Do It Yourself Fencing Repair – Replacing Posts in Fence Made Easy

Do it yourself fencing repair can be a challenge for the inexperienced but it doesn’t have to be. Knowing times are tough and as a thirty year veteran I will try to make fencing repair, changing rotted fencing posts and replacing panels in your fence doable for those who like to do it yourself and save money. I will address:

* Do it Yourself Fencing Repair

* Replacing rotted Fence Post

* Cedar fence Fence Post

* Treated Wood Post

* Galvanized Metal Fence post

* Changing a Wood Fence Picket

* Adding or Changing Fence Rail

There are as many How to Wood Fence and Fencing Repair as there are nails in fence pickets. The way that I describe here has worked for me here in the Dallas Texas metro area for many years.

Do it yourself fencing repair: Is easy if you go about it the right way but is very hard if you go about it the wrong way and can get very frustrating and costly.

Replacing Rotted Fence Post: Replacing posts in a Fence is one of the hardest things about fencing repair. I have seen DIYer’s try everything to get broken fence post out of the ground. One of my favorites is what I call the Grand Canyon. This is when a DIY will dig a hole so big around the fence post that they almost need a cement truck to bring in enough concrete to fill it. Have you ever dug a hole for a fence post? If so use the concept of digging a 8 inch diameter hole for a fence post against the concrete of the old fence post about 2-2 1/2 feet deep. Then take a sharp shooter shovel to clear a little dirt from each side of the concrete. Use post hole digger to remove the little bit of dirt that you loosened from the post hole. You now have a hole that is deep enough that with a little effort you can use a rock bar to lever the broken post and concrete into the hole you just dug so that it will be easy to lift out.

Put the new pole in the hole, take the old hard concrete and use as filler in the hole and put as much premixed wet concrete in the hole as needed to fill to the ground level then plumb the pole with a level. You can then wait 24 hours for the concrete to harden around the new fence post the nail the fence panels to it or you can go ahead nail the old or new fence panels to it, re-level the post and then use an old fence board to support it.

If you would like the easier way out then you can install a new fence post in next to the existing so that you do not have to dig the wood post out.

Cedar Fence Post: Cedar is naturally highly resistant to rot, decay, warping and bugs when used above ground. If it is saturated with moisture when installed in the hole with concrete around it and dries out, it will shrink leaving a void that will take on water. This creates a premature rotting process. This can also happen at the ground level if the concrete is not poured to a level that will help repel the water away from the fence post. You can use a good weather treatment to soak the post end prior to installing to extend the like of a cedar fence post. I have used Behr and Olympic with good success.

Treated Wood Post: Pressure treated wood post have a chemical that is resistant to rot and bugs. The tag on the end of the post at most retail chains like (Home Depot or Lowes) will tell you if it is good for ground contact. I have seen a lot of Landscape timbers used for posts in a fence. These usually do not have the proper treatment that will give it the rot protection so unless someone is on a very tight budget I will not recommend this type of wood post for fencing. Pressure treated pine fence post can warp or check from drying and shrinking (looks like a split). To minimize warping and twisting make sure that you attach the fence panels with the correct screws or nails. They need to be long enough to penetrate through the rail and the post by 2 1/2 – 3 inches. Also make sure that it is a Hot Dipped Galvanized screw or nail so that the chemicals in the wood do not deteriorate them.

I have seen that pressure treated wood post will last several years but can dry rot at the ground level but you can also minimize this by soaking the part that will come in contact with the ground in a good weather sealant.

Galvanized Metal Fence Post: Galvanized Metal Fence Post are my choice to use for fencing a backyard or changing out a rotted fence post. When they are installed correctly they can last a lifetime. Diameter of the hole they are to be cemented in to should be 8 – 10 inches and the depth should be a minimum of 30 inches and up to 48 inches. The type of soil and ground condition as well as the freeze line for your area will dictate this. They will cost a little more but in my opinion are worth the difference. Make sure that you get a heavy gauge like a.095 and put a dome cap on it so that it doesn’t act like a rain gauge. The appearance is not as natural as wood fence post but this can be easily by boxing it with a fence board or two.

Changing a Wood Fence Picket: Changing a Fence Picket is almost self explanatory. In the Dallas Texas metro the choices of fence pickets are starting with the best then to the last are Cedar (3-4 different grades), Composite ( recycled materials like Trex, Correct Deck ), Pressure Treated Yellow Pine and Spruce – Fir – and White Pine ( These are all in the white wood category). The white woods typically have a longevity of 7 – 10 years unless a good weather sealant is applied.

Once again make sure that your screws or nails are of the proper length and either hot dipped galvanized or aluminum.

You can attach a fence board to the top of the pickets or a nylon string to use to keep the top straight as you fasten them to the rails.

Adding or Changing Fence Rail: I have had the most success changing a fence rail by leaving the fence panel attached to the post. Use a sawzall with a metal cutting blade. Slip the blade in between the rail and the post so you can cut the nails or the screws. Use a Wonder Bar and a hammer so that you can wedge it between the rail and the fence board. Pry the fence board away from the fence rail. Follow the same procedure with all the fence boards. Take the fence rail out. Cut the new one to the same length. Drive the nails through the fence picket leaving the nail in. Insert the rail. Hammer to nails back into the fence rail. You then can use 3 1/2 inch hot dipped galvanized nail to hammer through the rail into the fence post.

How to Build Your Own Home – Lesson 1 – Preliminary Analysis

When I started building, I, like a lot of beginners, would spend time and money purchasing land and/or house plans only to find out later (sometimes, sadly, in the middle of construction) that I had made a terrible mistake. Either I had purchased the wrong location or I was forced to incur costs that I had not planned on or I couldn’t afford to build the home based on the plans I had purchased.

To minimize the money and time I would lose up front, I’ve learned to do “preliminary planning.” In this lesson, you’ll find out how to answer the most important question to start the ball rolling, “What size home can you afford to build?” Once you know this, you can now begin the process of purchasing the “right lot” and the “right set of house plans.”

A. What Size Home Should You Build

Before you purchase a lot or a set of house plans, you must first determine the size of home you can afford to build.

1. What Can You Afford?

To determine the size home you can afford to build you must determine how much money you can borrow, how much money you can (or want to) pay per month, decide what to include in your loan then determine the cost to build per square foot in your area.

a. Pre-Qualifying for a loan

You need to acquire this number by contacting a mortgage broker in your area or over the Internet. If you do not know a mortgage broker in your area, ask your current banker whom they recommend for a permanent loan. More than likely, your bank will have a mortgage department and they’ll want your business.

Provide the mortgage broker with the necessary information to find out the actual amount you can pre-qualify for. The lender should not charge you any money to pre-qualify you for a loan.

If you have a problem qualifying for a loan because of income, bruises on your credit or because you’ve recently changed jobs, find out what is causing the problem. Many problems can be repaired in 6 to 12 months. If you are turned down, go to another mortgage broker. Because of the variety of loans available on today’s market, another lender may still approve a customer that has been turned down. If you do have some credit issues, find a mortgage broker that specializes in dealing with credit problems. I’ve noticed that mortgage brokers that only deal with the (easy) good credit customers will not know how to work with someone who has had problems.

2. What Amount Can You Or Do You Want To Pay Per Month?

When you determine how much you can qualify for per month, you need to decide the amount you are willing to pay per month. When you’ve decided on this amount, you need to determine how much of this monthly payment will go toward property taxes and hazard insurance. The remaining balance is what you’ll have available to pay toward principal and interest.

3. What Should Be Included In The Loan

You should plan ahead so that your loan amount will cover every necessary expense from lender fees to costs for material, labor, subcontractors and overhead.

a. Lender fees

Lender fees normally include:

· – Closing costs on the construction loan [normally 2% of the loan amount]

· – Interest on the construction loan [normally the Prime Interest Rate + 2%]

· – Closing costs on the permanent loan [normally 4% of the loan amount]

b. The Projected Construction Cost (Material, Labor, Subcontractors and Overhead)

Up to this point you haven’t spent any money. Now you may need to spend a little money. I recommend you obtain a current copy of R.S. Mean’s Residential Cost Data. You can buy this manual online or you may find a copy at your local public library. Most of what you need will be found in the first chapter.

Honestly fill in the data concerning the style and quality of home you want to build. Means will explain how to determine the quality. Then add to the base home any additions, such as a deck an extra bathroom and/or a driveway. Then use the “location factor” for your area. [A home will cost more to build in San Francisco, California than Atlanta, Georgia] You will be amazed at how close this estimated cost to build your home will be to the actual cost.

I’ve heard so many builders say, “There is no way the home I’m building will cost this much”, only to be shocked when they see the actual cost upon completion.

If I were shopping for a builder, I would want to know this figure just to know if the builder was charging too much or grossly underestimating the cost of the home. Under estimating the cost creates more problems than over estimating the cost.

4. What Size Home Can You Afford?

Therefore, for example purposes, let’s assume the following: you are able to borrow $194,504.00 (based on your projected monthly mortgage amount), less lender fees of $16,046.00 and cost additions of $41,378.00, you will actually have $137,080.00 from which to calculate the final square footage that you can build. Based on $67.24 per square foot, you will be able to build a 2,038 square foot home.

Total Loan = $194,504.00

Less:

Lender Fees = – 16,046.00

Additions = – 41,378.00

Balance = $137,080.00

Square Feet = 2,038 ($137,080.00/$67.24)

Food for thought: You could have included anything you wanted in the loan. You could have included dining room furniture, a washer and dryer, or a trip to Europe. You decide. But any additional inclusions will ultimately decrease the square footage of the home you want to build.

WARNING: You would not believe the number of individuals, including builders that will go through this simple arithmetic, purchase a 2,000 square foot house plan, borrow $194,504.00 and start building away!!

When you purchase the plans, you’d still better not dare borrow money and start building before first determining what the actual cost is going to be. Our calculations are nothing more than a guesstimate.

Because it’s easier to design a home for a given lot rather than find a lot to fit a given set of house plans, I recommend you next move should be to “find a lot”.

Acne

One of the most popular skin disorders, Acne, is the term used for plugged pores (blackheads and whiteheads), pimples and even deeper lumps like cysts or nodules.

Although the effect of the disease is seen mostly on the face, it may spread on your neck, chest, back, shoulders and even on the upper arms.

Acne begins when tiny hair follicles become plugged with oily secretions from the skin's sebaceous glands that initially take the form of blackheads and whiteheads. While blackheads are small, flat spots with dark center, whiteheads are similar excepting for being colorless.
When these whiteheads or blackheads get swelled up, they form cysts or nodules. These cysts and nodules are basically the firm swellings below the skin surface that get infected too at times, give birth to acne.

Acne starts from the age group of twelve to seventeen in its mild form. It takes the severe form in mid-teens, sufficient enough in 40% indictors to see the physician.
Although it occurs in both sexes, teenage boys are more prone to suffer than the severe cases of it. The adults too are unable to escape this skin disorder. 20% population belonging to this age group, especially women, suffer from mild to moderate forms in their thirties and beyond, and are somewhat susceptible to rosacea. It is due to hormonal changes associated with their menstrual cycle and acne caused by cosmetics.

In most of the cases acne gets cured on it's own, but if it persists, it can result in serious and permanent scarring.

Various factors that cause adult and teen acne include hormonal changes, diet, evolutionary biology, vitamin deficiencies and more. It may develop due to family history of the condition, stresses and use of contraceptives or corticosteroids. Poor hygiene, unbalanced diet and stress can be the promoter factors of acne but are not the real causes.

Hand Numbness, Tingling, Pain or Weakness? Carpal Tunnel Syndrome Diagnosis and Treatment Options

Carpal Tunnel Syndrome is a condition in which the median nerve is impinged, most often at a point in the wrist where it passes through a narrow tunnel-like opening known as the carpal tunnel. This opening is formed by the transverse carpal ligament as well as the hammate and pisiform bones in the wrist.

Symptoms of Carpal Tunnel Syndrome include:

• Numbness or tingling in the thumb, index, middle finger and possibly part of the ring finger

• Pain in the wrist or hand

• Poor grip strength (trouble lifting and carrying items) or weakness in the wrist and hand

• Difficulty moving the fingers and wrist

• Muscle atrophy

If you have been suffering from any of the above symptoms, it is a good idea to determine whether it is because of Carpal Tunnel Syndrome. Although it is best to see a doctor for a definitive diagnosis, there are some quick tests you can try at home.

1. Tinel’s Sign: Hold your symptomatic hand out with the palm facing upward. Tap firmly and quickly on the center of the wrist crease for several seconds. If this tapping aggravates your symptoms, it’s likely to be Carpal Tunnel Syndrome.

2. Phalen’s Test: Press the backs of your hands together (with the elbows bent and forearms up). Fingers should be pointing down and the wrists bent at a 90 degree angle. Hold this position for one minute. Any aggravation in symptoms suggests Carpal Tunnel Syndrome.

3. Reverse Phalen’s Test: Press the palms of your hands together in a prayer position and lower your wrists and forearms as far as possible without letting your hands separate. Hold this position for one minute. Again, any worsening of symptoms suggests Carpal Tunnel Syndrome.

There are many reasons why someone may develop Carpal Tunnel Syndrome. Because the carpal tunnel is a narrow space, the median nerve running through it may become entrapped if there is any inflammation, fluid, or scar tissue buildup within the tunnel. This may occur due to:

• Overuse (repetitive use may irritate the median nerve where it runs through the carpal tunnel)

• Fluid retention (such as in pregnancy)

• Obesity

• Inflammation (this includes arthritis and infections)

• Misalignment of the wrist bones, elbow, or neck and shoulder regions

• Cyst or Tumor in the wrist

Choosing the Right Treatment for You

It is imperative to educate yourself on the treatment options available to you, so that you may make an informed decision as to whether to choose allopathic medicine (most M.D.s, or Medical Doctors) or alternative medicine (Chiropractic and/or Acupuncture). Read on to understand these very different approaches, and be sure to read my recommendations at the end.

Allopathic Medicine for Carpal Tunnel:

In the traditional western medicine approach, doctors perform orthopedic, nerve conduction velocity and electromyography tests to evaluate for Carpal Tunnel Syndrome. Treatment options include wearing a brace for several weeks, taking NSAIDs (Non-Steroidal Anti-Inflammatory Drugs) such as Ibuprofen or Naproxen, corticosteroid injections, and ergonomic evaluation and correction.

While ergonomic evaluation and counseling is a good idea, there are many potential problems with the other therapies in this model. Wearing a brace takes weeks and is often ineffective. Taking NSAIDs may decrease pain and inflammation, but this is a band aid rather than a solution. Moreover, long-term use of NSAIDs carries a risk of side effects and serious complications like ulcers (bleeding in the stomach or gut). Corticosteroids are also effective in minimizing inflammation, but they too fail to address what triggered the inflammation, and repeated injections may have negative consequences on the ligaments, immune system, and adrenal glands.

Taking the above measures often fails to provide relief. In fact, over 50% of people who try the above methods end up getting surgery. The surgical “solution” to this problem is to sever (cut) the transverse carpal ligament to make more room for the median nerve. Destroying this ligament destabilizes the structures within the tunnel. Although this provides relief for some, this means a period of limited use and physical therapy during the recovery. Moreover, there is always the risk that scar tissue resulting from the surgery will re-impinge the median nerve.

There are no therapies available in this model to address misalignments in the wrist bones, elbow, shoulder or neck. Most medical doctors are not trained in identifying or treating joint misalignments.

Alternative Medicine for Carpal Tunnel:

In addition to the orthopedic tests, alternative medicine doctors use palpation and muscle testing to identify the root of the problem. Expect an examination that evaluates the whole body in addition to the problem hand and wrist.

Palpation helps identify any misalignments that can irritate the median nerve. Muscle testing and biofeedback (called Professional Applied Kinesiology (PAK)) is another invaluable tool in the diagnosis and treatment of Carpal Tunnel symptoms.

Treatment options include chiropractic adjustments and acupuncture, and this may address other problem areas besides the wrist.

Chiropractic care has an impressive track record for resolving Carpal Tunnel Syndrome. Often the associated symptoms result from misalignment(s) of the wrist, elbow, shoulder, and/or neck. In such cases, chiropractic adjustments can quickly and easily remove pressure from the median nerve and restore normal joint mechanics. This eliminates pain and restores normal muscle strength. Mild soreness sometimes follows the adjustment but resolves within 24 hours.

An acupuncturist will evaluate your pulse and examine your tongue in order to determine the cause of the problem. The treatment will involve inserting a few thin, sterile needles at various points throughout the body to restore balance and provide relief. Acupuncture, supplements, and diet modification have also been effective at decreasing inflammation and providing relief for many people.

Recommendations:

1. Try Vitamin B6 if you are retaining too much fluid. This is a natural diuretic and may help.

2. If your job requires you to spend long hours at a keyboard or to do other repetitive motions for prolonged periods, get an ergonomic evaluation.

3. For one month, eliminate all sugar, sugar substitutes, and limit grains from your diet. These foods all increase inflammation and thus worsen the symptoms of Carpal Tunnel Syndrome.

4. See a chiropractor or acupuncturist specializing in Professional Applied Kinesiology (PAK) for natural treatments for your carpal tunnel syndrome. Go to icakusa.com and click on the “Find a Doctor” tab to search for someone near you.

Most people respond very well to chiropractic, acupuncture, and/or supplements and dietary measures. However, if these natural treatments fail to provide relief, the more invasive treatments offered by western medicine can be a back-up option.

Herpes – Testing For Herpes

Genital herpes is a sexually transmitted disease passed from skin to skin sexual contact. If you think you have been exposed to the virus, it is a good idea to visit a doctor to get a proper diagnosis. Many people do not get diagnosed with genital herpes because oftentimes the virus is not accompanied by symptoms, or the symptoms can easily and frequently get mistaken for other conditions. This lack of diagnosis, of course, leads to the high numbers of genital herpes cases.

If you experience the following symptoms and/or believe that you have been exposed to the genital herpes virus, you may want to consider going to get tested by your physician or at a sexual health clinic.

– Flu-like symptoms: fever, aches and soreness, swollen lymph nodes

– Tingling, itching, burning or pain in the genital area

– Appearance of painful red spots, which, within a day or two, develop into clear, fluid-filled blisters

– Painful urination

– Abnormal genital secretions

The best time to go to the doctor or clinic for herpes testing is when you first experience any of these symptoms, because a visual diagnosis may be made. Genital herpes can be caused by either herpes type 1 or type 2, so other testing besides a visual diagnosis is necessary to determine the exact type of herpes virus that you have.

Upon your doctor visit, you can expect to first be given a medical survey which will provide information about your medical history: general health, previous conditions and current and previous symptoms. This evaluation will probably include questions about your personal life, like how recently you participated in sexual activity, whether you used condoms, if you have had an STD before and if you have any reason to believe that you have been in contact with herpes. Answering these questions as candidly and truthfully as possible will help the physician in evaluating the chance that you have been infected.

Next, to verify HSV diagnosis, the doctor may suggest one or more tests (a swab test or a blood test) to conclude whether you have HSV-1 or HSV-2. Type 1 is the virus more usually associated with facial herpes, while HSV-2 typically causes genital herpes, although cross-infection can occur. Knowing which virus you have helps determine protocol for future outbreaks. You may need to schedule another appointment to get blood work. Once blood work is done, the doctor will discuss the results with you.

Once you are diagnosed, it is common to be shocked or nervous. You may want to schedule a follow-up appointment just to discuss the implications of your genital herpes diagnosis Here are some questions you may want to ask your doctor after diagnosis is confirmed:

– How did I contract genital herpes?

– How often can I expect outbreaks?

– How can I identify a genital herpes outbreak?

– Can I prevent future outbreaks?

– What are my options for treatment?

– How can I decrease the chance of spreading herpes to my sexual partner?

– Will I be able to have sex without infecting my partner?

– How does genital herpes differ from cold sores/facial herpes?

– What are additional resources?

– Are there any support groups in my area?

Once you have discussed this with your physician, you should ask him/her about treatments that can reduce herpes outbreaks. Natural treatments have proven to be very affordable and lack the side effects of pharmaceutical drugs.

Registered Nuts – Psych 101

6:42 PM

I pull into the lot and sit for a minute. I say a small prayer that goes something like, “God, why do you punish me so? I HATE YOU……Amen!”

I sigh a deep and agonizing sigh and hoist my tired ass outta my truck and into the pits of hell that is our Emergency Department.

This one tends to have the psychotic market cornered so as to promise an especially challenging shift. One that will one day assure my place amongst the ranks of chronically psychotic.

06:45

I’m met at the vacuum sealed double doors, coffee in hand and a bad attitude by a crash and a yell, “Hey, ..STOP HIM” I’m a tad stunned to see Atilla the Hun barreling towards me and a crack team of nurses and doctors all looking at him, pointing at me and caring less that he decided to make an untimely exit. As Mr Hun blazes by me I wish him well, pat him on the back and kindly hit the silver button on the wall, allowing him that very freedom that appears he’s willing to die (kill) for. We surround him in the parking lot where he is coaxed back inside by the unit clerk with the promise of a hot meal, a cool buzz (Ativan) and a quick admission to the floor in time for the NBA playoff game. All this love and attention because wifee wanted out and he wasn’t crazy about the idea. He’s put up for about a 1000 dollars a night, spoiled, pittied and pampered until he’s ready to say he’s sorry and he’ll be a good boy. 72 hours later he’s released with hugs abound. When presented with the $5200.00 bill he explodes at the admissions desk, shares a few expletives with the beleaguered clerk and vows to “never pay you sorry mutha*****!” No doubt the soon-to-be-ex-wife will soon end up in one of our local trauma centers, unfunded, unloved and unconscious.

7:04 PM

I’m sucking down my now lukewarm coffee and I am thinking, “All this already”….”AND I HAVEN’T EVEN STARTED MY SHIFT YET”.

No sooner do I sit down for report when I am approached in rapid succession by a flurry of angry, psychotic, confused patients and family members. “Can I have water?”… When is the doctor coming in?”…..”That 200 milligrams of Demerol just ain’t workin, can I get another ‘hunerd?”….”My father just took a shit in your garbage can and now he’s got the red thermometer in his mouth and the BLUE one up his….” “MA’AM,…I’ll be with you momentarily” (i.e. I’M DRINKING MY *****IN COFFEE)

The oncoming shift all look and feel as I do. There is distance in their stare. Want in their heart…And a loaded .45 caliber just under their fanny pack if a career change is near. The outgoing Nurses are bouncing around and singing like they are Oompa Loompa’s in Willy Wonka and the Chocolate factory. The elation at the end of another ER shift is truly palpable. You tend to be a little nicer, a little better nurse, a little more human, if only for a few moments. But we are just arriving and could give a damn about 90% of the crap that invades our Emergency rooms on any given day. All we care about is who is dying and how can we help. The animal’s will have to wait.

7:11

At once I establish who my patients are, why they are here and if they are pending admission to the Eternal Care Unit. I bury myself into the sickest one’s and assure that all is medically stable, comfort is being maintained, info is passed along, all the while offering up a healthy dose of compassion and professionalism. They are why I am here and why I chose this profession. My other 2 patients are chronic alcoholics, multiple visits, multiple attempts to dry them out at the tax payers expense, multiple personalities. Neither can see straight, pee straight or walk a straight line. Both have liver’s the size of Rhode Island. One has jaundice so bad it looks as though he spent his last drinking binge slurping Vodka Martini’s in a tanning booth. One will eventually get admitted as a medical patient because his blood alcohol level exceeded numbers that resembled surface temperatures of the Sun. He will go on to dry out overnight and sign out against medical advice by morning………. and, be drunk again by noon.

7:28

Contemplate suicide.

7:31

Can no way see leaving this bastion of humanity until I first answer a flurry of questions by the unruly masses still to be brought back from the waiting room. From the intercom and in broken english I hear, “Pinche Pendejo, I’ve been waiting for 13 hour’s and…………Click…. “Mrs Rosario, I am sorry that your hearing is diminished because you’ve got 3 pounds of earwax lodged in your auditory canal but I am presently caring for a man who is near death…..we are sorry for the delay… Please, GO SIT THE **** DOWN……..and thank you for choosing our hospital for your all of your personal hygiene needs.”

7:33

Contemplate homicide.

9:12

A naked man runs by the nursing station with little fanfare. We usher him back into a room and apologize to the parents of a visibly shaken 8 year old girl. A girl who has no business in an adult ER in the first place but who’s parents snuck her in so she could watch grandma vomit stool.

9:47

SMOKE BREAK.

9:52

Catch an earful from someone elses patient who is unhappy that no one has fed her, angry because no one has medicated her anxiety with an otherwise near fatal dose of Ativan, pissed off at the world for her crack habit, her Hepatitis C and a botched lesbian relationship. She demands that her “spouse” be brought back immediately, spouting, “She is my wife you know!”

“Not in Texas she’s not!”!

As she marches back to her room to gather her things and leave, I suspect I haven’t heard the last of this incident. It is a “Methodist” hospital system you know. Hell, if it were a Catholic Hospital, I’d get a raise and an email link to sensitivity classes online.

10:02

SMOKE BREAK

12:02 AM

“GODDAMIT, I BEAN HER WAITING FOR ALMOSE 22 HOURS….Click…..Mr Sanchez, I am sorry that your gun-shot wound from the time of the Alamo still hurts you but we are presently “extending our healing ministry of Christ” by physically restraining a morbidly obese manic-depressive who thinks the ghost of Liberace’ sexually assaults him in his sleep. Now please, ****-OFF!!!!”

We gang-tackle Mr Palmer, re-dress him…AGAIN….assure him that Liberace pulled out and ran off as soon as he hit the floor, then strap him to a gurney.

12:42 am

I am then accosted by an angry family member who is complaining about the smell emanating from the bed next to his wife’s. In easy to understand, non medical terms I explained that one of the many glorious smells perusing through any given ER at any given time is the smell of rotting flesh. In this case, rotting flesh from the necrotic toe of a non-compliant, renal transplant patient given a new lease on life as well as a few body parts in spite of his heroin addiction. He stopped the insulin, restarted the juice and blew nearly a 1/4 million dollars of other peoples money in the process. I escort the man back to his wife’s bedside, reassured her that her gallbladder wouldn’t hurt so much if she’d stop wearing t-shirts with Jack-In-The-Box logo’s (you get ’em free with the purchase of a “number 3 with double-cheese”) and change her diet to one with less fat.

01:30 am

Dinner time and I relax to eat a little chow and watch a little of the Republican Party Presidential hopefuls debate on a little TV in the nurses lounge.

01:31 am

SMOKE BREAK

02:19

Fearing for the fate of my country, my life, my fellow man, my sanity, I crawl into bed 5, hit the call-light and demand a pillow and a Xanax..

04:10

There is light at the end of the tunnel when I admit 2 patients in record time. I have 3 empty beds and Mrs’ Karnes, a 22 year old Vicodin addict who came into our ER because her “Doctor in (insert fictional place here) forgot to refill her (insert narcotic pain reliever or benzodiazapine here) and now she is out her meds. After giving an Oscar-worthy performance she convinces the “treat ’em and street em ER Dr type to aptly write out a total of 3 prescriptions, each representing one of 3 classes of narcotic medications. She asks for another (insert “D-D-D Demerol” here) shot for the road and swings by the nurses station to thank everyone for their professionalism, patience, a nice buzz….. and most of all for her up and coming 3 day stone-fest featuring Oober Buzz and the Benzo’s. We applaud her commanding performances and wish her a speedy overdose. She is reminded that her “red card’ means she must stop by admissions and pay her bill and that she must also call for a ride because we cannot allow her to drive in her intoxicated state.

04:27

The Vicodin Queen observed sneaking away in her Escalade, shards of red paper seen flying from driver side window.

05:40

“OK, THAT’S IT MUTHA-&$%#A, I BEEN HERE FER 23 MINUTES AND 15 SECONDS AND…..click…..Uhh, Mr Jones,

This is Mike, your nurse who was taking care of you…well, if you recall we discharged you not 20 minutes ago. You’ve already seen the ER Dr and you’ve already received your Dilaudid shot for your tooth pain you’ve had since just after the Crusades!”……………Mr Jones?…….”Yeah…..Okay……….” “You’re welcome Mr Jones……”

..”See you tomorrow”.

06:47

After A few rounds of Limbo the celebration quiets as the day crew comes ambling in. Each one reluctantly glances at the census board and are visibly shaken when they notice it full. 2 of which are patients they’d already seen the day before for the very same, non-urgent complaints. They didn’t fill their scripts, they didn’t call their follow up Doctor’s or their primary care Dr’s AND their “pain specialists” have put out restraining orders on them. All they know is that at any time, 24/hrs a day they can come into any ER with the law on their side, a bogus complaint, a false identity and demand that we get them stoned. And we do. By law, WE HAVE TO. They don’t bring any means or inkling to pay, they toss around that same pathetic chronic back pain or migraine story, display that same list of 20 meds they CAN’T take because they are “allergic” ( = doesn’t get them high) and cry and carry on until they are higher than a Polish satellite.

07:01

“AWWWWWWWWWWWWWWW…I NEED TO SEE A DOCTOR NOW YOU MUTHA…”…..click………………”Mr Baldinger……..Hello Sir, This is Mike, one of the Nurses here at Our Lady of Perpetual Pestilence Hospital. I apologize for the wait and I want to assure you that one of our fine (day) nurses will be with you momentarily to meet your every need. And please don’t worry about any red-cards, you don’t have to pay this time either. Besides, we are using BLUE cards now, which is a much softer color and………..CLICK……..JUST COME GET ME MUTHA FF……click. “Be right there friend, and don’t you fret Mr Baldinger, here at OL PeePee Hospital, Were here for YOU!!!……Click.

07:02

I inform the day crew that Mr Baldinger is in the waiting room attempting to steal the battery off of Mrs Martinez’s Hover-round.

They all run through the double doors and I double time out the back. As security rushes by, presumably for that little ruckus about to kick off in the waiting room, I release a deep, long sigh, mentally picture Mr Baldinger being hog-tied to a gurney and all to the amusement of a waiting room full of the world’s misfits. The drug addicts, psychotics, neurotics, non-compliants, drug-seekers, actors, beggars, the lonely, the homeless and the truly worthless are all equally represented. There are NO emergently sick patients out there. They are in the back with us. The truly sick who receive and appreciate our care, handling perhaps the last few moments of their lives as humbly and as kindly as their pain and regrets allow. Understanding the interruption when the worlds worst aren’t getting enough attention. I have to remind myself often that that is why I and so many other fine Nurses, Dr’s and ancillary staff put up with those who just plain shouldn’t be here. Shouldn’t be allowed there unless a true medical “Emergency” exists and who literally gobble up “HUNDREDS OF BILLIONS OF DOLLARS IN TAX PAYERS MONEY A YEAR!” I also remind myself that I did make a difference in someone’s life last night. I did bring a smile and a few laughs. And I can still comfort the sick and dying and always from the heart. And they know that. But I also know that this kind of work can drain the spirit and refill it with fear, hate and apathy (see above).

07:07

As San Antonio’s finest come blazing past me and abruptly come to a screeching halt at the ER entrance, I again briefly picture the drama unfolding inside. Driving away in my truck I smile large and begin to sing……….”Oompa Loompa Loopity Loo…I’ve got a special…

Vitiligo treatment – Cure of White Patches

Vitiligo is known as a disease that is normally caused due to deficiency of special type of cells called pigment cells. This cell is also known as melanocytes. But the matter of fact is that no one is aware about the reason of deficiency. The roots of these diseases are as old as the human history of skin diseases found in old books. In fact, the reasons that cause this disease are unknown and are still a mystery. If you search online regarding Vitilgo treatment then you will observe that there exist numerous websites that claim permanent cure. But the truth is that this is nothing more than a trick to sell their medicines. You should always keep in mind that no one will assure you that these white patches will never appear again after getting disappeared so no one can assure of complete vitiligo cure.

If you search online you will discover a number of Vitiligo treatments online. But, with herbal treatment, you will definitely acquire your original skin color by removing the white patches from your face. With this type of Vitiligo treatment, you will never have to undergo the hypo-pigmentation to remove white patches. Many people get inferiority complex due to vitiligo marks on skin. But, now you don’t need to be disappointed as you don’t need to undergo any painful, surgical or costly method for re-pigmentation of your skin as you can acquire this with natural treatment. There exits numerous treatments that are carried out with steroids. As steroids contain side effects so they may dangerously harm your skin. Besides this, herbal treatment involves all those ingredients that are provided by nature to cure your skin.

If you search online you will find that herbal treatment is compounded with the natural elements that are free from any type side effects. Furthermore, you don’t need to be worried about reappearing of white patches as when you under herbal treatment, you get your white patches disappeared at slow pace. What you need to do is just to follow the guidelines and precautions while apply it on your skin and you will notice the fast results within no time. To get the best herbal Vitiligo treatment, do carryout a comprehensive research online.

Clinical Depression and Its Symptoms

According to the definitions of most medical, psychological and psychiatric bodies, there is a commonality in the diagnosis of depression. Most depression tests have a very similar framework. Almost without exception, clinical depression will be diagnosed if a certain number of feelings, that are signs of depression, are present over a certain period of time.

Current theory suggests those clinical depression results from complex interactions between brain chemicals and hormones that influence a person’s energy level, feelings, sleeping and eating habits. These chemical interactions are linked to many complex causes–a person’s family history of illness, biochemical and psychological make-up, prolonged stress, and traumatic life crisis such as death of a loved one, job loss, or divorce. Following are some of the common symptoms of clinical depression:

Markedly diminished interest or pleasure in all, or almost all, activities most of the day, nearly every day.
Significant weight loss when not dieting or weight gain, or decrease or increase in appetite nearly every day. Note: In children, consider failure to make expected weight gains.
Insomnia or hypersomnia nearly every day
Psychomotor agitation or retardation nearly every day
Fatigue or loss of energy nearly every day
Feelings of worthlessness or excessive or inappropriate guilt (which may be delusional) nearly every day.
Exhaustion on waking
Disrupted sleep, sometimes through upsetting dreams
Early morning waking and difficulty getting back to sleep
Doing less of what they used to enjoy
Difficulty concentrating during the day
Improved energy as the day goes on
Anxious worrying and intrusive upsetting thoughts
Becoming emotional or upset for no particular reason
Shortness of temper, or irritability
Restlessness or decreased activity noticed by others
Thoughts of suicide or death
Teenagers may show depression by taking more risks and/or showing less concern for their own safety.

Effects of Bad Health Habits

Are you feeling restless and tired almost all the time? The reason could be your bad health habits. Each of us has all the options on how to improve ourselves and feel good. It all depends on our own hands whether we want to feel great or dwell ourselves to our usual habits that are not really good for us. We usually have habits and we are not aware that it is not doing any good to our health.

Let me show you some of the bad habits that you need to ditch to live and to have a better lifestyle.

Smoking

Every one of us including especially smokers knows that smoking is very dangerous to our health. It has many side effects on your health and the health of those around you. Smoking can cause lung cancer, complicate pregnancy, heart disease and many other diseases. If you love your life and want to live longer, stop smoking now.

Lack of physical exercise

Exercise is any bodily activity that enhances physical fitness and overall health. It is performed for various reasons. Frequent and regular physical exercises boost the immune system, and prevent heart diseases. Regular exercise also improves mental health, helps prevent depression and improves one’s self esteem.

Alcohol Consumption

Even in moderation, alcohol damages brain and body cells. Too much intake of alcohol would cause certain diseases like brain damage, liver problems, diabetes, high blood pressure and even cancer. Excessive drinking can interrupt normal sleeping patterns resulting in insomnia and lack of sleep can lead to stress and anxiety.

Lack of Sleep

Some people suffer from chronic sleeping disorder and frequently experience disruption. Some have sleep problems due to physical stress or condition and others suffer because of mental or emotional cause. Get immediate medical treatment if you already have serious sleep disorder to maintain a healthy lifestyle. Avoid taking sleeping pills as this could have some side effects. Consult your doctor before taking any medications to ensure your health.

Poor Diet

Basically junk foods are foods with little or no nutritional value at all. Some products with little nutritional value are considered unhealthy when eaten regularly. One harmful effect from eating junk food is lack of energy. Junk food can also cause heart diseases. Most junk foods are high in cholesterol it can damage your liver eventually.

Most people today are too busy and have fewer times to prepare nutritious foods. More and more people want a convenient life; quick and easy are more preferred by most. Now you know the reality of bad health habits, it’s all up to you on how you can live a healthy lifestyle and to live in a quality life. Remember we only have one life to live, so let us take good care of our most precious possession.

Type 2 Diabetes – Ways To Lower Your Triglyceride Levels

Looking to give your heart health a boost? If so, you will want to be paying close attention to what you can do to help bring down your overall triglyceride levels. Having high triglycerides is going to put you at an increased risk for heart disease and potentially even contribute to stroke. Triglycerides are the fats that clog arteries. Your mitochondria help to burn up fats and work hard until they one day become exhausted from having to cope with the high levels of sugar and fat in your diet. Then your blood triglyceride and cholesterol levels rise.

Fortunately, getting your numbers into a healthy range does not have to be all that challenging. Let’s look at four techniques you can use to keep your triglyceride levels intact…

1. Walking. That’s right – basic walking is often all it takes to start seeing marked improvements in your overall triglyceride level. Too many people think you need to spend hours each day in the gym laboring away, but this is not the case. Sometimes basic is best.

Head out for a 10 to 15-minute walk each day and watch the impact this has on your triglyceride levels.

2. Keep Tabs On Your Sugar Intake. Preventing Type 2 diabetes should be reason enough to ensure you are not eating high sugary food but if that is not motivating enough for you, consider the fact you can reduce your heart disease risk by doing so.

Large amounts of sugar will end up being converted to fat in the blood stream, thus raising your triglyceride levels. Sugar is often the biggest culprit when it comes to damaging your health – not dietary fat.

Make sure you are not overlooking this fact.

3. Check Your Trans Fats. Trans fats are no good. There is just no way around this one; you should not be consuming trans fats. But many people are letting them sneak into their food plan without even realizing it.

How do you know if trans fats are an issue for you? Start reading ingredient labels. If you see the term partially hydrogenated vegetable oil listed anywhere in the label, you know the food contains trans fats,

Many foods will list it on the nutritional label as well, so you might be able to check the label.

4. Serve Up Salmon. It has been said time and time again, but it can’t be stressed enough: you need to be eating fatty varieties of fish on a regular basis. This is the best way to help keep your heart disease risk in check as you will get a potent dose of omega-3 fatty acids, which are excellent for minimizing triglyceride levels.

Salmon is a perfect choice as it is also lower in total mercury content, so you can feel safe eating it multiple times each week.

There you have the most important points regarding your triglyceride levels. If you are letting those levels get out of hand, take steps today to help minimize them. It is easier than you think.

New Treatment for Diabetic Eye Complications

Diabetes is reaching epidemic proportions in the United States with more then 26 million Americans currently suffering with this serious disease. The most common of the eye complications are bleeding in the retina and macular swelling. Diabetic retinopathy is the leading cause of blindness in young Americans, and the swelling of the retina is due to chronic, long term retinal inflammation.

In an attempt to treat this very serious inflammatory condition, steroid injections have been given directly into the affected eye. It should be noted that this therapeutic modality in not FDA approved, but doctors have continued to employ it since it has been effective in reducing the swelling. The problem has long been that this treatment has substantially increased risk of ocular complications. In addition, frequent injections every few months are required in order for the therapy to be effective.

The steroid injections reduce retinal thickness thus improving vision.  The steroids inhibit this inflammation by suppressing the endothelial growth factor. This in turn decreases the vascular damage. These beneficial results only last about 3 months, but the potential side effects include cataracts, increased pressure in the eye, endophthalmitis (severe inflammation) and uveitis.

The goal is to increase the effectiveness of the steroid without increasing the negative side effects. Intraocular implants have been employed near the front of the eye, behind the natural lens, for treating multiple retinal conditions. These include cytomegalovirus (CMV) and posterior retinitis. These implants require sutures and thus have an increased risk of infection when used.

Iluvien is an injectable steroid that is currently under FDA investigation for Diabetic Macular Edema and will last up to 3 years after injection. It is injected with a 25 gauge needle which seals itself; not requiring any sutures. It can also be placed more posterior in the eye for higher effectively and thus better results; this will also decrease the chances of bad side effects so common with the other steroid injections.

Economic Growth in Chile

When you look at Latin America it is the likes of Brazil, Mexico, Colombia, etc who grab the headlines with other countries such as Chile often left in the shadows. However, while economic growth in Brazil and Mexico continues to push forward at a slower rate it was interesting to see that earlier this week it was announced that economic growth in Chile was actually well above expectations.

This perfectly illustrates the reason why so many expats are now considering Chile as their home of the future. It is a country which has been in the doldrums for some time, it is a country rich in natural resources and finally it is one which is beginning to fulfill its potential.

Economic growth in Chile

Economic growth in Chile was reported at 6.7% for January 2013 compared to the same period in 2012. This is a very impressive result and continues the 19 month long trend of economic growth in excess of 6%. This is the kind of figure which European counterparts can only dream of and even the likes of Brazil and Mexico are nowhere near this kind of growth.

While it is illegally that growth for the full year will match the 6.7% rise in January 2013, it is still expected to exceed 5.4% with potential for further upward revision. Even this figure of 5.4% is well in advance of the International Monetary Fund's prediction of 4.4% annual growth in 2013. If anything, the Chilean central bank is erring on the side of caution because there seems to be a great momentum behind the upward curve in Economic growth across the country.

What is behind the increase in economic activity?

While there is no doubt that retail sales, up 9.5%, and mining production, up 8.4%, during the last 12 months have had a major impact upon the overall growth figure, there is more to this than meets the eye. There is now a general feelgood factor through which Chile is likely to lead to more confidence from internal and international investors going forward. The fact that the country is finally beginning to fulfill potential income streams from its array of natural resources is a bonus which looking back has been replicated across many successful economies – most notably Australia in recent times.

Taking a step back from the situation, the Chilean government will need to ensure a balance between economic growth and sensible management of the economy. It would not take much to tip the economy one way or the other and overheating of the Chilean economy would be very difficult to cool down.

Benefiting from Latin America

Even though the likes of Brazil and Mexico continue to grab the lion share of both internal and external trade among Latin American countries, Chile is beginning to benefit from ongoing trading arrangements. Many of the Latin American governments have come together to speak as one voice on the international trading stage to gain more access and more business for the continent as a whole. While the vast majority of the new business is going the way of Brazil, Mexico, Colombia, etc there will be opportunities for the likes of Chile to build on recent economic growth and push ahead for the future.

Conclusion

As the expat community continues to flock to Latin America it will come as no surprise that more and more people are now looking at moving to Chile . Historically Chile is a country which has never really featured on the expat community map but it is one which is grabbing the headlines both with regards to economic performance and proactive government policies going forward.

It will be interesting to see when the ever-growing flow of expats to Latin America begins to slow and indeed wherever those who've moved there to side to stay long-term or perhaps repatriate to Europe once the economic environment is calmer. Either way the last few years have been something of a rollercoaster ride for Latin American countries having been on the brink of disaster back in the 1990s and now perhaps stronger than they have been in living memory.

Album Review: Andrew Bird – Break It Yourself

Chicago native Andrew Bird’s latest offering “Break it Yourself” stays true to the clever wit and one-of-a-kind whimsy that fans have come to expect from his music.

As a master of blending virtuoso violin playing and a signature whistling style that’s seemless in its own right (among other delightful flourishes), Bird manages to always effortlessly maintain a pop sensibility that warrants repeat playing without becoming too dull. It’s no different this time around.

On “Desperation Breeds”, the album’s opener, Bird delicately ruminates on the world’s bee shortage before slowly breaking into a high pitched violin squeal that dips into a mad frenzy of his trademark fingering skills. It almost literally seems to channel the frustration and confusion of the bees themselves.

“Eyeoneye”, a track that manages to correlate heartbreak and the complications of a tumor called a teratoma is as catchy as anything he’s done in the past, if not more so. The driving force of the melody makes vulnerability seem like a fun experience that no one should miss out on. This is especially clear towards the end when he sings/chants “Go ahead and defibrillate yourself” before the pounding drums build to a crescendo… and then fizzle with, of course, a light whistle; as if we just ran a hardcore marathon like it was nothing. Exhaustion doesn’t exist here, but exultation.

The hearbreak theme continues in “Near Death Experience Experience”, where the happiness of surviving a plane crash is dancing “… like cancer survivors… grateful simply to be alive”. But don’t let the dark subject matter fool you. The carefree mood of the song is so happy it’s like skipping down a sidewalk under a row of apple trees. Only when the apples hit your head do you realize the power conveyed in the lyrics of triumph over pain.

Who knew the subject of conquering fear and doubt could be so purely gorgeous? Take “Fatal Shore”, where a mellow Mr. Bird meditates on the subject as quietly subdued as ever, but no less emotionally powerful as some of his best tracks. The drums gently tap along with the guitar and bass like a gentle stroke on an aching back as Bird and vocalist Nora O’Connor harmonize beautifully while repeating such lyrics as “You never know any doubt like we who breathe in and out”.

A welcome comeback since 2009’s “Noble Beast”, we get a record not quite as immediately accessible or endlessly playful, but one that still stands as strong as most of his best work does. The details become more apparent with each listen, and that’s when the realization sets in: “Break it Yourself” isn’t just an album about a break-up. It’s actually a complete, beating entity, not too unlike a heart with its own love to give.

I personally wouldn’t want to break this kind of heart by myself. That’s where you, the listener, comes in… to feel the joy of heartbreak. An oxymoron that only makes sense in Andrew Bird’s world.

Boost Your Cold Calling Results in Commercial Real Estate

To make your prospecting system work for you in commercial real estate, you really do need to systemise it and set some priorities. Systems help build the future; Random undecided action does little for you as a commercial real estate agent.

When you set the priorities you will not be spending your time on things that do not matter or maybe have little results and conversions for you. It's tough enough finding the time to prospect every day, let alone spending time on things that are not good converters of business opportunity for you.

So what can you do here? You can set a plan up that keeps you focused on the highly converting prospecting processes. You need new business to make your career work for you and prospecting is the key to pulling it all together.

Here is a priority model used by salespeople that I have helped in shaping their market share.

  1. Practice your call pitch for 30 minutes at 8:00 am every day. This single one fact will help you convert more people faster to opportunities.
  2. Start the day with cold calls to new people. This should happen for a period of 2 hours. Start your calls at 8:30 am.
  3. It will take you 30 minutes to build momentum as part of the call contact process. After 30 minutes you will be comfortable with what you are doing and the conversations will flow. The calls will get easier.
  4. Remove any meetings from the start of a business day. That includes team meetings. Focus on prospecting before anything else. Do not let other people waste your prospecting time.
  5. Any follow up calls to established contacts should happen later in the day outside of your prospecting time. Create a habit of prospecting for new business. Do not let existing customers or contacts derail your prospecting system.
  6. Towards the end of the day you should enter the results of the calls into your database. Perhaps you can do that as you are making the calls; The data does however have to be entered and you must take responsibility for that.
  7. End the day with research related to new prospects that you are to call tomorrow. Who are they and why are you calling them. You will need to know those facts as part of the process.

So these are some very rigid rules. When you stick to them you will find that opportunities develop. In any market and at any time the business is out there; It is just a matter of opening up the relationships with the right people.

How to Cure Sinus Infection Using the BIG V – Part 1

It is known that the Hunzas, Maoris and inmates of Fiji, Hawaii and Samoa are incredibly fit, thanks to the food they eat which is loaded with the BIG V – VITAMINS. Nature ensures us a plentiful supply of vitamins but due to our lifestyle we are eating more processed foods which lack the vitality of raw foods. How to cure sinus infection using VITAMINS – get to know your vitamins and what they can do to cure sinus infection.

VITAMIN A Vitamin A combined with Vitamin D helps to build up resistance against winter's colds. You can get vitamin A from fish oils, eggs, cheese, dairy products, liver, apricots, spinach, broccoli, deep green leafy vegetables and carrots. How to test if you have enough Vitamin A:

1. Clench your fist tightly
2. Open out quickly
3. Before the blood can suffused back into the tissues, you can see a yellow pigment just beneth the skin. If you this temporary yellow hue is not visible, you might not be getting enough Vitamin A. How to cure sinus infection – load your fridge with these foods.

VITAMIN B2 (RIBOFLAVINE) If you lack this vitamin, may cause watery, bloodshot itching eyes and highly sensitive to light and you are also likely to catch the influenza germs. Vitamin B2 can be found in brewer's yeast, asparagus, cheese, almonds, liver, milk, broccoli, chicken and green leafy vegetables. Another great vitamin on how to cure sinus infection.

VITAMIN C Everyone knows this vitamin but consume most little. It is the most unstable of all vitamins, easily lost by heat, water and oxygen. When you are having an allergy like asthma, sinus or bronchitis, Vitamin C is at the tops on how to cure sinus infection. Sources are citrus fruits, leafy green vegetables, cabbages, potatoes, broccoli, cauliflower, papaya, blackcurrants and grapes.

If you notice broccoli seems to be a good source for all the above vitamins – so how to cure sinus infection – eat loads of broccoli !!

There are other vitamins which you can take to know how to cure sinus infection and I can not finish writing them in this article.

If you are the person who is a fast jet-setter and do not have the time to cook yourself a hot meal, you can think of supplements but ensure that you choose a company which is reputable and of quality.