On the Way to Hospice, Surprising Hurdles - NYTimes.com

<base href="data:">I've often wondered why more families don't call hospice when a loved one has a terminal disease — and why people who do call wait so long, often until death is just days away.<br><br>Even though more than 40 percent of American deaths now involve hospice care, many families still are trying to shoulder the burden on their own rather than turning to a proven source of help and knowledge. I've surmised that the reason is families' or patients' unwillingness to acknowledge the prospect of death, or physicians' inability to say the h-word and refer dying patients to hospice care.<br><br>But maybe there's another reason. A study in the journal Health Affairs recently pointed out that hospices themselves may be turning away patients because of certain restrictive enrollment policies. It's possible, too, that physicians who know of these policies aren't referring patients whom the doctors fear wouldn't qualify.<br><br>Surprisingly, this randomized national survey of almost 600 hospice programs represents the first broad inquiry into enrollment practices, though it's been nearly 30 years since hospice became a Medicare benefit.<br><br>Nearly 80 percent of hospice programs, the study found, reported having at least one policy that could restrict access. "It represents a barrier to people who want hospice care but can't receive it," said lead author Melissa Aldridge Carlson, a geriatrics and palliative care researcher at the Mount Sinai School of Medicine.<br><br>What kind of barriers are we talking about? More than 60 percent of hospices won't accept a patient on chemotherapy, and more than half won't take someone relying on intravenous nutrition. Many won't enroll patients receiving palliative radiation or blood transfusions; a few say no to tube feeding.<br><br>This made more sense a couple of decades ago, when Medicare developed the regulations requiring patients to forgo curative treatments when they entered hospice. Hospice patients must have a terminal disease, likely to cause death within six months, so such treatments were presumed futile.<br><br>But medicine evolves. Now, Dr. Aldridge Carlson pointed out, the distinction between curative and palliative treatments has grown blurry. "It's increasingly an artificial dichotomy," she said. "That's not the reality for most patients today with end-stage disease."<br><br>Chemotherapy, for instance, is often used to shrink tumors that cause pain; radiation can prevent nausea and vomiting for patients with bowel obstructions. Though neither will cure a terminal cancer, as palliative treatments they can improve quality of life. Blood transfusions can help anemic cancer patients feel better, too, at least for a while.<br><br>Why, then, would hospices not accept dying people using these treatments? First, these are expensive to provide. The national average Medicare reimbursement for hospice care is just $140 a day, the study notes, and it's not adjusted to reflect the cost of more complicated regimens. Besides, hospices worry about running afoul of Medicare regulations and being denied even that inadequate reimbursement.<br><br>This probably explains why the researchers found that smaller hospices were more likely than large ones to say no to patients receiving such treatments. "If you're a small hospice caring for someone with many medical issues and the reimbursement doesn't even cover the care – and then Medicare comes to take it back – that's a big hit," Dr. Aldridge Carlson said. Larger organizations with more patients and bigger budgets can better absorb the costs.<br><br>One bright note, though, is that almost 30 percent of the hospices studied offer some kind of open access enrollment without insisting on those prohibitions. Much more common in nonprofit hospices (a pity, because the real growth is in for-profit ones), open access usually means enrolling people who don't yet meet the Medicare criteria, then converting them to Medicare patients as they become eligible.<br><br>At Gilchrist Hospice Care in Baltimore, for instance, patients still using chemotherapy, radiation, transfusions and several other treatments can enter what it calls "expanded care," sometimes also known as "concurrent care." (At Gilchrist, however, such patients still must meet the six-month hospice eligibility requirement.)<br><br>"If you say, 'You can't get blood transfusions any more,' people say, 'Why would I go with your program?'" said Regina Bodnar, Gilchrist's clinical director. The hospice's concurrent program "is not so either/or."<br><br>People who enter hospice care with palliative treatments usually decide to forgo them anyway when they become less effective or more burdensome, Ms. Bodnar said, but "this allows people to make the transition over time." As the largest hospice program in Maryland, a nonprofit with generous donors, Gilchrist can afford this more flexible, but expensive, approach.<br><br>Could it be the future of hospice? That would require Medicare to make some changes in eligibility and reimbursement practices — a shift that might bolster Medicare's solvency, too.<br><br>"Hospice saves money because it keeps people out of the hospital," Dr. Aldridge Carlson said. Even more expensive outpatient treatments, like palliative radiation, are less costly than days spent in intensive care. Adjusting policies to allow more patients into hospice might bring costs down.<br><br>But as important, it could make the call to hospice a slightly less terrifying prospect and provide more families with the help they need at the end of life. "We need to take down the barriers to hospice care," Ms. Bodnar said, "and this is one way to do it."<br><br><i>Paula Span is the author of "When the Time Comes: Families With Aging Parents Share Their Struggles and Solutions."</i><div><br><a href="http://newoldage.blogs.nytimes.com/2013/01/03/hospice-obstacles/?src=recg">http://newoldage.blogs.nytimes.com/2013/01/03/hospice-obstacles/?src=recg</a><br><br></div>

On the Way to Hospice, Surprising Hurdles - NYTimes.com

I've often wondered why more families don't call hospice when a loved one has a terminal disease — and why people who do call wait s...

Read more »

Age of Autism

Welcome to Age of Autism, the Daily Web Newspaper of the Autism Epidemic. We are published to give voice to those who believe autism is an environmentally induced illness, that it is treatable, and that children can recover. For the most part, the major media in the United States aren't interested in that point of view, they won't investigate the causes and possible biomedical treatments of autism independently, and they don't listen to the most important people – the parents, many of whom have witnessed autistic regression and medical illness after vaccinations. We do all those things, and more.<br /><br><br /><br>We believe that autism is the defining disorder of our age, man-made and therefore preventable, and that it points to the truth about other problems that beset us, from ADD to asthma to Alzheimer's. We address those issues as well, along with exposing the special interests, bureaucratic inertia, and medical malfeasance that perpetuate denial and suffering.<br /><br><br /><br><a href="http://www.ageofautism.com/">http://www.ageofautism.com/</a>

Age of Autism

Welcome to Age of Autism, the Daily Web Newspaper of the Autism Epidemic. We are published to give voice to those who believe autism is an ...

Read more »

Autism Strains Yet Strengthens a Marriage - NYTimes.com

<base href="data:"><div style="font-family: Helvetica; font-size: 14px; color: black; text-align: left; "><p itemprop="articleBody" style="color: black; font-size: 1.2em; margin: 0px 0px 1em; line-height: 24px; font-family: Georgia, serif; font-style: normal; font-variant: normal; font-weight: normal; letter-spacing: normal; orphans: 2; text-align: -webkit-auto; text-indent: 0px; text-transform: none; white-space: normal; widows: 2; word-spacing: 0px; -webkit-text-size-adjust: auto; -webkit-text-stroke-width: 0px; background-color: rgb(255, 255, 255); ">Last summer, Nancy Clarke, 54, and Jay Petrow, 53, celebrated their silver wedding anniversary with family members in the backyard of their Westport, Conn., home. As Jay's brother, I was best man at their <a href="http://www.nytimes.com/1987/09/13/style/nancy-clarke-marries.html" style="color: rgb(102, 102, 153); text-decoration: none; ">1987 wedding</a> at our parents' house in Southampton, L.I., and since then have watched as he and Nancy have taken on an extraordinary challenge — raising an autistic and seriously disabled son, William, who is now 19.</p><p itemprop="articleBody" style="color: black; font-size: 1.2em; margin: 0px 0px 1em; line-height: 24px; font-family: Georgia, serif; font-style: normal; font-variant: normal; font-weight: normal; letter-spacing: normal; orphans: 2; text-align: -webkit-auto; text-indent: 0px; text-transform: none; white-space: normal; widows: 2; word-spacing: 0px; -webkit-text-size-adjust: auto; -webkit-text-stroke-width: 0px; background-color: rgb(255, 255, 255); ">For two decades Jay worked "10 to 10" as a magazine art director, and then five years ago decided to make a new beginning, starting a <a href="http://petrowgardens.com/" style="color: rgb(102, 102, 153); text-decoration: none; ">landscape design company</a>. Nancy, a Princeton graduate and former Wall Street trader, became a stay-at-home mom after William's birth. They also have a daughter, Anna, who's 15. Following is a condensed and edited version of our conversation about their marriage.</p><p itemprop="articleBody" style="color: black; font-size: 1.2em; margin: 0px 0px 1em; line-height: 24px; font-family: Georgia, serif; font-style: normal; font-variant: normal; font-weight: normal; letter-spacing: normal; orphans: 2; text-align: -webkit-auto; text-indent: 0px; text-transform: none; white-space: normal; widows: 2; word-spacing: 0px; -webkit-text-size-adjust: auto; -webkit-text-stroke-width: 0px; background-color: rgb(255, 255, 255); "><strong>Tell me about the first kiss.</strong></p><p itemprop="articleBody" style="color: black; font-size: 1.2em; margin: 0px 0px 1em; line-height: 24px; font-family: Georgia, serif; font-style: normal; font-variant: normal; font-weight: normal; letter-spacing: normal; orphans: 2; text-align: -webkit-auto; text-indent: 0px; text-transform: none; white-space: normal; widows: 2; word-spacing: 0px; -webkit-text-size-adjust: auto; -webkit-text-stroke-width: 0px; background-color: rgb(255, 255, 255); ">Nancy: We spent a weekend together with 10 other friends, which was the first time we met. I thought Jay was different — more approachable, someone I could be friends with. The ride back to the city took eight hours and it would have been much easier for Jay to drop me off first — I just thought he was being sweet by making me the last. As I was about to get out of the car I leaned across to give him a kiss on the cheek, but somehow the corner of my lip hit the corner of his lip and I got a jolt. It was like "Whoa!" and all of a sudden the weekend took on a different meaning.</p><p itemprop="articleBody" style="color: black; font-size: 1.2em; margin: 0px 0px 1em; line-height: 24px; font-family: Georgia, serif; font-style: normal; font-variant: normal; font-weight: normal; letter-spacing: normal; orphans: 2; text-align: -webkit-auto; text-indent: 0px; text-transform: none; white-space: normal; widows: 2; word-spacing: 0px; -webkit-text-size-adjust: auto; -webkit-text-stroke-width: 0px; background-color: rgb(255, 255, 255); ">Jay: She still tries to re-enact that kiss every time. There was definitely electricity.</p><p itemprop="articleBody" style="color: black; font-size: 1.2em; margin: 0px 0px 1em; line-height: 24px; font-family: Georgia, serif; font-style: normal; font-variant: normal; font-weight: normal; letter-spacing: normal; orphans: 2; text-align: -webkit-auto; text-indent: 0px; text-transform: none; white-space: normal; widows: 2; word-spacing: 0px; -webkit-text-size-adjust: auto; -webkit-text-stroke-width: 0px; background-color: rgb(255, 255, 255); "><strong>A year and a half later, Jay proposed. How did that come about?</strong></p><p itemprop="articleBody" style="color: black; font-size: 1.2em; margin: 0px 0px 1em; line-height: 24px; font-family: Georgia, serif; font-style: normal; font-variant: normal; font-weight: normal; letter-spacing: normal; orphans: 2; text-align: -webkit-auto; text-indent: 0px; text-transform: none; white-space: normal; widows: 2; word-spacing: 0px; -webkit-text-size-adjust: auto; -webkit-text-stroke-width: 0px; background-color: rgb(255, 255, 255); ">Nancy: I had been getting a little impatient and I asked him if it's appropriate for women to ask men to marry them. He said, "Maybe, but I wouldn't do that if I were you." So I just let go of it.</p><p itemprop="articleBody" style="color: black; font-size: 1.2em; margin: 0px 0px 1em; line-height: 24px; font-family: Georgia, serif; font-style: normal; font-variant: normal; font-weight: normal; letter-spacing: normal; orphans: 2; text-align: -webkit-auto; text-indent: 0px; text-transform: none; white-space: normal; widows: 2; word-spacing: 0px; -webkit-text-size-adjust: auto; -webkit-text-stroke-width: 0px; background-color: rgb(255, 255, 255); ">Jay: I told her: "When I'm ready to get married, I'll ask you. I don't want you to ask me."</p><p itemprop="articleBody" style="color: black; font-size: 1.2em; margin: 0px 0px 1em; line-height: 24px; font-family: Georgia, serif; font-style: normal; font-variant: normal; font-weight: normal; letter-spacing: normal; orphans: 2; text-align: -webkit-auto; text-indent: 0px; text-transform: none; white-space: normal; widows: 2; word-spacing: 0px; -webkit-text-size-adjust: auto; -webkit-text-stroke-width: 0px; background-color: rgb(255, 255, 255); ">Nancy: The night before my 29th birthday we went out to the River Café [in Brooklyn] and had a nice dinner. Afterward he got down on his knee and proposed. I was so stunned that I burst out crying.</p><p itemprop="articleBody" style="color: black; font-size: 1.2em; margin: 0px 0px 1em; line-height: 24px; font-family: Georgia, serif; font-style: normal; font-variant: normal; font-weight: normal; letter-spacing: normal; orphans: 2; text-align: -webkit-auto; text-indent: 0px; text-transform: none; white-space: normal; widows: 2; word-spacing: 0px; -webkit-text-size-adjust: auto; -webkit-text-stroke-width: 0px; background-color: rgb(255, 255, 255); ">Jay: I decided I didn't want to live without her.</p><p itemprop="articleBody" style="color: black; font-size: 1.2em; margin: 0px 0px 1em; line-height: 24px; font-family: Georgia, serif; font-style: normal; font-variant: normal; font-weight: normal; letter-spacing: normal; orphans: 2; text-align: -webkit-auto; text-indent: 0px; text-transform: none; white-space: normal; widows: 2; word-spacing: 0px; -webkit-text-size-adjust: auto; -webkit-text-stroke-width: 0px; background-color: rgb(255, 255, 255); "><strong>Not long after, you both quit your jobs. Were you crazy?</strong></p><p itemprop="articleBody" style="color: black; font-size: 1.2em; margin: 0px 0px 1em; line-height: 24px; font-family: Georgia, serif; font-style: normal; font-variant: normal; font-weight: normal; letter-spacing: normal; orphans: 2; text-align: -webkit-auto; text-indent: 0px; text-transform: none; white-space: normal; widows: 2; word-spacing: 0px; -webkit-text-size-adjust: auto; -webkit-text-stroke-width: 0px; background-color: rgb(255, 255, 255); ">Nancy: We had been married for about three years when we decided to take a trip around the world — 20 countries in 14 months. This was an adventure I had always dreamed about, but I was so serious, making money, on "track." Jay bumped me off the track.</p><p itemprop="articleBody" style="color: black; font-size: 1.2em; margin: 0px 0px 1em; line-height: 24px; font-family: Georgia, serif; font-style: normal; font-variant: normal; font-weight: normal; letter-spacing: normal; orphans: 2; text-align: -webkit-auto; text-indent: 0px; text-transform: none; white-space: normal; widows: 2; word-spacing: 0px; -webkit-text-size-adjust: auto; -webkit-text-stroke-width: 0px; background-color: rgb(255, 255, 255); ">Jay: We really wanted to see the world before the complexities and limitations of life engulf you, to step out of the normal routine of working hard, retiring and dying.</p><p itemprop="articleBody" style="color: black; font-size: 1.2em; margin: 0px 0px 1em; line-height: 24px; font-family: Georgia, serif; font-style: normal; font-variant: normal; font-weight: normal; letter-spacing: normal; orphans: 2; text-align: -webkit-auto; text-indent: 0px; text-transform: none; white-space: normal; widows: 2; word-spacing: 0px; -webkit-text-size-adjust: auto; -webkit-text-stroke-width: 0px; background-color: rgb(255, 255, 255); "><strong>Eighteen months after you returned, William was born. Things didn't work out according to plan, did they?</strong></p><p itemprop="articleBody" style="color: black; font-size: 1.2em; margin: 0px 0px 1em; line-height: 24px; font-family: Georgia, serif; font-style: normal; font-variant: normal; font-weight: normal; letter-spacing: normal; orphans: 2; text-align: -webkit-auto; text-indent: 0px; text-transform: none; white-space: normal; widows: 2; word-spacing: 0px; -webkit-text-size-adjust: auto; -webkit-text-stroke-width: 0px; background-color: rgb(255, 255, 255); ">Nancy: From the start everything was so hard with William. He didn't latch on. He didn't sleep. I'd held a lot of babies before, but it was so hard for me to hold my own; he just didn't koala into my own body. And then he started his head banging, out of frustration because he really couldn't communicate at all. Sometimes at home, other times in public.</p><p itemprop="articleBody" style="color: black; font-size: 1.2em; margin: 0px 0px 1em; line-height: 24px; font-family: Georgia, serif; font-style: normal; font-variant: normal; font-weight: normal; letter-spacing: normal; orphans: 2; text-align: -webkit-auto; text-indent: 0px; text-transform: none; white-space: normal; widows: 2; word-spacing: 0px; -webkit-text-size-adjust: auto; -webkit-text-stroke-width: 0px; background-color: rgb(255, 255, 255); ">Jay: You could just hear his head hitting the wall and the floor so that —</p><p itemprop="articleBody" style="color: black; font-size: 1.2em; margin: 0px 0px 1em; line-height: 24px; font-family: Georgia, serif; font-style: normal; font-variant: normal; font-weight: normal; letter-spacing: normal; orphans: 2; text-align: -webkit-auto; text-indent: 0px; text-transform: none; white-space: normal; widows: 2; word-spacing: 0px; -webkit-text-size-adjust: auto; -webkit-text-stroke-width: 0px; background-color: rgb(255, 255, 255); ">Nancy: — it created swelling and bruising. I couldn't bear to watch it and I couldn't stop him from doing it. I felt humiliated and like a failure.</p><p itemprop="articleBody" style="color: black; font-size: 1.2em; margin: 0px 0px 1em; line-height: 24px; font-family: Georgia, serif; font-style: normal; font-variant: normal; font-weight: normal; letter-spacing: normal; orphans: 2; text-align: -webkit-auto; text-indent: 0px; text-transform: none; white-space: normal; widows: 2; word-spacing: 0px; -webkit-text-size-adjust: auto; -webkit-text-stroke-width: 0px; background-color: rgb(255, 255, 255); ">Jay: Just after he turned 2, our neurologist told us he wasn't "right" and likely never would be, that we had a big job ahead of us. I'm the kind of person who usually thinks things will work out, but now I was devastated. And I certainly didn't understand all the <a href="http://www.jsonline.com/features/health/100266159.html" style="color: rgb(102, 102, 153); text-decoration: none; ">stresses it would put on our marriage</a>. William always demanded so much time and attention that it was hard to find balance and passion with each other.</p><p itemprop="articleBody" style="color: black; font-size: 1.2em; margin: 0px 0px 1em; line-height: 24px; font-family: Georgia, serif; font-style: normal; font-variant: normal; font-weight: normal; letter-spacing: normal; orphans: 2; text-align: -webkit-auto; text-indent: 0px; text-transform: none; white-space: normal; widows: 2; word-spacing: 0px; -webkit-text-size-adjust: auto; -webkit-text-stroke-width: 0px; background-color: rgb(255, 255, 255); ">Nancy: I remember leaving the neurologist's office on the Upper East Side after he had given us the news, pushing William in the stroller and just sobbing. My older sister Susan was with me and she kept saying, "It's going to be O.K.," and I told her, "No, it's not going to be O.K. This can't be fixed."</p><p itemprop="articleBody" style="color: black; font-size: 1.2em; margin: 0px 0px 1em; line-height: 24px; font-family: Georgia, serif; font-style: normal; font-variant: normal; font-weight: normal; letter-spacing: normal; orphans: 2; text-align: -webkit-auto; text-indent: 0px; text-transform: none; white-space: normal; widows: 2; word-spacing: 0px; -webkit-text-size-adjust: auto; -webkit-text-stroke-width: 0px; background-color: rgb(255, 255, 255); "><strong>That was a long time ago. What's William like now?</strong></p><p itemprop="articleBody" style="color: black; font-size: 1.2em; margin: 0px 0px 1em; line-height: 24px; font-family: Georgia, serif; font-style: normal; font-variant: normal; font-weight: normal; letter-spacing: normal; orphans: 2; text-align: -webkit-auto; text-indent: 0px; text-transform: none; white-space: normal; widows: 2; word-spacing: 0px; -webkit-text-size-adjust: auto; -webkit-text-stroke-width: 0px; background-color: rgb(255, 255, 255); ">Jay: Every night he wets himself, sometimes two or three times a night. He's 19 and man-size now. He also continues tantrums. Three years ago we had to call the local police because he got so angry and started throwing furniture around and broke the glass on the front door.</p><p itemprop="articleBody" style="color: black; font-size: 1.2em; margin: 0px 0px 1em; line-height: 24px; font-family: Georgia, serif; font-style: normal; font-variant: normal; font-weight: normal; letter-spacing: normal; orphans: 2; text-align: -webkit-auto; text-indent: 0px; text-transform: none; white-space: normal; widows: 2; word-spacing: 0px; -webkit-text-size-adjust: auto; -webkit-text-stroke-width: 0px; background-color: rgb(255, 255, 255); ">Nancy: Last night William unplugged all the wires to the Wii, VCR, stereo and DVD player that take hours to connect.</p><p itemprop="articleBody" style="color: black; font-size: 1.2em; margin: 0px 0px 1em; line-height: 24px; font-family: Georgia, serif; font-style: normal; font-variant: normal; font-weight: normal; letter-spacing: normal; orphans: 2; text-align: -webkit-auto; text-indent: 0px; text-transform: none; white-space: normal; widows: 2; word-spacing: 0px; -webkit-text-size-adjust: auto; -webkit-text-stroke-width: 0px; background-color: rgb(255, 255, 255); ">Jay: It's unrelenting when he becomes manic and just keeps coming at you. "Do you want to play Wii?," sticking the remote in your face. "Where's the train? I want the train."</p><p itemprop="articleBody" style="color: black; font-size: 1.2em; margin: 0px 0px 1em; line-height: 24px; font-family: Georgia, serif; font-style: normal; font-variant: normal; font-weight: normal; letter-spacing: normal; orphans: 2; text-align: -webkit-auto; text-indent: 0px; text-transform: none; white-space: normal; widows: 2; word-spacing: 0px; -webkit-text-size-adjust: auto; -webkit-text-stroke-width: 0px; background-color: rgb(255, 255, 255); ">Nancy: I could see Jay was beside himself so I jumped in. Now when we're in the midst of a terrible situation like this, I know that it's going to be O.K. because we have each other.</p><p itemprop="articleBody" style="color: black; font-size: 1.2em; margin: 0px 0px 1em; line-height: 24px; font-family: Georgia, serif; font-style: normal; font-variant: normal; font-weight: normal; letter-spacing: normal; orphans: 2; text-align: -webkit-auto; text-indent: 0px; text-transform: none; white-space: normal; widows: 2; word-spacing: 0px; -webkit-text-size-adjust: auto; -webkit-text-stroke-width: 0px; background-color: rgb(255, 255, 255); "><strong>Was there a time when you didn't think it would be O.K. between the two of you?</strong></p><p itemprop="articleBody" style="color: black; font-size: 1.2em; margin: 0px 0px 1em; line-height: 24px; font-family: Georgia, serif; font-style: normal; font-variant: normal; font-weight: normal; letter-spacing: normal; orphans: 2; text-align: -webkit-auto; text-indent: 0px; text-transform: none; white-space: normal; widows: 2; word-spacing: 0px; -webkit-text-size-adjust: auto; -webkit-text-stroke-width: 0px; background-color: rgb(255, 255, 255); ">Jay: I never wanted to get divorced, but the stresses got to be too much. I felt like I couldn't stay in our situation. Part of it was William and part of it was how stressed out Nancy was.</p><p itemprop="articleBody" style="color: black; font-size: 1.2em; margin: 0px 0px 1em; line-height: 24px; font-family: Georgia, serif; font-style: normal; font-variant: normal; font-weight: normal; letter-spacing: normal; orphans: 2; text-align: -webkit-auto; text-indent: 0px; text-transform: none; white-space: normal; widows: 2; word-spacing: 0px; -webkit-text-size-adjust: auto; -webkit-text-stroke-width: 0px; background-color: rgb(255, 255, 255); ">Nancy: I remember when Jay said: "Maybe we should consider a divorce. It just hurts so bad. I'm in pain." He also said: "If I were going to war I would want you to be in the trench next to me, but we're not soldiers, you're my wife."</p><p itemprop="articleBody" style="color: black; font-size: 1.2em; margin: 0px 0px 1em; line-height: 24px; font-family: Georgia, serif; font-style: normal; font-variant: normal; font-weight: normal; letter-spacing: normal; orphans: 2; text-align: -webkit-auto; text-indent: 0px; text-transform: none; white-space: normal; widows: 2; word-spacing: 0px; -webkit-text-size-adjust: auto; -webkit-text-stroke-width: 0px; background-color: rgb(255, 255, 255); "><strong>How did you get past those tough times?</strong></p><p itemprop="articleBody" style="color: black; font-size: 1.2em; margin: 0px 0px 1em; line-height: 24px; font-family: Georgia, serif; font-style: normal; font-variant: normal; font-weight: normal; letter-spacing: normal; orphans: 2; text-align: -webkit-auto; text-indent: 0px; text-transform: none; white-space: normal; widows: 2; word-spacing: 0px; -webkit-text-size-adjust: auto; -webkit-text-stroke-width: 0px; background-color: rgb(255, 255, 255); ">Jay: We try not to think about what our lives could have been — what we're missing out on. Rather we focus on what we have, especially each other. That's really helped bring us together. We developed the ability to communicate about these issues, which really helps. So, too, does a sense of humor.</p><p itemprop="articleBody" style="color: black; font-size: 1.2em; margin: 0px 0px 1em; line-height: 24px; font-family: Georgia, serif; font-style: normal; font-variant: normal; font-weight: normal; letter-spacing: normal; orphans: 2; text-align: -webkit-auto; text-indent: 0px; text-transform: none; white-space: normal; widows: 2; word-spacing: 0px; -webkit-text-size-adjust: auto; -webkit-text-stroke-width: 0px; background-color: rgb(255, 255, 255); ">Nancy: I had to learn about balance, not a forte of mine, and that my singlemindedness about helping William had costs associated with it. That somehow, in spite of everything, we had to operate as a family, with everyone's needs taken together. This was and is still very difficult to manage.</p><p itemprop="articleBody" style="color: black; font-size: 1.2em; margin: 0px 0px 1em; line-height: 24px; font-family: Georgia, serif; font-style: normal; font-variant: normal; font-weight: normal; letter-spacing: normal; orphans: 2; text-align: -webkit-auto; text-indent: 0px; text-transform: none; white-space: normal; widows: 2; word-spacing: 0px; -webkit-text-size-adjust: auto; -webkit-text-stroke-width: 0px; background-color: rgb(255, 255, 255); "><strong>Anna was born four years after William. How did you have the courage to have a second child?</strong></p><p itemprop="articleBody" style="color: black; font-size: 1.2em; margin: 0px 0px 1em; line-height: 24px; font-family: Georgia, serif; font-style: normal; font-variant: normal; font-weight: normal; letter-spacing: normal; orphans: 2; text-align: -webkit-auto; text-indent: 0px; text-transform: none; white-space: normal; widows: 2; word-spacing: 0px; -webkit-text-size-adjust: auto; -webkit-text-stroke-width: 0px; background-color: rgb(255, 255, 255); ">Jay: That was probably one of our hardest decisions because <a href="http://www.autismspeaks.org/" style="color: rgb(102, 102, 153); text-decoration: none; ">autism</a> does have a genetic component. We were scared that we'd have another child with special needs, and that would have been pretty devastating.</p><p itemprop="articleBody" style="color: black; font-size: 1.2em; margin: 0px 0px 1em; line-height: 24px; font-family: Georgia, serif; font-style: normal; font-variant: normal; font-weight: normal; letter-spacing: normal; orphans: 2; text-align: -webkit-auto; text-indent: 0px; text-transform: none; white-space: normal; widows: 2; word-spacing: 0px; -webkit-text-size-adjust: auto; -webkit-text-stroke-width: 0px; background-color: rgb(255, 255, 255); ">Nancy: Brave and stupid are flip sides of each other. With Anna, I realized what a leap of faith it is to have a baby.</p><p itemprop="articleBody" style="color: black; font-size: 1.2em; margin: 0px 0px 1em; line-height: 24px; font-family: Georgia, serif; font-style: normal; font-variant: normal; font-weight: normal; letter-spacing: normal; orphans: 2; text-align: -webkit-auto; text-indent: 0px; text-transform: none; white-space: normal; widows: 2; word-spacing: 0px; -webkit-text-size-adjust: auto; -webkit-text-stroke-width: 0px; background-color: rgb(255, 255, 255); "><strong>And how did she turn out?</strong></p><p itemprop="articleBody" style="color: black; font-size: 1.2em; margin: 0px 0px 1em; line-height: 24px; font-family: Georgia, serif; font-style: normal; font-variant: normal; font-weight: normal; letter-spacing: normal; orphans: 2; text-align: -webkit-auto; text-indent: 0px; text-transform: none; white-space: normal; widows: 2; word-spacing: 0px; -webkit-text-size-adjust: auto; -webkit-text-stroke-width: 0px; background-color: rgb(255, 255, 255); ">Jay: She did have special needs — she was in the "gifted" program during elementary school.</p><p itemprop="articleBody" style="color: black; font-size: 1.2em; margin: 0px 0px 1em; line-height: 24px; font-family: Georgia, serif; font-style: normal; font-variant: normal; font-weight: normal; letter-spacing: normal; orphans: 2; text-align: -webkit-auto; text-indent: 0px; text-transform: none; white-space: normal; widows: 2; word-spacing: 0px; -webkit-text-size-adjust: auto; -webkit-text-stroke-width: 0px; background-color: rgb(255, 255, 255); "><strong>I know William brings you joy too, I've seen it.</strong></p><p itemprop="articleBody" style="color: black; font-size: 1.2em; margin: 0px 0px 1em; line-height: 24px; font-family: Georgia, serif; font-style: normal; font-variant: normal; font-weight: normal; letter-spacing: normal; orphans: 2; text-align: -webkit-auto; text-indent: 0px; text-transform: none; white-space: normal; widows: 2; word-spacing: 0px; -webkit-text-size-adjust: auto; -webkit-text-stroke-width: 0px; background-color: rgb(255, 255, 255); ">Jay: William is usually the life of the party — at weddings and bat mitzvahs — he loves to dance and often "gets down" with the bride. He's got certain music that he loves to sing to — Wilson Pickett, Tom Petty and David Byrne. He croons like Frank Sinatra, has the passion of Gladys Knight, is so full of life and joyful that it just makes me happy and proud that he's my son.</p><p itemprop="articleBody" style="color: black; font-size: 1.2em; margin: 0px 0px 1em; line-height: 24px; font-family: Georgia, serif; font-style: normal; font-variant: normal; font-weight: normal; letter-spacing: normal; orphans: 2; text-align: -webkit-auto; text-indent: 0px; text-transform: none; white-space: normal; widows: 2; word-spacing: 0px; -webkit-text-size-adjust: auto; -webkit-text-stroke-width: 0px; background-color: rgb(255, 255, 255); "><strong>I know you've been remodeling the house you've lived in for nearly 20 years. Is that a metaphor for your relationship?</strong></p><p itemprop="articleBody" style="color: black; font-size: 1.2em; margin: 0px 0px 1em; line-height: 24px; font-family: Georgia, serif; font-style: normal; font-variant: normal; font-weight: normal; letter-spacing: normal; orphans: 2; text-align: -webkit-auto; text-indent: 0px; text-transform: none; white-space: normal; widows: 2; word-spacing: 0px; -webkit-text-size-adjust: auto; -webkit-text-stroke-width: 0px; background-color: rgb(255, 255, 255); ">Jay: No, not at all. I pushed for the house remodel after Nancy's sister, <a href="http://www.legacy.com/obituaries/newsday/obituary.aspx?n=susan-clarke-mcdermott&pid=149026642&fhid=2058#fbLoggedOut" style="color: rgb(102, 102, 153); text-decoration: none; ">Susan, died from pancreatic cancer </a>two years ago. She was only 54. I said to Nance: "We might as well do it now because we could be dead tomorrow."</p><p itemprop="articleBody" style="color: black; font-size: 1.2em; margin: 0px 0px 1em; line-height: 24px; font-family: Georgia, serif; font-style: normal; font-variant: normal; font-weight: normal; letter-spacing: normal; orphans: 2; text-align: -webkit-auto; text-indent: 0px; text-transform: none; white-space: normal; widows: 2; word-spacing: 0px; -webkit-text-size-adjust: auto; -webkit-text-stroke-width: 0px; background-color: rgb(255, 255, 255); ">Nancy: Susan's illness was really life-changing for us. Before that, it had been very difficult for me to leave William. But when she was diagnosed I knew I had to be with her. I looked at Jay and said, "I need to go." He said, "I know." She died four months later, and that time together was the biggest gift anyone could ever give me. My Aunt Mary always used to say, "Oh Jay, that's my angel."</p><p itemprop="articleBody" style="color: black; font-size: 1.2em; margin: 0px 0px 1em; line-height: 24px; font-family: Georgia, serif; font-style: normal; font-variant: normal; font-weight: normal; letter-spacing: normal; orphans: 2; text-align: -webkit-auto; text-indent: 0px; text-transform: none; white-space: normal; widows: 2; word-spacing: 0px; -webkit-text-size-adjust: auto; -webkit-text-stroke-width: 0px; background-color: rgb(255, 255, 255); "><strong>What exactly did she mean, Nancy?</strong></p><p itemprop="articleBody" style="color: black; font-size: 1.2em; margin-top: 0px; margin-right: 0px; margin-bottom: 1em; margin-left: 0px; line-height: 24px; font-family: Georgia, serif; font-style: normal; font-variant: normal; font-weight: normal; letter-spacing: normal; orphans: 2; text-align: -webkit-auto; text-indent: 0px; text-transform: none; white-space: normal; widows: 2; word-spacing: 0px; -webkit-text-size-adjust: auto; -webkit-text-stroke-width: 0px; background-color: rgb(255, 255, 255); position: static; z-index: auto; ">Nancy: He's made of good stuff. He's just always completely there for me.</p></div><a href="http://www.nytimes.com/2013/01/04/booming/autism-strains-yet-strengthens-a-marriage.html?src=recg&_r=1&pagewanted=all&">http://www.nytimes.com/2013/01/04/booming/autism-strains-yet-strengthens-a-marriage.html?src=recg&_r=1&pagewanted=all&</a><div style="font-family: Helvetica; font-size: 14px; color: black; text-align: left; "><br class="webkit-block-placeholder"></div>

Autism Strains Yet Strengthens a Marriage - NYTimes.com

Last summer, Nancy Clarke, 54, and Jay Petrow, 53, celebrated their silver wedding anniversary with family members in the backyard of their ...

Read more »

U.S. Settles Accusations That Doctors Overtreated - NYTimes.com

A group of doctors who performed unusually high rates of heart procedures on patients at a community hospital in Ohio settled with the Justice Department over accusations that some of the procedures were medically unnecessary, federal regulators announced on Friday.<br /><br><br /><br>The settlement covered accusations that the doctors and the hospital, then known as the EMH Regional Medical Center, had billedMedicare for unnecessary medical care from 2001 to 2006. The hospital agreed to pay $3.9 million to settle the accusations, and the physician group, the North Ohio Heart Center, agreed to pay $541,870, according to a Justice Department statement.<br /><br><br /><br>Federal regulators had accused the doctors and the hospital of performing unnecessary procedures known as angioplasties, in which a clogged blood vessel is opened. The procedure often requires insertion of a device called a stent to keep the blood vessel from closing again.<br /><br><br /><br>Besides the cost to Medicare, "performing medically unnecessary cardiac procedures puts patients' lives at risk," said Steven M. Dettelbach, the United States attorney for the Northern District of Ohio, which was involved in the investigation. "Patient health and taxpayer dollars have to come before greed," he said.<br /><br><br /><br>The high rate of heart procedures at the hospital was the subject of a front-page article in The New York Times in August 2006. Medicare patients in Elyria, Ohio, where the hospital is located, were receiving angioplasties at a rate nearly four times the national average, a figure that prompted questions from insurers and raised concerns about overtreatment.<br /><br><br /><br>The concerns included whether many patients in Ohio and elsewhere were receiving expensive and inappropriate medical treatments because of the high fees the procedures generated.<br /><br><br /><br>The settlement represents the latest in a series of actions brought against cardiologists and hospitals for performing questionable cardiac procedures. Patients typically have a choice of treatments, and many doctors say some individuals should be treated more conservatively with medicines rather than through costly procedures.<br /><br><br /><br>At the time, the Elyria cardiologists defended their high rates as a result of an aggressive style of medicine, and the doctors continued to defend the medical care they provided. They said the procedures they performed were medically warranted but might not have met the government's guidelines for reimbursement.<br /><br><br /><br>"We choose to settle rather than go to court," said Dr. John Schaeffer, the chairman of North Ohio Heart, which is now part of the hospital system, EMH Healthcare. The government did not single out any individual physicians, and neither the hospital nor the medical group said it disciplined any of the doctors.<br /><br><br /><br>"As the physicians on the ground when these decisions were made and the procedures were performed, we felt confident we were making the correct choices for our patients," he said in a statement on the group's Web site. "We still do."<br /><br><br /><br>The former manager of the hospital's catheterization lab, Kenny Loughner, filed a whistle-blower complaint in October 2006. Mr. Loughner, who will receive $660,859 from the settlement for alerting the government, described how doctors urged nurses and others to falsify complaints of chest pain to justify the unnecessary angioplasties. He also described the doctors' technique of treating patients in stages, forcing patients to come back for multiple procedures.<br /><br><br /><br>The government did not include the accusations in its findings, the hospital said, and they are without merit.<br /><br><br /><br>In a separate statement issued by EMH Healthcare, the system's chief executive, Dr. Donald Sheldon, said "no patients, to our knowledge, were ever at risk, and there is no question that the patients treated had heart disease and some degree of blockage." The hospital also said it was conducting an external peer review of its cardiac care.<br /><br><br /><br><a href="http://www.nytimes.com/2013/01/05/business/us-settles-accusations-that-doctors-overtreated.html?src=recg">http://www.nytimes.com/2013/01/05/business/us-settles-accusations-that-doctors-overtreated.html?src=recg</a>

U.S. Settles Accusations That Doctors Overtreated - NYTimes.com

A group of doctors who performed unusually high rates of heart procedures on patients at a community hospital in Ohio settled with the Justi...

Read more »

Daily Education and Technology News for Schools 01/06/2013

<ul class="diigo-linkroll"> <li> <p class="diigo-link"> <a href="http://www.edtechmagazine.com/higher/article/2013/01/how-professors-really-feel-about-digital-technology-study">How Professors Really Feel About Digital Technology [#Study] | EdTech Magazine</a> </p> <p class="diigo-description">The good news, technology has increased good relationships between professors and students -- the bad, it costs more personal time and can increase stress. Also, only 6.3 of professors feel their university rewards digital contributions - something that will need to change in organizations that want to be known as 21st century e-learning powerhouses. In this scenario, a research paper in a journal may be viewed more positively than a MOOC with 100, 000 participants - which is counter to which would benefit the institution most in terms of "marketing" (a dirty word among many academicians, I know) but not even marketing - but also the future of the organization as they transition to bricks and clicks is at stake. Nice write up from Jimmy Daly (thanks for sharing with me on Google plus).  "As a follow-up to their study on how professors view online learning, Inside Higher Ed partnered with Babson Survey Research Group to explore how college professors and administrators interact with technology. The survey, summarized in Digital Faculty: Professors, Teaching and Technology, posed questions about digital learning content, e-books, social media, communication, learning management software and a variety of other technology-related issues. Here are a few key points from this excellent report."</p> <p class="diigo-tags"> <span>tags:</span> <a href="http://www.diigo.com/user/coolcatteacher/education">education</a> <a href="http://www.diigo.com/user/coolcatteacher/news">news</a> <a href="http://www.diigo.com/user/coolcatteacher/research.">research.</a></p> </li> <li> <p class="diigo-link"> <a href="http://www.slideshare.net/gwynethjones/qr-codes-in-the-elementary-classroom">QR Codes in the Elementary Classroom</a> </p> <p class="diigo-description">A nice presentation by Gwyneth Jones about QR codes in the elementary classroom and library. If you're looking for ideas and simple explanations, this is a great slideshow.</p> <p class="diigo-tags"> <span>tags:</span> <a href="http://www.diigo.com/user/coolcatteacher/news">news</a> <a href="http://www.diigo.com/user/coolcatteacher/qrcode">qrcode</a> <a href="http://www.diigo.com/user/coolcatteacher/education">education</a> <a href="http://www.diigo.com/user/coolcatteacher/teaching">teaching</a></p> </li> <li> <p class="diigo-link"> <a href="http://home.sprynet.com/~gkearsley/engage.htm">Engagement Theory:</a> </p> <p class="diigo-description">A document that I've referenced about creating collaborative, engaging teams.  "Engagement theory is based upon the idea of creating successful collaborative teams that work on ambitious projects that are meaningful to someone outside the classroom. These three components, summarized by Relate-Create-Donate, imply that learning activities: occur in a group context (i.e., collaborative teams) are project-based have an outside (authentic) focus"</p> <p class="diigo-tags"> <span>tags:</span> <a href="http://www.diigo.com/user/coolcatteacher/research">research</a> <a href="http://www.diigo.com/user/coolcatteacher/news">news</a> <a href="http://www.diigo.com/user/coolcatteacher/education">education</a> <a href="http://www.diigo.com/user/coolcatteacher/collaborative">collaborative</a> <a href="http://www.diigo.com/user/coolcatteacher/writing">writing</a></p> <ul class="diigo-comments"> </ul> </li> </ul><p class="diigo-ps">Posted from <a href='http://www.diigo.com'>Diigo</a>. The rest of my favorite links are <a href='http://www.diigo.com/user/coolcatteacher'>here</a>.</p>

Daily Education and Technology News for Schools 01/06/2013

How Professors Really Feel About Digital Technology [#Study] | EdTech Magazine The good news, techno...

Read more »

Babe of the Week: Jenny McCarthy

<div dir="ltr" style="text-align: left;" trbidi="on">IWS is proud to announce that our Babe of the Week for this week is none other than Jenny McCarthy!<br /><br />Jenny began her amazing career as a Playboy Centerfold way back in 1993. <br /><br /><div class="separator" style="clear: both; text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgnRgFhXpsi_Rmmw74dPIK2VQeOKuUJRyjiKegEa4UZ9DwTZABYGCV6WAfzrFmDF_R25ANrboH9U0UNi3fU8wnLScfsiFgSgG7T-utFl-vr-_nhOldosYPXDWeNN1D3EKdUUo0ggUCZKWw/s1600/Jenny+McCarthy+Nude+Bikini+Hot.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" height="400" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgnRgFhXpsi_Rmmw74dPIK2VQeOKuUJRyjiKegEa4UZ9DwTZABYGCV6WAfzrFmDF_R25ANrboH9U0UNi3fU8wnLScfsiFgSgG7T-utFl-vr-_nhOldosYPXDWeNN1D3EKdUUo0ggUCZKWw/s400/Jenny+McCarthy+Nude+Bikini+Hot.jpg" width="265" /></a></div><br />From there she landed a spot on one of my favorite game shows of all time, MTV’s “Singled Out!” <br /><br /><div class="separator" style="clear: both; text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjZiL2Rl-m3_hDTzMYsn624dzWV5TC76YqhzzZlOU74Sgmkc0a2tMDUkRN0jfRM_btiEyTIHvoH1CP66hfmX9SGR-GDqz9F_poA0PzH2WYws0SGaCOgjIa8m_yPevoRkWbCCKmeYtBVt7I/s1600/Jenny+McCarthy+Upskirt.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" height="400" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjZiL2Rl-m3_hDTzMYsn624dzWV5TC76YqhzzZlOU74Sgmkc0a2tMDUkRN0jfRM_btiEyTIHvoH1CP66hfmX9SGR-GDqz9F_poA0PzH2WYws0SGaCOgjIa8m_yPevoRkWbCCKmeYtBVt7I/s400/Jenny+McCarthy+Upskirt.jpg" width="276" /></a></div><br />After that she married comedic actor Jim Carrey and became a movie star. <br /><br /><div class="separator" style="clear: both; text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEg8whX0-1KQfGcefKBUTZV3lz-sabsxsFCcCgCBC0dmjtCZirtN0bEIBS82hEh7rdFwN2LA3gY6QhGva3PvWobBq9HHE68g0dbKKWN02kg0LeGs4By4aN9orPNGuQ2SN6BQoJviwA9X4_o/s1600/Jenny+McCarthy+Yoga+Abs+Hot.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" height="400" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEg8whX0-1KQfGcefKBUTZV3lz-sabsxsFCcCgCBC0dmjtCZirtN0bEIBS82hEh7rdFwN2LA3gY6QhGva3PvWobBq9HHE68g0dbKKWN02kg0LeGs4By4aN9orPNGuQ2SN6BQoJviwA9X4_o/s400/Jenny+McCarthy+Yoga+Abs+Hot.jpg" width="281" /></a></div><br />Now she’s a correspondent for Dick Clark’s Rockin’ New Year’s Eve and is also one of the world’s leading authorities on Autism. <br /><br /><div class="separator" style="clear: both; text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgSzWHEmR0784822uzM_HxCJsUtBOYh08JjSW9pt54iCHiAGiIPAkoarFMoG7RssCiGCGgJotsciKHEIOoZ3HdFXWMPrQnYl4dcdavtkaK15_03ddyCa4zkZ2sY02x9-xhaS1vHESWlwm4/s1600/Jenny+McCarthy+Dance+Sexy+Drunk.JPG" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" height="400" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgSzWHEmR0784822uzM_HxCJsUtBOYh08JjSW9pt54iCHiAGiIPAkoarFMoG7RssCiGCGgJotsciKHEIOoZ3HdFXWMPrQnYl4dcdavtkaK15_03ddyCa4zkZ2sY02x9-xhaS1vHESWlwm4/s400/Jenny+McCarthy+Dance+Sexy+Drunk.JPG" width="200" /></a></div><br /><br />So, as you can see, there’s more to Jenny than great boobs and a hot ass. She smart, hard-working and very accomplished. And now she has IWS Babe of the Week to add to her trophy case! <br /><br />In other news we had a sad, yet still wonderful show last night on I’m With Stupid. Man, did we bring the heartache! It was just one sad story after another. Everything from losing basketball games to Lance Armstrong to people who personally have let us down. Make sure you have a box of tissues close by when you listen to this one. <br /><br /><object classid="clsid:D27CDB6E-AE6D-11cf-96B8-444553540000" codebase="http://download.adobe.com/pub/shockwave/cabs/flash/swflash.cab#version=9,0,0,0" height="105" id="143577" name="143577" width="210"><param name="movie" value="http://www.blogtalkradio.com/btrplayer.swf?file=http://www.blogtalkradio.com%2Fplaylist.aspx%3Fshow_id%3D4226361&autostart=false&bufferlength=5&volume=80&corner=rounded&callback=http://www.blogtalkradio.com/flashplayercallback.aspx" /><param name="quality" value="high" /><param name="wmode" value="transparent" /><param name="menu" value="false" /><param name="allowScriptAccess" value="always" /><embed src="http://www.blogtalkradio.com/btrplayer.swf" flashvars="file=http://www.blogtalkradio.com%2Fplaylist.aspx%3Fshow_id%3D4226361&autostart=false&shuffle=false&callback=http://www.blogtalkradio.com/FlashPlayerCallback.aspx&width=210&height=105&volume=80&corner=rounded" width="210" height="105" type="application/x-shockwave-flash" pluginspage="http://www.macromedia.com/go/getflashplayer" quality="high" wmode="transparent" menu="false" name="143577" id="143577" allowScriptAccess="always"></embed></object><br /><div style="font-size: 10px; text-align: center; width: 220px;">Listen to <a href="http://www.blogtalkradio.com/">internet radio</a> with <a href="http://www.blogtalkradio.com/im-with-stupid">Im With Stupid</a> on Blog Talk Radio<br /><br /><br /></div></div>

Babe of the Week: Jenny McCarthy

IWS is proud to announce that our Babe of the Week for this week is none other than Jenny McCarthy! Jenny began her amazing career as a Play...

Read more »

Homeward bound.....

<p>We had a lovely last KW meal in Santiago's Bodega. </p><p>Sadly we get on the road for Fort Lauderdale tomorrow morning. After spending a night there we then fly back to Ireland on Monday and will arrive in to Dublin on Tuesday morning.  We are sad to leave the island after a wonderful holiday.</p>

Homeward bound.....

We had a lovely last KW meal in Santiago's Bodega. Sadly we get on the road for Fort Lauderdale tomorrow morning. After spending a night...

Read more »

Home Spa Review and Giveaway

<div class="separator" style="clear: both; text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEj30tQrlNed1yijd7iuZom1K2_of8kwwYz59FzPfxnik9JNvQ_4FWnkKTwjiiA0RYeA4EM0wJtTp1_APUvJHS0WoKlK9U5jcumw3wH7rhhzqyAdPH04a8uUB5XOkqmsgT-SnKDt2nr2_30/s1600/home+spa.jpeg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" height="112" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEj30tQrlNed1yijd7iuZom1K2_of8kwwYz59FzPfxnik9JNvQ_4FWnkKTwjiiA0RYeA4EM0wJtTp1_APUvJHS0WoKlK9U5jcumw3wH7rhhzqyAdPH04a8uUB5XOkqmsgT-SnKDt2nr2_30/s320/home+spa.jpeg" width="320" /></a></div><div style="text-align: center;"><u><span style="font-family: Verdana, sans-serif;"><br /></span></u></div><div style="text-align: center;"><u><span style="font-family: Verdana, sans-serif;"><br /></span></u></div><div style="text-align: center;"><u><span style="font-family: Verdana, sans-serif;">Home Spa </span></u></div><div style="text-align: center;"><span style="font-family: Verdana, sans-serif;"><br /></span></div><div style="text-align: center;"><span style="font-family: Verdana, sans-serif;">Feel like all you do all day long is run around?</span></div><div style="text-align: center;"><span style="font-family: Verdana, sans-serif;"><br /></span></div><div style="text-align: center;"><span style="font-family: Verdana, sans-serif;">I get it, you just want time to relax and unwind with a great book, a spa treatment, a movie or a hot bath.</span></div><div style="text-align: center;"><span style="font-family: Verdana, sans-serif;"><br /></span></div><div style="text-align: center;"><span style="font-family: Verdana, sans-serif;">With going to the spa it gets pricey.</span></div><div style="text-align: center;"><span style="font-family: Verdana, sans-serif;"><br /></span></div><div style="text-align: center;"><span style="font-family: Verdana, sans-serif;">Why not have the aroma of a spa in your own home with Home spa shower sprays!</span></div><div style="text-align: center;"><span style="font-family: Verdana, sans-serif;"><br /></span></div><div style="text-align: center;"><span style="font-family: Verdana, sans-serif;">With the scent of these  100% all natural shower sprays  they clear your mind  and make you feel at ease,using the treatments found within spas.</span></div><div style="text-align: center;"><span style="font-family: Verdana, sans-serif;"><br /></span></div><div class="separator" style="clear: both; text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiS_rQx426fy9sm9q14F36UUp8SFzqIC13m_PzE8AP2B4zo9My_aL1hKNziJ_G8NvRbNWYA9Vo_tJmo4xb4oK1aBeximYo-hJcsza9nLGJZtzdtiERJ5xG0zXhqHniGvHT-6ACn5DQJenQ/s1600/homespa.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" height="320" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiS_rQx426fy9sm9q14F36UUp8SFzqIC13m_PzE8AP2B4zo9My_aL1hKNziJ_G8NvRbNWYA9Vo_tJmo4xb4oK1aBeximYo-hJcsza9nLGJZtzdtiERJ5xG0zXhqHniGvHT-6ACn5DQJenQ/s320/homespa.jpg" width="320" /></a></div><div style="text-align: center;"><br /></div><div style="text-align: center;"><br /></div><div style="text-align: center;"><span style="font-family: Verdana, sans-serif;">Give the bottle a little shake first, start the shower, bath or whirlpool tub,then pump three sprays into your shower stream then hop in and let the scents of the home spa take you away.</span></div><div style="text-align: center;"><span style="font-family: Verdana, sans-serif;"><br /></span></div><div style="text-align: center;"><span style="font-family: Verdana, sans-serif;">You will feel so relaxed and like you are at a spa in no time.</span></div><div style="text-align: center;"><span style="font-family: Verdana, sans-serif;"><br /></span></div><div style="text-align: center;"><span style="font-family: Verdana, sans-serif;"><br /></span></div><div style="text-align: center;"><span style="font-family: Verdana, sans-serif;">Scents:</span></div><div style="text-align: center;"><span style="font-family: Verdana, sans-serif;"><br /></span></div><div style="text-align: center;"><span style="font-family: Verdana, sans-serif;"><u>Lavender:</u></span></div><div style="text-align: center;"><span style="font-family: Verdana, sans-serif;"><u><br /></u></span></div><div class="separator" style="clear: both; text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEi7EulzpIMwR0KfX059cuCanYdyxjDU92zj75mOI6rgWkHwSL-sNN_rlCbUSmIdgrZ1im9OQfo1jYptff8LrY0mP_kCnZjK03cpiDocuQxLcsUk-mKv8ldOUUbw8U2in1IiARv2YgpyvRw/s1600/lavender.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" height="320" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEi7EulzpIMwR0KfX059cuCanYdyxjDU92zj75mOI6rgWkHwSL-sNN_rlCbUSmIdgrZ1im9OQfo1jYptff8LrY0mP_kCnZjK03cpiDocuQxLcsUk-mKv8ldOUUbw8U2in1IiARv2YgpyvRw/s320/lavender.jpg" width="320" /></a></div><div style="text-align: center;"><span style="font-family: Verdana, sans-serif;"><u><br /></u></span></div><div style="text-align: center;"><span style="font-family: Verdana, sans-serif;"><br /></span></div><div style="text-align: center;"><span style="font-family: Verdana, sans-serif;"> let all of your worries be put to rest and relax and unwind with the sweet and relaxing scent of Lavender.</span></div><div style="text-align: center;"><span style="font-family: Verdana, sans-serif;"><br /></span></div><div style="text-align: center;"><span style="font-family: Verdana, sans-serif;"><u>Pink Grapefruit:</u></span></div><div style="text-align: center;"><span style="font-family: Verdana, sans-serif;"><u><br /></u></span></div><div class="separator" style="clear: both; text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjTzNzbYoHplqTRxvNJ2jICwdV1CkTv01D3pcYnzaweqm9hoobkuKYvrYM-yHmj_DjyiXdgeohRVtVviLjfQpvRiWvl2wdvX3WUI2R-HXvJYLyAleKxS8-TD5nTj6mtgtNSLOQMTHd3vxA/s1600/pink+grapefruit.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" height="320" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjTzNzbYoHplqTRxvNJ2jICwdV1CkTv01D3pcYnzaweqm9hoobkuKYvrYM-yHmj_DjyiXdgeohRVtVviLjfQpvRiWvl2wdvX3WUI2R-HXvJYLyAleKxS8-TD5nTj6mtgtNSLOQMTHd3vxA/s320/pink+grapefruit.jpg" width="320" /></a></div><div style="text-align: center;"><span style="font-family: Verdana, sans-serif;"><u><br /></u></span></div><div style="text-align: center;"><span style="font-family: Verdana, sans-serif;"><u><br /></u></span></div><div style="text-align: center;"><span style="font-family: Verdana, sans-serif;">Love the smell of the candles burning inside of the spa while your getting a massage?</span></div><div style="text-align: center;"><br /></div><div style="text-align: center;"><span style="font-family: Verdana, sans-serif;">Your bathroom will be smelling like it in no time with the exotic scent of Pink Grapefruit!</span></div><div style="text-align: center;"><span style="font-family: Verdana, sans-serif;"><u><br /></u></span></div><div style="text-align: center;"><br /></div><div style="text-align: center;"><br /></div><div style="text-align: center;"><span style="font-family: Verdana, sans-serif;"><u>Eucalyptus: </u></span></div><div style="text-align: center;"><span style="font-family: Verdana, sans-serif;"><u><br /></u></span></div><div class="separator" style="clear: both; text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEimctQhnwOKs_xhBIV_JOoeYnlWpZv7nXJ_nvUfs8ZWLuVJahHQR14yuMJeD_lMw_7SqsJv2nepPgcZw1-8ukBqvA5S4T4I6zPF7UMQThIwjQUaTYxaui8ZkjB4tJSB9x8K1q4pHYSlUEc/s1600/Eucalyptus.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" height="320" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEimctQhnwOKs_xhBIV_JOoeYnlWpZv7nXJ_nvUfs8ZWLuVJahHQR14yuMJeD_lMw_7SqsJv2nepPgcZw1-8ukBqvA5S4T4I6zPF7UMQThIwjQUaTYxaui8ZkjB4tJSB9x8K1q4pHYSlUEc/s320/Eucalyptus.jpg" width="320" /></a></div><div style="text-align: center;"><span style="font-family: Verdana, sans-serif;"><u><br /></u></span></div><div style="text-align: center;"><span style="font-family: Verdana, sans-serif;"><u><br /></u></span></div><div style="text-align: center;"><span style="font-family: Verdana, sans-serif;">Have a sinus infection?</span></div><div style="text-align: center;"><span style="font-family: Verdana, sans-serif;"><br /></span></div><div style="text-align: center;"><span style="font-family: Verdana, sans-serif;">Put on a pot of tea or coffee, grab a book and relax and unwind.</span></div><div style="text-align: center;"><span style="font-family: Verdana, sans-serif;"><br /></span></div><div style="text-align: center;"><span style="font-family: Verdana, sans-serif;">Pump some spray in the shower stream, then get in and relax</span></div><div style="text-align: center;"><span style="font-family: Verdana, sans-serif;"><br /></span></div><div style="text-align: center;"><span style="font-family: Verdana, sans-serif;">with the detoxifying scent of Eucalyptus to help you say goodbye to those pesky sinus infections! </span></div><div style="text-align: center;"><span style="font-family: Verdana, sans-serif;"><u><br /></u></span></div><div style="text-align: center;"><br /></div><div style="text-align: center;"><span style="font-family: Verdana, sans-serif;"><u><br /></u></span></div><div style="text-align: center;"><span style="font-family: Verdana, sans-serif;"><u>Tangerine:</u></span></div><div style="text-align: center;"><span style="font-family: Verdana, sans-serif;"><u><br /></u></span></div><div class="separator" style="clear: both; text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjLuwiMwoyEdr9a7PEpPEsum4IGO5gega6-WfudZuYx0g4x-67yNQ9Sxc2DMxfjIoAkxR6XViW08JJSebGLFwSPGEteMfTfqqcD4PEHw_FHoQoCYykwFaqZa9IwoYGbBGdMEisaRIkmFrQ/s1600/tangerine.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" height="320" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjLuwiMwoyEdr9a7PEpPEsum4IGO5gega6-WfudZuYx0g4x-67yNQ9Sxc2DMxfjIoAkxR6XViW08JJSebGLFwSPGEteMfTfqqcD4PEHw_FHoQoCYykwFaqZa9IwoYGbBGdMEisaRIkmFrQ/s320/tangerine.jpg" width="320" /></a></div><div style="text-align: center;"><span style="font-family: Verdana, sans-serif;"><u><br /></u></span></div><div style="text-align: center;"><span style="font-family: Verdana, sans-serif;">Not only will you feel like your at a spa but you will feel like you are on a tropical vacation!</span></div><div style="text-align: center;"><span style="font-family: Verdana, sans-serif;"><br /></span></div><div style="text-align: center;"><span style="font-family: Verdana, sans-serif;">Talk about soothing!</span></div><div style="text-align: center;"><span style="font-family: Verdana, sans-serif;"><u><br /></u></span></div><div style="text-align: center;"><span style="font-family: Verdana, sans-serif;"></span></div><div style="text-align: center;"><span style="font-family: Verdana, sans-serif;">1. Enter to win by telling me what do you do to unwind after a long day?</span></div><br /><div style="text-align: center;"><span style="font-family: Verdana, sans-serif;"><br /></span></div><div style="text-align: center;"><span style="font-family: Verdana, sans-serif;"><br /></span></div><div style="text-align: center;"><span style="font-family: Verdana, sans-serif;"><br /></span></div><div style="text-align: center;"><span style="font-family: Verdana, sans-serif;"><br /></span></div><div style="text-align: center;"><span style="font-family: Verdana, sans-serif;">Want an extra entry? </span></div><br /><br /><div style="text-align: center;"><span style="font-family: Verdana, sans-serif;"><br /></span></div><div style="text-align: center;"><span style="font-family: Verdana, sans-serif;">2. Follow my blog.</span></div><br /><br /><div style="text-align: center;"><span style="font-family: Verdana, sans-serif;"><br /></span></div><div style="text-align: center;"><span style="font-family: Verdana, sans-serif;">3.Then also follow me via Twitter, here. https://twitter.com/kelli_bliss </span></div><br /><br /><div style="text-align: center;"><span style="font-family: Verdana, sans-serif;"><br /></span></div><div style="text-align: center;"><span style="font-family: Verdana, sans-serif;">4. then tweet about the giveaway and make sure you use #HomeSpa</span></div><br /><br /><div style="text-align: center;"><span style="font-family: Verdana, sans-serif;"><br /></span></div><div style="text-align: center;"><span style="font-family: Verdana, sans-serif;">5. leave me a link here to your tweet.</span></div><br /><br /><div style="text-align: center;"><span style="font-family: Verdana, sans-serif;"><br /></span></div><div style="text-align: center;"><span style="font-family: Verdana, sans-serif;">Note that 5 winners will be selected and best of all you get to pick the scent of your choice! </span></div><br /><div style="text-decoration: underline;"><div style="text-align: center;"><span style="font-family: Verdana, sans-serif;"><br /></span></div></div><div style="text-align: center;"><span style="font-family: Verdana, sans-serif;">Good Luck!</span></div><div style="text-align: center;"><br /></div><div style="text-align: center;"><span style="font-family: Verdana, sans-serif;"><u><br /></u></span></div><div style="text-align: center;"><span style="font-family: Verdana, sans-serif;"><u><br /></u></span></div><div style="text-align: center;"><span style="font-family: Verdana, sans-serif;">Best of all they are online and you can order these wonderful amazing shower sprays and they will be shipped to your house the next day!</span></div><div style="text-align: center;"><span style="font-family: Verdana, sans-serif;"><br /></span><span style="font-family: Verdana, sans-serif;">Winners are Gina, Tricia, Janette, Meg and Jennie! Congratulations ladies!! </span></div><div style="text-align: center;"><span style="font-family: Verdana, sans-serif;"><br /></span></div><div style="text-align: center;"><span style="font-family: Verdana, sans-serif;">Check them out here!</span></div><div style="text-align: center;"><span style="font-family: Verdana, sans-serif;"><br /></span></div><div style="text-align: center;"><span style="font-family: Verdana, sans-serif;"><a href="http://homespashowerspray.com/">http://homespashowerspray.com/</a></span></div><div style="text-align: center;"><br /></div><div style="text-align: center;"><span style="font-family: Verdana, sans-serif;">Or Here on Face Book!</span></div><div style="text-align: center;"><span style="font-family: Verdana, sans-serif;"><br /></span></div><div style="text-align: center;"><span style="font-family: Verdana, sans-serif;"><a href="https://www.facebook.com/pages/Home-Spa-Shower-Spray/281369181923788?ref=tn_tnmn">https://www.facebook.com/pages/Home-Spa-Shower-Spray/281369181923788?ref=tn_tnmn</a></span></div><div style="text-align: center;"><span style="font-family: Verdana, sans-serif;"><u><br /></u></span></div><div style="text-align: center;"><span style="font-family: Verdana, sans-serif;"><br /></span></div>

Home Spa Review and Giveaway

Home Spa  Feel like all you do all day long is run around? I get it, you just want time to relax and unwind with a great book, a spa treatme...

Read more »

Book Review: Cabinet Issue 47: Logistics

<a href="http://cabinetmagazine.org/issues/47/index.php"><b><i>Cabinet Issue 47: Logistics</i></b></a><br />Cabinet Magazine, 2012<br />Paperback, 112 pages<br /><br /><img alt="book-cabinet47.jpg" src="http://www.archidose.org/Blog/book-cabinet47.jpg" title="Cover of Logistics" /><br /><br />I've seen <a href="http://cabinetmagazine.org/"><i>Cabinet</i></a> magazine in bookstores a number of times, but it wasn't until issue 47 that I went ahead and bought one. It's partly the cover that lured me into it—a photograph by Christoph Morlinghaus "of a plant outside Los Angeles that manufactures metal beverage cans." Strongly linked to the issue's theme of "Logistics," the peek into hidden yet crucial spaces in our consumer culture is very appealing to me. Fortunately, the issue is not limited to visually revealing the spaces for the storage and transport of goods, as in the cover; it explains how these spaces work and their crucial roles in the global economy.<br /><br />The editors do not attempt to encapsulate the essays with an introduction, instead letting each author or interviewee add their voice to the mix. While logistics can be defined as "the detailed coordination of a complex operation involving many people, facilities, or supplies," the eight contributors hone in on storage, shipping, and retail. The companies one might expect in these terms are well represented: UPS, FedEX, USPS, Amazon.com, but so are things like the Traveling Salesman Problem, <a href="http://cabinetmagazine.org/issues/47/twilley.php">cold storage for food</a>, and the Universal Product Code, or UPC, what might be the key to all of today's logistical possibilities.<br /><br />As a "magazine of art and culture," I'm glad to see <i>Cabinet</i> tackle a theme that has the potential to be great, zonk-yourself-out-at-bedtime reading. But <a href="http://cabinetmagazine.org/issues/47/index.php">the authors</a> skillfully illustrate the complexity of logistics, as well as how the polar scales of it all—the enormity of warehouses, networks, and infrastructure versus the individual items that we buy at the store or arrive at our door. It gives me a greater understanding of just what happens when I buy something (and makes me questions just such an act), but it also leaves me wondering what the theme for Issue 48 might be.<br /><br /><b>US: <a href="http://www.amazon.com/gp/product/1932698469/ref=as_li_qf_sp_asin_il_tl?ie=UTF8&tag=aweeklydoseof-20&linkCode=as2&camp=1789&creative=9325&creativeASIN=1932698469" target="_blank"><img alt="Buy from Amazon.com" border="0" src="http://www.archidose.org/books/buy-from-tan.gif" /></a> CA: <a href="http://www.amazon.ca/gp/product/1932698469/ref=as_li_qf_sp_asin_il_tl?ie=UTF8&tag=aweeklydoseof-20&linkCode=as2&camp=1789&creative=9325&creativeASIN=1932698469" target="_blank"><img alt="Buy from Amazon.ca" border="0" height="28" src="http://www.archidose.org/books/buy-from-tan-ca.gif" width="90" /></a> UK: <a href="http://www.amazon.co.uk/gp/product/1932698469/ref=as_li_qf_sp_asin_il_tl?ie=UTF8&tag=aweeklydoseof-20&linkCode=as2&camp=1789&creative=9325&creativeASIN=1932698469" target="_blank"><img alt="Buy from Amazon.co.uk" border="0" height="28" src="http://www.archidose.org/books/buy-from-tan-uk.gif" width="90" /></a></b>

Book Review: Cabinet Issue 47: Logistics

Cabinet Issue 47: Logistics Cabinet Magazine, 2012 Paperback, 112 pages I've seen Cabinet magazine in bookstores a number of times, but...

Read more »

Better, if Not Cheaper, Care for the Dying - NYTimes.com

<base href="data:"><div style="font-family: Helvetica; font-size: 14px; color: black; text-align: left; "><div id="opinionator" style="color: rgb(0, 0, 0); font-family: Georgia, serif; font-size: 13px; font-style: normal; font-variant: normal; font-weight: normal; letter-spacing: normal; line-height: normal; orphans: 2; text-align: -webkit-auto; text-indent: 0px; text-transform: none; white-space: normal; widows: 2; word-spacing: 0px; -webkit-text-size-adjust: auto; -webkit-text-stroke-width: 0px; "><div align="left"><div class="entry-content"><div style="color: rgb(51, 51, 51); font-size: medium; margin-top: 0px; margin-right: 0px; margin-bottom: 0.7em; margin-left: 0px; padding-top: 0px; padding-right: 0px; padding-bottom: 0px; padding-left: 0px; line-height: 1.375em; ">It is conventional wisdom that end-of-life care is an increasingly huge proportion of health care spending. I've often heard it said that people spend more on health care in the year before they die than they do in the entire rest of their lives. If we don't address these costs, the story goes, we can never control health care inflation.</div><div style="color: rgb(51, 51, 51); font-size: medium; margin-top: 0px; margin-right: 0px; margin-bottom: 0.7em; margin-left: 0px; padding-top: 0px; padding-right: 0px; padding-bottom: 0px; padding-left: 0px; line-height: 1.375em; ">Wrong. Here are the real numbers. The roughly 6 percent of Medicare patients who die each year do make up a large proportion of Medicare costs: 27 to 30 percent. But this figure has not changed significantly in decades. And the total number of Americans, not just older people, who die every year - less than 1 percent of the population - account for much less of total health care spending, just 10 to 12 percent.</div><div style="color: rgb(51, 51, 51); font-size: medium; margin-top: 0px; margin-right: 0px; margin-bottom: 0.7em; margin-left: 0px; padding-top: 0px; padding-right: 0px; padding-bottom: 0px; padding-left: 0px; line-height: 1.375em; ">The more important issue is that just because we spend a lot on end-of-life care does not mean we can save a lot. We do know that costs for dying patients vary widely among hospitals, which suggests that we can do better. And yet no one can reliably say what specific changes would significantly lower costs. There is no body of well-conducted research studies that has proved how to save 5, 10, much less 20 percent.</div><div style="color: rgb(51, 51, 51); font-size: medium; margin-top: 0px; margin-right: 0px; margin-bottom: 0.7em; margin-left: 0px; padding-top: 0px; padding-right: 0px; padding-bottom: 0px; padding-left: 0px; line-height: 1.375em; ">Recent studies find that hospice may reduce costs in the last year of life for cancer patients by 10 to 20 percent. But they find no savings from hospice care for patients who die of other conditions, like emphysema or heart failure. No one is sure why hospice care doesn't save more. It may be because patients are enrolled in hospice care too late, or because hospice services themselves are labor-intensive and not cheap.</div><div style="color: rgb(51, 51, 51); font-size: medium; margin-top: 0px; margin-right: 0px; margin-bottom: 0.7em; margin-left: 0px; padding-top: 0px; padding-right: 0px; padding-bottom: 0px; padding-left: 0px; line-height: 1.375em; ">Even if we can never save a dime, however, there are good reasons to think about changing end-of-life care practices. While end-of-life care has improved considerably over the last 30 years, many Americans still die in hospitals when they would rather die at home. Nearly 20 percent of deaths occur in an intensive care unit or immediately after discharge, and too many patients experience symptoms like pain that are controllable with appropriate palliative care.</div><div style="color: rgb(51, 51, 51); font-size: medium; margin-top: 0px; margin-right: 0px; margin-bottom: 0.7em; margin-left: 0px; padding-top: 0px; padding-right: 0px; padding-bottom: 0px; padding-left: 0px; line-height: 1.375em; ">Here are four things the health care system should do to try to improve care for the dying, even if they won't save money.</div><div style="color: rgb(51, 51, 51); font-size: medium; margin-top: 0px; margin-right: 0px; margin-bottom: 0.7em; margin-left: 0px; padding-top: 0px; padding-right: 0px; padding-bottom: 0px; padding-left: 0px; line-height: 1.375em; ">First, all doctors and nurses should be trained in how to talk to patients and families about end-of-life care. When I was starting out, I was lucky enough to be able to witness how a great oncologist communicated with patients and their families when it was clear they were going to die, but I received no formal training whatsoever. It is hard to improve care for the dying if health professionals don't know how to talk about it. Fortunately, there are excellent communication techniques and training programs available - they don't have to be invented from scratch.</div><div style="color: rgb(51, 51, 51); font-size: medium; margin-top: 0px; margin-right: 0px; margin-bottom: 0.7em; margin-left: 0px; padding-top: 0px; padding-right: 0px; padding-bottom: 0px; padding-left: 0px; line-height: 1.375em; ">A related intervention - an idea that never actually was in the Affordable Care Act but inspired the death panel accusation - is that physicians should be paid a one-time fee to talk with patients about their preferences for end-of-life care. Even if physicians are well trained in communication, these conversations take time and are emotionally draining. This should be recognized through compensation.</div><div style="color: rgb(51, 51, 51); font-size: medium; margin-top: 0px; margin-right: 0px; margin-bottom: 0.7em; margin-left: 0px; padding-top: 0px; padding-right: 0px; padding-bottom: 0px; padding-left: 0px; line-height: 1.375em; ">Third, every hospital should be required to have palliative care services available both in the hospital and at the homes of dying patients who are discharged. Over 40 percent of hospitals with more than 50 beds do not have palliative care services. And we don't know how many actually have palliative care services once patients are sent home. These services should be delivered by trained experts in diagnosing and managing common symptoms of the dying, like pain, nausea, insomnia, shortness of breath, fatigue and depression.</div><div style="color: rgb(51, 51, 51); font-size: medium; margin-top: 0px; margin-right: 0px; margin-bottom: 0.7em; margin-left: 0px; padding-top: 0px; padding-right: 0px; padding-bottom: 0px; padding-left: 0px; line-height: 1.375em; ">Finally, we need to revise eligibility for hospice care. Right now doctors must certify that patients have six months or less to live and patients must agree to forgo life-sustaining treatments. The decision about whether to put a patient in hospice care should not be based on unreliable predictions about how long he has left to live but rather on his needs for specialized care, like morphine infusions.</div><div style="color: rgb(51, 51, 51); font-size: medium; margin-top: 0px; margin-right: 0px; margin-bottom: 0.7em; margin-left: 0px; padding-top: 0px; padding-right: 0px; padding-bottom: 0px; padding-left: 0px; line-height: 1.375em; ">These changes could be made in at least two ways. <a href="http://www.jointcommission.org/about_us/about_the_joint_commission_main.aspx" style="color: rgb(0, 0, 102); text-decoration: none; ">The Joint Commission</a> - the nonprofit group that certifies health care organizations - could make training physicians and nurses to talk about end-of-life care and having palliative care available a requirement for hospital accreditation. Alternatively, Medicare, private insurers and, after 2014, state exchanges could require hospitals to provide communication training and palliative services as a condition for payment.</div><div style="color: rgb(51, 51, 51); font-size: medium; margin-top: 0px; margin-right: 0px; margin-bottom: 0.7em; margin-left: 0px; padding-top: 0px; padding-right: 0px; padding-bottom: 0px; padding-left: 0px; line-height: 1.375em; ">Unfortunately, there is no evidence that these interventions will save money. And I can't definitively prove they will make the care of dying patients better. But doing nothing to try to help the dying when the rest of the health care system is improving care is not an option.</div></div></div></div></div><a href="http://opinionator.blogs.nytimes.com/2013/01/03/better-if-not-cheaper-care/?pagewanted=print">http://opinionator.blogs.nytimes.com/2013/01/03/better-if-not-cheaper-care/?pagewanted=print</a><div style="font-family: Helvetica; font-size: 14px; color: black; text-align: left; "><br class="webkit-block-placeholder"></div>

Better, if Not Cheaper, Care for the Dying - NYTimes.com

It is conventional wisdom that end-of-life care is an increasingly huge proportion of health care spending. I've often heard it said tha...

Read more »

God's Surgeons in Africa - Brian Till - The Atlantic

<base href="data:"></base><br /><div style="color: black; font-family: Helvetica; font-size: 14px; text-align: left;"><div style="-webkit-text-size-adjust: auto; -webkit-text-stroke-width: 0px; background-color: white; color: black; font-family: Georgia, 'times new roman', times, serif; font-size: 13px; font-style: normal; font-variant: normal; font-weight: normal; letter-spacing: normal; line-height: 19px; orphans: 2; text-align: -webkit-auto; text-indent: 0px; text-transform: none; white-space: normal; widows: 2; word-spacing: 0px;"></div><div style="border: 0px; font-family: Georgia, 'Times New Roman', Times, serif; font-size: 16px; line-height: 24px; margin-bottom: 10px; margin-top: 10px; outline: 0px; padding: 0px; vertical-align: baseline;">In 1994, God told David Thompson to start training surgeons in Africa. Thompson was in the fifteenth year of a mission to Gabon at the time, in West Africa. "I just realized that I couldn't keep up with the demand," Thompson told me. "I was just operating night and day and I knew I was going to burn out. And I knew that when I burned out I was going to leave, and that everything would go back to the way it was before I arrived."</div><div style="border: 0px; font-family: Georgia, 'Times New Roman', Times, serif; font-size: 16px; line-height: 24px; margin-bottom: 10px; margin-top: 10px; outline: 0px; padding: 0px; vertical-align: baseline;">Thompson is tall. He wears a mustache, and has deep creases alongside his eyes and mouth. I asked him how God had spoken to him. "I had a habit of spending about an hour a day early in the morning reading the Bible and praying and meditating on it and listening to see what God said to me," he said. Thompson grew up at a mission in Cambodia, and while he was a senior in college, in Pittsburgh, both of his parents were killed amid the Tet Offensive in Vietnam, where they were serving as missionaries. "Often times, in those moments, when I would be saying, 'God what are you telling me?' I would just get a very clear thought in my mind: 'You need to do this, this is how you can solve this problem.'"</div><div style="border: 0px; font-family: Georgia, 'Times New Roman', Times, serif; font-size: 16px; line-height: 24px; margin-bottom: 10px; margin-top: 10px; outline: 0px; padding: 0px; vertical-align: baseline;">The need for surgeons in sub-Saharan Africa is so profound that it's genuinely difficult to comprehend. "I was born by C-section, and when I was two months old I had an emergency operation on my stomach. When I was 23, I had appendicitis," Adam Kushner, a lecturer at Columbia Medical School, told me. "Those are three relatively simple procedures. A lot of people that have problems like those in say, Sierra Leone, just die," he said. "I mean, can you imagine a kid falling out of a tree, and then being disabled for the rest of their life because they couldn't get their arm fracture fixed? It's insane." Kushner's organization, <a href="http://www.humanitariansurgery.org/" style="border: 0px; color: #00598c; font-family: inherit; font-style: inherit; margin: 0px; outline: 0px; padding: 0px; text-decoration: none; vertical-align: baseline;">Surgeons OverSeas</a>, estimates 56 million people are in need of surgical care on the continent -- twice the population suffering from HIV/AIDS.</div><div style="border: 0px; font-family: Georgia, 'Times New Roman', Times, serif; font-size: 16px; line-height: 24px; margin-bottom: 10px; margin-top: 10px; outline: 0px; padding: 0px; vertical-align: baseline;">In 2009, Kushner worked with the Ministry of Health in Sierra Leone on an audit of the country's surgical capacity. Sierra Leone has a population of six million, roughly the size of Los Angeles and Houston combined, and the study found nine surgeons practicing in the country. The World Health Organization (WHO) estimates that a health system needs one surgeon for every 20,000 citizens to meet the burden of disease. By that measure, Sierra Leone has a shortage of 291 surgeons.</div><div style="border: 0px; font-family: Georgia, 'Times New Roman', Times, serif; font-size: 16px; line-height: 24px; margin-bottom: 10px; margin-top: 10px; outline: 0px; padding: 0px; vertical-align: baseline;">The deficit is equally dire elsewhere in Africa. Kenya and Uganda, with two of the continent's strongest medical education systems, have 355 and 100 surgeons respectively, meeting 19 percent and 7.4 percent of need based on WHO projections. Rwanda has 35. "Everyday I see things that just make me rage inside," Jim Brown, a missionary surgeon in Cameroon, told me.</div><div style="border: 0px; font-family: Georgia, 'Times New Roman', Times, serif; font-size: 16px; line-height: 24px; margin-bottom: 10px; margin-top: 10px; outline: 0px; padding: 0px; vertical-align: baseline;">The results of these deficits are often horrific, as surgical procedures that should be safe and routine -- appendectomies, caesarian sections, and amputations, for instance -- are carried out by general practitioners with little or no training, rather than surgeons. "Every week, almost every day, we have someone in here draining stool from an abdominal incision, or a ureter tied off, or the wrong operation done somewhere else," Brown said, standing atop a ward with 70 beds stretching in three directions. "And very often they die." Brown is slight, with an insufferably honest face and a subtle trace of southern to his locution.</div><div style="border: 0px; font-family: Georgia, 'Times New Roman', Times, serif; font-size: 16px; line-height: 24px; margin-bottom: 10px; margin-top: 10px; outline: 0px; padding: 0px; vertical-align: baseline;">"The ones that really get me are the ones that are told they had surgery -- they get anesthesia and incisions and they take their money, but they don't actually operate. They usually come up here after their third or fourth attempt somewhere else, and they've never had a fistulectomy, or a myomectomy, or whatever it is they need." At another hospital where Brown worked, prior to moving to Mbingo, he found that O.R. staff members were performing surgeries themselves after hours and on weekends.</div><div style="border: 0px; font-family: Georgia, 'Times New Roman', Times, serif; font-size: 16px; line-height: 24px; margin-bottom: 10px; margin-top: 10px; outline: 0px; padding: 0px; vertical-align: baseline;">"One of the biggest problems I see," Kushner told me, "is that ministries of health are hesitant to pursue surgical programs because the donors don't want it. The money is coming in and earmarked for certain programs. And even though you see a need for another type of program, you don't want to piss off your donors. There's this perception that surgery is expensive."</div><div style="border: 0px; font-family: Georgia, 'Times New Roman', Times, serif; font-size: 16px; line-height: 24px; margin-bottom: 10px; margin-top: 10px; outline: 0px; padding: 0px; vertical-align: baseline;">In 1994, David Thompson took the message he received -- to pivot from performing surgery to teaching it -- to a meeting of missionary surgeons in Brackenhurst, Kenya. The vision was to post a U.S. board-certified surgeon at a Christian hospital with reasonable capacity, and to augment the teaching by luring other surgeons, perhaps 10 or 15 each year, to visit the hospital for short-term teaching stints. Almost no one thought it could work.</div><div style="border: 0px; font-family: Georgia, 'Times New Roman', Times, serif; font-size: 16px; line-height: 24px; margin-bottom: 10px; margin-top: 10px; outline: 0px; padding: 0px; vertical-align: baseline;">Thompson took on his first resident in 1997, in Gabon, as a pilot program. "Within about five years I had enough help that I got my life back. And the other hospitals saw that it was working and it kind of starting spreading," Thompson said. The organization grew in fits and starts, some early programs going under while others managed to flourish. In 2011, Thompson's organization, the <a href="http://www.cmda.org/wcm/CMDA/Navigation/Missions/PanAfricanAcademyofSurgeons/PAN_AFRICAN_ACADEMY_.aspx" style="border: 0px; color: #00598c; font-family: inherit; font-style: inherit; margin: 0px; outline: 0px; padding: 0px; text-decoration: none; vertical-align: baseline;">Pan African Academy of Christian Surgeons </a>(PAACS), was training 43 residents at 10 hospitals across the continent. It has 28 graduates, all of whom remain in Africa, working for underserved populations. The organization's operating budget for 2011 was $550,000.</div><div style="border: 0px; font-family: Georgia, 'Times New Roman', Times, serif; font-size: 16px; line-height: 24px; margin-bottom: 10px; margin-top: 10px; outline: 0px; padding: 0px; vertical-align: baseline;"><span style="background-color: white;">Mbingo Hospital is tucked high in a lush valley near Bamenda, a city of half a million in northwest Cameroon. It's the home of the largest residency run by PAACS, and Jim Brown, from South Carolina, is the program's associate director. The site was founded as a leprosy clinic in 1952, and became a hospital a decade later. Today, it's a sprawl of low yellow buildings with red metal roofs. The entire place looks like it was laid with perfect rolls of sod, millennia ago, and then left to grow wild.</span></div><div style="border: 0px; font-family: Georgia, 'Times New Roman', Times, serif; font-size: 16px; line-height: 24px; margin-bottom: 10px; margin-top: 10px; outline: 0px; padding: 0px; vertical-align: baseline;">On my first night at the hospital, I asked a visiting pediatric surgeon, Jacob Stephenson, who trained at UCSF and University of Washington, how the skill of the PAACS trainees compared to that of his residents at home in Virginia. "In terms of technical skills, I would say they're comparable, maybe even a little better," he said. "In other ways I'd say they're stronger." Overwhelmingly, the string of surgeons that visited Mbingo while I was there agreed with Stephenson's assessment, particularly on the strength of the residents' diagnostic skills and judgement. "They are very good at problem solving and making clinical decisions with much less technology to rely on," Stephenson said. "You can't just tick a box and order a CT scan. That means you have to get very good with other ways of assessing a patient."</div><br /><div style="-webkit-text-size-adjust: auto; -webkit-text-stroke-width: 0px; background-color: white; color: black; font-family: Georgia, 'times new roman', times, serif; font-size: 13px; font-style: normal; font-variant: normal; font-weight: normal; letter-spacing: normal; line-height: 19px; orphans: 2; position: static; text-align: -webkit-auto; text-indent: 0px; text-transform: none; white-space: normal; widows: 2; word-spacing: 0px; z-index: auto;">More ...</div></div><a href="http://www.theatlantic.com/health/archive/2012/12/gods-surgeons-in-africa/266635/?src=longreads">http://www.theatlantic.com/health/archive/2012/12/gods-surgeons-in-africa/266635/?src=longreads</a><br /><div style="color: black; font-family: Helvetica; font-size: 14px; text-align: left;"><br class="webkit-block-placeholder" /></div>

God's Surgeons in Africa - Brian Till - The Atlantic

In 1994, God told David Thompson to start training surgeons in Africa. Thompson was in the fifteenth year of a mission to Gabon at the time,...

Read more »

Jack Schaap Blames Decreased Giving at Church for His Molestation of 16-Year Old Church Member

<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjC7IE_vqkIElZ6QdUsPKRHvdEM2KmRrB05S9HVBcNgk6xgs5yM79EJY-jP7QB2DxQu-0D0Tyk_cD15BZ-OUk-M3Kf7Ukmvt9MfQ8a5-vy3J7stUZGNwypfylc9qFfFA9PFmhLonCR1O71v/s1600/schaap.jpg" imageanchor="1" style="clear: left; float: left; margin-bottom: 1em; margin-right: 1em;"><img border="0" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjC7IE_vqkIElZ6QdUsPKRHvdEM2KmRrB05S9HVBcNgk6xgs5yM79EJY-jP7QB2DxQu-0D0Tyk_cD15BZ-OUk-M3Kf7Ukmvt9MfQ8a5-vy3J7stUZGNwypfylc9qFfFA9PFmhLonCR1O71v/s1600/schaap.jpg" /></a>Jack Schaap <a href="http://www.suntimes.com/news/17373403-418/hammond-pastor-blames-health-financial-woes-for-his-relationship-with-teen.html" target="_blank">has told the U.S. District Court in Hammond</a>, Indiana, that decreased donations to the church and his working too many hours led to his having sex multiple times, in multiple states, with a 16-year old church member that he was counseling.<br /><br />Yep, financial difficulty and being overworked are to blame for his sex crimes against a young girl in his church. If that is true,  90% of Americans will be molesting teenagers this year. <br /><br />Schaap's lame excuse might give pastors another reason to preach the 10% tithe, telling church members they must fork over 10% of their income because if they don't, it might put too much stress on the head man-o-God, and he might accidentally have sex with a teenager. Save a teenager, tithe to your church. I'm only half joking; I've heard some incredibly asinine, nonsensical reasons to tithe given by mega church pastors already. And don't forget, Perry Noble has already <a href="http://fbcjaxwatchdog.blogspot.com/2011/04/perry-noble-blames-homosexuality-on-non.html" target="_blank">blamed the spread of homosexuality on non-tithers</a>, so why not blame sexually abused teenagers on non-tithers also?<br /><br />I hope the judge sees through this nonsense, and I hope the judge ignores the 140 letters of support from First Baptist Hammond church members, including Schaap's wife, and gives Schaap the maximum sentence on January 15th. He will likely be sentenced to 10 years, probably more.<br /><br />The truth is Schaap's molestation crimes had nothing to do with finances of the church or a busy work schedule. Pastors all over the country are over-worked and churches everywhere are under financial strain, and they aren't regularly finding comfort by having sex with teens in the youth choir.<br /><div style="text-align: center;">------------------------------------------------------- <i><b> </b></i></div><div style="text-align: center;"><i><b>“I believe First Baptist Church gradually evolved into a cult that was in complete idolatry of my father [Jack Hyles] and, after his death, complete idolatry of Jack Schaap." </b></i>Linda Murphrey, Sister-in-law of Jack Schaap.</div><div style="text-align: center;">------------------------------------------------------- </div><br />Everybody but the die-hard FBC Hammond members understand that Jack Schaap is just another in a long line of perverse sexual offender pastors and lay people at FBC Hammond going all the way back to the 1950s, starting with Schaap's late father-in-law, Jack Hyles. Ministers at FBC Hammond, as at most fundamentalist, independent Baptist churches, are authoritarian rulers who have absolute power and whose judgements and actions are not to be questioned. If you want to read about the history of FBC Hammond and a chronology of the sex crimes and cover-ups at that church, read "<a href="http://www.chicagomag.com/Chicago-Magazine/January-2013/Let-Us-Prey-Big-Trouble-at-First-Baptist-Church/index.php?cparticle=5&siarticle=4#artanc" target="_blank">Let Us Prey: Big Trouble at First Baptist Church</a>". A "Godfather"-type movie - in three parts - could be made about the shenanigans at that one church. <br /><br /><div class="separator" style="clear: both; text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEg0CikUiv32F8LJqnROD9V0-BatnFO_BKZyB0vZ8EjswzLS8JubYdzVwr5-vouvj8vIxPJFXRya4v7QeY_oZGC8wrDjXb6RluGbb66arzytirMnqNoA1duPRfiRAggRjbtcjluZb27lOUd6/s1600/schaapolish.png" imageanchor="1" style="clear: left; float: left; margin-bottom: 1em; margin-right: 1em;"><img border="0" height="297" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEg0CikUiv32F8LJqnROD9V0-BatnFO_BKZyB0vZ8EjswzLS8JubYdzVwr5-vouvj8vIxPJFXRya4v7QeY_oZGC8wrDjXb6RluGbb66arzytirMnqNoA1duPRfiRAggRjbtcjluZb27lOUd6/s320/schaapolish.png" width="320" /></a></div>Schaap was and is a sick man who as time went on began preaching graphic, sexual sermons at FBC Hammond. Only a man who has a twisted mind, and who answers to no authority, would be able to deliver the sermon Schaap did in 2010 that best demonstrates his sickness.  At a youth conference, in the middle of his sermon he <a href="http://www.youtube.com/watch?v=Tr0UpQXYkGs" target="_blank">simulated masturbation for over a minute with a long stick held close to his crotch</a> while he stroked the stick and made painful, orgasmic sounds as he talked to God. Watch it <a href="http://www.youtube.com/watch?v=Tr0UpQXYkGs" target="_blank">here</a>, and you'll see what I mean. It is simply unbelievable that a man could behave this way - in front of a audience of teenagers especially - and not be escorted off the property or arrested for his X-rated performance.<br /><br />What can we learn from this? Simple. Churches that have a history of sexual abuse by pastors, especially those that have a history of denying the abuse, covering up the abuse, and then repeatedly lying about the abuse, they will produce more sexual abusers eventually. Churches that can't come clean to their members and to their communities about the past actions of their sexually abusive pastors - and the actions of those who covered it up - are breeding grounds for more misbehaving pastors.<br /><br />I'll wrap this up by sharing with you another quote from Linda Murphrey, daughter of Jack Hyles and sister-in-law of Jack Schaap:<br /><br /><div style="text-align: center;"><i><b>“Don’t get me wrong—I certainly believe Jack Schaap is guilty of a crime and deserves punishment. But I wondered: <span style="color: red;">If my dad [Jack Hyles] had been taken off his self-constructed throne long ago and people had known the full truth about who he was, perhaps Jack Schaap would never have been given the liberties, the complete lack of accountability, and the power that eventually led to his own demise</span>. Instead, he was allowed and encouraged to perpetuate what my father began..."</b></i></div><br />How true. Are you in a church that has yet to be completely truthful about the past of a sexually-abusive pastor, or his successor who helped cover it up?

Jack Schaap Blames Decreased Giving at Church for His Molestation of 16-Year Old Church Member

Jack Schaap has told the U.S. District Court in Hammond , Indiana, that decreased donations to the church and his working too many hours led...

Read more »

MSJS 2013

<div dir="ltr" style="text-align: left;" trbidi="on">Matt gives you Cliffs Notes.  Jay gives you Cliffs Notes.  You, pass the test.<br /><br /><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhAEZctT4nNDzpzUs9zCBZgYfXPJSUDYLUXOu-5x6uuXrOPMMpqqBEwvF7ptRe5bHMH4gSRLY8sVvCj_izT4-nqY_c6xRYK8_wt4h4o1RdWKKE_d8gQDvcMgtVQgiCbCvvkwwdi2rqpRfQ/s1600/John+Boehner+Crying+Speaker+of+the+House.jpeg" imageanchor="1" style="clear: right; float: right; margin-bottom: 1em; margin-left: 1em;"><img border="0" height="300" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhAEZctT4nNDzpzUs9zCBZgYfXPJSUDYLUXOu-5x6uuXrOPMMpqqBEwvF7ptRe5bHMH4gSRLY8sVvCj_izT4-nqY_c6xRYK8_wt4h4o1RdWKKE_d8gQDvcMgtVQgiCbCvvkwwdi2rqpRfQ/s400/John+Boehner+Crying+Speaker+of+the+House.jpeg" width="400" /></a>Y’know what?  Some people think it’s easy to be an international internet radio star, but really?  It’s not.  For instance…<br /><br />Jayman and I talked on the phone yesterday in order to come up with new topic ideas that would continue to provide you with quality entertainment at a fair price over the course of 2013.<br /><br />Allow me to illustrate how tough it can be as I transcribe parts of our aforementioned phone call…<br /><br /><b>Matt:</b>  So…this Saturday…What should we do?<br /><b>Jay:</b>  I dunno.  It’s January and the physical clift problem has been solved, so there isn't much going on.<br /><b>Matt:</b>  I know.<br /><b>Jay:</b>  We could piss Schmoop off by doing another Joke Show.<br /><b>Matt:</b>  No…She’s pissed off enough today.  It’s only 10:30 and she’s already told me to go to hell 3 times.<br /><b>Jay:</b>  That’s unfortunate.  I hate it when sick women begin to recover from their ailments.<br /><br />See what I mean?  Even Schmoop, whom we both love and adore, provided us with no help other than saying...<br /><br /><i>“You two buffoons want a show topic?  How about a topic revolving around as to how tired of your show I am, and I wish you guys would just end it?”</i><br /><br />See folks?<br /><br />Comments like that are not helpful, even if Schmoop <i>did</i> later retract her comment by using her oh so overused, and pedestrian, <i>“I have three tubes jutting out of my stomach.”</i> defense.<br /><br />Of course this line of conversation gave rise to an idea in Jayman’s mind…<br /><br /><b>Jay:</b>  Y’know…We could do a three way show.<br /><b>Matt:</b>  What?<br /><b>Jay:</b>  Yeah…Schmoop and Miss could talk.  Or Jo and Warrior Kat could talk.<br /><b>Matt:</b>  That’s hot.<br /><b>Jay:</b>  I know right?<br /><br />Of course, I talked to our lemonade friend Missy and to Schmoop about this idea and what did they do?<br /><br />Uh-huh…They shot it down.  Prudes.  So, we were left with few ideas, however…As dickhead Sean Hannity would say,<i> “Do not let your heart be troubled.”</i><br /><br />Eventually, Jayman and I did come up with some great show ideas.  No, seriously.<br /><br />This coming Wednesday, January 9th at 11 AM ET, we have a guest lined-up who will discuss the hideous problem of Human Trafficking.<br /><br />On Saturday January 12th at 11 PM ET, Jayman and I will be doing a “local news” show, as we illustrate how screwed up our communities are.<br /><br /><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgEZh2qLoLYefE20bNQYPbHx3hyzxWaS5iZ_J5uw0k3sHxvVViEwXDJ96ojipgGBc9ntVdtJPP45VqWuwGVmz873amsONZx3ETepoaOFyaBwRcCpA_Lw3dAvLATGyZfzVWrPSMYGcJ6VV0/s1600/Jessica+Lowndes+Hot+Sexy+Nude+90210.jpg" imageanchor="1" style="clear: right; float: right; margin-bottom: 1em; margin-left: 1em;"><img border="0" height="400" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgEZh2qLoLYefE20bNQYPbHx3hyzxWaS5iZ_J5uw0k3sHxvVViEwXDJ96ojipgGBc9ntVdtJPP45VqWuwGVmz873amsONZx3ETepoaOFyaBwRcCpA_Lw3dAvLATGyZfzVWrPSMYGcJ6VV0/s400/Jessica+Lowndes+Hot+Sexy+Nude+90210.jpg" width="266" /></a>And hopefully, on either January 30th at 11 AM or Saturday February 2 at 11 PM we will have a VERY special guest on with us who will  help to make your Super Bowl Party menu tasty and surreal.<br /><br />See?  We’re not just a couple of adorable goofballs, babies…We plan this stuff out!!*<br /><br />And …If you’d like to be a guest on our show or have a show topic idea, get a hold of either one of us.  We are always open to new ideas, new guests, and new and interesting sexual propositions and positions.<br /><br />Oh and by the way…Today’s show?<br /><br />It’s all about <a href="http://www.blogtalkradio.com/im-with-stupid/2013/01/06/the-heartache-show" target="_blank"><i><span style="color: blue;">HEARTACHE</span></i></a>.<br /><br />We will be talking heartache that we have personally endured and talking heartache we would like to impart upon others, so join us LIVE tonight Saturday January 5th at 11 PM ET as we let our souls bleed.<br /><br />Join the IWS Radio fun LIVE tonight at 11 PM ET by clicking <a href="http://www.blogtalkradio.com/im-with-stupid/2013/01/06/the-heartache-show" target="_blank"><i><span style="color: blue;">HERE</span></i></a>, and/or by calling in with <i>your</i> personal heartache at 661.244.9852.<br /><br /><i>Cheers!!</i><br /><i><br /></i><i>* to a degree</i></div>

MSJS 2013

Matt gives you Cliffs Notes.  Jay gives you Cliffs Notes.  You, pass the test. Y’know what?  Some people think it’s easy to be an internatio...

Read more »