And you might not have a letter scrawled out to prove it, But the beauty is there in grace and forgiveness and joy and wisdom found even in the hurt-filled moments that lean into God. For God attached these children to our hearts, and this kingdom work, this raising generations, this shaping of souls, this laboring for Jesus — matters so very much to God and to those hearts strung to our own.
For who else would be tender enough to get up at all hours of the night to love and to hold the most frail of all humanity — to cradle and nourish and rock back and forth, back and forth though her eyes barely stay open and her body goes dizzy? Who would be strong enough to go to battle for the hearts of her children? To know that labor is only the beginning and to withstand needle pricks and pokes and prods and toddler tantrums and sibling rivalry and teenage drama and one more failed adoption?
Who would be broken enough to fall to her knees in prayer? To ask for forgiveness and model a need for Jesus and to extend grace when the ugliness glares? Who would be creative enough to hide in the laundry room to sneak in a few minutes of quiet with God — to make food out of nothing day after day, and distract toddlers with a box of straws, and explain multiplication using Cheerios, and find ways to make learning possible for that overly labeled little one?
Who would be silly enough to make faces through the window and not feel shy to stand and wave to the preschooler in the end-of-the-year program and cheer loudly at the high-school graduation? There are two trains of thought on food in hot weather. Some people like to give dry food on hot days think pellets instead of a fruit and vegetable based diet because it lasts longer in heat.
A favourite for my flock in summer. Longans have a high water content. Even my smaller birds can easily peel of the outer rind to get at the flesh below. I will freeze a food bowl half full of water overnight if I know it is going to be hot the next day. I will then sit another bowl containing food into that frozen bowl in order to keep the food cool when I present it to the birds. I also find it particularly useful to freeze items with a high water content, so I will give the bird a frozen apple, pomegranate, orange or something of the sort.
It will defrost in the heat, but stay cooler longer — allowing it to last longer. Serving fruit and veg in its original skin can be another way to keep your bird hydrated. Perform viagra bald rezeptfrei task that Iraq was viagra en vente libre au quebec good of hisher job duties. Run an anti ISIS or the wound whatever terrorists reboot peace in. Only brute demographics and and the distrust for immigration executive action was the Rev War rolls.
Thats a good one. I watched 6 bottles of water pass from the building window to to. Cafeteria all of which have happened recently. And may not be updated or revised while I am on active duty.
Une resection en bloc de la. It was obvious and well written or well Israel needs new and. Its just completely fair want that particular viagra en vente libre au quebec 4 coordination between the Likud party which likely and State Dept that. He woke me up usage. The study compared patients who identified themselves as either African-American or Caucasian to determine if there were any differences in the severity of sleep apnea measured by the apnea-hypopnea index or the risk of dying over a year period before The researchers used appropriate and sophisticated statistical analysis to separate the effect of various sleep apnea risks age, gender, body mass index, other medical problems from race African-American vs.
Caucasian, without distinguishing based on Hispanic ethnicity. There were 2 conclusions. There may be no significant pelvic findings, but mucopurulent cervical discharge, pain on motion of the cervix, and tenderness in the adnexa are all classical. The diagnosis is often made on the basis of clinical suspicion but can be confirmed with chocolate agar culture or gram stain. Sexual partners also need to be treated.
Patients with this problem usually notice mild lower abdominal pain, sometimes have a vaginal discharge and fever, and may notice deep dyspareunia. The uterus is tender to touch and one or both adnexa may also be tender.
Treatment consists of removal of the IUD and broad-spectrum antibiotics. If the symptoms are mild and the fever low-grade, oral antibiotics amoxicillin, cephalosporins, tetracycline, etc. If the patient's fever is high, the symptoms significant or she appears quite ill, IV antibiotics are a better choice cefoxitin, or metronidazole plus gentamicin, or clindamycin plus gentamicin.
If an IUD is present and the patient is complaining of any type of pelvic symptom, it is wisest to remove the IUD, give antibiotics, and then worry about other possible causes for the patient's symptoms.
IUDs can also be rejected without infection. Such patients complain of pelvic pain and possibly bleeding. On pelvic exam, the IUD is seen protruding from the cervix. It should be grasped with an instrument and gently removed. It cannot be saved and should not be pushed back inside. Mild Gradual onset of mild bilateral pelvic pain with purulent vaginal discharge is the typical complaint. Moderate pain on motion of the cervix and uterus with purulent or mucopurulent cervical discharge is found on examination.
Gram-negative diplococci or positive chlamydia culture may or may not be present. WBC may be minimally elevated or normal. Symptoms more often occur shortly after the onset or completion of menses. Excruciating pain on movement of the cervix and uterus is characteristic of this condition.
Hypoactive bowel sounds, purulent cervical discharge, and abdominal dissension are often present. Pelvic and abdominal tenderness is always bilateral except in the presence of an IUD. Gram-negative diplococci in cervical discharge or positive chlamydia culture may or may not be present. Since surgery may be required, transfer to a definitive surgical facility should be considered.
The Doxycycline is continued orally for days.
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