#cardiac specialists in my area

[murphysmom67]

March 4/23

I preface this post by saying I am not an alarmist. I do not exaggerate or fabricate. When I write about psychiatric concerns, I write as though it is a legal document and I will support and stand behind it.

I believe the following needs to be said and, most importantly, acknowledged by those concerned. It is essential, indeed crucial, to this man's welfare, life and even death, that those who have the power must intercede on his behalf immediately. I mention no names because this information is highly personal and extremely distasteful. Those to whom it is addressed will know the individual.

I have worked as a Psychiatric Nurse since 1980. In 1991 I was employed as a Nurse Counsellor with a private caseload. I had a degree in Psychology but wanted to learn about therapeutic theory and techniques. I studied through more university courses, professional reading, conferences and courses with specialists in my area of interests - PTSD, Sexual Trauma and MPD (Dissociative Identity Disorder). The majority of my caseload at any one time involved adult survivors of childhood sexual abuse, Cult survivors, and those diagnosed with DID. After over 20 years experience with these clients I believe I am competent in these areas.

I have been privy to this man's psychiatric and familial history as well as his clinical progress over the past 4 years. I have had the pleasure of working with someone who has the insight and maturity to understand this man far better than I ever could. I offer information relevant to his psychiatric condition and hope I have contributed useful insight.

As of this writing, I must express my professional apprehension about this man and his present circumstances.

I have come to understand that whenever a new project is begun for the use of his acting abilities, part of the "deal", offered by his ex-partner and possibly others, is access to the man for sexual performance, escort service, torture. Because of his extreme acting abilities and popularity, the ex-partner can charge thousands for his "services". What is of paramount importance, is that this man is UNABLE to refuse. He has been trained, abused, tortured to teach him to comply. He was then programmed as a sexual escort and taught to never refuse, complain or argue with the buyer. It is made explicitly clear that he is disposible and can be killed if the buyer sees fit. He is replaceable, not as an artist but as a sexual object.

As a therapist, with experience with this kind of trauma, I feel it is absolutely essential to rescue him. He is getting older. As an individual who has already had to endure reconstructive surgery, and knowing what these people do to him, he is at risk of tears, abdominal perforation of the bowel, fissures and cardiac arrest. The consequent blood loss internally could kill him in a few minutes. He is at risk of choking, bruising and fracture of the oropharynx as well as torn tissue.

Psychologically, thank god, he has defenses created in childhood, however he is at high risk of shock leading to catatonia, a psychotic reaction to trauma that the mind cannot tolerate. Eventually he will recall what he is forced to do and the shame will overwhelm him in spite of the fact that he didn't want to comply.

My greatest concern is that he will lose hope that anyone will save him. He will realize he is helpless and the only option is to die. His supports are long distance and TPTB have not allowed him physical access. He will commit suicide and I wouldn't blame him. He is remarkable in that he has lasted this long. I fear that his death may be made to look like suicide if they kill him. Certainly a common occurrence in these times.

I hope you will acknowledge and take action. I rarely feel this strongly about a "client" (he's not but I am involved), but I rarely am in a position to feel this helpless.

I have an abundance of images in my mind of what they are doing to this man, as well as his ex-partner who has some extremely perverted sexual needs. I could not tolerate these images without voicing my exigent concerns. Please do not allow this to continue.

[kushitworld]

Unlocking the Heart of SEO- Maximizing Online Visibility for Cardiologists

In today's digitally driven world, establishing a robust online presence is paramount for professionals across various industries, including the field of cardiology. With the vast majority of individuals turning to the internet to seek information, solutions, and even healthcare services, optimizing online visibility has become a crucial aspect for cardiologists aiming to reach their target audience and expand their patient base.

Search Engine Optimization (SEO) stands at the forefront of enhancing online visibility. For cardiologists, leveraging SEO strategies can significantly impact their practice by ensuring they appear prominently in search engine results when potential patients seek cardiac-related information or services.

Understanding the Heart of SEO

SEO involves a series of practices aimed at improving a website's ranking on search engines like Google, Bing, and Yahoo. For cardiologists, the goal is to secure a higher ranking when individuals search for cardiac-related terms, procedures, or specialist services. By aligning with the algorithms used by search engines, cardiologists can enhance their online visibility and attract more patients.

Tailoring Content for Cardiac Audiences

Creating informative and relevant content lies at the core of effective SEO strategies. Cardiologists can optimize their online presence by producing high-quality, educational content that caters to their target audience's needs. This could include blog posts, articles, or videos discussing various cardiac conditions, treatment options, preventive measures, and healthy lifestyle choices.

Utilizing Local SEO Tactics

Given that healthcare services are often sought within a specific geographical area, employing local SEO tactics is crucial for cardiologists. This involves optimizing content with location-specific keywords, ensuring the practice appears in local listings and directories, and encouraging patient reviews and testimonials on platforms like Google My Business.

Enhancing Website Performance and User Experience

Search engines prioritize websites that offer a seamless user experience. For cardiologists, ensuring that their website is mobile-friendly, loads quickly, and provides easy navigation is imperative. Additionally, optimizing the website's technical aspects, such as using relevant keywords, meta tags, and structured data markup, can significantly boost its visibility in search engine results.

Embracing the Power of Social Media

Social media platforms provide an excellent avenue for cardiologists to engage with their audience, share informative content, and build a reputable online presence. By regularly posting educational content, patient testimonials, and updates about cardiac advancements, cardiologists can expand their reach and attract more patients.

Tracking and Adapting SEO Strategies

SEO is not a one-time effort but an ongoing process that requires monitoring and adaptation. Utilizing analytical tools to track website traffic, user behavior, keyword performance, and conversion rates enables cardiologists to assess the effectiveness of their SEO strategies. This data-driven approach allows for continuous optimization and refinement of SEO tactics to maximize online visibility.

Conclusion

In the competitive landscape of healthcare, establishing a strong online presence through effective SEO practices is essential for cardiologists to connect with patients actively seeking cardiac care. By tailoring content, optimizing websites, embracing local SEO, and utilizing social media, cardiologists can unlock the heart of SEO and maximize their online visibility, ultimately expanding their patient base and positively impacting cardiac health within their communities.

[theivorybilledwoodpecker]

Ashley and Chris started trying to conceive during summer 2018. She went off her birth control, she says, and “we got pregnant that very first cycle.” The couple felt “super excited that it happened so quickly.” (Xpress is using pseudonyms for the couple, who live in the Asheville area, to protect their privacy.) They began telling loved ones about her pregnancy and posed for a pregnancy photo shoot. “I was ready to put [the photos] in the mail as soon as we got home from an appointment” for a 12-week ultrasound and genetic testing, she says. That Friday afternoon appointment changed everything. During the scan, “I noticed the ultrasound tech was just a little bit more quiet,” Ashley recalls. The couple sat in the waiting room, “looking at the pictures of the baby, just feeling excited,” Ashley says. “Then the doctor just kind of rushes in and goes, ‘Let’s talk about these pictures,’” Ashley recounts. The physician informed them their baby had extra fluid behind its neck, and referred Ashley to a doctor who specializes in high-risk pregnancies. “I felt like I blacked out at that moment,” Ashley says. She doesn’t remember much else about that afternoon or the following weekend. The next week, Ashley and Chris found obstetrics specialists at UNC Chapel Hill and Duke University. In Ashley’s 13th week, health care providers at Duke extracted fluid from her placenta to conduct DNA testing. The couple had to wait another two weeks for the test results: Her baby, a girl, had a diagnosis of Turner syndrome, Ashley tells Xpress. “The baby didn’t just have extra fluid behind her neck; she also had it surrounding her heart, and surrounding her brain as well,” she says. Turner syndrome is a chromosomal condition that primarily affects females, according to the Mayo Clinic. People born with Turner syndrome may have heart defects and abnormal kidneys; if the child reaches adolescence or adulthood, she can have slow growth, shortness, stalled sexual development and struggles with conception, among other issues. Ashley says she was told, in her case, if her daughter were to survive throughout the pregnancy she’d likely require cardiac surgery upon birth, Ashley says. If she were to survive postnatal cardiac surgery, she would experience very high medical needs throughout her lifetime. “I think what really did it for us was that we didn’t want the baby to have a life of suffering,” Ashley says. “We chose to suffer so that she didn’t have to.” She calls the experience the darkest time of her life. North Carolina law requires Ashley to receive state-directed counseling and undergo a 72-hour waiting period before terminating a pregnancy. For the counseling, her nurse at Duke “had to read me a script of all my options I had instead of an abortion,” Ashley tells Xpress. “[The nurse] even apologized — she’s like, ‘I’m so sorry, I’m required by law to do this.’” The nurse informed Ashley about her options, such as raising a special needs child, and Ashley began “sobbing,” she recalls, and pulled the phone away from her ear. After the counseling, Ashley waited the required 72 hours before physicians provided an abortion at 16 weeks of pregnancy. Her loved ones knew about the pregnancy, and Ashley says some assumed she’d miscarried. “I didn’t know who was safe to say, ‘No, I didn’t miscarriage — we had to have an abortion,’” she explains. “I do remember [voicing my fears] to my husband. He [said] ‘It’s nobody else’s business!’”She adds, “And I [said] ‘I know it’s not their business. But it’s my truth.

It is despicable that Ashley had to go through this. Forced birthers, you don't have the right to do this to people. She had to make an unimaginable decision, and your opinion as to what she should have chosen is irrelevant.

All you do is cause pain and suffering.

[dpr-lahore-division]

With compliments from, the Directorate General of Public Relations,

Government of the Punjab, Lahore Ph. 99201390

 No.995

HANDOUT (A)

‘Maryam’s Maseehai:’ CM Maryam Nawaz Sharif Launches' Chief Minister’s Children's Heart Surgery Programme' to Save Lives of Children with Heart Diseases

Lahore, 16 September 2024:

Chief Minister Punjab Maryam Nawaz Sharif officially launched ‘Chief Minister's Children's Heart Surgery Programme' for the free treatment and surgery of children with heart disease, during her visit to Lahore’s Children's Hospital Cardiac Surgery Ward. She distributed 'Child Surgery Cards' among the deserving patients under the Programme. She said,”The operation of a sick child will be done in a private hospital if there is no place in the government hospitals.” She inspected HDU and other departments of the hospital, and reviewed various facilities available in the cardiac surgery ward.

Madam Chief Minister inquired about the well-being of the young patients, gave them gifts and also played Ludo with them. She interacted with the children, and prayed,”May Allah grant you health, we all pray for you.” She also talked to the parents of the sick children, and inquired them about the availability of various facilities. She said,”It is my mission to free every citizen of Punjab, including children, from the system of queues and waiting.” She added,”The number of specialist surgeons and allied staff will be increased to multiply the capacity of pediatric heart surgery in government hospitals.”

Chief Minister Maryam Nawaz Sharif said,”In the first phase, pediatric heart surgery facility is being provided in 6 government and designated private hospitals including PIC and Children's Hospital Lahore, Multan's Children's and PIC, and Faisalabad and Rawalpindi Cardiology Institutes.” She added,”In the second phase, facilities for pediatric heart surgery will also be provided in the hospitals of Wazirabad, Dera Ghazi Khan, Bahawalpur and Sargodha.” She also observed the dashboard developed to monitor the Programme.

Madam Chief Minister said,”I am extremely happy to launch the project as a mother, not as the Chief Minister.” She added,”I can understand the shock that mothers go through on the death of a child.”She also visited the 'play area' for children with heart diseases in the Children's Hospital Lahore, and reviewed various facilities available for them there.

Chief Minister Maryam Nawaz Sharif said,”The provision of modern facilities of children's heart surgery is a sincere effort to wipe the tears of mothers and remove the diseases of young children.”She was briefed by the authorities concerned,”More than 5000 young children die every year due to lack of timely heart surgery.” Sha added,”In Pakistan's first treatment center for children, sick children from Khyber Pakhtunkhwa and other provinces will also be treated.” She highlighted,”Children suffering from heart diseases will not have to wait for long.”

*****

[citymedicalfertility]

Critical Care Medicine at City Medical & Fertility Center

Understanding Critical Care Medicine

Critical care medicine, often referred to as intensive care medicine, is a specialized branch focused on diagnosing and managing life-threatening conditions requiring comprehensive and continuous care. This field is integral to internal medicine, as it encompasses the treatment of a wide range of severe and complex illnesses and injuries.

Our Expertise in Critical Care

At City Medical & Fertility Center, our critical care units are designed to handle emergencies with the utmost efficiency and precision. Our team comprises experienced intensivists, nurses, and support staff who work round the clock to ensure patients receive timely and effective treatment.

Our critical care services include:

Advanced Monitoring: Continuous monitoring of vital signs and organ functions.

Respiratory Support: Including mechanical ventilation for patients with severe respiratory distress.

Cardiac Care: Management of acute cardiac conditions such as heart attacks and severe arrhythmias.

Infectious Disease Management: Comprehensive care for severe infections and sepsis.

Post-Surgical Care: Intensive monitoring and support following major surgeries.

State-of-the-Art Facilities

Our centers in Greater Noida and Noida are equipped with cutting-edge technology to support critical care medicine. The facilities include:

ICU Beds: Designed for comfort and equipped with advanced life-support systems.

Diagnostic Equipment: High-resolution imaging, laboratory services, and other diagnostic tools essential for accurate and timely diagnosis.

Pharmacy: Well-stocked with all necessary medications and supplies for critical care.

Locations and Accessibility

City Medical & Fertility Center is conveniently located at:

Greater Noida: Shop No- 203 & 204, Tradex Tower, 1, Alpha-I Commercial Belt, Block A, Alpha I, Greater Noida, Uttar Pradesh 201306.

Noida: Shop Numbers 19, 20, 21, and 22 LGF, Antariksh Golf City, opposite Bhagat Singh Park, Sector 150, Noida, Uttar Pradesh 201306.

Both locations are strategically situated to provide easy access to residents in these bustling areas, ensuring that critical care services are within reach during emergencies.

Why Choose City Medical & Fertility Center?

Expertise: Our team of critical care specialists is highly trained and experienced in managing complex medical conditions.

Comprehensive Care: We offer a multidisciplinary approach, ensuring all aspects of a patient’s health are addressed.

Patient-Centric Approach: Our care plans are tailored to meet the individual needs of each patient, ensuring personalized and compassionate care.

Cutting-Edge Technology: We continuously invest in the latest medical technologies to provide the best possible outcomes for our patients.

Accessibility: With two well-equipped centers, we ensure that critical care services are accessible to a larger population.

Testimonials

Our commitment to excellence in critical care medicine is reflected in the positive feedback we receive from our patients and their families. Here’s what some of them have to say:

“The critical care team at City Medical & Fertility Center saved my life. Their prompt and effective treatment made all the difference.” – R. Sharma, Greater Noida.

“I am grateful for the compassionate care my mother received during her stay in the ICU. The staff was attentive and professional.” – S. Mehra, Noida.

Contact Us

For more information about our critical care services or to schedule a consultation, please visit our internal medicine service page or contact us at the following locations:

Greater Noida: Shop No- 203 & 204, Tradex Tower, 1, Alpha-I Commercial Belt, Block A, Alpha I, Greater Noida, Uttar Pradesh 201306.

Noida: Shop Numbers 19, 20, 21, and 22 LGF, Antariksh Golf City, opposite Bhagat Singh Park, Sector 150, Noida, Uttar Pradesh 201306.

City Medical & Fertility Center is your trusted partner in health, providing unparalleled critical care medicine to ensure the well-being of our community.

[juniperallergy]

Mountain Cedar's Annual Super Bowl Sabotage

My Super Bowl plans have been consistently thwarted by the infamous Mountain Cedar. Without fail, this juniper tree unleashes its pollen barrage over central and southern Texas every winter, particularly targeting San Antonio and the nearby hill country right in time for Super Bowl Sunday. As one of the 20% of Texans afflicted with cedar pollen allergies, I've had to forfeit my Super Bowl celebrations for multiple consecutive years due to a bout of 'Cedar Fever'. However, a solution to this Cedar-induced chaos emerged, but more on that shortly.

Understanding Anaphylaxis

Anaphylaxis stands as a severe, life-threatening allergic reaction necessitating immediate medical attention. Symptoms can arise suddenly and escalate swiftly, encompassing:

A notable drop in blood pressure

Rapid yet feeble pulse

Swelling in the throat and tongue, inducing breathing or swallowing difficulties

Hoarse voice

Generalized hives, itching, or swelling

Dizziness or fainting

Risk of cardiac arrest

Even if an epinephrine injection mitigates symptoms, urgent medical aid remains imperative.

Identifying Insect Allergy Causes

Allergic reactions stem from the immune system's excessive response to otherwise innocuous substances. In the case of insect venom, initial exposure prompts the production of specific antibodies. Subsequent exposures can trigger these antibodies, provoking widespread inflammation. Common insect culprits provoking allergies include:

Stinging Insects:

Bees, Hornets, Wasps, Yellow Jackets, and certain Ants.

Non-Stinging Insects:

Mosquitoes, Bed Bugs, Kissing Bugs, Fleas, and specific Flies.

The Importance of Allergy Specialist Consultation for Insect Allergies

Consulting an allergy specialist for insect allergies is vital owing to the potential severity and unpredictability of allergic reactions. Insect stings or bites can evoke immune responses ranging from mild discomfort to life-threatening anaphylaxis.

Allergy specialists possess the expertise to accurately diagnose insect allergies through comprehensive testing, pinpointing specific triggers and their sensitivities. Armed with this knowledge, personalized treatment plans can be devised.

Prompt consultation with an allergy specialist facilitates effective management of insect allergies, mitigating the risk of severe reactions and enhancing the overall quality of life for individuals afflicted with these allergies.

Preventing Insect Allergies: Strategies for Minimising Risk

Although complete avoidance of insect encounters may prove challenging, especially outdoors, several measures can mitigate the risk of insect allergies and reactions:

Vigilance Outdoors: 

Remain attentive in insect-prone areas like parks, gardens, or wooded regions, refraining from disturbing nests or hives.

Protective Attire: 

Don long sleeves, trousers, closed shoes, and a hat when outdoors, especially in high-insect-population areas, to serve as a physical barrier against stings or bites.

Fragrance Avoidance: 

Steer clear of fragranced products when outdoors, as insects, particularly bees and wasps, may be attracted to such scents.

Insect Repellent Application: 

Apply insect repellent on exposed skin to deter insects, opting for formulations containing DEET, picaridin, or oil of lemon eucalyptus and adhering to product instructions.

Calm Response: 

Maintain composure and stillness if an insect alights on you, refraining from swatting or sudden movements, as many insects are less inclined to sting when unthreatened.

Indoor Retreat during Peak Activity: 

During peak insect activity times, typically in the afternoon, minimise outdoor activities to reduce the likelihood of encounters.

Food and Drink Covering: 

Keep food and beverages covered when dining outdoors to diminish insect attraction.

Regular Property Maintenance: 

Seal any crevices or openings in windows and doors to prevent insect ingress into living spaces.

Professional Pest Control: 

For individuals with a history of severe insect allergies or those residing in insect-prone locales, professional pest control services can help curb insect populations.

Allergy Awareness:

 Remain cognizant of specific insect allergies, collaborating closely with an allergy specialist to formulate a management plan, including carrying prescribed medications such as epinephrine and acquainting oneself with their usage in emergencies.

Recall that seeking guidance from an allergy specialist is paramount for tailored counsel based on individual allergies and medical history.

Diagnosis and Treatment Modalities

Your allergist will necessitate comprehensive information regarding past insect encounters, associated symptoms, and any prior emergency interventions. While testing may not always be imperative, skin or blood tests can aid in identifying the allergen triggering your symptoms.

Treatment regimens may encompass over-the-counter medications for mild reactions and prescription medications like self-administered epinephrine for severe cases. Your allergist may also explore the viability of vespid immunotherapy to bolster your immune system's tolerance over time.

At Juniper Allergy, our seasoned allergy specialists boast extensive knowledge, training, and practical experience in effectively diagnosing and managing insect allergies. Upon confirmation of an insect venom allergy, you'll receive an emergency treatment strategy, inclusive of a prescription for self-administered epinephrine for future insect stings or bites.

Furthermore, our specialists may propose a customised medication regimen and evaluate the feasibility of vespid immunotherapy tailored to your specific requirements. Analogous to immunotherapy for environmental allergens, vespid immunotherapy entails gradual exposure to minute amounts of the triggering allergen, facilitating immune system desensitisation over time.

Your Next Step

For bespoke guidance and expert consultation, do not hesitate to contact our specialised team at Juniper Allergy. Schedule an appointment today to discuss your symptoms, treatment options, and any lingering concerns.

Reach out today or email us at clinic@juniperallergy.com to embark on the journey towards comprehending and managing your insect allergy effectively.

Contact Details:

Address:255 East Sonterra Blvd Suite 209 San Antonio, TX 78258 

Contact NO: (210) 888-1297

Email ID :help@juniperallergy.com

Facebook ID:https://www.facebook.com/juniperallergy 

Instagram ID: 

https://instagram.com/juniper.allergy?utm_medium=copy_link  Tik Tok  Link: https://vm.tiktok.com/ZTd5JGpqJ/

[venovenous]

My grandparents are in town for my graduation and they brought along with them framed photos of my siblings and I as children that they've had in their house as long as I can remember growing up. I think they are preparing to die within the next few years. My grandpa has been in and out of the hospital with cardiac problems and my grandma told me today that she has liver disease. They always come to me with questions about their health problems since I work in healthcare but the issue is they're so health illiterate that I can't always understand whats going on with them, or they'll show me their notes in mychart and it will be something different from what they say is going on. They also live in a rural area so good healthcare is hard to come by. After my grandma's diagnosis of cirrhosis, they told her the next available appointment with a specialist isn't until September. They live over an hour away from the nearest hospital. When my grandpa had a heart attack he needed to be airlifted to a hospital capable of caring for him.

The best thing for them in terms of their health would be to come live with us in the city, but I know they would hate that. I think they've kind of accepted that they're looking near to the end and just want to live their lives as they wish. Trying to make an effort to be in their lives as much as possible. We've grown distant as I've gotten older, but when I was a kid they were my world. I loved my grandparents more than I loved being at home with my family. I always felt unconditionally loved by them. It hasn't hit me yet, but it's going to be really difficult when I fully realize that they're becoming ill. All I can do is be there for them and love them.

[rupalichadda]

The Best Gynecologist Doctor in Delhi - Dr. Rupali Chadha

Introduction

You looking for the best gynecologist Doctor in Delhi who combines expertise with compassion? Look no further than Dr. Rupali Chadha. Here we talk about Dr. Rupali Chadha delve into the exceptional qualities and care provided that sets her apart as one of the top gynecologists in the city.

 Dr. Rupali Chadha's Expertise Dr. Rupali chadha has firmly established herself today as one of the fast, upcoming and brilliant obstetrician and gynecologist in South Delhi. A strong interest in research in the early days, followed by some outstanding work in the field of endoscopy and reproductive medicine has helped her to become one of the best laparoscopic specialist in South Delhi. Her area of interest involves high risk pregnancy including patients with multiple cardiac abnormalities, complicated laparoscopic gynae surgeries, vaginal delivery after caesarean section (VBAC), infertility management and others. Her vision? All women deserve exceptional and professional service paired with a human and empathetic touch to bring forth a solution and happiness in their life. Today Dr. Rupali Chadha is busy expanding her base with a clinic in Chittaranjan Park in South Delhi and a dynamic future plan of expansion to Greater Kailash and surrounding areas in South Delhi. Here are some reasons why Dr. Rupali Chadha is the Best Gynecologist Doctor in Delhi:

High-Risk Pregnancies

1. Dr. Rupali Chadha is an expert in handling pregnancies that are high-risk, protecting the mother's and the unborn child's health and wellbeing.

2. She has gained her patients' trust by skillfully and sympathetically managing a number of challenging cases.

Advanced Gynecological Procedures

You always take care of others, but who takes care of you? ”

Your health is our priority and that single factor drives our specialist Dr. Rupali Chadha, who believes in personalized, compassionate and empathetic care, tailored to your needs, delivered with exceptional and dedicated service, to serve all your needs in every walk of life.

It’s time for something new in women’s health, a new page, perhaps a new chapter to be rewritten on the priorities of woman’s health and care. Come see and understand why we are different.

Awards Endoscopy ICON award for outstanding work in the field of Endoscopy (2021) – ISAR

Approach to Women's Health

1. In addition to medical care, Dr. Chadha emphasizes lifestyle changes, mental health, and preventative care in her holistic approach to women's health.

2. She thinks that providing women with the information and resources they need to make wise health decisions is important.

Patient Testimonials Here are some testimonials from Dr. Rupali Chadha's patients, highlighting their experiences under her care:"Dr. Rupali Chadha's compassionate care and expertise guided me through a difficult pregnancy, and I couldn't be more grateful for her support." - Ms. S from Delhi

 "I underwent a successful laparoscopic surgery under Dr. Chadha's care, and her dedication to my recovery was truly commendable." - Ms. R from Gurgaon

Conclusion

In conclusion, Dr. Rupali Chadha stands out as the best gynecologist in Delhi due to her unparalleled expertise, compassionate care, and holistic approach to women's health. If you're seeking exceptional gynecological care in the city, Dr. Chadha is the ideal choice for comprehensive and personalized treatment. Book an appointment with her today for a healthier tomorrow.

 "Dr. Rupali Chadha's commitment to women's health and well-being is truly admirable, making her a trusted name in the field."

[bandjhospitals]

https://www.bjhospitals.com/blog/how-to-find-and-choose-a-cardiologist

How to Find and Choose a Cardiologist?

Heart disease is a leading cause of death worldwide, and finding the right cardiologist is essential for treating and preventing heart disease. A cardiologist is a specialist who diagnoses and treats conditions related to the heart and circulatory system. 

But how do you find the right cardiologist for you? Whether you're looking for cardiologists in Navi Mumbai or any other location, this guide will steer you through the process of finding the perfect match for your heart health needs. This blog will discuss the critical factors to consider when choosing a cardiologist, and how to find a good one:

Understanding Your Needs:

Before beginning your search, it's essential to determine your specific heart health needs. Are you seeking preventive care, diagnostic tests, or treatment for a pre-existing condition? Understanding your requirements will guide your selection process.

Location and Availability: 

Whether you're seeking a cardiologist in Navi Mumbai or any other location, consider a cardiologist who is conveniently located and has flexible availability. Heart diseases can sometimes demand urgent attention. During critical moments or getting regular checkups, having a cardiologist within a reasonable distance can be a lifesaver.

Seek Recommendations or Referrals:

A trusted starting point is seeking recommendations from your primary care physician, friends, family, or colleagues. Their insights can help you identify potential cardiologists and their reputations in your preferred area.

Research Credentials:

Credentials are the foundation of trust. Ensure that the cardiologist you're considering is board-certified and has the necessary qualifications. Verify their education, training, certifications, and affiliations with reputable medical associations.

Consider the Cardiologist’s Experience:

When it comes to heart health, experience matters. Look for cardiologists who have treated a range of cardiac conditions and have a successful track record in their field. Experienced cardiologists often bring a wealth of knowledge and expertise to the table.

Read Patient Reviews:

The experiences of other patients can provide valuable insights into a cardiologist's approach, bedside manner, and overall patient experience. You can check the patient's reviews on their Google My Business profile or on the doctor's website if it is available.

Communication and Bedside Manner:

Opt for a cardiologist who takes the time to listen, explains treatment options clearly, and involves you in decision-making.

Research Hospital Quality:

Consider cardiologists who are affiliated with renowned hospitals or medical centers. Affiliations often reflect the quality of care provided and the availability of advanced technologies for diagnosis and treatment.

Choosing a cardiologist is not a decision to be taken lightly. It's an investment in your heart's health and your overall well-being. Through thorough research, recommendations, and personal consultations, you can find a cardiologist who not only has the necessary expertise but also resonates with your values and concerns.

Remember, your heart deserves the very best care, and finding the right cardiologist is the first step towards a healthier heart and a healthier you.

[rin-the-cat]

It's always interesting to read the Doctor's notes after a visit.

"We discussed variety of reasons why a person may have joint pains especially PIPs." we did? Because I don't remember that part of the conversation.

This part is not this Doctor's fault because this is old history that was put in at a diffrent office some 15 years ago.

"Psychotic Disorder: learning disorder - abstract

Sister"

Oh that's interesting, given my only sister died when she was like 2 days old. (it's meant to say brother, my brother has a learning disability)

More rambling behind the cut:

The way different clinics keep switching from one system to another (I don't know if it happens in urban areas, but these are small town clinics that I'm talking about. It'll be a Fairview clinic for a few years, then switch to an Alina and later to Health partners etc. Then you go to say a Fairview clinic somewhere and they will have your records from those few years that that your home clinic was a Fairview clinic. This particular specialist visit has history from two different small clinics in my hometown, even though those two clinics were never under the same umbrella at the same time, at some point they have both been Fairview clinics. When I went to my current clinic for the first time, they had some records from the first of those two clinics but not the other. I had to bring my Marriage certificate to change my name in the system even though i had never been to that clinic before. The receptionist was quite embarrassed when she asked if I still wanted (insert dads name here) as my emergency clinic and I told her he'd been dead for 10 years. But at any rate, I can see all the records for my last GI workup (I'm going to do another GI workup since it's been worse lately and it's nice to be able to see what they did before) however I can't see the results for the cardiac workup I had done just a few years before that at the same clinic. 🤷‍♂️

[migrainepaininwestbloomfield]

Fascination About Sleep Apnea in Novi

Mr. Zaslow and his specialists in thoracic operation maintained that had a well-timed diagnosis been manufactured, Mr. Rabkin might have effortlessly been transferred from the Local community Medical Middle to the hospital which was capable of doing the requisite surgical repair of acute ascending aortic dissections. According to this difficulty, Neighborhood Health care Center, which can be a Component of the RWJ Barnabas Health Program, will not be a cardiac surgical procedure Middle effective at performing emergent surgical fix of the aortic dissection.

Over 30 depositions had been taken in this subject as well as the parties ended up prepared to carry on to the demo. Nevertheless, the situation was settled amongst all get-togethers two weeks before the demo day.

PVL is often a sort of brain problem that requires the periventricular white to make any difference in the brain. Harm to the white issue results in the Demise and decay of injured cells, leaving vacant places in the Mind known as lateral ventricles, which fill with fluid (an ailment referred to as leukomalacia). Following the MRI, considered one of his treating medical professionals attributed his developmental delays in the area of speech to general through the PVL.

Dr. Sheila is incredibly Expert, proficient, and compassionate. She listens to you and her treatment plans are 100% helpful. My loved ones And that I…

At enough time, Hodgkiss’ wife was Keeping the pair’s 10-thirty day period-previous newborn within the rear with the unit and witnessed the incident. Hodgkiss, who didn't see the crash but read it, ushered them along with a downstairs neighbor to basic safety, according to his lawyer.

We argued that the spa’s staff have been negligent in permitting overly hot h2o to gather from the pedicure chair basin and that the producer from the chair was negligent in failing to design and put in safeguards to maintain excessively very hot drinking water from collecting in the basin. The settlement was arrived at Along with the spa and Together with the producer.

$1,000,000 Restoration in Wrongful Demise Drowning Situation Extend Daryl L. Zaslow represented the Estate of the 43-calendar year-previous person who drowned through a scuba diving lesson. The decedent was using an open-up drinking water scuba diving class to get his diving certification when he was separated from his husband or wife and dive instructors. Following the decedent was discovered and pulled with the drinking water his diving equipment was subjected to comprehensive forensic investigation and testing and the effects confirmed that the scuba products did not malfunction. An autopsy discovered only that the Dying was a result of drowning and there have been no health care events for instance a cardiac arrest or stroke that could have prompted the tragedy.

So, when she went beneath the belt, her hair bought caught within the gears and the Component of her scalp was ripped off, said Eichen, including that Patel experienced to have a skin graft as a consequence of her injuries.

Last but not least, the defendant’s obstetrical professional testified that as the property birth didn't incorporate the use of Digital fetal monitoring it was difficult to learn if the baby was in very hostile intra-uterine surroundings and required a crisis cesarean area. Click here to examine more about the situation.

Depending on their heritage, it had been felt that she had Neighborhood-acquired pneumonia (CAP). Ms. Horvath subsequently developed progressive hypoxia and tachypnea with radiographic proof of acute respiratory distress syndrome (ARDS). ARDS can be a speedily progressive condition happening in critically ill people. The leading complication in ARDS is always that fluid leaks into the lungs creating breathing complicated.

The water was incredibly very hot and prompted severe burns to our client’s ft and ankles. He put in various months hospitalized in a burn unit and endured several surgical techniques to help save his legs. Unfortunately, 1 leg at the end is essential for an amputation underneath the knee.

A narrowed airway. You could have inherited a narrow throat. Tonsils or adenoids can also enlarge and check here block the airway, notably in kids.

According to this situation, transthoracic echocardiography can from time to time detect a resource, though the standard test is TEE (transesophageal echocardiography) due to its higher sensitivity depending on far better photographs which might be unaffected by lung interference. CT angiography of good vessels can be indicated to establish big thrombi or atherosclerotic plaques from the aorta which will routinely function embolic resources. While both equally these checks ended up subsequently done at Jersey Metropolis Health care Heart and have been standard, the Plaintiffs took care of the TEE was done far too late only once the cardiac emboli experienced traveled to Mr. Ramos’ brain – Hence describing why the emboli were not present in the heart.

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[gwydionmisha]

COVID’s Meat Grinder

Not surprisingly, me having been a 14th century specialist before my break with academia and having been interested in yersina pestis since before even that other major plague struck like lightening and burned through the most vital and creative of two generations, I have thought about the Great Pestilence a lot in the past two years.  I have written about that and the Great Plague of Athens in this space and others off and on.

What I haven't written of much or possibly at all is how much I've been thinking about wars.  About all the soldiers marching into or later airlifted into meat grinders in places like the Somme or Galipoli or Gettysburg or Omaha Beach or Dien bien Phu.  Really all of the Crimean War, or our American Civil War or WWI, and big chunks of all the wars after, once the gun tech reached a certain level.

I think about this when it comes to medical workers in the current Covid crisis.  I think about two years of Doctors, nurses, and paramedics, exhausted beyond weeping begging over and over for people to where their masks and stay inside.  I think of wave after wave grinding them down to burnt out nubs.  I think of men baaing like sheep as they leave their troop transports because that was the only protest they were allowed as they were marched towards the meat grinder battles of WWI, most to come back badly damaged or not at all.  You generally can't see neurological and cardiac damage the way you can see missing limbs or a ruined face, but oh the scars are their and so is the PTSD by whatever name an era chooses to call it.

In my highly vaccinated area, in the gap between the Delta spike and the Omicron wave that is drowning us now, the hospital sucked up 130+ nurses out of surrounding nursing home to fill the holes left by those leaving one way or another.  (Burnt out, damaged irreparably, psychological damage, and those who don't care enough about other people that infecting and killing people for the Republican political cause made them no longer suitable for a profession that is fundamentally about empathy when practiced well).  I kept thinking of the terrible stage in war where the old men and children are the only ones left to call up as a last defense.  The healthy nurses went over the top long ago and the people left are people like Squirrel in the most vulnerable categories still able to work.  Those nursing homes are now killing fields staffed by a skeleton crew.

Those people lost to death and disability and physical and emotional fatigue...  We aren't getting them back.  All that skill and intelligence and experience, they have moved on one way or another.  The best case scenario here is things like private practice and medical bureaucracy.  Far too many are gone for good.  The first health care worker to die in NYC's first wave was a gay man.  So many followed him.

The first wave could have been less deadly if people like 45 and Boris Johnson and Jair Bolsanaro weren't entirely devoid of ethics and empathy, but a lot of the early part couldn't be helped.  It was better in places like the one where I live with responsible leaders who saw saving lives as the goal; it was a nightmare in most Republican controlled areas where killing as many people as possible for capitalism is a linchpin of the "pro-life" agenda.  After that first wave though?  That's all pretty much on purpose.  Selfishness from the International down to the individual level.

Healthcare workers are being endlessly pushed into the meat grinder, and it is inexcusable and irreparable.  We'll be lucky if the system recovers in a generation and that's an optimistic view.  The people?  So many of the people won't, and there's not really a token attempt anymore at saving them.

[thisbluespirit]

Where exactly is St Jude’s?

Yes, it’s another The Hidden Truth post, because why not obsess about nearly non-existent obscure 1960s TV shows?  (A motto I am prepared to live by, as you’ll have worked out by now.)

Of course, given that we have less than 1/4 of the series left, it’s also pretty much unanswerable, but I see no reason not to a) ask the internet about the backdrop and b) speculate wildly regardless.

So, St Jude’s hospital is not a real hospital. It’s based in London somewhere, and, judging from the backdrop, probably on the periphery of central London (as opposed to dead centre or along the north bank of the Thames).  It’s a teaching hospital.  It has a noted pathology department led by a world-famous expert in the field (Professor Lazard seems to spend a lot of time jet-setting off to give lectures, write books, and deal with cases on royal demand).

The biggest clue is the view from Professor Lazard’s window(s).  We see this several times in each episode, from several angles:

We can see here that it’s part of a modern wing of the hospital (as the other wing projecting out at a right angle suggests).  It’s quite high up, so the lack of London landmarks on the skyline suggests it’s not very central, as it’s almost impossible to avoid all London landmarks from a height in that case.  The hospital also has older buildings as part of the complex, of which we can see the rooftops and chimneys.  This is pretty typical for a hospital of the era, though.  (Old workhouse infirmaries and charity hospitals incorporated into the new NHS.)

Whether all we can see is the hospital complex or not, I don’t know.  The most significant building is this large one - another part of the hospital, office block, flats, or multi-storey car-park, maybe?  Does it look familiar to anyone who knows London?

(Amusingly, though, it is nearer/further away in some episodes than others!!)

The wider view at other points is generally trees and rooftops, nothing very distinctive, other than said block.

What is said re. location in canon?  In Sweets to the Sweet, a young man collapses in the West End (filmed in Marble Arch Underground car-park) and is rushed to St Jude’s, but that doesn’t mean it has to be the nearest hospital, although it could well be.

In Cross Examination, a man who died within their area has his autopsy performed at St Luke’s mortuary (presumably St Luke’s Chelsea, then used for geriatric patients), but again, whether that is because it’s close or for other reasons is impossible to say.

Both of these would suggest it might be somewhere on the western periphery of central London.

However, Cross Examination, suggests that it’s situated in a run-down area of London with a high crime-rate (according to the police inspector) and then there’s the matter of names.  The streets mentioned as being near the hospital are all as carefully non-existent as the hospital - Hanley Street, close to Balkan Street, near “the bomb-site.”

Balkan St is more unusual - the only Balkan-anything in London is Balkan Way, in Shadwell, which would fit with the vaguely south/east vibe of the run down/crooked & the not yet filled in bomb site.  But then, so could a lot of London areas!

Then there’s St Jude’s itself.  The most prominent St Jude’s parish in London was in Bethnal Green, north of Shadwell.  In 1964, there were two hospitals based there: Bethnal Green Hospital, close to St Jude’s Street, where a Group Pathology lab had been established in 1954, with a nearby Cardiac/Chest specialist hospital (which, if amalgamated, could fit with the West End patient being taken there, as there were chest complications).

Basically, unless something on the skyline of the view above looks familiar to someone, or more of the series is found, it’s completely impossible to say.  Maybe they never committed even to a rough area anyway!  But until proven otherwise, I’m going to imagine it’s somewhere roughly on the eastern edge of central London, vaguely Bethnal Green-Stepney-Whitechapel-Shadwell way, because I like my random theory and shaky detective work.  ;-p

[theemptybloggercometh]

The convoluted process that we have to go through in the UK to get hormones on the NHS by being referred to a specialist, attending at least two assessment sessions (after waiting for what seems like forever) which are held months or possibly years apart and then finally being prescribed the meds by our GPs under the guidance of the specialists has been justified on the grounds that trans healthcare is complex. But can’t the same be said about any other area of medicine that GP’s deal with such as mental health? I was instantly prescribed anti-depressants during the one appointment with my GP where I described how I had been feeling. (I’m mindful that not everybody has found it so simple especially those with more complex mental health conditions and histories in addition to how my level of privilege certainly helped) GP’s should be able make an elementary assessment of and management plan for gender dysphoria and in the cases that are more complex they should seek help from specialists in trans healthcare or endocrinology – just like they would consult with a cardiologist for a patient on cardiac meds. Training would need to be given (where none exists at present about any trans issues) to combat the misinformation and downright lies that currently make many GP so scared about courting any controversies that they shift the buck to the GICs. If GP’s have concerns about prescribing hormones, they should explain to use the specific clinical reasons to us which need to be based on the best evidence available and we need to have the ability to get a speedy second opinion from a gender specialist. This would mean having longer appointment with GP’s and challenging the practice of how some in GIC’s jealousy guard their specialism. I fear it’s not going to be easy to reform trans healthcare; indeed, one could say that the problems and the barriers to solving these problems are a microcosm for the issues that the NHS is facing more generally.  

[tiredoflyme]

This week has added a new symptom to my ever growing list. While I've been going downhill neurologically for months now, I can now add cardiologist to my list of specialists. Three doctors over 2 months told me my pulse was unusually high (90-100) so I got a pulsometer to track at home.

At the beginning of this week, I was making breakfast when I started to feel dizzy and "wrong." The day before, I had to lay down on the kitchen floor for similar reasons so my roommate grabbed the meter and it turned out my pulse was ~170.

I didn't really grasp how bad that was but I messaged one of my specialists who called me 2 hours later and told me that a pulse that high was a "cardiac event" and I needed to go to urgent care or the ER. By that time I'd been laying down for a while and it was down to 80.

The next morning it was ~155 so I went to the urgent care. By the time I got there and they did an EKG, it was normal and back down in the low 80s. The doctor suggested it might be SVT (supraventricular tachycardia) which only lasts 20-30 minutes per episode so it's hard to catch. They said that the cardiology appointment I'd made in 3 weeks wasn't soon enough and I needed to be seen in 2-3 days. They gave me info on a cardiac specific urgent care in the area so the next day when my pulse was 147 in the morning, I went there. Again, normal EKG although my pulse was still faster than average.

My Lyme specialist had ordered a bunch of tests two weeks ago to see if the bastard little spirochetes were active again but the results haven't come back yet so I don't know. My worst fear was that the Lyme was moving into my cardiac system but the doctor assured me that Lyme carditis presents with very different symptoms.

They fitted me for a 24 hour heart monitor to see if they could catch the event in real time and scheduled me for an echocardiogram 2 days later. The echo was normal and I don't have the results of the monitor yet. The clinic is waiting to see what all the test results are before they assign me a doctor from their main group in case I should see one who works with specific conditions versus a general cardiologist.

During all of this, two of the techs, while hooking me up for testing, told me it was "probably just anxiety." Yes, in the past months my anxiety has gotten worse. But it's been at the same pace as my neuro issues and overall fatigue and weakness, which is why my doctors were categorizing it with that set of problems. I'm not saying it couldn't be from anxiety, but my anxiety attacks have never presented with cardiac symptoms before.

Besides anxiety, I think it might be specifically related to my standing and physical efforts, especially in the morning when it's such a dramatic change from sleeping in bed to standing in front of the stove. Symptoms of SVT and POTS (postural orthostatic tachycardia syndrome) can overlap so I think it's worth looking a bit deeper than "just anxiety."

Thankfully, regardless of dismissive techs, no one else has treated me that way this week. I just want the cardiologist to explore other causes and use anxiety as an explanation only when all others have been exhausted. It's been such a relief to be taken seriously by my doctor, the doctor at urgent care, and the clinic doctor. And I'm confident the cardiologist will be the same way.

[hellyeahtrickster]

It occurs to me that I have friends here that I don't have contact with in other spheres, so ... life update: my mother passed away unexpectedly last Friday. I'm doing as well as one would expect. Been going through her things as both a walk down memory lane and a goodbye. I keep coming across things she never got around to using, and it hits hard that now, she'll never have the chance. And I can't stop thinking of the stories we watched together that now she won't know the ending to, or shows I wanted to try with her. And then there's all the things we used to do together on the regular -- all the places I can never go with her to again. And all the places we wanted to go to "someday", but now she never will.

We were two weeks out from our second COVID shots, and 4 weeks from being totally vaccinated. We were finally going to get back to EPCOT, to see the Flower and Garden show. Finally going to get back to the Florida Mall. Going out to lunch. That I won't be doing this things with her anymore ... it's unfathomable. I can't wrap my head around it.

Thanks, anti-mask / anti-vaccine Covidiots, for prolonging the presence of this pandemic -- basically stealing the last year of my mother's life. She was anxious to see her elderly mother again, because we don't know how long *she* has left ... and now she never go to see her mother again. I knew losing my mom would happen someday, but my mother was relatively young yet, so I thought it would be a while ....

It doesn't help that she died after the second night on a new bed. See, she slept on her side all the time, what with the couch being narrow, but with a twin mattress, the bed was much wider. She snored a lot -- I highly suspect she had sleep apnea. When I found her the next morning, she was on her BACK. The doctor agreed that her cardiac arrest could have been caused by sleep apnea. In trying to make my mom more comfortable .... Yeah, I know, it's not my fault, but I cannot shake that thought away, that she's not here anymore because we tried to do something nice for her. How cruel the humour of the universe can be.

(I'd put the rest of this behind a cut, but I don't see that option anymore? Sorry!!)

And it REALLY doesn't help that, not only have I lost the person I was closest to, but now I am stuck alone with the person I least want to be with: my dad. I'm pretty liberal, and he's pretty conservative. We fight a LOT. We haven't really since mom died (things got a little tense here and there, but not like we usually are) ... but I know it won't last. It can't -- not when he believes BLM are terrorists, or that gays have an agenda. And now he keeps wanting to do things with me, like watch my shows, and a petulant part of me is like, no, this is mom's territory -- stay out. I don't want to do anything with him. (Especially since I know he'll start ranting once the shows start talking about racism and homophobia.)

My parents always had a volatile relationship. Mom didn't know you could get pregnant the first time, and when she found out she was pregnant, her Catholic family bullied her into marrying him.* And he cheated on her at LEAST once (with a girl who was only a few years older than me at the time -- I was 15, she was 19, he was 33). My mother was far from perfect, so I don't blame all the marital problems on him. But my point is they were married "in name only" for about the last 25 years, so it's ... offensive to me now that he would dare to act bereaved.

I know he can be hella manipulative, make himself seem generous so as to be loved, and then turn on you like a viper, getting irrationally angry. I can't drive, we live in a very rural area with no public trans, there are no friends or fam less than an hour away, I've had next to no job for the last 17 years, I barely feel like a functional human being (am coming to seriously suspect I have ADHD and Dyscalculia; I have diabetes and suspect have PCOS and a thyroid problem; all these things having strong interconnections; and I have no insurance, nor do I qualify for aid, thanks to living in Florida), and I feel utterly trapped. There's a reason Rapunzel is my fave princess. I've had bad experiences with cabs, so using Uber / Lyft kind of terrifies me. Plus, he'd want to know where I'm going, and likely either insist on coming too, or insist I can't go, because his house, his money, his rules. The ONLY time each year I get away is when I go to Dragon Con (and I'm worried he might forbid that in the future -- he has once before).

And then there's the problem of ... he has no one. As much as I can't stand him, he lost his job because of COVID, he's lost his wife, he has no real friends (total homebody), and like it or not, he has supported me financially for so long. Even if someone else were to take me in, or I can get a job and save to leave ... how can I leave him (a person with severe rheumatoid arthritis / in not-great health)? I owe him too damn much, and I feel like it would be entirely callous of me. Yes, I realise that that's the abuse talking, but ... it's also true?

Anyway, I feel like I'm on Sliders, and keep stepping into progressively worse timelines.

* Let me mention that I have long suspected my mother is -- was -- on the autism spectrum, but when I mentioned it to one of her sisters, the sister seemed skeptical, saying that if anything, mom had a penchant for reading out loud, so they thought maybe she had a reading disability, and took her to a specialist, but "that's it". (Mom was in "remedial" classes through high school, so it doesn't sound like they did enough -- and maybe couldn't because the science just wasn't there.) I explained that mom frequently seemed to have trouble grasping concepts, especially humour. Like when a radio ad featured someone reciting a love-letter to a tomato, she was all, "That's stupid -- tomatoes can't read!" Try as I might, I could not get her to understand that the love letter was a playful way to tell US about what makes the tomato so good.)

Anyway, when I talked to my grandmother recently, she said that my mom "always had a special way of looking at things," and that she guessed mom was "what do they call it -- neuro-something? 'Aspie'? High-functioning, but still." And I told my cousin about it, and he said, "Wait, I thought it was common knowledge in our family that your mom was autistic?" (Note: we have other, officially diagnosed family members who are on different areas of the spectrum.) People always commented when I was growing up that it was like my mom's role and mine was reversed -- like I was the parent, and she was the child.

But to think my family had *recognised* that something was up, and left me, a child, to deal with it on my own?? To think they *pressured* someone who was "special" into having a child?

I know my mom loved me, but my whole life, she said she wished I'd never been born, and so she'd never have married my dad -- I know both can be true, that she loved me but wished she'd never had me (she'd have never known what she was missing). She only survived her marriage because I was there; I've always felt she'd have had a better life if she hadn't married him. When she tried to leave him, her mother would not take her in, because divorce was against her mother's Catholic beliefs (never mind that my uncle divorced twice)

I loved my mother, but were fought a lot, and she frequently exasperated me as we struggled to communicate. She frequently left words out, but did not believe that she did; when we met her last PCP the first time, he looked at me and said, "Is she always like this, or is she having a stroke?" And she would always angrily proclaim that I wasn't listening, when most of the time, it's that I couldn't get her to understand that she was working from a misconception or misunderstanding in the first place, because she would focus on ONE THING, to the exclusion of all else.

An example of an exchange (copied from a letter I wrote to a friend): We got into a weird argument yesterday. She had asked me for pain reliever, a glass of tap water (you're supposed to drink a full glass of water with the pills), and a "cold water" from the fridge (it's too cold to drink it all at once, but we both prefer ice water in general). Later, I was picking stuff up from her table-tray, including a bottle of pain reliever, and put a bunch of stuff away. When I passed by again, she asked for more cold water. I happened to look as see that she had the tap water glass still full, even though she had asked tor it half an hour before. I asked if I needed to bring the pain pill bottle back, because she hadn't drunk the tap water yet -- had I taken the pill bottle too soon, or had she forgotten to drink the water? She was all, "no, I said I need COLD water!" I said I knew that, and I would bring it; I was just asking of she had taken her pills already, or if I needed to bring the pill bottle back too. Her (again): "I said I need COLD WATER!" Me: "I know, and I will bring that -- I just want to know why you haven't drunk the tap water yet? Did you take your pills?" Her: "No, I'll take them at bed!" Me: "So I should bring back the pill bottle? Did I put it away too early?" Her: "YOU DON'T LISTEN! I SAID I NEED COLD WATER!" Me: "And I said I will bring that -- I'm just asking if you also need your pain pills?" Her: "You already took the bottle!! Did you forget that already?"

And then I finally spotted the white pain pills on the napkin under the tap-water glass, so I knew that no, I didn't need to bring it. But it's a frequent struggle to figure out how to phrase questions so I get the answer I need -- nearly every time, I get her screaming at me that I don't listen.

She loved me, but she was never mothering. She hated to be touched, so never hugged me; I was pretty touch-starved. I learned to read because she was a very slow reader when reading me stories; I got impatient and learned to do it for myself. She couldn't help me with my homework. She resented having to take me to school recitals and science fairs. She wasn't someone I could get advice from. I admit I was often envious of characters who had physically-loving, compassionate, wise mother-figures (who weren't so binary about morality -- and so weren't always screaming that this or that character should die, no matter how small the transgression).

But I wish she were still here to frustrate me -- that's so much better than not having her at all. And I wish I had been better at keeping my temper.

She was an atheist, and firm in that belief. Maybe she's right, or maybe her firm belief is affecting me, because I would dream frequently about others I have loved and lost, and swear I feel them, but with her ... nothing. Just a gaping hole in the fabric of my waking life, threatening to suck all the light and hope into it.