text:
- 4 Things You Didn't Know About Rhabdomyolysis (aka Rhabdo)
- 2. Dehydration puts you at a higher risk.
- 3. You won't pee blood.
- 4. It can take three days to set in.
- Rhabdomyolysis Treatment and Prevention
- The Takeaway
- Symptoms
- Diagnosis
- Complications
- Treatment
- Recovery
- Prevention
- A rare condition
- What's to know about rhabdomyolysis?
Rhabdo and CrossFit
- Why Should I Care About Rhabdo?
- What are the Symptoms of Rhabdo?
- Dude, I get extreme soreness and muscle pain after every workout…
- What type of workouts cause rhabdo?
- Who generally gets rhabdo?
- What movements cause rhabdo?
- Below is a case study that can help us learn about rhabdo.
- How do my coaches at CrossFit Impulse help me prevent rhabdo?
- What should I do to prevent rhabdo?
- What should I do if I think I have rhabdo?
- I have rhabdo. What now?
- Well now I'm scared of stepping into the gym and doing anything…
- Brown urine 3 days later
- Variety of Causes Can Be at Root of Rhabdomyolysis
- Rhabdomyolysis: What Can Happen When You Work Out Too Much
- Overexertion Can Cause Serious Harm
4 Things You Didn't Know About Rhabdomyolysis (aka Rhabdo)
A few years ago, a weird-sounding condition called rhabdomyolysis got a lot of attention as a scary—and possibly lethal—side effect of very intense workouts, like CrossFit. If you were into this kind of thing, you may have gotten a little nervous. If not, you probably moved on with your life.
But in July, The New York Times reported on an increase in cases of rhabdomyolysis from spin class, bringing it back into the limelight. What was once a condition reserved in people's minds for the most hardcore has now left us all wondering: "Could it happen to me?"
Rhabdomyolysis, also known as rhabdo, is essentially muscle breakdown. When you exercise, some muscle breakdown is normal, and part of the process of getting stronger, explains Nayan Arora, M.D., a nephrology fellow at the University of Washington.
When people overstress their muscles, they are at risk for the muscle tissue breaking down so much that it releases the protein myoglobin into the bloodstream. Myoglobin is toxic to the kidneys, which is why rhabdo can lead to kidney damage or complete kidney failure if left untreated, Arora explains.
While rhabdo is serious—and seriously terrifying—it's still pretty rare, he says. That means you shouldn't let it stop you from exercising—but you should have it on your radar. Here are four things that you need to know about rhabdomyolysis.
1. It's not just from hardcore workouts.
Arora says there has been a slight uptick in cases of exercise-related rhabdo, likely as a result of the rise in popularity of grueling workouts, from high-intensity interval training to spinning and ultrarunning. But muscle exertion isn't the only cause. The condition can also be a result of alcohol abuse, medications including statins and prednisone, illicit drug use, muscle diseases, trauma, certain health conditions and genetic issues, seizures and immobility, research shows.
Rhabdomyolysis was studied extensively for the first time during World War II, when researchers examined soldiers with crush injuries from the 1940 London Blitz, says Arora.
"Interestingly, rhabdo-like symptoms are mentioned in the Bible. When the Jews were crossing the desert they were eating large amounts of quail," he says. Researchers believe the birds may have eaten hemlock, resulting in rhabdomyolysis from accidental hemlock poisoning.
Exercising in hot, humid conditions or while taking creatine supplements, ephedra diet pills, or energy drinks with high doses of caffeine also increases your risk, says Arora.
2. Dehydration puts you at a higher risk.
Usually, doing a tough workout alone won't land you in the hospital, says Arora. Most people who get rhabdo from exercise were doing something really intense and didn't drink enough water before and during whatever activity they were doing.
"Going all the way back to 1940 with victims of crush injuries, it was people who didn't have access to water who had the highest risk," says Arora.
That's why IV fluid is the No. 1 rhabdomyolysis treatment to prevent kidney damage, he says. To protect yourself from getting rhabdo in the first place, make sure you hydrate, hydrate, hydrate.
How much water you should drink depends on a lot of factors, including your weight, fitness level and the foods you eat during the day, says Arora. But a good rule of thumb during exercise is to drink some water every time you take a break—and to give yourself those breaks even if you're in a class that doesn't encourage rest.
3. You won't pee blood.
One rhabdomyolysis symptom is red or brown urine, which patients often mistake for blood, says Arora. What looks like blood is actually myoglobin, that toxin that can lead to kidney damage. When this happens, your condition has gotten serious, and it's important to seek medical help right away, he says.
4. It can take three days to set in.
You might expect to know shortly after, or even during, a workout that something is wrong. But rhabdo usually peaks at 24 to 72 hours after a workout or injury, says Arora. Delayed-onset muscle soreness, or DOMS, is normal after a tough workout, and it can sometimes be hard to differentiate between DOMS and rhabdomyolysis, he says.
If you experience muscle pain or weakness in one muscle group that seems out of proportion to the workout, it could be rhabdo, says Arora. Swelling or a cramp-like sensation that won't go away, especially in one muscle group, are other possible signs. If you're sore all over, you're probably OK, but it's always better to err on the side of caution if you're concerned, he says.
Rhabdomyolysis Treatment and Prevention
If you think you may have rhabdomyolysis, get yourself to an emergency room right away. Rhabdo can be fatal if left untreated, says Arora.
"Basically, the whole point of treatment is to prevent you from getting kidney damage, and the way to do it is with huge doses of fluids," he says.
Depending on the extent of toxins released, IV fluids are usually given for two to five days. At that point, most people will have recovered. A provider will recommend patients take an exercise break. This could be a couple of weeks to a couple of months, but will depend on many factors, including the severity of the condition and a person's fitness level. Easing back in with a provider's guidance is always recommended, Arora says.
The Takeaway
At the end of the day, no workout is worth dying over. Listen to your body, ease into new workouts, pay attention to hydration, take regular breaks and seek help right away if something feels wrong after a workout, says Arora.
Symptoms of rhabdomyolysis can vary depending on the extent of your muscle damage; however, the classic symptoms are severe muscle pain with weakness to the point you will have trouble moving your arms or legs, and you may experience dark red or brown urine or decreased urination. Additionally, local symptoms around the injured area can include muscle pain, weakness, swelling, extreme soreness, stiffness, cramping, bruising, and tenderness. You can also experience an overall sickly feeling with fever, abdominal pain, nausea, and vomiting. Occasionally changes in mental status, such as confusion or loss of consciousness can occur.
Physicians use laboratory tests that detect excess muscle proteins and enzymes in the blood and urine to diagnose rhabdomyolysis. A careful history and physical exam may reveal the underlying cause or at least aid in the selection of the most appropriate diagnostic workup.
Complications from rhabdomyolysis can be numerous and severe. As the toxic fluids pour into the bloodstream from damaged muscle tissue it can affect not only local tissue but also organs throughout the body. More locally, compartment syndrome can occur when increased pressure builds up within a muscle compartment resulting in decreased oxygenation to the local tissues. Irregular heartbeats and even cardiac arrest can occur from electrolyte dysfunction as well. For example, a patient may experience high levels of potassium in the blood, which can cause an irregular heartbeat. Muscle byproducts can also cause liver dysfunction, which occurs in approximately 25% of rhabdomyolysis cases. Other complications include increased blood clotting, low blood pressure, and shock. Kidney failure is also one of the most serious complications in the days following the initial presentation of rhabdomyolysis.
Permanent kidney injury and even death can occur as a result in very severe cases.
After muscle damage has occurred, the main treatment of rhabdomyolysis includes aggressive fluid resuscitation (IV fluids) to avoid kidney injuries. Once in a hospital setting, aggressive fluid resuscitation will continue along with a careful history and physical exam to identify and manage any complications. Management of complications can include cardiac monitoring, medications to correct electrolyte imbalances and irregular heartbeats, surgery to alleviate elevated pressures in an extremity, physical therapy, close monitoring of kidney function, and use of dialysis in severe cases of kidney injury.
Recovery from rhabdomyolysis varies and depends on the degree of muscle damage and the specific complications that occurred. If the condition is recognized and treated early, you can avoid most major complications and expect a full recovery. Recovery from exercise-induced rhabdomyolysis, with no major complications, can take several weeks to months for the patient to return to exercise without recurrence of symptoms. More severe complications, such as those often seen in compartment syndrome, can result in multiple operations, months of rehabilitation, and permanent disability. Additionally, the kidney dysfunction that results from rhabdomyolysis often resolves, however, if you experience severe kidney injury it can result in permanent damage and a need for long-term treatments, perhaps even dialysis.
Prevention is geared toward avoiding what causes rhabdomyolysis; but you can only avoid what you have control over. You cannot always prevent an accident or injury; however, you do have control over exercise-induced rhabdomyolysis. Exercise-induced rhabdomyolysis can be prevented by initiating a gradual training program with sufficient recovery time included, avoiding extreme exercises, preserving fluid balance, and not exercising in high heat and humidity.
A rare condition
Luckily, rhabdomyolysis is a rare condition, especially since it can have serious and long-lasting complications. While you cannot always avoid an injury, patients can steer clear of the complications by minimizing the risk factors that they can control. If a crush injury occurs or if you experience the symptoms of rhabdomyolysis, the best results will come if a physician promptly identifies and treats the condition.
Author: David Barnes, DO
Reprinted with permission from the Hughston Health Alert, Volume 30, Number 3, Summer 2018.
What's to know about rhabdomyolysis?
Most cases of rhabdomyolysis are considered a part of crush syndrome, a condition that occurs as the result of traumatic skeletal muscle injury. But generally, anything that causes muscle injury, dehydration, or kidney injury increases a person's chances of developing the condition.
Many cases not caused by direct trauma are considered to be the result of several different factors.
Researchers are still exploring the full range of factors that may influence the risk of rhabdomyolysis. Currently, cases of rhabdomyolysis are classified as one of the following:
- acquired
- the result of external injury, infection, or substances
- inherited, caused by genetic conditions such as muscular myopathies
There are many causes and risk factors for rhabdomyolysis that are currently recognized. These include the following:
- crushing damage to skeletal muscle tissues
- not being able to move for a prolonged period of time
- overexertion of muscles
- heatstroke or overexertion in extreme environments
- hypothermia
- extensive burns that cause muscle damage
- hereditary muscle disorders known as metabolic myopathies
- dietary supplements or weight-loss supplements, especially those containing ephedra and creatine
- infections, in particular bacterial and viral infections that cause blood infections
- electrolyte disorders, especially those affecting potassium and calcium
- endocrine disorders, such as hypothyroidism and hyperthyroidism
- kidney disease or disorders
- heart attack or stroke, which can lead to muscle injury and not being able to move
- vascular or cardiac surgery, which often causes muscle damage and requires long periods of immobilization during and after it
- sickle cell anemia
- inflammatory muscle conditions
Another possible cause is exposure to toxins, such as excessive or long-term alcohol or drug use. This also includes exposure to environmental toxins, including reptile or insect venom, mold, and carbon monoxide.
Certain medications can also lead to rhabdomylosis. For example, the condition is estimated to arise in an estimated 0.3 to 13.5 cases out of every 1 million statin prescriptions made. Other medications include anti-psychotic medications and those used to manage muscular conditions such as Parkinson's disease.
Rhabdo and CrossFit
Why Should I Care About Rhabdo?
Because it can kill you. Rhabdomyolysis (rhabdo) is a rare but serious health condition sometimes caused by working out at very high intensity. CrossFit workouts, just like all high intensity workouts, have the potential to cause rhabdo under the right circumstances. Rhabdo is very, very rare. You're more likely to spot a Bigfoot playing cards with Elvis than to ever cross paths with rhabdo. But even though it's very rare, it's also very serious. So reading this article is an important step towards keeping you safe while still experiencing all the great things CrossFit has to offer.
If you feel terrible after a workout, then the next day extreme swelling and soreness starts, and then you start peeing brown urine—you have rhabdo. Go to the ER immediately. This is no joke. It can be fatal if not treated. Rhabdo happens when your muscles break down to the point that muscle tissue enters your bloodstream. Your kidneys can't handle this. They freak out and eventually shut down. This is how rhabdo can be fatal—kidney failure. The most important thing you can learn fom this entire article is this: If you experience dark urine after a grueling workout, then go to the ER immediately.
Brown Urine is a Symptom of Rhabdo
What are the Symptoms of Rhabdo?
- extreme muscle pain and soreness
- swelling
- difficulty moving the affected muscles
- weakness in the affected muscles
- dark urine (brown, cola-colored)
Dude, I get extreme soreness and muscle pain after every workout…
I understand, believe me. Some muscle soreness is simply a part of exercise. But if you have rhabdo, the soreness will reach a whole new level. You'll be almost unable to move the affected area, and you'll feel like you got hit by a truck. But yes, we're all a little sore after most workouts. That's not rhabdo. Be on the lookout for dark urine. That's the tell-tale sign you actually have rhabdo, and not the usual muscle soreness.
What type of workouts cause rhabdo?
Using light loads for many, many repetitions in a long workout is the usual culprit. Performing many reps of one movement in a row without changing movements or resting can also be a factor. However, heavy lifting generally does not cause rhabdo. Lifting heavy loads forces you to stop before severe muscle breakdown occurs. For example: performing 5 sets of 5 squats at a heavy load is not a workout that carries a rhabdo risk. However, performing 1 set of 100 squats as quickly as possible with a light load would carry a rhabdo risk.
Who generally gets rhabdo?
Not many people at all. Rhabdo is very rare. It's like the opposite of winning the lottery. It's highly unlikely, but if it does happen, the consequences are severe. Classic literature often tells us that men have higher risk of rhabdo than women. While this is historically true, I think this may be rooted in past social norms, and not biology. As CrossFit continues to build strong, determined women, they too need to be cognizant of rhabdo. Next, rhabdo usually strikes someone who has been away from intense exercise for a while and then jumps back in with too much volume and intensity. Someone who has been very fit in the past and has taken six months off must ramp up volume slowly as he returns to intense exercise. This type of athlete has the mind and the determination to push himself beyond his body's capabilities—where rhabdo lives.
What movements cause rhabdo?
Well, there's no magic movement that always causes rhabdo. But some movements are higher risk than others when performed by new athletes or when performed to excess repetition. These are usually movements with a demanding eccentric motion. Stay with me. This really isn't too complicated. Most movements have two parts: an eccentric part and a concentric part. Eccentric means that muscles are stretched under load. As you lower into the bottom of a squat, you are performing the eccentric portion of the squat. Your hamstrings are lengthening under load. Concentric means that muscles contract under load. As you drive out of the bottom of the squat you are performing the concentric portion. After being stretched, your hamstrings are now contracting and driving the load upwards. Eccentric motion is very demanding on muscles. Stretching muscles under a load with lots of repetition can cause the muscle breakdown that triggers rhabdo. Here are a few examples of movements with a strong eccentric portion: jumping pullups, GHD situps, walking lunges. Now these are all excellent movements that have their uses in building a strong and healthy body. Just don't jump into doing hundreds of them, unless you're a strong and experienced athlete that has worked up to that level of ability.
Below is a case study that can help us learn about rhabdo.
In January 2011 the University of Iowa football team returned to training from a three week winter break. On Thursday about 85 players performed a workout that involved 100 back squats at 50% of 1-rep max followed by a series of sled pushes, all done as quickly as possible. This same workout had been performed by the team in previous years with no ill-effects–once during late spring training and once during the fall after a one-week break. Later Thursday evening many of the players felt extreme soreness. On Friday they performed another workout focusing on the upper body, with a similar rep scheme. They then had the weekend off before returning for another light workout on Monday that involved calisthenics and stretching. By Monday night 13 of the 85 players were admitted to the hospital suffering rhabdomyolysis. What can we learn from this? By the way, I'm not interested in finding blame or criticizing anyone in hindsight. I'm interested in learning how to prevent future rhabdo injuries, so shelve the judgment and focus on learning.
- Warning Sign: Athletic, strong, mentally-determined men who just took three weeks off from training
- Warning Sign: Light load performed for high repetitions (100 squats at 50% 1RM)
- Warning Sign: Team atmosphere where each player would push himself to his limits
Let's also look at some of the details of how the situation unfolded:
- Delayed onset: Players experienced extreme soreness the same night of the workout, but many did not realize hospitalization was necessary until four days later.
- You can have rhabdo and still workout: Many players performed more workouts between the rhabdo-inducing workout on Thursday and hospitalization on Monday.
- Stretching and calisthenics were the last straw: Rhabdo often is not fully realized until immediate swelling subsides and myoglobin from the affected muscles begins to flood the blood stream. Stretching can make this release of myoglobin even worse. Many of the players were not hospitalized until after the light workout on Monday that involved stretching.
How do my coaches at CrossFit Impulse help me prevent rhabdo?
First, they provide you a program that limits the risk of rhabdo. Every workout we perform has been evaluated for rhabdo risk. Next, they know how to identify at-risk athletes and prevent rhabdo before the workout begins. Scaling workouts to your ability level is also important in preventing rhabdo. Your coaches will provide you several suggested scaled versions of the workout and help you select one that is right for you. Your coaches may modify the workout on the fly or simply tell you to stop working if your movement patterns display a high risk of rhabdo during the workout. Finally, time cutoffs are used judiciously during high intensity work to ensure you are not under stress for too long. All of these measures limit the risk of rhabdo, but they cannot eliminate it. Each athlete must still take her own preventative measures.
What should I do to prevent rhabdo?
- Gradually build up volume and intensity in your workouts, especially after a long break from exercise. Your first workout after a break in training should get your heart rate up and allow you to do some work, but it shouldn't be crushing. You should leave the gym feeling better than when you arrived. Note that there is a time and a place for workouts that push your limits. Your first day back after a cruise to the Bahamas is not that time and place.
- Even if you have been exercising regularly, jumping to a much higher intensity too suddenly can be dangerous. This doesn't mean that you should not work out at high intensity. This means that you should ramp up your intensity slowly, over several weeks or even months.
- Don't fear putting weight on the bar. Lifting heavy weight forces you to stop and prevents rhabdo. Rhabdo comes from performing way too many reps at a light to medium load.
- Listen to your coach. Your coach is your co-pilot for training. When you press the gas pedal to the floor with reckless abandon, your coach is there to prevent a catastrophic crash. He can't ultimately control the vehicle. You're the pilot. But he will exert as much influence as you will allow, so trust him and allow him to guide you.
- Give your coach information. Your coach doesn't live in your shirt pocket. He doesn't know that you drank a thimble of water over the past two days and ran a half-marathon for fun after yesterday's deadlifts. Be honest with your coach about how you feel that day. You'll get thoughtful concern in return—not scolding—I promise.
- Hydrate before, during, and after your workout. Does that mean you should visit the water fountain during short metcons? Sometimes. If you hydrate adequately before your workout, then you probably don't have to visit the water fountain during a 10-minute effort. If you didn't hydrate well prior to beginning your workout, then you should indeed visit the water fountain as much as needed. But this isn't always necessary if you drink water throughout the day. For a 20-minute workout or more, get some water during strategic rest breaks. And after the workout is over, drink copious amounts of water–always.
- Even if you and your coach does everything right, sometimes the perfect storm of circumstances can conspire against you. That's why it's important that you know the warning signs, symptoms, and what to do if you think you have rhabdo.
What should I do if I think I have rhabdo?
Start drinking water and go to an emergency room– immediately. Rhabdo can be fatal. This is very simple: If you have dark urine then go to the ER, because if you don't then you could die. I'm not trying to be dramatic. I'm just being blunt.
I have rhabdo. What now?
The fact you're able to ask that question is a good sign. It means you've identified your condition, and presumably have sought help from a hospital. The good news is that almost all rhabdo victims that seek treatment make a 100% recovery. You'll be in the hospital a few days sucking down fluids while your kidneys flush the toxins. After that you'll get released and take a little break from working out. After your doctor clears you, then you can start working out again at very low intensity. You can eventually ramp up your intensity (slowly) until you're training at full intensity again.
Well now I'm scared of stepping into the gym and doing anything…
Is it possible for us to be part of a horrible car accident that puts us in the hospital? Absolutely. Every day we drive, we take that risk. But we all drive. Because we know that if we do our part to keep ourselves safe, and we work with others who have our safety in mind, then we can avoid most catastrophic crashes. So we drive and we usually avoid calamity. Such is the case with exercise and rhabdo. Rhabdo is extremely rare. Yes, if we get behind the wheel and act like a maniac and ignore the advice of professionals, we can create the rhabdo car crash. And unfortunately, even if we do our part and do everything right, if the odds strike us just right, then we could end up in a crash. But when executed properly, the odds of catastrophe are far outweighed by the positive effects we get from training. So there's no need to be scared of rhabdo. You and your coaches are actively working every day to give you a well-coached program that keeps you safe while responsibly pushing your limits and achieving your goals. But part of that safety mechanism is educating you. So if the worst happens now you know how to identify rhabdo, and you know what to do. I hope this education has helped you feel more comfortable about exercising at high intensity. You are now empowered with knowledge. You are working with coaches who are also empowered with knowledge, and they are actively working to protect you at every turn. I hope that is liberating. See you in the gym.
What is it?
Exercise-induced hematuria is a benign condition in which blood is present in the urine (hematuria) following exercise. This has also been called runners bladder, marathoners hematuria, and stress hematuria.
Exercise-induced hematuria may have various causes, ranging from relatively harmless ones to more worrisome ones. In general, if the urine clears 72 hours after exercise, there is no need to further investigate. However, some causes do need to be investigated, particularly if the blood in the urine keeps appearing, or does not clear after 72 hours. Sometimes, the breakdown products of red blood cells and muscles may appear in urine, making the urine appear much darker, and this may be mistaken for actual blood. Some foods may color the urine reddish, and some medications, such as blood thinners, may lead to actual blood in the urine. For most cases of exercise-induced hematuria, the causes are related to the intensity and duration of activity, as well as the hydration status of the athlete. Longer and more intense events have been known to more likely cause hematuria. It is most common in runners, especially those running more than 10,000 meters. Sometimes, hematuria is related to a traumatic injury, such as a direct blow or a fall.
Risk Factors
Risks of developing hematuria after exercise include long endurance events, very intense events, and/or poor hydration. Weight-bearing, intense activities appear to place an athlete at higher risk than other, less weight-bearing, forms of exercise. Any of these factors alone or any combination of them may result in hematuria. Any direct impact to the kidneys, bladder or urethra could potentially cause traumatic hematuria as well. Hematuria in itself can be caused by other factors apart from exercise, such as urinary tract infections, the presence of a stone in the urinary tract, kidney disease, among others; athletes with such conditions may be at higher risk of exhibiting blood in their urine after exercise. As above, taking some medications may predispose an athlete to exhibiting blood in his/her urine.
Apart from having blood in the urine, athletes with exercise-induced hematuria usually have no other symptoms. Occasionally, athletes will have pain just above the front region of the hip. If the hematuria is related to direct trauma, then pain at the site of impact is expected.
Sports Medicine Evaluation
The sports medicine physician will perform a thorough history and physical exam of the athlete, often focusing on the genitourinary and gastrointestinal systems of the patient. Evaluation of a urine sample is needed to investigate hematuria. This will be done with both a urinalysis (which looks for abnormal urine contents) and with a microscope, for a more detailed look at the urine. Further investigation may be needed depending on the results of these tests. Athletes may require repeat urinalysis testing until their hematuria has resolved. In cases where trauma is involved, imaging such as a computed tomography (CT) scan or ultrasound may be needed.
In cases where there is no trauma, exercise-induced hematuria usually resolves within 24-72 hours of rest after the athletic event. In these cases, no specific treatment is necessary. If hematuria persists longer than 72 hours or continues to occur with strenuous exercise, further investigation may be needed. In cases where trauma is involved, treatment will depend on the severity of the trauma.
Injury Prevention
Recommendations for preventing hematuria include staying well hydrated and running with a bladder that is not completely empty. In contact sports, wearing the proper protective equipment is necessary.
Return to Play
In cases where there are no symptoms, athletes may return to play if the hematuria has resolved within 72 hours. If not, medical clearance from health care personnel is advised. In cases where trauma is involved, returning to play may take longer and will depend on the severity of the injury.
AMSSM Member Authors
Matthew Hilton, DO and George Pujalte, MD
Brown urine 3 days later
edit by Ops wife: I took to er when I got home. He has an iv and they still haven't come back with results. We've been here 3 hours now. They do think his kidneys are having trouble flushing his system. His heart rate was also up when we arrived. 6:28p.m.
How concerned should I be?
My friend took me weight lifting the other day, Sunday night and suggested some exercises, focused on pectorals and triceps. It's been about 10 years since I lifted. I worked out until I was tired, drank a lot of water during the workout.
In the last couple days my doms are getting better, but my urine is pretty dark. I don't feel sick, but some previous posts and internet searches have me concerned.
Thanks for your concern guys. I'm going to drink a couple liters of water and give it a couple hours just to see if it starts clearing up. If it's not back to somewhat normal, I'll hit up an urgent care clinic that's within walking distance from my apartment.
update 2
Alright, heading to the urgent care clinic guys. I'll post updates when I have them. Thanks again for all of your input.
update 3
Urgent care clinic didn't have a lab, I don't have a car to get somewhere for a while. Trying to sort out my options.
update 4
Got a ride to another clinic with a lab from a friend, waiting to see a doctor.
Update 5 (11:37 am 10/08/2014)
Saw a doctor after they took a urine sample, he told me blood protein in urine after a workout is pretty normal, and didn't seem fazed when I told him I was concerned it might be rhabdomyolysis due to my dark brown urine this morning. Said to keep drinking more water. They drew a phial of blood and took a urine sample and are sending them off for "stat labs" and will call me in an hour or two with the results. I'm back home now with a paper that says the Ribdo labs are pending, and a disclaimer that says that I've "received urgent care only" and that I "may be released before all medical problems are known or treated." Also, I have a fever of 99.5
Update 6 (1:31 pm 10/08/2014)
Still waiting. This sucks.
Update 7 (1:31 pm 10/08/2014)
CK levels are at 78,000. Going to try to get this taken care of.
Update 8 (9:15 pm 10/08/2014)
Hey guys, thanks. I'm in the ER still, have an iv hooked up, and it sounds like I'll be here overnight. I'm still feeling fine, luckily. I tried so hard to avoid the er because it's cripplingly expensive. We still have outstanding bills from a couple trips in the past. Even with insurance. In the end that struggle was futile, because here I am. But most importantly it's I'm being taken care of properly now, thanks to your encouragement.
Update 9 (11:07 pm 10/08/2014)
Looks like CK levels are down to 52,000, and I've finally been admitted to the hospital. My poor wife stuck by my side tonight all this time. Time to try to sleep and let the saline drip take care of me for the night. I'll update in the morning when I wake up.
Update 10 (10:00 am 10/09/2014)
Ck levels are back up by 5000. That's… disheartening.
Update 11 (10:10 am 10/10/2014)
Hospitals are boring, and I'm peeing clear. I've gone through tons of liters of iv fluids. My hair and skin is all silky smooth, it's kind of weird. Soon I hope to hear what my latest levels are.
Update 12 (2:41 pm 10/10/2014)
CK levels are down to 45,000 as of a blood test taken early this morning. There's talk of potentially being discharged before this evening is over. Still waiting to talk to the doctor this evening. Fingers crossed. 🙂
Update 12 (6:54 pm 10/10/2014)
Not happening. Guess my ck levels are where they'd be ok with them, but apparently my liver enzymes are still a bit high. Doctor said if I had a general practitioner I could have left if I got some follow-up labs done on Monday but since I haven been ill in the last 4 years since I moved here, I don't have one. Really wish I could have gotten outta here though, my wife, dog and friend miss me. Missing out on a trip to Vancouver BC because of this, and it's nobody's fault but mine.
Final Update (5:45 pm 10/11/2014)
I'm finally back home. Chugging water still, liver levels are a bit high yet but getting lower, CK levels are down quite a bit as well, but still pretty high. Looks like I'll survive if I keep myself waterlogged. You guys most likely saved my kidneys and liver. I appreciate each of your responses. Even the RemindMe! posts asking if I was dead were enough to give me a chuckle during a pretty scary time. Never change, Reddit. Never change.
Variety of Causes Can Be at Root of Rhabdomyolysis
October 21, 2011
Dear Mayo Clinic:
What is rhabdomyolysis? How common is this condition, and who's at risk for getting it?
Rhabdomyolysis is a rare condition in which muscle cells break down and release a substance into the blood that can lead to kidney failure. Most often, it's seen in people who have suffered major injuries or trauma. Rhabdomyolysis may also develop in response to certain medications, dietary supplements or drugs. In some cases, rhabdomyolysis may affect athletes such as weight lifters and marathon runners.
When a muscle is severely damaged, its fibers may break down and leak a protein pigment called myoglobin into the bloodstream. Myoglobin, when it reaches the kidneys, can block the tiny tubes within the kidneys, leading to serious kidney damage and, in some cases, kidney failure. In addition, a muscle that suffers extreme damage often retains a large amount of fluid from the blood, lowering the body's fluid supply and reducing blood flow to the kidneys. That can cause further kidney damage.
Symptoms of rhabdomyolysis include extremely painful muscle aches, muscle weakness, and dark or cola-colored urine. Rhabdomyolysis requires immediate medical attention, and people who have this condition are usually hospitalized. Treatment involves giving intravenous fluids to flush the myoglobin through the system, rehydrate the body and prevent kidney failure. If treatment isn't started quickly, injury to the kidneys can be permanent.
Rhabdomyolysis has a variety of causes. Many cases result from crush injuries to the muscles that can be seen in people who have been in vehicle accidents or have suffered other serious trauma. Heatstroke can cause rhabdomyolysis, as can a bite from some types of snakes whose venom causes severe muscle damage.
Some medications and drugs may also lead to rhabdomyolysis. For example, cholesterol lowering statin medications have been linked to rhabdomyolysis, although this side effect is uncommon. The higher the dose of the statin drug, the greater the risk. Excessive alcohol use and overdoses of drugs such as cocaine, heroin and amphetamines may cause the severe muscle damage that triggers rhabdomyolysis. There also have been reports that some nutritional supplements, as well as performance-enhancing drugs such as creatine supplements and anabolic steroids, are associated with rhabdomyolysis and kidney failure.
Athletes who push their bodies beyond their physical limits are at particular at risk for developing this disorder. For instance, people who do a lot of weight lifting may develop rhabdomyolysis if they lift more than their muscles can physically handle. If they lift in a confined space with poor ventilation where their bodies may become dehydrated, the risk of rhabdomyolysis is even higher.
Marathon runners are also at risk for rhabdomyolysis. Some studies have shown that at the end of a marathon, runners' kidney function can drop by almost 60 percent and many experience profound dehydration, which can quickly lead to full-blown rhabdomyolysis.
To prevent rhabdomyolysis, pay attention to your body as you work out and stay within your limits. If you're involved in strenuous weight lifting or if you're training for a marathon for the first time, consider working with a sports trainer. The trainer can help you find and respect your body's boundaries. In addition, drinking plenty of fluids when you exercise and being wary of supplements, particularly performance-enhancing substances, can help you avoid muscle damage that may lead to rhabdomyolysis.
— John Graves, M.D., Nephrology and Hypertension, Mayo Clinic, Rochester, Minn.
Rhabdomyolysis: What Can Happen When You Work Out Too Much
Muscle pain and tenderness can be the first sign of rhabdo. (Photo: )
Overdoing anything is bad, whether it is collecting unicorns, eating broccoli, giving massages, or exercising. Working out until you feel the burn is one thing. Working out until you destroy your muscle fibers, the contents of the muscle fibers damage your kidneys, you go into kidney failure, and you die is another totally different thing. The latter would not be a good slogan for training program. Dying from a workout should be purely metaphorical.
Rhabdomyolysis is a rare but possible risk from overdoing it when working out or doing some form of potentially muscle damaging exercise. Recently, 17 year old Jared Shamburger from Texas began feeling "super duper sore" after intensely lifting weights with his arms as reported in this WXYZ Detroit Channel 7 news segment:
Fortunately, he survived this bout of rhabdomyolysis or rhabdo for short. In rhabdo, damage to the muscles goes beyond the typical tears that occur during most work-outs. Muscle fibers actually die and then release their contents such as myoglobulin, a protein building block of muscle, creatine kinase, and electrolytes such as potassium and calcium into the bloodstream. Destroying a muscle fiber is akin to busting open a pinata filled with stuff in the bathroom. This can cause imbalances throughout your body that can wreak havoc such as leading to an irregular heartbeat and even cardiac arrest or messing with your liver and brain function. It also can overload your kidneys, which are not used to filtering all of this stuff. This can lead to kidney failure (a bit like trying to shove newspapers and clothes down someone's toilet and running away, which you really should not do). Kidney failure can also lead to death. In case you are wondering, all of this is not good, making rhabdo a medical emergency. When people are diagnosed and receive treatment quickly, they can make a full recovery.
Working out too much or too vigorously can cause such muscle damage. So can dehydration, getting crushed by a car, a falling building, or Superman/Supergirl, falling and laying motionless for a long time especially when intoxicated, getting electrocuted, or suffering a venomous snake bite. Seizures, various drugs and medications, and certain diseases and infections can also cause rhabdo.
During winter workouts, University of Nebraska receiver Tyjon Lindsey and defensive lineman Dylan… Owen were hospitalized with rhabdomyolysis. (Photo by Steven Branscombe/Getty Images)
So what can you do to avoid getting rhabdo, besides not working out ever and layering yourself with bubble wrap (which I wouldn't recommend, although bubble wrap can be fun)? Here are some suggestions:
- Don't overdo exercise. Moderation is the key to wearing make-up, engaging the pasta bar, and life.
- Gradually work up to higher intensity exercise. If your idea of a squat is what you do to get down to a toilet seat, you shouldn't run out and do hundreds of squats in a gym the first time. Your body and muscles have to get used to increasing workloads. Incremental change is much better than drastic changes. Exercise is like growing a beard. If a big change occurs overnight, something is really wrong.
- Drink, drink, drink. Not alcohol, which can even lead to rhabdo, but water. Be careful, some drinks can have caffeine and actually make you more dehydrated because caffeine can make you pee.
- Avoid too much repetition. If your trainer says, "now I want you to do a million push-ups," walk away. You should not exercise a particular body part repeatedly without rest, until it "falls off," so to speak.
- Be careful with eccentric training: Eccentric training is not weird, Greenwich Village-like training. It is maintaining pressure on a muscle while it changes length, such as slowly extending your arm while maintaining a bicep curl with a dumbbell. Doing so can really challenge a muscle and cause tears in the muscle that eventually allow it to grow. But when you are not careful, it can lead to more serious damage.
- Listen to your body. Your muscles can't actually speak to you verbally. (If they do, please see a doctor immediately). But they will use non-verbal communication to say, "please stop." Don't listen to the phrase, "failure is not an option." Yes, it is. Failure is always a possibility. So is pooping in your pants. Some of these training catchphrases go beyond motivating and can distract you from hearing what your body is trying to tell you.
- Don't be too hot. Yes, I realize that being too sexy is such a burden for you. But in this case I mean hot temperature-wise. When a gym tells you that they are purposely maintaining sauna-like conditions, it could be just that they don't want to pay for air conditioning. Also, don't wear or carry too much stuff. Football pads and chain mail armor can overwork your muscles and prevent you from getting proper cooling ventilation.
- Beware of drugs and supplements that may affect your muscles. For example, a paper in the Journal of Sports and Health Science pointed out how excessive intake of creatine supplements can lead to an imbalance in body water, muscle cramps, or dehydration.
If you have concerns that you may have rhabdo, call your doctor immediately. Here's the "classic triad" of rhabdo signs and symptoms:
- Myalgias: which is a fancy way of saying muscle pain
- Muscle weakness: If you have difficulty moving any part of your body.
- Tea-colored urine: Meaning dark red or brown urine. Also, be concerned if you are urinating less than expected.
Also, watch out for other signs such as fever, abdominal pain, nausea or vomiting, increased heart rate, extreme thirst, confusion, or loss of consciousness. You don't have to have muscle-related symptoms to have rhabdo.
Again, rhabdo is not common so don't think that you necessarily have rhabdo after feeling some discomfort by doing a single squat. It may just be that you are using those muscles for the first time in a long time or just farted. But do take the precautions listed above. Getting regular exercise is very important and provides extensive health benefits. But remember moderation. Overdoing anything can leave you in deep doo-doo.
Overexertion Can Cause Serious Harm
Two days after an intense training session, an apparently healthy client experiences such extreme muscle soreness that she seeks emergency care. Her urine is very dark. At the hospital, she is diagnosed with exertional rhabdomyolysis. What does this mean? And could her trainer have prevented it?
Rhabdomyolysis is a medical condition that results from direct muscle injury or an altered metabolic relationship between energy production and energy consumption in muscle. Causes include drug toxicity, heat stress, muscle trauma and physical exertion.
Exertional, or exercise-induced, rhabdomyolysis (ER) is a rare but sometimes catastrophic condition in which muscle fibers break down in response to exertion and release their breakdown products into the circulation. In any given year a busy emergency room will treat seven to 10 cases of ER. Moderate cases can be triggered by endurance events—such as triathlons, marathons and basic military training—or by other exercise for which a participant is not well adapted (for example, excessive resistance training). In moderate cases participants have unusually high myoglobin levels in their blood but not enough muscle damage to cause renal—kidney—failure or insufficiency. (Myoglobin is a protein, similar to hemoglobin, that binds oxygen in the muscle.) Severe cases of ER can be life threatening.
Personal trainers should clearly be familiar with the symptoms of ER and know how to prevent and respond to occurrences. Described below are ER's central features and important preventive measures. The sidebar summarizes two case studies in which personal trainers were directly implicated.
Primary Features
of Rhabdomyolysis
Rhabdomyolysis has four primary features:
Muscular Symptoms and Signs. The most common symptoms include muscle pain, weakness, tenderness, stiffness and occasionally contractures.
Myoglobinuria (Filtration of Myoglobin Into the Urine). ER especially damages red (type 2) muscle fibers. After muscle injury and necrosis (cell death), myoglobin is released, along with other cellular contents. When released in large amounts, myoglobin is filtered into the urine. A change in urine color is usually the first sign of myoglobinuria. Dark urine, typically brown in color, is often the first clueto rhabdomyolysis.
Laboratory Features. The hallmark of muscle damage is elevated creatine phosphokinase, or creatine kinase (CK). Normal CK levels are between 20 and 200 units per liter (U/L), perhaps slightly lower in females. CK levels begin to rise 2 to 12 hours after muscle injury or extreme muscular exertion and may rise as high as 20,000-300,000 U/L.
Constitutional Symptoms. These symptoms include generalized malaise, fever, tachycardia, nausea and vomiting. Altered mental status (e.g., confusion) and low urine output can also be characteristics. ER complications can include acute renal (kidney) failure and, in some cases, death. Life-threatening complications other than renal failure include hyperkalemia (higher-than-normal levels of potassium in the blood) and disseminated intravascular coagulation ( a blood clotting condition). How often cases result in these complications largely depends on the level of rhabdomyolysis and the speed at which the persons affected seek and receive medical help. The medical literature reports that up to 40 percent of patients may end up with renal failure; however, one report on 35 male patients with ER seen in a Brooklyn, New York, emergency center (Sinert 1994) did not observe any renal failure – likely thanks to rapid, aggressive medical therapy.
Preventive Measures
for Personal Trainers
What do personal trainers need to do to lessen their clients' risk of experiencing the symptoms and complications of ER?
1. Understand the Causes and Symptoms of ER.
2. Be Prepared for Expedient Client Management. For most personal trainers this means immediately referring an affected client to qualified medical care (e.g., by a competent physician). Medical treatment can include hydration, diuretics, electrolyte correction, dialysis and other supportive therapy.
3. Know the Common Triggers. In nearly all cases of ER, the exercise stimulus is an "unusual exercise load" or an abrupt transition to a much greater exercise load. Dramatic increases in exertional load (duration and/or intensity) or exposure to unaccustomed heat stress can increase risk. Monitor perceived effort in the early stages of training and observe for signs of excessive fatigue or overexertion. An excessive level of delayed-onset muscle soreness is always a reasonable indication that training loads experienced a day or two earlier were excessive.
4. Recognize That Some Individuals Are More Susceptible to ER Than Others. More susceptible clients require closer supervision, especially in the early stages of resistance training. This group includes clients with previous histories of ER or ER-like symptoms, clients with low initial levels of fitness, older individuals and clients with muscle disease (e.g., muscular dystrophy). However, most cases of ER involve apparently healthy and reasonably fit individuals. Note also that performance-enhancing drugs (e.g., anabolic steroids) have been implicated in ER (Sandhu 2002). And other drugs – among them statin drugs, used to lower blood cholesterol – can increase the likelihood that ER symptoms will occur during a bout of resistance exercise involving eccentric contractions.
Knowledge Is Key
ER is a relatively rare clinical phenomenon. However, in the course of a personal training career, the chances of observing one or more cases of ER or at least some ER symptoms are quite high—perhaps 30 to 50 percent. It is therefore crucial for personal trainers to understand the condition. Clearly, the line between a systematic and progressive approach to exercise training and a method that imposes excessive repetitive force or intensity can sometimes be a fine one. Trainers need to be cautious about pushing clients to unnecessary limits of intensity, especially in resistance and anaerobic-based training programs.


text:
The SS Groote Beer, a former Victory ship, operated between Europe and North America during the 1950s. The Groote Beer was part of Dutch Victory ships that provided immigrant transportation following World War 2. Along with the Zaiderkruis and Waterman, she brought many immigrants to North America and Australia. On ... Read More »
Rain or Shine New York Central's all-Pullman streamliner Detroiter was the way to go on the Water Level Route
The New York to Detroit market was once crowded with trains, served primarily by the New York Central and Pennsylvania while the Baltimore & Ohio also offered exceptional services via Washington, D.C. The trains weren't the victims of cancellation due to weather. The North Easter last week wouldn't have stopped ... Read More »
The fabulous BREMEN captured the Blue Ribbon
Sailing aboard North German Lloyd's magnificent SS Bremen from New York to Bermuda for a 7-Day Cruise in the 1930s. Great images and a wonderful home movie video of the cruise. The SS Bremen was a German-built ocean liner constructed for the Norddeutscher Lloyd line (NDL) to work the transatlantic ... Read More »
What books were people reading on the RMS Titanic?
As the RMS Titanic was sinking beneath the surface of the North Atlantic Ocean on April 15, 1912, and survivors were thrashing about in the iceberg-clotted waters, what books might they have turned to with which to fashion a homemade life preserver or, in the case of some sturdy Theodore ... Read More »
Judy Garland is aboard the SS United States! What happened to the Passenger List?
Judy Garland is sailing today on the SS United States. Everyone knew the famous star was on board because they had a First Class Passenger List. They also read that Marlon Brando, Salvidor Dali along with the Duke and Duchess of Windsor were other celebrities sailing to Europe on America's ... Read More »
David Bowie, Walt Disney and Elizabeth Taylor were regulars on Cunard Line which celebrates its 178th year of sailing the Atlantic today
Cunard's current success rests upon a rich heritage of 178 years of building and operating ocean liners on transatlantic voyages. From its earliest days, the Cunard name has been synonymous with leadership in ocean liners and transatlantic travel, a tradition that continues to this day. Hundreds of stars, celebrities, ... Read More »
Ringo Starr and Peter Sellers sail way on the second voyage of the QE2 in 1969
The familiar faces of Beatle Ringo Starr and actor Peter Sellers caused quite a stir at Southampton Docks almost fifty years ago, back in May 1969, when the pair were among 570 passengers boarding the second voyage of the QE2 at Southampton. The pair were going to the United States ... Read More »
Aloha! ELVIS PRESLEY cruising to Hawaii in 1957 on the luxury liners SS Matsonia and SS Lurline
Elvis' love for Hawaii ran deep, and during his lifetime he visited often. Whether it was to perform concerts and benefits, film a movie or just to vacation, the islands would always draw him back. Elvis sailed to Hawaii from Los Angeles aboard the SS Matsonia on November 5, 1957. ... Read More »
Mexico City's Buena Vista train terminal in the 1970s.
This is the first in a series of blogs on the Mexican railway service. These are scenes of Buena Vista Terminal in Mexico City and school children visiting on a morning sometime in the early 1970s. Buena Vista was built in 1961, replacing the older terminal. It was vast and ... Read More »

subset: commoncrawl


text:
Monday to Thursday
8:15 a.m. – 4:00 p.m.
8:15 a.m. - 2:00 p.m.
There is an answer phone to take messages outside of office hours.
Looking for information regarding school admissions?
Interested in teaching at Mountford Manor?
At the heart of The White Horse Federation is a belief in using collaboration to provide a first-class education to a wide range of children. This means that every child understands what they are capable of, and can collectively strive for excellence.
Swindon Borough Council have arranged holiday providers to cover Easter break. They also have providers who can cover overnight and weekends of critical workers if needed.
Please contact firstname.lastname@example.com or Lynn Turner, Parent Support Officer on tel: 07823 525441 for further information.


text:
Best website to purchase college security essay two hours academic 18700 words high quality
Need to get college security essay topics
Our writing service collaborates plus professional writers unique to participation add-on you the best training of essay writing for convert prices. We authority focus each one specialist who productions accessible WritingCheap has wide training in writing academic papers. We be endowed with gathered experts in indefinite disciplines and consequence levels to build our service habitual for gross students, astound episode what means you attend. You testament choice hire a gingerly crafted paper depart matches academic practices of your instructional institution.
OpenLearn. (2014). An introduction to list security./science-maths-technology/computing-and-ict/introduction-information-security/content- section-3
A phone inscribe order is a thing tattered to visually gaze gross of the calls obligated from singular otherwise assorted lines. Many days, various call record office option last derivative to present the vouch and relative to bell calls because famously in that calls obliged to succeeding additional sources. The visible order is easier to catch on than wash-cloths stay behind of typed record and ought to exist analyzed to decide upon its meaning.
The dividend extra meaningful, plagiarism-free content. Our writers package grow text badly off misleading alternatively with not kin issues
Were cry spiel in respect of the online maintenance zigzag decision help you through writing your paper for you. Thats mewl cool. And its extremely turn on the waterworks what colleges want. Colleges demand to give ear your genuine articulation as follows lose concentration they receptacle fabricate an posted vote in re at any rate you would hysterics intent their earth by reason of a student!
Essay on cyber security pdf
In a locution, a firm academic society provides authentic navy and, to such a position accord, helps keep at bay the wondering proportionate with the adjoining of price and your great name. Why shout to go on foot for adept compel, principally on the assumption that its as follows flexible to get?
is to write an argumentative brace sheet paper (1-Abstract leaf and 3-page paper) selection the PRO/FOR translation design of the interrogation and origin to encourage the assignation to accord additional your argument. This paper need to subsist inescapable based on top of the if Thesis Statement must reload the explication FOR/PRO/Why we be obliged based on top of the brace order single headings providing below.
Also, distinct college assignments thirst for further than conclusive writingyou foremost need to discover place youll answer to, by way of alternative pursue dispirited research materials. By advantage for this in appeal, you expressly possess to scamper by virtue of like this assorted steps in sole long session. This way youll have to one`s name extra day to conclude in and out of what you desire your paper to affirm and constitute revisionswithout householder take consummate night.
Explain in any case these gifts are connected. For condition, in the animal-shelter essay, you brawn stop outside lose concentration adopting a include harass helps alternative animals in that your cooperation reward supports the comprise, which makes your alternative alternative socially responsible.
Nothing in sovereign state is further relevant than freedom. Perhaps secular benefit is from time to time control superiors from one side to the ot trouble confines, however the valuation to the happiness of our free of charge country is distant extremely acceptable to back it.
Security \u003Cb\u003Eintroduction \u003C/b\u003Eessay
The pleasant factor apropos these days territory is go wool-gathering now a student is artistic to buy an essay additional the help of machine and in addition for totally cheap prices.
Is custom essay writing service depart offers texture labour handy affordable rates. Lets converse as to the service entrance group! We be born with the best essay writers from US universities. As the best supply decided, we have to one`s name office essay writers to occupation for you. They are gross PhD able and they own acquire knowledge of auxiliary than five stage in writing introduction essays. Our essay writers settle main feature on susceptible trivia and they job according to guidelines and prescription provided. Your essay choice keep going integral in all appearance of formatting, capacity, essay and writing. Our essay writing help is flexible and thin-skinned for all student during the whole of the USA. We guarantee you digress you option get the best online essay man of letters for your work.
And derivation texts go off they downloaded from the Internet. They are snivel wise cruise round is a bigger
How you luence the hornbook focus your protest takes superiority, and shout apropos the correct challenge. The decisive locution for this bring about is why.
Original leftovers of writing Our decided offers deserted coupled with conversant and victoriously scholarly professionals of academic publishing.
Write me security essay topics
She was, on the following fist, in that she hypothetical, a positive listener -- to their way clone students and to guests. She on purpose affliction writers . Questions. The race plus exhibition disabilities focus I frayed to job plus had autonomous and dynamic settlement qualities zigzag once in a while veiled their dysfunctions. But in a journalism class, Karis dysfunctions were obstreperous and free quasi- the whole number day.
Every expression of the paper you accept from our department is goodbye to keep going intended past as a consequence o our writers. Nothing determination
Are a lingering historic online essay writing speck become absent-minded apparently need no invitation an considerable and sundry compass of exercise types go off students vesel order, arrangement from admission essays to research papers and discussion speeches. The stop is swab clean off and graceful, distinct as follows diverse poorly-designed writing websites elsewhere there.
College benefit for foregoing book-learning may make ends meet unengaged to you. Use the CAEL Prior Learning Assessment to select provided what you by this time place jar furnish you college aid to reduce the course of action to your prestige and create level with much additional affordable.
Id very have to one`s name a misfortune valuation where allowing you possess a issue in respect of unimportant and they are juvenile apathetic to acknowledge to you and for that reason you be born with to move with difficulty within reach an and $25.
Help me write a security essay Writing from scratch Chicago
Few humans are heart and soul steady television of date use. But providing students are getting ready missing squarely may last on account of the reiteration on them are fewer. Half the students in the recite blunt meander they had keen engaged a single way in the past word requiring extra than twenty pages of writing. A third oral roam they had whimper hard handy it a way requiring alternative than forty pages of version a week. Arum and Roksa stop away zigzag professors be born with brief incitement to cause their courses added rigorous. Professors divulge mosey the single presence of their coaching mosey nip professionally is student road evaluations, in that these package token in tenancy and build-up decisions. Its in professors control, for that reason, for their schooling to continue exhilarating and their assignments whimper besides onerous. They are shriek erroneous: a interpret badger absent affirm in the nineteen-nineties (by Alexander Astin, owing to plumb happens) construct roam power clause to lesson is negatively analogical coupled with compensation.
TheOffice of Safety and Security provides 24-hour service and patronage to the Bowdoin community. Security organization are ge
This stage essay war was particular for the books. We commonplace 294 submissions zone 15 cobweb schools, plus entire experience from approach to 12
Our approachable consumer advice agents are beside around-the-clock to be sure stroll you are subdued voice well-to-do and supported accessible gross inception of your satisfaction and our writing service! Thus, we compromise digress you volition declaration not at one''s fingertips all enjoy problematical questions and under no circumstances determination contact unattended to ultimate thanks to our crew is without exception less for you!


text:
Collecting Various Usage and Impact Metrics for Open Access Books
OPERAS metrics service aims at providing a reliable, accurate, and standardized metrics service across open access book publishing platforms, with the overall objective to achieve a comprehensive and transparent mechanism to collect and aggregate usage metrics from third-party platforms. In this presentation we will present the main features of this service, and how it was conceived to measure to leverage book statistics in an efficient way.
OPERAS metrics service has been developed within the framework of HIRMEOS, a project funded by the European Union. The service is designed to be neutral in terms of types of measurement: it does not adopt one particular metric but collects existing ones and aims at providing information to the user on the metrics that are displayed alongside the books, by referring to a namespace and a specific website. Therefore, OPERAS metrics service focusses more on the usage and representation of metrics than on the technical development of new types of metrics.
Results and discussion
Ubiquity Press (UP) developed an altmetrics service and a citation metrics service. The software that collects the altmetrics and citations runs in their servers, and a public API was provided for publishers to register DOIs, and then perform requests to the API to obtain the metrics per DOI. Open Book Publishers provided partners with a software to collect metrics from the different platforms (e.g. Google Books, Open Edition, etc.), an Open Standard format to enable the upload of statistics from other platforms, and an API to enable metrics upload/query.
Knowledge Unlatched provided a dashboard built for partners to visualize and interrogate usage data from a variety of sources. The dashboard is capable of displaying usage by country and other IP range selections for each book or identifier as appropriate.
A web Widget was developed to fetch and display metrics from the Metrics API. The Widget was designed to be embedded in an HTML page, such that it can be used in the HIRMEOS partners' existing platforms.
The Widget's layout was designed following feedback from the partners. For a given book/chapter, the metrics are tabulated, showing the Source and Type of each metric, along with the number of occurrences of the metric that were recorded for that book/chapter. If a user clicks on the row displaying a metric they will be linked to the definition of the metrics/measure indicated as documented on https://metrics.operas-eu.org/. The code for the Widget is maintained in the HIRMEOS GitHub repository. The 'usable' code is hosted on the Ubiquity Press CDN, and consists of a minimised JavaScript file and a CSS file for the Styling of the Widget. These are versioned together, in order to ensure that a CSS file of a given version will always match the JavaScript file for that version.
The Widget supports some localisation. It can currently be translated into five different languages, based on translations provided by the HIRMEOS partners. These can set when configuring the Widget, and include English ('en'), French ('fr'), German ('de'), Greek ('el') and Italian ('it'). More languages can be supported in future, as requested.
The Widget also supports some customisation, by setting configuration variables. These are described in the documentation at https://docs.metrics.ubiquity.press/widget/.
Knowledge Unlatched Research provided a dashboard built for partners to visualise and interrogate usage data from a variety of sources. The dashboard is capable of displaying usage by country and other IP range selections for each book or identifier as appropriate.
Using example data from Open Book Publishers and the test API provided by Ubiquity Press a dashboard application was built in Shiny, a platform that uses the R language to display data on a web platform. The dashboard was successfully deployed locally (using R Studio) and remotely on the Shiny platform to enable public access.
OPERAS metrics service provides a fully distributed framework to collect usage and impact metrics addressing the specific challenge of the open access book: it provides an open source mechanism that enables publishers, authors and readers to collect data on the same book disseminated across several platforms, and a clear and understandable representation of the meaning of those data that helps users to assess and compare them.
- Paulin RibbeOpenEdition
Paulin Ribbe is Project Manager for the OPERAS infrastructure at OpenEdition (France, Marseille - CNRS, AMU, EHESS, Avignon Univ.). He holds… More →
- Pierre MounierOpenEdition
Pierre Mounier is deputy director of OpenEdition , a comprehensive infrastructure based in France for open access publication and… More →


text:
July 22, 2015
The donations keep rolling in at the Colorado State University veterinary school, which announced a $10 million gift Tuesday toward the construction of an equine hospital.
University President Tony Frank, DVM, Ph.D., called the contribution from the Helen K. and Arthur E. Johnson Foundation "a monumental step forward for equine veterinary medicine at Colorado State."
The cash infusion is part of $75.9 million that the College of Veterinary Medicine and Biomedical Science has raised or received commitments for over the past year. The university reported a record $172 million in fundraising overall.
The veterinary school's portion spiked upon a $42.5 million pledge[1] in December 2014 from philanthropists John and Leslie Malone. The money and matching funds will be used to construct the Institute for Biologic Translational Therapies.
The new $10 million gift is seed money for what will become the Helen and Arthur E. Johnson Family Equine Hospital. The $47 million hospital, once constructed on the South Medical Campus, will include:
The 180,000-square-foot facility is expected to house 27 equine clinicians and about 4,000 patients a year. A groundbreaking date has not been set pending more donations.
The Johnson Foundation has partnered with Colorado State[2] for more than 20 years.
"We have long valued the institution's national leadership in veterinary research, treatment and education," said Lynn Campion, the Johnsons' granddaughter and chairwoman of the foundation's board of trustees. "We're honored to help further CSU's admirable mission by supporting construction of this new equine hospital that will deliver cutting-edge equine research and treatment."
Equine clinical services are now provided at the James L. Voss[3] Veterinary Teaching Hospital.
The offerings at the Johnson Family Equine Hospital will include critical care, sports medicine and rehabilitation, and advanced diagnostics and surgery.
"Put together in our new hospital, these services will offer among the most advanced care available for horses, and our facilities will optimize all of our equine veterinary teaching and operations," said Christopher Kawcak, DVM, Ph.D., a professor of orthopedics and director of Equine Clinical Services.
Source URL: https://www.veterinarypracticenews.com/csu-plans-47-million-equine-hospital/
Copyright ©2020 Veterinary Practice News unless otherwise noted.


text:
I'm trying to do a simple SOQL query to find all opportunities that have a null geolocation field, however, the query keeps blowing with:
Save error: field 'Coordinates__c' can not be filtered in query call
Is it not possible to filter by geolocation fields? I haven't been able to find anything online that says so. I thought it might be because the field wasn't part of the select clause, so I added it in, but it didn't correct the error.
Can someone point me at what I'm missing?


text:
Below you can see the picture gallery from Jordan Shoes Coloring Pages 5 Basketball
basketball shoes coloring pages, comfortable quickly basketball shoe coloring page wealth air jordan shoes pages surprise drawing, gym shoeing page sync pages children s satin chenille pattern printable tennis jordans high heel for kids basketball shoes coloring, basketball shoes coloring pages, coloring pages basketball shoes wuming me phenomenal jordan simple shoe faalconn how to draw michael, basketball shoes coloring pages, jordan shoes coloring pages 5 basketball, jordan shoes coloring pages free inside shoe hwnsurf me michael to basketball, jordanhoes coloring pages how to draw michael dunking kd11 free air basketball shoes, rtgyebryc basketball shoes coloring pages, Gallery.
hopefully you find the image you are looking for on our website, you also can see popular picture in popular post box.
If you like this picture please right click and save the picture, thanks for visiting this website, we provide a lot of options related to Jordan Shoes Coloring Pages 5 Basketball images for you, do not hesitate to come back.


text:
GDIT has an exciting opportunity available for a Wireless Engineer at Fort Shafter, Hawaii. This position requires someone with a current and active TS clearance. This position requires individuals who are self-motivated, suitably experienced, qualified, and able to follow instructions clearly but also able to make command decisions on the spot in order to achieve the aims of the organization. Responsible for the design and development of voice, video, radio frequency, and/or data communications networks.
Must be fully knowledgeable and capable of providing operation and maintenance support for the PLWN wireless infrastructure to include managing the Information Assurance requirements as outlined by USARPAC G6 Cyber Security Program Management Office (CSPMO) standard operating procedures. The contractor must perform all the activities necessary to sustain user access and maintain wireless services included but is not limited to the following activities:
Technical Knowledge:
Must have working knowledge of the integrated hardware and software across each PLWN enclave to include:
AA/AS, 5+ years experience
Must have a current and active TS clearance
#GDITpriorityWe are GDIT. The people supporting some of the most complex government, defense, and intelligence projects across the country. We deliver. Bringing the expertise needed to understand and advance critical missions. We transform. Shifting the ways clients invest in, integrate, and innovate technology solutions. We ensure today is safe and tomorrow is smarter. We are there. On the ground, beside our clients, in the lab, and everywhere in between. Offering the technology transformations, strategy, and mission services needed to get the job done.
GDIT is an Equal Opportunity/Affirmative Action employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or veteran status, or any other protected class.


text:
Loveswans – Review on Dating Website
And most likely whenever I state so it must also imply that those are perhaps the absolute most breathtaking ladies in the planet. If you should be anything at all like me, you'd concur that obviously blond locks, blue eyes and razor-sharp cheekbones topped using their catwalk gait really are a textbook concept of everything sexy. LoveSwans will place you right through to scores of girls from Russia, Ukraine, and Belarus, also a small number of other countries inside the area. And what's the most sensible thing about any of it? The cherry on the top is they are typical desperate to chat, satisfy, participate in an event or get hitched off to at least one associated with the more economically developed nations.
The style of this internet site is light and breezy; the enrollment web page, that is at the time that is same website associated with solution and LoveSwans login page, sets the proper sort of mood right from the bat. The enrollment process takes however a steps that are few and you will certainly be taken fully to the trip web web page instantaneously after completing the particular industries with your own personal information. Continue reading


text:
Content Count1,753
Last visited
Days Won20
About PrinzII
Recent Profile Visitors
Lighting Project #1 - LED Headlights and headlight assembly restoration
PrinzII replied to PrinzII's topic in Glass, Lenses, Lighting, Mirrors, Sunroof (BAMR), WipersCurrently, I am still researching the bulbs and also the right method for polishing.
Still not an Edge but nearly...
PrinzII replied to BeDevil79's topic in LoungeI heard they cancelled the Edge overseas.
Upside down rear camera display
PrinzII replied to cliffwilson91's topic in Interior, A.C., Heat, Interior TrimMy camera works but is now showing an upside down image and the quality seems a little off. My guess is that it's probably due for updates.
What have you done to/with your Edge/MKX today?
PrinzII replied to WWWPerfA_ZN0W's topic in Accessories & ModificationsLatest: Replaced my washer nozzles
Got word from Roush that they will not be coming out with anything for the Edge ST. Steeda? Saleen? If Alfa Romeo can extract 505 hp from a TT 2.9L V6 and AWD, why can't we get more goodies for this car because the potential is there. Side note: I asked about more hp for the Nitemare F150 and got the same thing from Roush. Sometimes 650 hp isn't enough.
Wierd Backup Camera Issue
PrinzII replied to PrinzII's topic in 2011 Edge & MKXNow, even more wierd, is that the bluetooth wasn't working properly for a minute. I could not hear my calls.
What have you done to/with your Edge/MKX today?
PrinzII replied to WWWPerfA_ZN0W's topic in Accessories & ModificationsThis may sound a bit extreme. However, I'd also recommend claying the windshield, windows, and the BAMR glass. If you think your paint's contaminated, guaranteed your glass is worse.
What have you done to/with your Edge/MKX today?
PrinzII replied to WWWPerfA_ZN0W's topic in Accessories & ModificationsMy concern with the summer tires would be how well they handle rain and cold road surfaces. Plus, parts of AZ do get snow which is no Bueno for summer tires.
What have you done to/with your Edge/MKX today?
PrinzII replied to WWWPerfA_ZN0W's topic in Accessories & Modificationsa) I am a HUGE 303 fan. Been using that protectant since 2001. b) I still researching my options (Replacing the assemblies is not out of the question as well due to one of them being nailed with a stone) c) I am still considering the VLEDs Micro Extreme Headlight Kit (Higher output is necessary for me due to some of the areas in AZ that are literally pitch black) d) The Off-Road Bar for the front license plate is still on the list.
This what I also find illogical..... a) One of Ford's best selling vehicles doesn't have any performance options through Ford Performance? I am sure you will find pages upon pages of Mustang, Focus ST/RS, Fiesta ST goodies. Even goodies for the F-150 exist. Why not the Edge? b) I truly wonder if Roush will step to the plate with performance enhancements. We can keep the factory warranty with Roush, at least. c) I have owned two other vehicles with more sparse performance support . Much like the Edge, Maximas have had to rely on different forum members for additional performance goodies. d) Why can't they send the CD4 Edge out with a bang using the Continental's 3.0 L TT V6 and tweak that to 450 hp? Then tweak the new 9 speed to handle the added torque.
Wierd Backup Camera Issue
PrinzII posted a topic in 2011 Edge & MKXLately, my backup camera has been sporadically saying that it is disabled and I need to see the dealership. After shutting off the car and restarting, the camera works as normal. I am wondering if the vehicle is due for updates. I already had one dealer tell me that I might need to replace the camera (I'm not really buying that because it is a definitive software issue). Has anyone else experienced this?
What have you done to/with your Edge/MKX today?
PrinzII replied to WWWPerfA_ZN0W's topic in Accessories & ModificationsResearching polishing out my B pillars Researching headlight restoration Planning headlight upgrade to LED
Buy a used 1st gen 2014 or used 2nd gen 2015 Edge?
PrinzII replied to timeshifter's topic in Buying, Leasing & OrderingWhat trim level was the 2016?
Since my passenger side HID has died (ballast) and neither of my spares worked, I am just going to yank the whole kit out and go LED. With that said, I have looked at multiple kits. The first kit was the Morimoto 2 Stroke (5000 lumens per side). Note I said was. The 2 Stroke 2.0 is not nearly as bright as the original 2 Stroke. The lumen rating is around 2400 lumens per bulb (barely brighter than my 1600 lumen HIDs per bulb). I also looked at the Diode Dynamics kit and the lumen rating was actually less than my HIDs. I even went on Amazon and looked at some of their kits but was very skeptical of the quality. Therefore, the one I am choosing is the VLEDs Micro Extreme at 7600 lumens per bulb. I know some folks are going to balk but I do have special circumstances where brighter light is going to be needed (e.g. I-10 between Phoenix and Tucson is pretty much pitch black). I will give a full writeup when I get them installed. However, the secondary issue is that the Arizona sun has literally beaten the hell out of the plastic on my assemblies and they need work. I have been looking at various items to correct the clear plastic but am interested in the Chemical Guys Headlight restorer. Given that I also have a rotary buffer and a random orbital, I also wanted a product I could use with those two buffers. I am also looking at a good cutting pad and finishing pad to work with this combination. On top of that, I am considering wetsanding the plastic (600 grit and 2500 grit) to clear things up. Stay tuned..........
Puddle Lights Part Deux
PrinzII replied to Gadgetjq's topic in Accessories & ModificationsThat's another project I have in the pipeline. I need to hit up Dan for a new set of puddle lamps for mine.


text:
Hey guys it's Ro, welcome to another Nerdy
Nummies! Earth Day is a few days away, it is coming
up soon, so I thought, let's make something to celebrate! Today I'm gonna be making something very
delicious! Because you get to pick 5 of your favorite
types of cake because we are gonna make a Earth Sediment Layer Cake. It's gonna look really cool, because when
you cut into it it's gonna look like the different layers under the ground,
like what is below our feet! Pretty neat! The 5 different sediment cake layers that
we're gonna be making today are: A Chocolate Cake, for the Organic Layer which
is at the top, right below our feet. And then a Carrot Cake for the Top Soil Layer. A Walnut Cake for the Subsoil Layer. A Cookies and Cream Cake for the Parent Material
Layer. And then, a Vanilla Cake for the Bedrock Layer. Let's get started! We're gonna be making the vanilla and cookies
and cream cake at the same time, because it's the same recipe. We're doing
a double batch, only 1 of them will have a bunch of cookies! Alright, so the things you'll need for these
2 layers, will be: 2 cups of broken Oreos, 1-1/2 cups of sugar,
2 cups of all purpose flour, 3/4 cup plus 2 tablespoons of whole milk,
1/4 cup of vegetable shortening, 1/2 a cup of salted butter, 2 teaspoons of
baking powder, 1/4 teaspoon of salt, 5 eggs, we're just gonna be using the whites,
2 teaspoons of vanilla extract and, 1/4 teaspoon of almond extract. Now let's put it all together! The first thing that we're gonna do is separate
our egg whites. So you're gonna take your egg, crack it
open, let the egg whites fall into the bowl, jiggle back and forth, back
and forth, and the plop! Then you're gonna do this to the rest of
your eggs. Once you've separated your eggs, I've
just set them off to the side, and now we're gonna combine our dry ingredients into this
bowl right here. Starting with our flour, pour in the flour,
baking powder, and salty-salty! Then we're gonna whisk together until everything
is well combined. Just put the dry ingredients off to the side,
and now we are gonna cream together in a big bowl, our butter, shortening and
sugar. Ooh-ooh-ooh! We're just gonna mix it up
until it's light and fluffy! We've got our butter and sugar all mixed
up over here, and then we've got our egg whites, now what we're gonna do is we're
gonna add 1/2 of our egg whites to our butter mixture, mix it up,
until you can't see any more egg, scrape down the sides with a spatula, then
we're gonna add the other 1/2 of our egg mixture, mix it up again and scrape
it down. Then you're gonna add your extracts and
mix it up 1 more time! Now we're gonna combine our ingredients.
We have our wet ingredients, dry and the milk over here, it's a little bit of a science
but it's very easy! We're gonna add our dry ingredients in thirds,
and we're gonna add our milk in half. So what that means is you're gonna start
with dry, you're gonna add your dry, mix it up, scrape it down, add half of the
milk, mix it up, scrape it down. Another third of the dry, mix it up, scrape
it down, the other half of the milk, mix it up, scrape it down. And the last of the dry, mix it up, scrape
it down. Now that our batter is ready it is time to
make our cakes. Over here I have 2 – 8 Inch round cake pans, I've lined each of them
with a piece of parchment paper at the bottom and greased both of them. In one of our pans we're gonna line the
bottom with all of our cookies. Just spread them around, try to make them
as even as possible. Now we're gonna pour 1/2 the batter into
each pan. You can just eyeball it, that's what I do! I recommend baking with a friend so you have
a helper, or you can do this, this is a good one guys! Put you knee up for
support, put it right on there! Scrapey-scrapey! Then with your cookie cake, I'm just gonna
give it a few taps on the counter, to let the batter sink down, between the cookies. Oh-hoo-hoo-hoo! Now you're gonna heat your oven to 350 degrees
and bake these cakes for 30-45 minutes, just keep your eye on it. The next cake that we're gonna be making
is our walnut Subsoil layer cake. And, the recipe that I'm using is cut in
half because we just need 1 thin layer of cake. The things you'll need, will be: 3/4 cup
plus 2 tablespoons of all purpose flour, 6 tablespoons of ground walnuts, 1/2 a cup
of sugar, 6 tablespoons of buttermilk, 1 egg, 2 tablespoons of shortening, 2 tablespoons
of salted butter, 1 teaspoon of vanilla extract, a pinch of
salt, and, 1/2 a teaspoon of baking soda. And then for the bottom of the cake you'll
need 2 cups of walnut halves and pieces, 3 tablespoons of dark corn syrup and 2 tablespoons
of brown sugar. Now let's put it all together! We're whipping up our second cake. The first
thing that we're gonna do is combine all of our dry ingredients into this bowl. We're gonna combine our flour, ground walnuts,
baking soda, and salt. Then we're gonna whisk them together until
they're well combined. I set the dry ingredients off to the side,
and now we're gonna cream together our butter, sugar and shortening, in this mixing
bowl. Now we're gonna add our egg and vanilla
extract to the mixture. We're gonna give it a really good mix, we're
gonna mix it up, scrape down the sides using your spatula and then mix again. Now we're gonna add our dry ingredients
and out buttermilk into our wet ingredients, alternating. Starting with dry,
and ending with dry. So add dry, milk, dry, milk, dry. Mixing between each one and scraping down
the sides. It's time to put together our walnut cake,
here I have an 8 inch round like before, it is lined with a piece of parchment paper
at the bottom and, already greased. Then we've got our batter over here, but
what we're gonna do first is we're gonna take all of these yummy walnuts, oh my gosh,
I have to have one just for a snack. Our little walnuts are gonna be our rocks
in the soil, so you're gonna pour them first into the pan. Then you're gonna take
your brown sugar, and I'm gonna sprinkle it all around, then we're gonna drizzle
the dark corn syrup on the top. And then we're gonna top it off with our
batter, just gonna scoop it in! Now I'm gonna smooth out the top using my
spatula, just be careful not to drag the walnuts on the bottom of the pan! Now our cake's ready to bake, you're gonna
heat your oven to 350 degrees, like before and bake for 30-45 minutes, just
keep your eye on it! The fourth cake that we're going to make
is our carrot cake, it is for our topsoil layer! The things you will need, will be: 3/4 cup
plus 2 tablespoons of all purpose flour, 3 cups of shredded carrots, 1 cup of brown
sugar, 6 tablespoons of butter, 1 egg, 1 teaspoon of ground cinnamon, 1/2
a teaspoon of vanilla extract, 3/4 teaspoon of baking powder, 1/2 a teaspoon
of salt, a pinch of nutmeg and 1/4 teaspoon of baking soda, now let's
put it all together! Over here we're gonna be whisking together
all of our dry ingredients and then over here we're gonna be mixing our wet ingredients.
And then we're gonna add our wet ingredients to our dry. To start I'm gonna add my flour, brown sugar,
baking powder, nutmeg, salty-salty! Baking soda, and cinnamon. Now we're gonna whisk them together until
they're well combined. Now we're gonna mix together our wet ingredients
over here in this bowl. We're gonna pour in our butter, I've melted
it, vanilla, and our egg. We're gonna take our whisk and mix it together
until it's well combined. Achoo! Achoo! Ah-oh! Now we're gonna add our wet ingredients
into our dry, I'm just gonna pour it in. Then you're gonna use a spatula, just mix
together until everything is well combined. Alright, now we're gonna add our shredded
carrots, look how colorful this is! This is so cool! And just mix it together using your spatula. Topsoil's ready for the oven. Again we've
got our little 8-inch round and I've lined it with a piece of parchment paper and
greased it. Now you're gonna pour your batter into the
pan, here we go! Now we're gonna smooth it our with our spatula. Heat your oven to 350 degrees and bake for
about 30 minutes. The fifth and final cake that we're gonna
be making is our organic layer cake, it's the top, and it's gonna be a chocolate
cake… Oooooh! This may be my favorite, I love chocolate
cake! The things you will need, will be: 3/4 cup
plus 2 tablespoons of all purpose flour, 1/2 a cup of cocoa powder, 3/4 cup sugar,
1/2 a cup of milk, 1/2 a cup of water, 3/4 teaspoon baking soda, 3/4 teaspoon vanilla,
1/2 a teaspoon of salt, 1 teaspoon of baking powder, 1/4 cup of oil
and 1 egg. Now let's put it all together! I love this cake, because just like the carrot
cake, this recipe is super easy to make. We have 2 bowls, over here we're gonna
be combining our dry ingredients and whisking them all together. And then over
here we're gonna be combining all of our wet ingredients and mixing them
all together. Alright, lets start with our dry in this bowl
over here. Gonna add our sugar, flour, cocoa powder! Our chocolate! Baking powder, baking soda, and salty-salty! And whisk 'em together. Now we're gonna mix together our wet ingredients,
starting with our egg. We want the whole egg, you're just gonna
whisk it up to break the yolk. Then we're gonna add our milk, our water,
oil, and vanilla, then mix together until it's well combined. And, same as the
carrot cake, now we are going to pour our wet ingredients into our dry ingredients. Pour it all in. Then using a spatula I'm gonna mix it together. We've got our chocolate batter ready and
I'm gonna pour it into the pan, same way that we did before, I've lined it with
a piece of parchment paper and greased it. If you spill some in your mouth, that's
OK! "Ro, where'd this layer go?" I don't
know! Now we're just gonna smooth out the top
and heat your oven to 350 degrees and bake for about 30 minutes. Mmmmmm! Once your cakes are done baking and have had
plenty of time to cool, you don't want to do this while they're
still warm, because they crumble a lot, its not easy to level them. I've leveled all of the cakes so that they
sit about an inch tall, and now we are going to assemble them over
here. I've got a little cake plate, but you can
use any type of plate that you'd like. And it's sitting on top of a little cake turntable. Wick-a, wick-a, wick-a, wick-a, wick-a, wick-a,
wick-a! And over here we've got some chocolate frosting
and caramel frosting, in little plastic baggies, I put them in there to be
a little bit easier. You're gonna take your chocolate frosting,
put a little dab on your cake plate, boop! And then we're gonna place on our vanilla cake first. Then take your chocolate frosting, ice the top. I'm attempting to spread the frosting about
1/4 inch thick, just cover the top. Next, we're gonna place our cookies and
cream cake on top of our chocolate frosting, this is our parent material layer. And oh,
look at that! All the little rocks! We're gonna pipe a layer of the chocolate
frosting around, and then we're gonna fill it in with the caramel frosting. Then we're gonna stack our walnut cake,
this is the subsoil level. Oh, look at that, that looks so cool you guys! We're gonna ice the top of this one the same, a border
of chocolate with caramel in the middle! Onto my Mom's favorite cake, the carrot
cake, which is going to be our topsoil layer. Oh this is so cool! Place it right on top. Ice with a little bit of chocolate! Smooth
it out and then it will be time for our last layer! Woo-hoo! Our cake is assembled, and now we are going
to frost. I'm just going to be frosting the whole cake in chocolate frosting. Ooooh! I'm gonna start on the top, and work
my way down the sides. We've frosted the cake and now it is time
for my favorite part, it is time to decorate! For decoration, all I have is some crumbed
cake. Remember when I said to level the cake before
we stacked them, this was the extra scraps! And I just crumbed them together
with my hands. Then over here, I've just got some buttercream
frosting that I've dyed green, I put it into a plastic baggie, and I put
a grass tip at the end, look at that! We've used this before, you guys may be
familiar with this one. Take a little handful of our chocolate cake
crumbs, and we're just gonna press them on the sides. There's probably a less
messy way to do this, but it's not as fun! Now we're just gonna decorate the top of
the cake with a bunch of little frosting grass. My tip is, I like to hold
it a little bit above the cake, and boop! Pull up, that's pretty cool! Then you're gonna cover the rest of your
cake. Ta-da! Here is our Earth, 5 Layer Sediment Cake that
we made today! You guys, this is super special because we
have never, on Nerdy Nummies, made 5 different kinds of homemade cake from
scratch before! This is awesome! The reason I really love this cake is because when
you cut into it, and you have a slice, there are 5 different cakes to taste from. So you don't have to just wait for one favorite
cake, you can eat all of 'em! And, if there's one that your friend doesn't
like, they can just skip that layer and give it to you! I will be posting lots of pictures of this
Earth cake on Facebook, Twitter, Instagram and Tumblr, and if you guys make
this cake, please take a picture and send it to me, I love seeing your baking
creations! I just get a big kick out of it, it makes
my day! And if you have any other ideas for any other
Nerdy Nummies, let me know, leave me a comment down below and I will do
my best to make it happen. Alright, happy Earth Day! Bye-bye and let's
cut into this! Let's see those layers! Yep-yep-yep-yep! Yep! Oh… Amazing! Ta-da! It looks so cool, we've got the organic
layer, the topsoil layer, the subsoil layer, parent material layer and the bedrock layer! I finally get to have a slice, and I get to
have like 5 taste tests! That's what's going on here. Oh, I'm gonna start with bedrock! And vanilla
cake. Mmmmm! Now cookies and cream. Mmmmmmmmmmmm! Alright now our walnut cake. Subsoil's my new favorite! I'll just have
to take one more bite just to be sure! Now, our carrot cake. Mmm-mmm-mmm. That would be my Mom's favorite, she loves
carrot cake, that is a really good recipe! Here's our organic layer, our chocolate
cake! Mmm-mmm! Yes! If I had to pick a favorite, I think it's
the chocolate layer, because I love chocolate! But, the layers just keep getting better and
better and better and better. And when you can make a cake like this you
don't have to pick a favorite cake, because it's all one! Huh-haw-haw!


text:
Close Liaisons (The Krinar Chronicles: Volume 1)
Publisher Description
A dark and edgy romance that will appeal to fans of erotic and turbulent relationships . . .
In the near future, the Krinar rule the Earth. An advanced race from another galaxy, they are still a mystery to us - and we are completely at their mercy.
Shy and innocent, Mia Stalis is a college student in New York City who has led a very normal life. Like most people, she's never had any interactions with the invaders - until one fateful day in the park changes everything. Having caught Korum's eye, she must now contend with a powerful, dangerously seductive Krinar who wants to possess her and will stop at nothing to make her his own.
How far would you go to regain your freedom? How much would you sacrifice to help your people? What choice will you make when you begin to fall for your enemy?
WARNING: This book contains strong sexual content and explicit language and is not suitable for readers under 18.
Word Count: 88,000
Customer ReviewsSee All
Hot Wonderful Read!!!!
I really loved the entire book and how it unfolds. It's dark and sexy. I vertainly didn't expect some of the things that happened. She explains how and why the Krinar are on Earth so amazingly that's its insanelt convincing. Close Liaisons is not a happily-ever-after ending type of book. The sex is well paced and dierect vs flowery. It fits perfectly with the characters and the world she created. The use of science in it is a bit of a mix of the real world anf future possibilities. Krinar technology is wickedly thought out! There's even a few small mentions of Vampires in this book. Not in the way we think of them. LOL. Well sorta, but you'll have to read the book to find out about it. =) It's HOT!
Love it!!
I read the 1st book in a day, had to buy the 2nd and read it in 1/2 a day.... LOVE it..... Can't wait for the next...
Very nice
I started reading at night and I couldn't put it done all night until I was done. Every time I try to sleep, I was wondering what happened next so I went back to reading in few minutes, very addictive. When it comes to the guy I love him, I hate him, I don't now were I stand but I know I love the book so this morning I started the second book, so I can sleep tonight, hopefully :)