Лёгкий язык повествования не даст тебе заскучать, а оригинальное представление «любви» формулами сделает чтение занимательным.
26 Scruples for a Fulfilled Life by Sudhir Mittal
Price: Free! Words: 11,210. Language: English. Published: July 4, 2014. Categories: Nonfiction » Philosophy » Ethics & moral philosophy, Nonfiction » Inspiration » Spiritual inspiration
Be it a householder, renounced saint, monarch or a monk, all must invariably reach the same supreme perfection of life. Human life is not for God, but it is God who is for human life. We live for ourselves, so as to say for our own beneficence first; and God is merely one of the ways we can live; perhaps the best one. Read here twenty six scriptural principles which never fail making life 'best'.
Placebos del Estado by Adolfo Sagastume
Price: $4.99 USD. Words: 14,130. Language: Spanish. Published: July 3, 2014. Categories: Nonfiction » Philosophy » Ethics & moral philosophy, Nonfiction » Religion and Spirituality » Gnosticism
El despertar da la consciencia requiere profundos estudios y análisis de nuestra psicología y comportamiento individual, familiar, político, religioso y social. Ahora profundizamos en la clasificación de los comportamientos regidos por los programas estatales locales, estatales y federales.
A Copernican Revolution in Ethics by Magnus Vinding
Price: Free! Words: 9,350. Language: English. Published: June 25, 2014. Categories: Nonfiction » Philosophy » Ethics & moral philosophy
This book aims to answer which beings belong to the moral universe, and to examine some of the most basic ethical implications of this answer. The conclusion in short: We need to realize that humanity is not the sole object of ethics. We need a Copernican Revolution in ethics. [The book 'Speciesism: Why It Is Wrong, And The Implications of Rejecting It' is an updated version of this book.]
Prometheus Bound by Jeff Katzman
Series: The Prometheus Trilogy. Price: Free! Words: 47,990. Language: English. Published: June 6, 2014. Categories: Nonfiction » Social Science » Sociology, Nonfiction » Philosophy » Ethics & moral philosophy
Prometheus Bound explores the timeless elements of the human condition that command us as we all play the power game in our lives. This book is especially for those who want to form a clearer picture of the interaction between the church, the economy, the state, the academy, and the family. It is also for those who want to have a better model and understanding of the world going on around them.
The Simple Case For Going Vegan by Magnus Vinding
Price: Free! Words: 2,820. Language: English. Published: May 25, 2014. Categories: Nonfiction » Philosophy » Ethics & moral philosophy
This essay aims to show that we are morally obliged to go vegan by our own core values. It presents a simple argument for veganism based on an ethical principle that we all hold valid, and goes on to argue that the only reason we are not vegan is that we are speciesists, and that this is no more justifiable than supporting other forms of discrimination such as racism or sexism.
Conditions premières d'un travail non servile by Simone Weil
Price: $6.00 USD. Words: 12,980. Language: French. Published: May 22, 2014 by Editions de L'Herne. Categories: Nonfiction » Philosophy » Ethics & moral philosophy, Nonfiction » Philosophy » Political
Ouvrière sur presse chez Alsthom puis fraiseuse chez Renault, Simone Weil découvre en 1934 le travail à la chaîne. Elle écrit "Condition première d'un travail non servile" puis "Expérience de la vie d'usine" qui développent une philosophie du travail parmi les plus originales qui soient.
Enter At Your Own Risk by David Quesnel
Price: $2.99 USD. Words: 14,080. Language: English. Published: May 16, 2014. Categories: Nonfiction » Psychology » Mental health, Nonfiction » Philosophy » Ethics & moral philosophy
Just as the title suggests, this way of thinking is not for everyone, therefore, it might anger some readers. It is not that it is meant to anger people, but it is because of the fact that it is very difficult to question the things we love, or things we see no wrong in.
Così parlò Zarathustra - Un libro per tutti e nessuno by Friedrich Nietzsche
Price: $0.99 USD. Words: 102,320. Language: Italian. Published: May 14, 2014 by Gingko edizioni. Categories: Nonfiction » Philosophy » Ethics & moral philosophy
Capolavoro letterario del 19° secolo, uno dei più grandi successi nella storia della letteratura filosofica, opera enormemente influente nelle arti e nella filosofia, lettura coinvolgente e mistica di vigorosa intuizione poetica, Così parlò Zarathustra è l'opus magnum di Nietzsche e, benché tra le più complesse, ancora oggi la più venduta e più letta delle sue opere.
Why "Happy Meat" Is Always Wrong by Magnus Vinding
Price: Free! Words: 9,870. Language: English. Published: May 6, 2014. Categories: Nonfiction » Philosophy » Ethics & moral philosophy
This essay attacks the "happy meat" position head-on. It argues that this position is morally indefensible and that it not only causes immense amounts of suffering, but also, somewhat ironically, serves as the very foundation of our abuse of non-human beings today. This reveals the moral urgency of stopping the spread of this position and of rejecting it completely.
La Filosofia è la Vita, Vol. V by Maurizio Bisogno
Price: $2.95 USD. Words: 12,040. Language: Italian. Published: April 30, 2014. Categories: Nonfiction » Philosophy » Ethics & moral philosophy, Nonfiction » Philosophy » Contemporary philosophy
Questo è il quinto volumetto della mia serie "La Filosofia è la Vita".
Foundational Thoughts in Judaism by Per K. Brask
Series: Philosophical Works by Danish Thinker Andreas Simonsen. Price: $8.99 USD. Words: 38,760. Language: English. Published: April 24, 2014 by FICTIVE PRESS. Categories: Nonfiction » Religion and Spirituality » Judaism, Nonfiction » Philosophy » Ethics & moral philosophy
An important 20th-century religious-philosophical work by the late Danish philosopher, Andreas Simonsen. Now available in English in an edited translation by poet and dramaturge Per K. Brask. Simonsen explains where Judaism stands on complex moral and ethical issues, and discusses their relevance to our lives today. A must read for Christians and Jews, believers and non-believers alike.
Prosophy. After philosophy by Paolo-Ugo Brusa
Price: Free! Words: 47,720. Language: English. Published: April 14, 2014. Categories: Nonfiction » Philosophy » Contemporary philosophy, Nonfiction » Philosophy » Ethics & moral philosophy
A short essay on i. Postmodernist perspectives in philosophy, their plus sides and shortcomings; ii. General biography, or the most encompassing view over their common condition humans can possibly share; iii. Proethics, both preternatural and unavoidable for everyone to fulfill their native freedom. Fourth edition, fully revised. Same as newly printed softcover (www.lulu.com, ISBN 9781326073053).
A Arte De Coexistir: Respeito Às Diferenças by CLEBERSON EDUARDO DA COSTA
Price: $7.99 USD. Words: 14,040. Language: Portuguese. Published: April 14, 2014. Categories: Nonfiction » Education and Study Guides » Collaborative & team teaching, Nonfiction » Philosophy » Ethics & moral philosophy
Existem muitas formas de desumanização e, uma delas, talvez a mais crucial, seja aquela que está sistematizada no desrespeito às diferenças, na medida em que esse desrespeito - nos sentidos micro e macro - leva o indivíduo para longe da sua capacidade de coexistir e, consequentemente, para longe da possibilidade de aprendizagem, crescimento e desenvolvimento pessoal e para a criação de guerras...
How To Philosophize With A Hammer by Phil Wheeler
Price: Free! Words: 11,650. Language: English. Published: March 30, 2014. Categories: Nonfiction » Biography » Autobiographies & Memoirs, Nonfiction » Philosophy » Ethics & moral philosophy
A semi-autobiographical, somewhat humorous look at the meaning of life; with detours into sex, kids, friends, and German Philosophy.
Inner Bushido - Strength Without Conflict by Sean Hannon
Price: $9.95 USD. Words: 29,590. Language: American English. Published: March 19, 2014. Categories: Essay » Sociology, Nonfiction » Philosophy » Ethics & moral philosophy
Inner Bushido challenges many long-held assumptions about Samurai ethics, and offers a practical re-interpretation of the seven virtues of Bushido. Hannon takes an unorthodox approach to exploring this system of values, offering an intellectually honest analysis of the Samurai code of conduct, making it applicable to the daily lives of Western audiences.
Why We Should Go Vegan by Magnus Vinding
Price: Free! Words: 18,350. Language: English. Published: February 17, 2014. Categories: Nonfiction » Philosophy » Ethics & moral philosophy(5.00 from 2 reviews)
We should go vegan! That is the unambiguous conclusion of this short book. This conclusion is reached through a broad examination of the consequences of our not being vegan – both in relation to human health, environmental pollution, the risk of the spread of diseases, and in relation to the beings we exploit and kill. The bottom line: We have a strong ethical obligation to go vegan.
Keeping the Peace: A Guide to Video Game Journalism by Nicholas Laborde
Price: Free! Words: 2,860. Language: English. Published: February 16, 2014. Categories: Nonfiction » Computers and Internet » Games, Nonfiction » Philosophy » Ethics & moral philosophy
Video game journalism is the behemoth mass media machine that determines whether or not video games soar to new heights or fail miserably. Have you ever wondered how it all works? Yes? No? Have no fear! In "Keeping the Peace: A Guide to Video Game Journalism," you will gain a satirical insight into how the game industry works, but specifically as it relates to journalism and journalists.


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Event: The RAAZ 3 team including Bipasha Basu, Esha Gupta, Vikram Bhatt and Mahesh Bhatt pose for the shutterbugs at a press meet held to celebrate the success of their 3D thriller film.
Guest List: Bipasha Basu, Esha Gupta, Vikram Bhatt, Mahesh Bhatt
Bollywood celebs Kangana Ranaut, Vishal Bhardwaj, Randeep Hooda, Aanand L Rai, Vikas Bahl, Vidhu Vinod Chopra, Anupama Chopra, Prasoon Joshi among others were snapped at the special screening of RANGO...
Bollywood celeb Adah Sharma promoted her upcoming film COMMANDO 2.
Bollywood celebs Riya Sen, Kyra Dutt, Gulshan Nain, Vivek Vaswani among others were snapped at the special screening of LONELY GIRL.
Bollywood celebs Ranveer Singh, John Abraham, Kiran Rao, Manyata Dutt, Poonam Dhillon, Baba Siddiqui, Shekhar Suman comes out to vote.
Bollywood celebs Varun Dhawan and Alia Bhatt were snapped at Mehboob studio.


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What is the difference? Your web-site only shows aromatherapy , is this good for weight loss? Are you wrapped in ace bandage type cloth? Thank you
Spa N. asked on Jan 29, 2013
It is listed under the massage services page. The detox wrap is a 45 minute service which starts with a dry brush massage, essential oil blend application and the wrap is a cocoon type wrap...you resemble a baby in a bunting...with relaxation time 20-30 minutes depending on the prep time. The Massage detox wrap includes an addition of 30 min of light relaxing massage with the oil blend. Many times people find that their pants or shoes fit less tight after the wrap as it does move a lot of fluid and can be helpful in inch loss. I hope this is helpful. I'm sorry I did not see your question sooner.
Rhonda R. from Merchant replied on Jan 30, 2013


text: Home > Lifestyle > Health and your money Health and your money All sections in Health and your money » Choosing your Insurance » Disability Insurance » Dread Disease Insurance » FAQs » Gap Insurance » Health and Money News » Medical Schemes » Retirement » Retrenchment Protect your income Income protection is insurance designed to protect an individual's ability to earn an income. Health and your money News Doctors fearful of malpractice order unnecessary tests In a survey, 97 percent of ER physicians said they had patients undergo procedures that weren't medically needed. More in Health and your money News The unseen costs of medical malpractice Cost of medicine in South Africa set to skyrocket 2015 Budget lacklustre on the health front SA cutting down on travel and socialising this Xmas Health and your money Should you have the right to sell your organs for profit? I can sell you my old car at a profit. Why shouldn't I be allowed to do the same with one of my kidneys? It will benefit me, and the recipient. But is it as simple as that? See all Health and your money » Health and your money Get clued up on debt The two types of debt that you may find yourself in are: good debt, and bad debt. See all Health and your money » News 2015 Budget lacklustre on the health front Healthcare got a rather cursory and perhaps disappointing mention in Wednesday's Budget speech that looked very like a reiteration of what's gone before - especially when it came to National Health Insurance. See all News » Retirement Beating depression after retirement Many of us equate the word "retirement" with relaxation, holidays and sleeping late. But for some, it can be the start of depression. See all Retirement » Take action Quiz Are you practical? » Ask CyberShrink » Subscribe General Newsletter » Like Health24 on Facebook » For love or the money, what really rules our hearts? The story of money Health and your money Will a sugar tax solve SA's obesity problem? A growing number of consumer bodies and health experts in SA are calling for the introduction of a sugar tax. But will this really help us overcome our sugar-related health woes? See all Health and your money » News Doctors fearful of malpractice order unnecessary tests In a survey, 97 percent of ER physicians said they had patients undergo procedures that weren't medically needed. See all News » Health and your money For love or the money, what really rules our hearts? It's an age old question, for love or money? This infographic from Coupon Cabin examines if what really matters is the size of your wallet and not your heart. See all Health and your money » Multimedia Avoiding money problems in relationships Money is the number one source of conflict. See all Multimedia » advertisement From our sponsors 10 facts about diabetes and insulin you need to know How to care for your vaginal flora JHB - Free Caregiver Workshop with TENA experts - 15 February JHB - Free home visit and assessment with a TENA nurse advisor Live healthier Hello? » SEE: Interesting facts about hearing loss Earworms: Let it go Is it bad to sleep with earplugs all the time? SEE: Do women hear better than men? The reason why men often appear not to be listening could be because they actually can't hear you. Confident smile? » Acidic drinks can harm your kids' smiles The facts on bleaching your teeth Am I taking good care of my teeth? Why are my teeth stained? We know the rules – brush your teeth twice a day and floss to keep them healthy. But, have you ever wondered what causes those stains that sometimes appear?


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Ten Things That Really Annoy Me About Lithium Kent R. Olson, MD Medical Director, SF Division California Poison Control System
#10: It Has a Narrow Therapeutic Window, and it can be Nasty Commonly used for bipolar disorder Therapeutic levels 0.6-1.2 mEq/L Toxicity with levels as low as 1.5-2 –Lethargy, confusion, tremor, ataxia, muscle jerking or rigidity –Agitated delirium, coma, convulsions –Symptoms may persist for days to weeks
#9: It Doesn't Bind to Activated Charcoal Alternatives: –Emesis, lavage - ? value –Kayexalate? –Whole bowel irrigation: preferred method
#8: It Elevates the White Blood Count Usually mild, but don't be surprised to see WBC 15,000 or more –Mostly granulocytes –Enhanced PMN production Could lead to needless workup for infection
#7: The ECG is Nonspecific Kinda looks like hypokalemia –T-wave flattening or inversion common –NSSTTW changes common –QT interval may be prolonged Bradycardia, sinus node arrest - rare
#6: It Can Mess up your Sodium Level Nephrogenic Diabetes Insipidus –Can occur with therapeutic use –Lack of renal response to ADH –Loss of free water in the urine Clinical findings: –Volume loss, leads to Li retention –Elevated serum Na+
#5: It can Mess with the Anion Gap Na + Cl - HCO 3 - Anion Gap (10 mmol/L)
#5: It can Mess with the Anion Gap Na + Cl - HCO 3 - Anion Gap (4 mmol/L) Li +
#4: Funky Pharmacokinetics Two-compartment model: Li level reaches equilibrium slowly –Initial: extracellular fluid ~ 15 L –Later: total body water ~ 50 L ~ 4-6 hrs [Li] = 4[Li] = 1.4
#4: Kinetics, continued... Slowly enters brain cells Difficult to get it back out Rebound after hemodialysis
#3: It's Only Way Out is Through Your Kidneys Expect toxicity if: –Worsening renal function –Sudden volume depletion (eg, GI flu)
So where are we so far? Patient with Altered MS NSSTTW changes Li Level 4.5 mEq/L What do we do?
#2: History is Usually Not Available or is Incomplete Is this an acute OD or chronic use with accidental toxicity? What is the pre-existing baseline Li? BUN? Cr?
Consider: Our patient with ALOC, Li 2.5 mEq/L is not on Li routinely, took an acute OD of 14 LiCO3 (8 mEq each) tablets 2 hrs ago BUN/Cr = 10/1.1 Is this a serious Li OD?
Or... Our patient is on Li chronically, has been increasingly confused and weak for several days, has had vomiting and diarrhea. BUN/Cr = 30/2.2
Or, how about this scenario? A patient was seen to take an acute overdose of Li tablets, is brought to the ED where Li = 9 mEq/L Is emergency hemodialysis indicated?
#1 Reason Why I Find Lithium Annoying: Dialysis Isn't So Hot Acute OD with high Li level: patients do okay anyway, without dialysis Chronic intoxication with moderate level, altered mental status: it takes days to weeks to recover anyway, despite dialysis
So What Do We DO? Give IV fluids (NS initially) Try to get good Hx Follow Li levels Consider hemodialysis if –Acute OD with level > 10-11 mEq/L –Chronic intoxication with level > 4 and Sx
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