Showing posts with label at. Show all posts
Showing posts with label at. Show all posts
Tuesday, December 27, 2016
Relaxing at the park
Relaxing at the park
(taken with camera phone)
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Thursday, December 22, 2016
Hardys first class at Canine Affair Center
Hardys first class at Canine Affair Center
This morning Hardy and I attended his first class at Canine Affair Center - a basic obedience and manners class with Mary. There were two other dogs, both adults - a very large 1 1/2 year old Wheaten Terrier and a Golden Retriever. We worked on watch me, sit, down, stays, come front and left finishes. Hardy was terrific! We worked particularly on sit from a down; something he seems to have forgotten. Although we didnt work on walking during class, we worked on keeping a loose leash walking into and out of the training hall.
Hardy is still exploring the house and loves coming across one of the cats; neither of whom is nearly as happy to see him! Apparently Laurels foot is bothering her because she is taking it easy all by herself. Tomorrow Im teaching my first Introduction to Training Levels class so I am working hard to get ready!
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Sunday, December 18, 2016
Hardy and I spend a couple hours at the Honda place
Hardy and I spend a couple hours at the Honda place
Hardy went with me when I took my van down to the Honda dealership in Akron (about an hour away) so that they could fix the problem with the locks and alarm. Hardy went there when he was about 9 weeks old when I was having the same problem. After several visits in June, the problem resolved itself although its obvious now that it wasnt actually fixed.
When we got there, all the service people came by to say hello and comment on how much he has grown. He had on his vest but when people asked if they could pet him, I told him to "go say hello". This is the part that is so much easier for him than Laurel. He likes people but he is not nearly as enthusiastic about it as she. I made an interesting observation while sitting in the waiting room. I dont have a patch on Hardys vest that tells people not to pet him. I do on Laurels and based on how many people ignore it, didnt think it actually worked. However, while we were in the waiting room, every other person there, at one time or another, came over to talk and pet Hardy. Usually, people are polite and ask first but every once in awhile, there is someone who has no personal boundaries and just wont act appropriately! We were lucky - everyone was very good with both saying hello to Hardy and then ignoring him. For his part, Hardy did very well. He asked quietly and politely when he needed to go out and actually fell asleep while we were waiting. We got to practice going in and out commercial doors, going into a restroom stall together and finding a place where he is out of the way in the waiting area. We did have to move at one point because we were being stalked by a millipede - Hardy really wanted to play with him and although I dont know for a fact that eating one is poisonous, I decided it wasnt a good time to find that out. When we got home, Hardy told Laurel all about his hard day working and then took a long nap.
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Tuesday, December 13, 2016
Big weekend at Canine Affair Centers C WAGS Trials
Big weekend at Canine Affair Centers C WAGS Trials
This weekend we attended a C-WAGS trial at Canine Affair. Laurel and I competed, I was the C-WAGS Rep and on the trial committee. That made for some busy & long days but as always, it was tons of fun and great to see old friends and make some new ones. Brent took Hardy over to the AKC Puppy STAR class Saturday morning where they worked on "leave it" and loose leash walking before doing a little pre-agility - working around the equipment and going through jump standards without a bar and jumping onto the table on the floor. Then, they came and spent the rest of the weekend at the trials with Laurel and me. Hardy did a great job lounging quietly in his crate; coming out occasionally to meet and visit with people and to do some things with all the people, crates and dogs around.
Obedience was on Saturday with Rally on Sunday and because until last week Laurel had been off since Labor Day due to the ruptured ligament in her foot, I wasnt sure what to expect with her. From the very first class, it was obvious that she was very happy to be back! She ended up Qing in all 10 classes with some nice placements - 4 firsts, 4 seconds and a third with half her scores 99 (out of 100) or higher!
All in all, a great weekend! Heather always does a great job as trial secretary and general go-to-person! Mary and everyone else with Canine Affair have a lovely facility and are terrific hosts! And as always with C-WAGS, the competitors are supportive and encouraging to each other. When Laurel wasnt competing, she relaxed and slept in her crate and Hardy already has that skill. Laurel was thrilled to see all her friends again and it was fun to introduce Hardy to everyone. I was proud of them both!
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Hardy I Spent the Day at the Mobility Place Auto Dealership
Hardy I Spent the Day at the Mobility Place Auto Dealership
When it got hot here last week, I discovered that for the fourth time since Ive had my 4 year old wheelchair-modified Honda Odyssey, the air conditioning was not working again. Dont get me wrong, I absolutely love my van and would recommend it but I am getting tired of the unending air conditioning problems.
I needed to take it down to Akron (about an hour from here) to Mobility Works (the wheelchair van dealership) so that they could determine what was wrong and what they needed to do to fix it. I decided to take Hardy with me so that he could practice some public access. We got there at about 10:15 am and spent about 3 hours in the waiting room. Besides having Hardy practice laying around with things going on around him, we also spent some time working on having him pick up his leash and his mat for me. Since there wasnt anyone else in the waiting room for part of the time, I felt comfortable clicker training there.
Hardy was terrific and when we left, we practiced the new way Im going to have him get into his crate when were out by ourselves - he gets up on the backseat before I get in with my chair; then I move the crate so that the opening is to the back. When I ask him to, he jumps off the seat into the crate. Hes getting very good at it and its working well for us.
While we were down in Akron, I stopped by the Honda dealership to have our oil & filter changed and our tires rotated. Once again, Hardy spent the time in the waiting room. There were more people there but most were very polite and didnt approach Hardy or attempt to entice him to interact with them. Occasionally, I will release him with " Do you want to say hello" to go over and get petted. Usually, though, I explain that when he has his vest on and is working, it would be better to ignore him because he is very friendly and would love to say hello and get petted but then its harder for him to do his job.
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| Hardy hanging out at the mobility van dealership |
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Sunday, December 11, 2016
Dog Days at the Botanical Gardens
Dog Days at the Botanical Gardens
Today was LEADs Dog Days at the Cleveland Botanical Gardens. They invite different dog organizations to come down and spend one Sunday during the summer with them. They provide umbrellas, a table, chairs, and water. We were invited to participate last summer and then we asked Canine Affair Center to join us. Our agility instructors (who happen to be married), Rob and Ana put together an agility course and had dogs demo and then did a "try it" session. It was a huge success so we decided to do the same thing this summer.
This was Hardys first Dog Days - he stayed up in Canada last summer when I came down with Laurel to do it. Besides being there in their capacities as service dogs, they also got to participate in the agility demo! While vested, Hardy is really very good at ignoring other people (thats much easier for him than it is for Laurel!) but people can be so funny! One gentleman came up to Hardy, who was laying down, and kept calling him to come visit (over and over and over). Hardy didnt move but looked at me. I explained that he was working so he was doing what he was supposed to do by not moving. Then I released Hardy by telling him to "go visit" so he got up and went to the man who told him to "go back and lay down - youre working so you shouldnt get up." I dont know if Hardy was confused but I certainly was!
For the first part of the afternoon, we had 3 service dogs hanging out under the umbrella together. Everyone got along beautifully and generally spent time under the table laying on the cool pad or in the water. One of the dogs in Hardys agility class, Boo, came for a visit and although he doesnt always like other dogs, he and Hardy laid back to back in peaceful companionship.
Neither Laurel nor Hardy do any agility outdoors. Laurel has allergies and although my power chair could get around, I tend to get big bruises on all my joints if I bounce around too much. Since that doesnt really work for me, I havent done any dog sports outside. Also, Laurel has allergies to grasses, weeds and trees so doing stuff outdoors aggravates those as well. A couple weeks ago, we went to Rob and Anas house because they have all the agility equipment set up in their backyard and Laurel and Ana did a couple practice runs. I worked with Hardy on the channel weaves and the tire jump but we didnt do any courses or any of the contact equipment.
Rob and Ana decided to invite some beginner dogs to demo an easier course so we decided that Rob would run Laurel on the "big dog" course and Ana would run Hardy on the "baby dog" course. They each did a couple practice runs and Hardy demonstrated that he is, in fact, a 15 month old adolescent boy dog.
Laurel did very well with her demo run - she had a little problem with the weave poles the first time through but all in all, she did great! She was focused on Rob and was just having a blast! Hardy jumped 16 inches (because of his age, we are still practicing at 12 inches) and he was totally awesome! He was fast and focused and didnt look his age at all! I was so proud of both my Labs (and to be honest, my big brown boy really surprised me)!
After the demo, we went back to the table. Unfortunately, we were joined by a dog (not a service dog) that kept lunging while barking and growling at other dogs walking past our table. This is certainly not the impression we want people to have when they think of Lake Erie Assistance Dogs! Then, just when we were getting ready to leave, that same dog lunged at Hardy who was about 3-4 feet away from him and bit him on the nose. It didnt break the skin and Hardy is fine (although Laurel got very upset), but it felt like a bad end to a really lovely afternoon. I will make sure that he has plenty of opportunities to be in the company of friendly dogs and watch for any signs of stress and/or reactivity. Certainly, even though this was not a big traumatic situation, its not what I want my young SDiT (or my SD, for that matter) to be involved in. However, when all things are said and done, I was very proud of both my Labs and thought it was a lovely summer afternoon!
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Tuesday, December 6, 2016
Considering Lasik At 40
Considering Lasik At 40
f you’re considering lasik after 40, there’s a major consideration. When corrected for distance, what happens to the reading? Some of my patients who are 40 and older and moderately nearsighted, take their glasses off to read. It’s easier. These patients who have lasik have one of two choices. Use reading glasses to read or have the surgeon set you up with one eye for reading and one eye for distance (monovision). There are considerations. If you are doing a lot of close up work, or a drive for a profession, monovosion can be a strain on the eyes for both far and near. Patients who already wear contacts know about this situation. If you’ve had monovision with contact lenses, chances are monovision will work with the lasik. If you don’t wear contacts, ask your eyecare professional to try contacts on you to see if you’re a candidate for monovision. This should be a fairly straight forward procedure. If you feel awkward, you’ll probably have to have both eyes corrected for far. If you take your glasses off to read normally, this might not be an ideal situation leading to frustration.
I’ve had quite a few of my patients option for lasik with excellent results. We try to cover this above situation so the patient understands what their options are.
-Dr. Robert Rothbard
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Saturday, December 3, 2016
Hardy had another big day at Dogs in the Park
Hardy had another big day at Dogs in the Park
John posted this last night on Facebook:
"Hardy Update: Little chocolate lab enjoyed 2 Puppy Classes, followed by a great outdoor puppy walk with friends Brody, Gulliver, Lexie, Cooper, Akira, Cheyenne and Lacy! Then the little guy protested through the 7pm puppy class - telling us all how grossly unfair it was to not be his turn."
When I pointed out that with four hours of puppy class and puppy walk, Hardy should have been sound asleep at 7:00, John responded:
"Yes, youre absolutely right, Linda! And by staying in his crate during the 7pm class and sleeping through parts of it, Hardy is beginning to learn both how to take turns, and how to self regulate. BTW, he thoroughly impressed his classmates with a fantastic whistle recall from out of group play, in the lake and out of sight! He is one well trained and smart little pup!"Since I did the homework after the Instant Recall workshop in July, and actually blew the whistle and then treated 50 times in one session each day for a week, Im hoping that helped his ability to do such a great job with the recall!
I understand also that although his eyes are still somewhat goopy, they are getting better and dont seem to bother him at all!
Also, not that Im counting but in 11 days, well see the little puddly in person again!
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Thursday, December 1, 2016
Diabetic Eye Disease Month at D’Ambrosio Eye Care
Diabetic Eye Disease Month at D’Ambrosio Eye Care
D’Ambrosio Eye Care wishes to announce that Prevent Blindness America has designated November as National Diabetic Eye Disease Awareness Month. This is an important time to spread the word about this potentially blinding disease. We need to work to help patients avoid the complications of diabetic retinopathy, which blinds over 8,000 Americans each year. The vision loss from diabetic retinopathy can be prevented if its caught and treated in time. A recent study found that more than one third of those diagnosed with diabetes do not adhere to vision care guidelines recommending a dilated eye exam every year.
As part of Diabetic Eye Disease Awareness Month we are urging people with diabetes to have a dilated eye exam every year. The longer a person has diabetes, the greater his or her risk for developing diabetic retinopathy. However, diabetic retinopathy does not only affect people who have had diabetes for many years, it can also appear within the first year or two after the onset of the disease.
Patients can help to reduce the risk of developing diabetic eye disease by not smoking, controlling their cholesterol and lipid profile and blood pressure, as well as working to eat a heart-healthy diet rich in fish, fruit and green leafy vegetables and exercising.
The key to successful treatment of diabetic retinopathy is early detection and intervention. If you or someone you know has diabetes or is even pre-diabetic, please feel free to schedule a diabetic eye examination at D’Ambrosio Eye Care by calling us Toll Free at 800.325.3937.
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Monday, November 28, 2016
Silky Alpaca at Mother Earth News Fair
Silky Alpaca at Mother Earth News Fair
Silky Alpaca’s bulky yarn and Lopi, along with some very nice lace weight and hand-spun yarns will be showcased at the Mother Earth News Fair in Puyallup, WA June 4-5. Silky Alpaca yarns will be joining other farms in the Hidden Treasures Group to offer alpaca socks, sweaters, rugs, etc. And yes, of course, we’ll have a few of those precious Pendleton blankets and scarves available. So think about getting your Christmas shopping done in June this year and join us at the Mother Earth News Fair. We will feature spinning demonstrations, fiber and yarn tips, and alpaca livestock and lifestyle information.
See you June 4-5 in Puyallup!
More Details
"Silky Alpaca Blog Event Page"
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Saturday, November 26, 2016
Beauty Haul March 2014 at CVS Using Coupons Rewards
Beauty Haul March 2014 at CVS Using Coupons Rewards
You all know that I coupon a bit, right? Well last week, there were a ton of coupons and great deals at CVS, so I picked up a few things! I figured I would share some thoughts on couponing, rewards in general and trying new products.
I dont believe in using coupons for the sake of a deal. I coupon to save money on items I already plan to spend money on, thus, actually saving money!
If you decide to start couponing, the most important thing to remember is that you dont buy something just because you have a coupon for it. There are a few times to break these rules, like when you are interested in trying out something new, or if you dont buy brand specific items. Or, maybe there is a fantastic deal on a pack of toothbrushes, where you end up paying $1.00. That is a great item to pick up to make care packages or donate to a local shelter!
I am very picky about the brands I use and I am the type of shopper that once I find out what I like and what works, I buy it for the rest of my life. For example, toilet paper. Did you know you can be allergic to toilet paper? I didnt either, until I went through puberty and learned that I am ridiculously allergic to Quilted Northern toilet paper. Im also allergic to Dove soap. Olay products make my skin burn.
Needless to say, when I try a new product, I expect a disaster and I try not to pay one penny more than I have too. Also, when I try something new and I dont break out in hives, small red bumps, feel like my skin is on fire or have a weird tingling feeling? Im stoked.
Even beauty products, I have to be careful with. My eyes are seriously sensitive and I cannot tell you how many times mascara has gotten into my eye and all of a sudden my eye ball is beet red, watery, itchy and swollen.
Case in point, the new Bombshell lash mascara. Im allergic to it. You want to know how I found out?
Sometimes, when I go to sleep at night, Ill wash my face but not my eyes. Yeah I know, blah blah blah. Im tired yo! Well, one night I fell asleep and when I woke up, my eyes were crusted shut and swollen. I was freaking out. I cleaned it all with warm water and opened my eyes to red, super gunky eyes. No bueno. The day before that I had worn fake eyelashes (that I had taken off) and Bombshell mascara. I figured out later it was the mascara and not the eyelash glue. It was awful, yall.
However, my overwhelming fear of having a bad reaction to a make-up product is vastly lower than my desire to try out every single beauty product I can get my hands on. I love trying new things and sure, its a risk but to me, its worth it.
Except the toilet paper thing. I only buy the purple Cottonelle and that is ALL I will buy. Cause that just aint a body part you gamble with. You get what Im sayin?
Back to my point, I like coupons. I do not buy anything just because of a coupon. I get excited when something I actually buy has a coupon. I also get excited when something I already want to try has a coupon.
Which brings me to CVS and my coupon experience this last week. Ive been wanting to try a few new things, specifically foundations. Typically, I dont like buying my foundations at the drugstore when Target sells them because Target is always $3-4 less than CVS and Rite-Aid, but Target has been out of my shade. I didnt really have a choice, but I was going to make sure I got enough bang for my buck. Armed with coupons, I hit up the CVS right by my house and purchased the following:
First Transaction:
I had a Almay $5 off two products manufacturer coupon, plus CVS was running $6 extrabucks for two Almay eye products. I picked up the Intense i-color Volumizing Mascara in Mocha and the Intense i-color Shadow Stick for brown eyes.
Cost Breakdown: $5.99 + 5.99 - $5.00 (man. coupon) = $6.98 (+6.00 extrabucks)
I had a Maybelline CVS $2 off $10 plus, I got $3 back in extracare bucks on any eyes, lips or nail products, so I picked up the Color Tattoo in Tough as Taupe and Color Show nail polish in Pretty in Peach.
Cost Breakdown: $6.99 + 4.39 - $2.00 (cvs coupon) = $9.38 (+$3.00 extrabucks)
I had a $1.00 Wet n Wild product manufacturer coupon, which I used on the Megalast Lipstick in 907 Mauve.
Cost Breakdown: $1.99 - $1 (man. coupon) = $.99.
Original Total: $27.26
Paid: $19.25
Saved: $8.01
Second Transaction:
I had a $2.00 off Revlon purchase of over $12.00, plus CVS was running a Buy One, Get one 50%, plus I had a $6.00 coupon from the previous transaction. I grabbed the Revlon ColorStay foundation for Combination skin in Sand Beige and a Revlon duel-ended Eyeliner and Highlighter in Emerald.
Cost Breakdown: $13.49 + $9.79 - $4.90 (sale) - $6.00 (extrabucks) - $2.00 (man. coupon) = $10.38
Original Total: $19.76
Paid: $11.76
Saved: $8.00
Third Transaction:
I had a $3.00 off any two Covergirl eyes, lip or nail manufacturer coupon so I picked up two lipsticks, in Honeyed and Delicious.
Cost Breakdown: $8.29 + $8.29 - $3.00 (man. coupon) - 3.00 (extrabucks) = $10.58
Original Total: $17.83
Paid: $11.82
Saved: $6.01
Total Cost Summary:
Original Total: $64.85
Paid: $42.83
Saved: $22.02
Remember, these were all things I wanted but werent a necessity. Well, other than the foundation. I did need that. The other things I figured I would wait until I have coupons or saw sales on the things Id like to have because I want to save as much as possible. With the coupons, sales and extrabucks, I was able to save a little over 30% of the total cost!
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Friday, November 18, 2016
BoA celebrates her 15th anniversary at her Japanese debut stage
BoA celebrates her 15th anniversary at her Japanese debut stage
Article: "15 years in the blink of an eye" BoA to perform on her Japanese debut stage once again
Source: TV Report via Naver
1. [+1,104, -32] No words come to mind other than amazing. I applaud BoA for the time and effort she put into overcoming everything :-)!
2. [+803, -22] That junior high schooler is now her in thirties... time flies so fast ?
3. [+678, -3]4 BoA unni is no. 1 ?
4. [+451, -21] Oh my, 15 years already ?
5. [+118, -9] When everyone else her age was playing and in school, she debuted at 15 to promote in Japan all by herself while maintaining Korean activities. Now shes already 30 years old and a director at SM. Cant imagine the difficulties and pain to get to where she is now. What an amazing woman.
6. [+108, -9] Even if she wasnt a singer, she wouldve succeeded in whatever else she pursued because shes such a hard worker
7. [+93, -7] The original Hallyu star, she set up the foundation for Korean stars in Japan
8. [+81, -7] SM needs to take care of BoA more. If not for her, TVXQ SNSD Super Junior wouldnt even exist. Lee Soo Man would still be releasing albums and performing at night clubs to pay back all his debt. Why is her 15th anniversary fan meet size only 150 people? Shes not some nameless singer, shes a top level solo singer in Japan.
9. [+82, -11] BoA you are truly the no.1 female solo
10. [+54, -3] Shes already in her thirties? Doesnt look like that at all
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Tuesday, November 15, 2016
Hardy spent today at Working Dog Weekend event
Hardy spent today at Working Dog Weekend event
Hardy, Brent and I spent today at the Working Dog Weekend event at Lake FarmPark. Ive taken Laurel in past years but this year more than ever I really appreciated what a great place the FarmPark is for service dog training, whether the Working Dog event is going on or not. Im thinking that a membership might be a worthwhile tool for our training plan.
Working Dog Weekend is an annual event at which various dog related vendors and exhibitors are in attendance along with a dog friendly audience as well as some unsuspecting visitors who didnt realize there was a special event going on.
In general, the FarmPark is a beautiful place with nice paths to walk on, farm animals and some farm-related exhibits. Besides this event, they have a wine tasting event and a arts and crafts show, a farmers market, and a harvest festival, to name a few.
Today, Hardy got to see llamas and alpacas, Clydesdales and Belgium draft horses, sheep, and huge tractors pulling wagons carrying people around for the first time. He wasnt a big fan of the tractors as they came past us so of course, we spent lots of time letting them do just that. When we went to see the Clydesdales, they were standing very still and the first time one of them moved, Hardy jumped. We hung around long enough for him to get comfortable watching them. Then, we went into the arena and met some Belgium drafts who were standing right at the doors to their stalls. Up close, they have huge heads and are pretty intimidating (although they are generally gentle giants). It took Hardy a while to get close to the stall door but we waited around until he could do it. He found the llamas and alpaca interesting but much less worrisome! He also watched intently while a flyball team demonstrated that sport and then during a police dog demonstration. He was pretty thrilled by the dogs trying out dock diving as well as those playing Frisbee. We also saw a Border Coolie herding sheep and enjoyed watching our friends doing agility and freestyle.
The benefit and curse of the day was the fact that most people there were dog friendly. Unfortunately, that didnt necessarily mean that they were dog knowledgeable! As a result, many people came up to Hardy - some asked first but most did not. Both children and adults "mugged" him by grabbing his tail or his face. I kept thinking how dangerous that behavior could be with the wrong dog. I was very proud of Hardy though because he remained relaxed and nonplussed throughout and waited for me to ask him if he "wanted to say hello" before he approached people or responded to their attention.
I do believe he got tired of dogs "goosing" his behind - I know I certainly did! Too many people had dogs on flexis without paying attention to where they were going or what they were doing! Other people were just unconscious or unconcerned about what trouble their dog might be getting themselves into and once again, I thought how dangerous that could be. Hardy handled it all like a trooper and I worked to keep him away from uninvited interest from people or other dogs but I couldnt always do that since they would approach from all directions and climb over me to get at him. Brent commented that most people werent paying attention to my attempts to get them to control themselves or their dogs! I dont know if I suddenly become mute when in my chair but it certainly seems like I do!
Still, it was an enjoyable day; Hardy handled a number of "firsts" with calm confidence and had great opportunities to practice his public access skills in the most difficult situation to date!
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Sunday, November 13, 2016
Saturday, November 12, 2016
Hardy Gets to Practive Correct Service Dog Behavior at the Hospital
Hardy Gets to Practive Correct Service Dog Behavior at the Hospital
Yesterday morning, I took Hardy with me to the Cleveland Clinic Pain Center for a routine pump refill at 8:30 am. I have an intrathecal pump implanted which sends Baclofen (an antispasticity medication) right into my spinal column. Every six weeks or so, I go in so that they can put more Baclofen into the pump using a syringe and needle through the pumps port. Usually, the refill goes perfectly fine - theres one stick, the needle ends up in the port and theres no problem getting the medication into the pump. Finding the port in mine tends to be more difficult since its my second pump so theres lots of scar tissue. As a result, its hard to feel the borders of the pump which is necessary in order to locate the relatively small port entry so occasionally, theres a minor problem when the nurse has difficulty getting the needle into the port resulting in multiple needle sticks.
Ive had a pump now for at least 10 years and yesterday something unique happened. The nurse thought she had gotten the needle into the port and began injecting the Baclofen. After putting in a couple ccs, she became concerned about the location of the needle. She went to find out whether we could use the fluoroscope (like an x-ray machine). We moved into the surgical suite to use the machine and discovered that the needle was not in the port and in fact, the pump was oriented pretty much opposite of what we had thought. My nurse withdrew the needle and using a new one, got it right into the pump.
After completing the refill, she contacted my doctor regarding the medication that she inadvertently injected subcutaneously. The concern was how concentrated the medicine was and what the effect would be as I absorbed it. Baclofen is a drug that can be dangerous if you get too much of it or stop taking it suddenly - you need to taper the amount going up or down. Since no one knew how quickly I was going to absorb it and one possible effect of an overdose is death, my doctor decided that I should stay in the hospital overnight.
I had to spend time in the surgical recovery at the Pain Center while they found me a hospital room. My refill nurse asked whether Hardy could stay with me and the recovery room nurses set me up in a cubical at one end of the room so that he could.
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| Hardy watching in the recovery room |
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| And Hardy sleeping there |
My roommate was there for a pain pump trial and was just amazed at all the things Hardy and Laurel do for me. She has a black Lab at home and was very hopeful that she might learn to do some things to help her at home. Although she doesnt live anywhere near me, a friend of mine is a trainer near her so I will put them in touch when the time is right. She was very sweet and told me that I was there for the night so that she could meet me and feel hopeful about her future! That made an annoying event seem much more positive for me too!
I sent Brent and Hardy home at about 9:30 pm. Hardy could have stayed the night but I wasnt up to taking him out so I thought hed be better off at home. I came home at about 12:00 today - which is Brents and my 32nd Anniversary!
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| Hardy visiting in my hospital room |
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| Hardy visiting me on his mat on my bed |
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| Hardy visiting me in bed at the hospital |
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Friday, November 11, 2016
Tuesday, November 8, 2016
Multifocal Lens Implants IOL at D’Ambrosio Eye Care
Multifocal Lens Implants IOL at D’Ambrosio Eye Care
Intraocular lenses, or IOLs as they are more commonly known, are artificial lenses that are used to replace natural lenses that have become clouded with cataracts. They can also be used as a solution for people who suffer from presbyopia, a condition in which the lens becomes less flexible, thus losing its ability to focus on near objects. Before the U.S. Food and Drug Administration approved the use of intraocular lenses in 1981, patients who had cataract surgery were forced to wear thick eyeglasses or contact lenses to improve their vision.
Monofocal Lens Implants vs. Multifocal Lens Implants
Traditional, or Monofocal IOLs, can only offer patients improvement at one set distance, usually for seeing far away. At D’Ambrosio Eye Care we offer our patients Multifocal Implants to help our presbyopic and Cataract Surgery patients see more clearly at a range of distances. This technology allows us to replace the eye’s natural lens with a new, artificial lens that can help restore visual clarity to near, intermediate and distance vision.
If you have any questions about Cataracts, Cataract Surgery or Lens Implants please feel free to phone D’Ambrosio Eye Care Toll Free at 800.325.3937 to schedule a consultation and examination.
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Sunday, November 6, 2016
Im Not Good at Life Part 1
Im Not Good at Life Part 1
Ive always been honest on this blog. I want this to be a reflection of me, broken, imperfect, silly. I write about things I like and things that have happened to me. I write for me. I write because if I dont, I feel weird.
Today Im writing to say that I suck at life.
Im just not good at it.
I dont like dealing with things. Id rather do anything else than deal with anything. Does that make sense? I often shame myself into accomplishing tasks that other people do without thinking. Like... Laundry. Sure, no one likes doing laundry and if they do, well. Poor them. I see laundry and I get overwhelmed. I get anxious. Ill do it tomorrow, I say to myself.
Original Artwork Via
Tomorrow comes and I see the laundry and I know I need to do it. I can recognize this. I know I have nothing to wear to work the next day. I know I am wearing the last pair of underpants I have, you know, the ones with the holes that are the backups of the back-up backups. The ones where, if I got in a car accident and died, these would be the last pair of underwear I would want to be wearing when they take my body to the morgue. Yet? The next day I wake up, curse myself that I didnt do the laundry and either go commando or I find a pair of underwear that Ive had since high school and no matter how much I yank and pull they just do. not. fit.
I go to work and chide myself, I need to be better! Do better! Look at my coworkers. I bet they are wearing underwear. I bet they do laundry on a regular basis. I bet they didnt pick up the shirt from the pile by the bed, smell it and figure, eh. good enough. All throughout work Im like yes! Im going to go home and organize my life. I cant live this way! Except when I get home I eat a taco and there is a whole lot of nope-ing happening.
Nope, Im not doing laundry tonight. Im tired. Nope, Im not cleaning up my make-up area. Nope, Im not fixing the pillows on the couch. Nope, Im not vacuuming or dusting. Im just going to stay here, in the dark, and try not to move. Or do anything.
Unless its fun. Oh! People want to meet up for dinner? YES. My sister wants us to stop by for a game night? Count me in! Date night? Sure! Target run? Please. Im already in the car.
This, Ive concluded, is not normal. We are gone from home more nights than we are home. We do anything we can to not be at home. Why? Because our house sucks. No one has vacuumed or dusted or done laundry or fixed the pillows on the couch in ages.
I believe this is part of the reason why I even stopped writing. I cant be creative in a house where every corner has a project or a pile. I cant use my imagination to create another world when Im busy imagining that pile of laundry isnt in the middle of the bedroom floor.
I need to change it. I want to change it. Yet I dont. I cant handle it all. I cant work for eight hours and then come home and scrub toilets. I cant work every day of the week and then spend all weekend pulling weeds.
Its suffocating.
Today, as Bryan and I were cleaning our bedroom I told him, I feel like I could be the kind of woman that just disappears. That walks away from it all and leaves everything behind. Bryan asked me, "Wouldnt you miss Shepherd too much?" Yes. I would. I dont think I could ever do it, really, because of the damage it would do to him.
But that doesnt stop me from imagining the freedom I would feel as I ran. And that makes me feel like maybe... just maybe, there is something truly wrong with me.
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Friday, November 4, 2016
Male Attendance at Title X Family Planning Clinics — United States 2003–2014 MMWR
Male Attendance at Title X Family Planning Clinics — United States 2003–2014 MMWR
Male Attendance at Title X Family Planning Clinics — United States, 2003–2014 | MMWR
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| MMWR Weekly Vol. 65, No. 23 June 17, 2016 |
| PDF of this issue |
Male Attendance at Title X Family Planning Clinics — United States, 2003–2014
Weekly / June 17, 2016 / 65(23);602–605
Ghenet Besera, MPH1; Susan Moskosky, MS2; Karen Pazol, PhD1; Christina Fowler, PhD3; Lee Warner, PhD1; David M. Johnson, MPH2; Wanda D. Barfield, MD1 (View author affiliations)
View suggested citationSummary
What is already known about this topic?Although both men and women have reproductive health care needs, reproductive health services traditionally focus on women. Since 1970, the Title X program has provided family planning and related preventive health services with priority for services for low-income women and men. Most clients are women, but the Title X program also promotes use of clinics by men through delivery of male-focused health services.
What is added by this report?Title X service sites have increasingly provided services to male clients. During 2003–2014, 3.8 million males visited Title X service sites in the United States and the percentage of all family planning users who were male nearly doubled from 4.5% (221,425) in 2003 to 8.8% (362,531) in 2014. In 2014, the percentage of family planning users who were male ranged widely by state from ?1% in Mississippi, Tennessee, and Alabama to 27.2% in the District of Columbia.
What are the implications for public health practice?Health care settings might want to adopt the framework employed by Title X clinics to better provide family planning and related preventive health services to men.
Although both men and women have reproductive health care needs, family planning providers traditionally focus services toward women (1,2). Challenges in providing family planning services to men, including preconception health, infertility, contraceptive, and sexually transmitted disease (STD) care (3,4), include their infrequent use of preventive health services, a perceived lack of need for these services (1,5), and the lack of provider guidance regarding men’s reproductive health care needs (4). Since 1970, the National Title X Family Planning Program has provided cost-effective and confidential family planning and related preventive health services with priority for services to low-income women and men. To examine men’s use of services at Title X service sites, CDC and the U.S. Department of Health and Human Services’ Office of Population Affairs (OPA) analyzed data from the 2003–2014 Family Planning Annual Reports (FPAR), annual data that are required of all Title X-funded agencies. During 2003–2014, 3.8 million males visited Title X service sites in the United States and the percentage of family planning users who were male nearly doubled from 4.5% (221,425 males) in 2003 to 8.8% (362,531 males) in 2014. In 2014, the percentage of family planning users who were male varied widely by state, ranging from ?1% in Mississippi, Tennessee, and Alabama to 27.2% in the District of Columbia (DC). Title X service sites are increasingly providing services for males. Health care settings might want to adopt the framework employed by Title X clinics to better provide family planning and related preventative services to men (3).
To describe male client attendance at service sites funded under the National Title X Family Planning Program, CDC and OPA analyzed data from the 2003–2014 FPAR.* FPAR contains data from all entities that receive Title X grants to support the delivery of family planning and related preventive health services. In 2014, about four million clients were served through approximately 4,100 Title X service sites. Data were included from Title X service sites in the 50 states and DC and used to describe 1) trends in the percentage of family planning users who were male; 2) state-level variation in the percentage of family planning users who were male; 3) demographic characteristics of males who were family planning users; 4) percentage of males who adopted or continued use of a contraceptive method and method type; and 5) receipt of testing for chlamydia, gonorrhea, syphilis, and human immunodeficiency virus (HIV) among males. A family planning user was defined as a person who had at least one family planning encounter at a Title X service site in a calendar year, where an encounter consists of a documented, face-to-face contact with a family planning provider for the purpose of delivering services to clients who want to avoid unintended pregnancies or achieve intended pregnancies. For the purposes of inclusion in FPAR, written documentation of the services provided during the family planning encounter in the client record is required.
During 2003–2014, a total of 3.8 million males visited Title X service sites, and the percentage of family planning users who were male nearly doubled from 4.5% in 2003 to 8.8% in 2014 (Figure 1). The percentage of family planning users who were male increased each year during 2003–2014, with the exception of 2010–2011, when no change was observed (Figure 1). Among males aged 20–29 years, an increase occurred every year during 2003–2014, and among males aged ?30 years, an increase occurred every year except 2011. In contrast, the percentage of users who were male and aged <20 years peaked in 2009 and 2010 at 1.8% and subsequently decreased (Figure 1). There was also a 63.7% increase in the overall number of male clients visiting Title X service sites from 221,425 in 2003 to 362,531 in 2014.
In 2014, 34.6% of male family planning users were white, 27.6% were Hispanic, and 24.2% were black. Approximately half of male users (49.0%) were aged 20–29 years, with lower percentages aged 30–39 years (20.4%) and 15–19 years (14.4%) (Table). By state, there was wide variation in the percentage of total family planning users who were male, from lows in Mississippi (0.7%), Tennessee (0.7%), and Alabama (1.0%) to highs in Rhode Island (16.1%), Delaware (19.1%), and DC (27.2%) (Figure 2).
The majority (87.5%) of male users adopted or continued use of a contraceptive method at the conclusion of their last family planning encounter in 2014, with the male condom being the most common (71.9%). Two thirds of males (66.6%) were tested for chlamydia. Receipt of chlamydia testing was highest among males aged 20–24 years (76.9%) and lowest among males aged <15 years (15.5%) (Table). In 2014, for every 10 male family planning users overall, Title X service sites also performed 7.5 gonorrhea tests, 3.3 syphilis tests, and 5.7 confidential HIV tests. By state, for every 10 male family planning users, the number of gonorrhea tests performed ranged from 0.7 (New Mexico) to 10.7 (Delaware); the number of syphilis tests performed ranged from 0.02 (New Mexico) to 9.5 (Alabama); and the number of HIV tests performed ranged from 0.02 (New Mexico) to 9.3 (Alabama).
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Discussion
Although women continue to represent >90% of Title X family planning clients, the percentage of family planning users who are men is increasing. During 2003–2014, the percent of family planning users who were men nearly doubled, with the most consistent increases occurring among men aged 20–29 and ?30 years. During the past 15 years, OPA has aimed to increase the number of men who use Title X services by funding projects and training to improve outreach and male-centered appropriate service delivery (6).
In 2014, CDC and OPA published Providing Quality Family Planning Services: Recommendations of CDC and the U.S. Office of Population Affairs, which describes services that should be offered in a family planning visit, and guidance for providing those services to both men and women (3). Recommended services for men include education and counseling on a range of issues related to preventing or achieving pregnancy, including, but not limited to, preconception health, infertility, contraception, and STD and HIV care (3). Preconception health, infertility, and STD and HIV services are included as family planning services because they improve the overall health of women and men and can influence their ability to conceive or have a healthy birth outcome (3). Title X sites also connect men with broader primary care services, through referral or direct provision of services.
These recommendations can be used by providers to offer family planning services to men, thereby improving their access to sexual and reproductive health care (3,4). Family planning services are embedded within a broader framework of services, such that providers assess the client’s need for related preventive services even when the primary reason for their visit relates to preventing or achieving pregnancy (3). The recommendations are also designed to optimize opportunities to provide men with reproductive health services by converting a standalone visit (e.g., a complaint related to an STD) to a more comprehensive family planning visit that also addresses issues related to unintended pregnancy prevention (e.g., sexual risk, reproductive health planning, and contraception) (3,4). This approach is especially important for serving the family planning needs of men, who might not otherwise receive these services (4).
The findings that provision of male condoms and testing for STDs were common among male users of family planning services and that most male family planning clients were Hispanic or black are similar to those reported in other studies (7,8). Meeting men’s needs related to contraception and STD testing is essential, considering the role men can play in preventing unintended pregnancy and given the high rates of STDs among men, especially low-income and minority men (2,4,9). Addressing these needs as an opportunity to promote “dual protection” (i.e., preventing both unintended pregnancy and STD) benefits both men and their partners.
The findings in this report are subject to at least two limitations. First, because only summary information on a limited number of client characteristics is required to be collected from Title X grantees for the FPAR, certain types of client characteristics (e.g., sexual orientation and education) and services provided (e.g., preconception care and infertility) could not be assessed. Second, there are possible errors in reporting from service sites. However, using administrative data routinely reported by clinics eliminates the possibility of biases related to relying on client self-report, especially as it relates to sexual and reproductive health topics.
Meeting the sexual and reproductive health needs of men and women is important for improving their overall health. Although men’s use of family planning services remains low compared with that of women, an increasing number of men seek family planning and related preventive health services at Title X service sites. To meet the needs of the growing number of male clients, these services should be offered using a client-centered, male-focused approach in health care settings (e.g., Federally Qualified Health Centers and urology and family practice health care settings) that provide sexual and reproductive services to men.
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Corresponding author: Ghenet Besera, GBesera@cdc.gov, 770-488-6326.
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1National Center for Chronic Disease Prevention and Health Promotion, CDC; 2Office of Population Affairs, US Department of Health and Human Services, Rockville, Maryland; 3RTI International, Research Triangle Park, North Carolina.
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References
- Kalmuss D, Tatum C. Patterns of men’s use of sexual and reproductive health services. Perspect Sex Reprod Health 2007;39:74–81. CrossRef PubMed
- Sonfield A. Looking at men’s sexual and reproductive health needs. Guttmacher Rep Public Policy 2002;5:7–10.
- Gavin L, Moskosky S, Carter M, et al. Providing quality family planning services: recommendations of CDC and the U.S. Office of Population Affairs. MMWR Recomm Rep 2014;63(No. RR-4).PubMed
- Marcell AV, Gavin LE, Moskosky SB, McKenna R, Rompalo AM. Developing federal clinical care recommendations for men. Am J Prev Med 2015;49(Suppl 1):S14–22. CrossRef PubMed
- Chabot MJ, Lewis C, de Bocanegra HT, Darney P. Correlates of receiving reproductive health care services among U.S. men aged 15 to 44 years. Am J Mens Health 2011;5:358–66. CrossRefPubMed
- Office of Population Affairs. Male family planning services. Washington, DC: US Department of Health and Human Services, Office of Population Affairs; 2016. http://www.hhs.gov/opa/title-x-family-planning/initiatives-and-resources/male-services/
- Finer LB, Darroch JE, Frost JJ. Services for men at publicly funded family planning agencies, 1998–1999. Perspect Sex Reprod Health 2003;35:202–7. CrossRef PubMed
- Raine T, Marcell AV, Rocca CH, Harper CC. The other half of the equation: serving young men in a young women’s reproductive health clinic. Perspect Sex Reprod Health 2003;35:208–14.CrossRef PubMed
- CDC. Sexually transmitted disease surveillance 2014. Atlanta, GA: US Department of Health and Human Services, CDC; 2015. http://www.cdc.gov/std/stats14/surv-2014-print.pdf
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* http://www.hhs.gov/opa/title-x-family-planning/research-and-data/fp-annual-reports.
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FIGURE 1. Trends in the percentage of family planning users who were male, Title X service sites — United States, 2003–2014
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TABLE. Distribution of male family planning users by race/ethnicity, age group, chlamydia testing, and primary contraceptive method, Title X service sites — United States, 2014
| Demographic characteristic | (%) N = 362,531 |
|---|---|
| Race/Ethnicity | |
| Black* | 24.2 |
| Hispanic† | 27.6 |
| White* | 34.6 |
| Other§ | 13.7 |
| Age group (yrs) | |
| <15 | 2.5 |
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