By S. Fasim. Augustana College, Sioux Falls South Dakota.

Worksheet 5-12 My Comparison Alternative Exercise Critical Comparison Comparison Alternative Tagging yourself with loathsome labels Sticks and stones can break your bones cheap aygestin 5 mg visa women's health clinic hobart, and words can really hurt you 5 mg aygestin fast delivery menstruation 25 day cycle. It’s so easy to tag yourself with demeaning labels, and when you do, you inevitably feel worse. Chapter 5: Untangling Twisted Thinking 69 To pinpoint the loathsome labels you give yourself, take the quiz in Worksheet 5-13. Worksheet 5-13 The Loathsome Label Quiz ❏ Loser ❏ Pathetic ❏ Misfit ❏ Freak ❏ Clod ❏ Klutz ❏ Fat pig ❏ Failure ❏ Nerd ❏ Pitiful ❏ Stupid ❏ Monster ❏ Disturbed ❏ Crazy ❏ Idiot ❏ Jerk ❏ Imbecile ❏ Fool ❏ Moron ❏ Dummy (well. They always involve overgeneralization and black-and-white thinking (see the section “The Information Reality Scramblers” earlier in this chapter). Labels represent concepts that hold no redeeming value; they don’t help you, and they often lead to increased emotional distress. Worksheet 5-14 Label Replacement Exercise Event Corresponding Label Label Replacement Thought I spilled a drink at a I’m a total klutz! There’s nothing wrong when I was talking with showing some about my mother’s emotion. Sure, I wish I’d gotten my preference, but I can still succeed in my chosen career. I do have extra weight, and I don’t like it, but it doesn’t help to call myself a pig. If you stop calling yourself useless, hurtful names, and replace the labels with more reason- able perspectives, you’ll feel better. Therefore, we recommend that you complete the Label Replacement Exercise in Worksheet 5-15 each time you hear those destructive labels in your mind: 1. Tune into what you’re telling yourself when you feel upset, and listen for any time that you tag yourself with a hurtful label. Come up with alternative perspectives to the labels and record them in the right- hand column. In creating label replacements, try to accept any portion of the event that has truth in it, such as having gained some weight, but look at the issue more real- istically. Because labels tend to be overarching ratings (that is, they imply a bigger problem than the event that triggered them), your replacement thoughts should be specific and look for positive possibilities. Chapter 5: Untangling Twisted Thinking 71 Worksheet 5-15 My Label Replacement Exercise Event Corresponding Label Label Replacement Thought Now that you’ve completed the Label Replacement Exercise, take a few minutes to reflect on what self-labels have been doing to you and how it feels to change them (see Worksheet 5-16). You may accuse yourself of being inept, inca- pable, or inadequate and therefore fully culpable for all your suffering. When the Self-Blame Reality Scrambler is at work, you attribute all fault and blame to yourself. In this section, we give you a tool for figuring out if you use the Self-Blame Reality Scrambler. After you begin to understand that your problem isn’t completely your fault, you can take action on the portion for which you own responsibility. The Rating Responsibility Exercise helps you see that most problems have many causes and that you only own a portion of the responsibility. After you understand the causes of the problem, you’ll be more ready to do something produc- tive about it. Robin blames herself for her recent divorce and believes that she is almost entirely respon- sible for her husband leaving the marriage for another woman. Robin considers herself boring and unattractive, and she berates herself for not seeing the signs early enough to prevent what happened. Robin decides to take the Rating Responsibility Exercise (see Worksheet 5-17), focusing on the blame she places on herself for her divorce. Worksheet 5-17 Robin’s Rating Responsibility Exercise I blame myself for: My recent divorce I rate the blame at: 95% All Possible Causes of Your Problem Percentage of Responsibility My husband’s roving eye. My husband’s grief over losing his 10%: He could never talk about mother, father, and brother over the last these losses, and I know they got year and a half. My husband can easily find women more 5%: Yeah, but I do look better than attractive than me. Chapter 5: Untangling Twisted Thinking 73 All Possible Causes of Your Problem Percentage of Responsibility We had stopped talking about our days. As you can see, Robin initially assigns 95 percent of the blame for the divorce on herself. At the end of the quiz, Robin reassesses her level of responsibility because she’s able to see things a bit more objectively.

Forty-six ciprofloxacin patients had stance/swing abnormalities compared to 8 control patients aygestin 5mg low price pregnancy 9 weeks symptoms. Of these cheap aygestin 5mg without a prescription menopause bleeding after 9 months, 36 ciprofloxacin patients and 4 control patients had the abnormalities at baseline. Neuropathy and hypesthesia were reported at the same incidence in both groups (one patient in each group for each event; 0. Due to coding conventions, an investigator term of “tethered cord” coded to neuropathy; this accounted for both cases of neuropathy. Both cases of hypesthesia were not considered drug-related and resolved within 5 days. The incidence of convulsions was the same in both treatment arms (3 patients each, 0. The overall incidence rate of adverse events by 1 year was 45% (151/335) for ciprofloxacin and 36% (124/349) for comparator. The most common adverse events in both treatment groups were those occurring in the Body as a Whole (17% [58/335] and 9% [31/349], respectively), digestive (15% [50/335] for ciprofloxacin and 9% [31/349] for comparator), musculoskeletal (11% [36/335] and 7% [25/349], respectively), respiratory (7% [23/335] and 8% [28/349], respectively), and urogenital (8% [27/335] and 6% [22/349], respectively) body systems. The investigator(s) assessed most adverse events as mild or moderate in intensity for both treatment groups. Adverse events, other than those affecting the musculoskeletal and central nervous systems, that occurred in > 1% of the 335 ciprofloxacin treated patients, up to 1-year post-treatment were: accidental injury 5% (17); abdominal pain 4% (12); diarrhea 5% (16); vomiting 5% (16); dyspepsia 3% (9); nausea 3% (9); rhinitis 3% (10); fever 2% (7); headache 2% (6); asthma 2% (6); rash 2% (6); and pyelonephritis 2% (7). The most common events for control (other than musculoskeletal events) were pharyngitis and accidental injury (4% each; [22/507] and [21/507]). No trends that appear to be uniquely associated with ciprofloxacin treatment were identified. The most common clinically significant changes (as defined by the applicant) were ≤ 0. None of these events were considered by the investigators to be related to study drug. One comparator patient (and no ciprofloxacin patients) had the adverse event of tachycardia. The rate of arthropathy in the ciprofloxacin group exceeded that of the comparator group by more than 6% (i. In the ciprofloxacin group, the majority of musculoskeletal adverse events were mild or moderate and resolved by one year of follow-up. The events included arthralgia, abnormal gait, abnormal joint exam, joint disorder (i. All events occurring by six weeks resolved, the majority within 30 days of the end of treatment. Ciprofloxacin patients were more likely to report more than one event and on more than one occasion compared to the control patients. These events occurred in all age groups and the rates were consistently higher in the ciprofloxacin group compared to the comparator group. Of note, an adolescent female in the ciprofloxacin treatment group discontinued study drug after 7 days for wrist pain that developed after 3 days of treatment. A diagnosis of overuse syndrome secondary to sports activity was made, but a contribution from ciprofloxacin cannot be excluded. The incidence of neurologic events within six weeks of treatment were similar between the ciprofloxacin and comparator groups (2. The overall incidence rates of adverse events regardless of relationship to study drug and within 6 weeks of treatment initiation were 41% (138/335) in the ciprofloxacin group versus 31% (109/349) in the comparator group. The most frequent events were gastrointestinal: 15% (50/335) of ciprofloxacin patients compared to 9% (31/349) of comparator patients. Discontinuation of drug due to an adverse event was observed in 3% (10/335) of ciprofloxacin-treated patients versus 1. Other adverse events that occurred in at least 1% of ciprofloxacin patients were diarrhea 4. Although this study was not randomized and the patient population was not the same as in Study 100169, the incidence of arthropathy in the ciprofloxacin-treated patients is supportive of the results seen in Study 100169. As in Study 100169, the incidence rates of these adverse events were reported in all age groups. Three studies were conducted in non-cystic fibrosis patients to evaluate the pharmacokinetics of oral ciprofloxacin in various pediatric age groupings, including a 19-21 limited number of neonates 5-14 weeks of age. Peltola and colleagues concluded that an oral ciprofloxacin dose of 30 to 45 mg/kg/day (approximately 10 to 20 mg/kg every 12 hours) should be suitable to treat 19-22 severe infections in pediatric patients.

His boss hadn’t come in that day buy 5mg aygestin visa women's health center of grants pass, it turns out and Larry was only a few minutes late as a result of the traffic generic aygestin 5mg without prescription menopause vaginal dryness, but the inner voice kept at him for most of the day. This dialogue that Larry had with his inner voice illustrates that the voice was his inner child. It may seem harsh, critical and uncaring; on the contrary, your inner voice is the child’s protector. It once guided your behaviour so that you acted in a way so as not to cause potential abandonment, and to protect yourself from feeling overwhelmed by your care takers. In fact, it should be embraced, as it reflects a true connection with the child you once were and his or her attempts to survive in this world. It’s a connection to your past and a window into how you functioned at that time, which is still influencing your present behaviour. Your response is then directed by your need to stay within the parameters of this system. The upshot of this is that you’re often being controlled by your inner four-year-old child’s need for love, security, and acceptance. The legacy of these coping techniques may be that you have a set of behavioural tendencies that fit the common stereotypes of the perfectionist, the caregiver, the clown, or the renegade. You originally developed these tendencies in response to emotional childhood events. As a child you responded to these events in a manner that made you feel less threatened and more comfortable, safe and accepted. As an adult your actions are still based on the same patterns that you developed as a child. The inner voice actually brings you back to your childhood and how you experienced life at that time. The inner voice is really a child’s response to events that are occurring now and how that child feels it measures up to its internalized parental values under the circumstances. Your belief system doesn’t change very easily, especially if it seems to still be working for you. The belief system that you have in place now, that gives rise to the inner voice, was most likely first established in your childhood and has persisted into adulthood unchanged because it worked. Everything that occurs now is interpreted from a point, which is fixed in the past when the belief was first developed. So even though an event is occurring now and you have much more, knowledge, wisdom and experience that could help you cope, you’re still habitually relying Inner Child • 161 on the coping mechanisms that worked for the child you once were. That inner child is still reacting to current events with the emotional, psychological and physical responses of your past. A belief-system pattern that arose out of a core-wounding childhood experience produces physical sensations when triggered. This is in response to the fear and anxiety you felt at the time of the original experience. You have a characteristic way of physically responding to your emotions that is entirely unique to you. This could be headaches, neck tension, shoulder pain, chest or abdominal pain, diarrhea, nausea, constipation or muscle spasms. When you experience a physical reaction to something stressful, you’re actually feeling the original physical memory pattern from your childhood, in response to a threatening episode from your past. Accompanying this is the general physiological response to stress, which includes rapid heartbeat, breath-holding, sweating, sleep disorders and fatigue. In Larry’s inner- voice dialogue, there was the obvious surface fear of being late for work and the potential consequences that being late might cause for him as an adult. However, the true fundamental fear, resided in his inner child’s response to this event. The most significant point here is that you have to dive deeper to truly understand what’s motivating your behaviour. For Larry, what actually was underlying his fear of being late for work was an earlier fear of not being good enough. His parents were very demanding and critical and nothing that Larry did was “good enough. By being ‘perfect’ and controlling himself and his surroundings as best he could, Larry was able to minimize being yelled at or punished back when he was a child.

After writing out your answers to the preceding list of questions cheap aygestin 5mg otc menstrual hygiene management, write down as many of your personal strengths as you can think of generic aygestin 5 mg with mastercard women's health clinic saginaw mi. Committing to a New Game Plan You can reduce the amount of energy you spend worrying about jobs and money if you commit yourself to making some changes. In addition to the ideas in the previous sections, we suggest you develop a game plan for your money and your career. Setting short-term goals You’ll never get where you want to go unless you have a map. Lots of people go through their entire lives without ever thinking about what they want to accomplish. Look at your money and career, and ponder what you really want to achieve in the next couple of years. Chapter 14: Facing a Career Crisis and Financial Woes 229 Considering short-term career goals Take a vocational interest inventory at your local community college. Brainstorm job possibilities that can make use of your personal strengths and interests. Make a list of these job possibilities and, assuming you’ve updated your resume, prepare to market yourself. Prior to putting in applications, we recommend that you practice interviewing with your friends or a vocational counselor or therapist. When you’ve got a polished resume and you’re ready to face an interviewer, you need to find a job. Don’t just rely on sending out resumes to jobs listed in your local paper or on the Internet. In addition to those sources, consider ✓ Looking in the phone book for companies that you can imagine putting your skills to use. If you stop spending it in one area, it flows around that area just to be spent somewhere else. The only way to save it is to chan- nel your money carefully into a reservoir or holding tank. Because this isn’t an investment book, we’re not going to suggest specific types of investments. Rather, the purpose of this book is to help you under- stand and deal with anxiety. So if you’re anxious about money, you’ll have less anxiety if you have more money saved. And it doesn’t matter much where you put it — money adds up even in a savings account with zero per- cent interest. More often than not, nowadays that dream is just that — a dream that won’t ever find fulfillment, at least as it was originally envisioned. Sure, you’re right to feel concerned and maybe even disappointed that you may not be able to retire when you want or live the retirement lifestyle that you once expected. But the trait of flexibility we talk about earlier in this chapter applies here too. You should know that research reported in the Journal of Occupational Health Psychology in 2009 actually found that people who work part time instead of completely retiring are healthier both physi- cally and mentally. This finding held up even when controlling for variables like age, education, and wealth. So consider that the goal of complete retirement may not even be especially good for you! You don’t have to make as much as you did prior to semi- retiring or work as many hours. That’s because part-time work can go a long way toward stretching whatever retirement account dollars you already have. Consider looking for an encore career that gives you more satisfaction and meaning than just money. Or try something brand new that comes with less stress but connects you with people. At this time in your life, your job doesn’t need to build your ego or impress other people.

She was sure she wanted her period generic aygestin 5 mg on line menopause 35, not a pregnancy and this seemed to be her God-given right 5 mg aygestin otc pregnancy 24. Three weeks later she had a flare up of colitis due to Salmonella in food; it also gave her a urinary tract infection. This time she took Quassia herb to kill invaders in addition to the maintenance parasite program which she had begun to neglect. She treated her urinary tract infection with betaine-hydrochloride (to acidify the stomach), began using plastic utensils to reduce her nickel intake (see Prostate Pain, page 124)) and drank a lot of water. This experience taught her valuable lessons that she was eager to learn, benefiting her family and herself immensely. Her parasites were only intestinal flukes and their stages, and Endolimax, an amoeba. It was a simple task for her to clear her problems by killing them and by sterilizing her dairy foods. He had intestinal flukes and all their reproductive stages in his body, also pancreatic flukes, Capillaria roundworm, and Diphyllobothrium erinacea scolex. He was started on half-doses of kidney herbs and only part of the parasite program in view of his colostomy and possible diarrhea. Two weeks later we continued testing, finding pinworms, Haemonchus, Leishmania tropica, Paragonimus, Sarcocystis, Stephanuris and Trichuris (whip worm. His blood test showed a high thyroid hormone level (T4), contributory to over activity of his bowel He was started on goat milk, vitamin C (3 gm. The thymus is under the top of the breastbone and is a very important organ of immune function. He was given a list of benzene-polluted products to avoid and was started on the parasite killing herbs after killing the flukes instantly with the frequency generator. Two weeks later his side was very much better, his benzene was gone and he was eager to rid himself of lower back pain, which he also had. This ended his problems and began a new chapter of better care for his health by his parents. Tim Melton, age 16, had several colitis attacks yearly, requiring hos- pitalization, from third grade to the present. He had been an iced tea drinker and had numer- ous oxalate and cysteine crystals deposited. The first step is to simply kill enteric (bowel) free-loaders and get into good bowel habits. In fact, very many parasites temporarily invade the bladder because the body is trying to excrete many of them. Pets should not be kept indoors since they have many of these para- sites, too, and they are easily transmitted to us. Schistosomes are the real perpetrators but after the bladder wall is weakened, other parasites and their bacteria and viruses ac- cumulate here too. Dental metal, environmental toxins, including radon, asbestos, formaldehyde, must be cleaned up. They get worse and worse until pain killers are necessary just to get out of bed and move about the house. Did they migrate to the uterus from the intestine or did they develop there from eggs? Once an avenue to the uterus is established, numerous other parasites move in the same direction: Clonorchis, the human liver fluke and even Eurytrema, the pancreatic fluke, can invade the uterus wall. This disarms your organs so they are left helpless against fluke stages left there by the blood and lymph. There are solvents in grocery store bread, grocery baked goods and cholesterol-reduced foods. Use no powdered mixture intended for weight loss or weight gain, nor vitality supports, nor dietary supple- ments. Some solvents (I often see methyl ethyl ketone and methyl butyl ketone) choose the uterus to ac- cumulate in.

Insulin would slow gluconeogenesis (choice A) and fatty acid release from adipose (choice B) discount aygestin 5 mg free shipping menstrual period. This would favor fatty acid release from the adipose and ketogenesis in the liver discount 5 mg aygestin fast delivery pregnancy 6 months. In a few tissues, most importantly red blood cells, glycolysis represents the only energy-yielding pathway available. Glucose is the major monosaccharide that enters the pathway, but others such as galactose and fructose can also be used. The first steps in glucose metabolism in any cell are transport across the membrane and phosphorylation by kinase enzymes inside the cell to prevent it from leaving via the transporter. Most of the carbohydrates in foods are in complex forms, such as starch (amylose and amylopectin) and the disaccharides sucrose and lactose. In the mouth, secreted salivary amylase randomly hydro- lyzes the starch polymers to dextrins «8-10 glucoses). In the intestine, the dextrins are hydrolyzed to the disaccharides maltose and isomaltose. Disaccharides in the intestinal brush border complete the digestion process: Maltase cleaves maltose to 2 glucoses • Isomaltase cleaves isomaltose to 2 glucoses • Lactase cleaves lactose to glucose and galactose • Sucrase cleaves sucrose to glucose and fructose Uptake of glucose into the mucosal cells is performed by the sodium/glucose transporter, an active transport system. They have different affinities for glucose coinciding with their respective physiologic roles. Their high affmities for glucose ensure glucose entry even during periods of relative hypoglycemia. When the glucose concentration drops below the Km for the transporter, much of the remainder leaves the liver and enters the peripheral circulation. Glucose stimulates the first phase (within 15 minutes) Fusion of vesicles with release of preformed with plasma membrane insulin. Insulin Regulation of Glucose Transport in Muscle and Adipose Cells Although basal transport occurs in all cells independently of insulin, the transport rate increases in adipose tissue and muscle when insulin levels rise. If either mitochondria or oxygen is lacking, glycolysis may occur anaerobically (erythrocytes, exercising skeletal muscle), although some of the available energy is lost. In the liver, glycolysis is part of the Note process by which excess glucose is converted to fatty acids for storage. Important enzymes in glycolysis include: Arsenate inhibits the conversion of glyceraldehyde 1. Hexokinase is widely distributed in tissues, whereas glucokinase is found only in bisphosphoglycerate by hepatocytes and pancreatic ~-islet cells. Table 1-12-2 identifies the differences in their mimicking phosphate in respective Km and Vmax values. Near-complete deficiency of glucokinase activity is associated with permanent neonatal type 1 diabetes. Glyceraldehyde 3-phosphate dehydrogenase: catalyzes an oxidation and addition of inorganic phosphate (P) to its substrate. Glycolysis Is Irreversible Three enzymes in the pathway catalyze reactions that are irreversible. The rightward shift in the curve is sufficient to allow unloading of oxy- gen in tissues, but still allows 100% saturation in the lungs. In the well-fed state, galactose can enter glycolysis or contribute to glycogen storage Glycogen Glucose 6-P Administration of galactose during hypoglycemia r-. Along with other monosaccharides, galactose reaches the liver through the portal blood. Once transported into tissues, galactose is phosphorylated (galactokinase), trapping it in the cell. Galactose l-phosphate is converted to glucose l-phosphate by galactose I-P uridyltransferase and an epimerase. The pathway is shown in Figure 1-12-5; important enzymes to remember are: Galactokinase • Galactose l-phosphate uridyltransferase Genetic deficiencies of these enzymes produce galactosemia. Cataracts, a characteristic finding Clinical Correlate in patients with galactosemia, result from conversion of the excess galactose in peripheral blood to galactitol in the lens of the eye, which has aldose reductase.

Many of our clients find that charting these out regularly for three or four months alleviates a considerable amount of their negative feelings purchase aygestin 5 mg on line menstruation tissue. Rethinking risk Another important way to challenge your anxious thoughts is to look at how you assess the likelihood that an event may occur buy discount aygestin 5 mg line menstrual 14 day to you tube. When you feel anxious, like many people, you may overestimate the odds of unwanted events actually occurring. For example, when was the last time you heard a news bulletin reporting that no one got bitten by a snake that day, or that half a million airplanes took off and landed and not a single one crashed? No Chapter 5: Becoming a Thought Detective 77 wonder people overestimate disaster. Because disasters grab our attention, we focus on dramatic events rather than routine ones. That’s why it’s useful to think about the real, objective odds of your predicted catastrophe. When you find yourself making negative predictions about the future — such as the horrible time you’ll have at a party, your odds of failing a test, or the likelihood that you’ll end up in financial ruin — ask yourself the following reas- sessment of risk questions: ✓ How many times have I predicted this outcome, and how many times has it actually happened to me? In addition to asking these questions, whenever possible, look up the statisti- cal evidence as it relates to your fears. Nevertheless, the answers to the preceding questions will help you reassess your true risk and stop habitually making catastrophic predictions about the future. On any given day, the odds of being struck by Notice how the actual odds don’t match very lightning are about 1 in 250 million, and the life- well with what people fear most. Many more time odds of being killed by a few other means people fear thunderstorms, snakes, spiders, are as follows: and flying in airplanes than driving a car or being killed by a firearm. Finally, we should note that your ✓ By a poisonous snake, lizard, or spider: individual odds may vary. If you regularly stand About 1 in 700,000 outside during thunderstorms, holding your golf clubs in the air, your chances of being struck by ✓ In air or space transport: About 1 in 5,000 lightning are a little higher than average. Dennis tightly grips the pan over the stove, watch- ing the color of the meat carefully. He frets that the meat is too tough and that the vegetables look soggy from overcooking. The stress is contagious, and by the time the company arrives, Linda shares his worries. Almost every time that he and Linda entertain, Dennis believes that the food they prepare will be terrible, their guests will be horrified, and he’ll be humiliated. Naturally, he answers the reassessment of risk questions and starts to change his anxious thoughts. In doing so, Dennis comes to realize that he and his wife have never actu- ally ruined a dinner, although he has predicted it numerous times before. Furthermore, he tested his second prediction that his guests would feel hor- rified if the dinner did turn out badly. He recalled that one time he and Linda attended a barbeque where the meat was burned to the extent that it was inedible. Everyone expressed genuine sympathy and shared stories about their own cooking disasters. They ended up ordering pizza and considered it one of the more enjoyable evenings they’d spent in a long time. Deconstructing worrisome scenarios Even faced with the evidence of the unlikelihood of the events you fear happening, you may be thinking that bad things still do, in fact, happen. But you may still be stuck with the what-if worry — what if your concern truly happens? First we show you how to cope with smaller, every- day worries, and then we address worst-case scenarios. In other words, outcomes that, while unpleasant, Chapter 5: Becoming a Thought Detective 79 hardly qualify as life threatening.