Optimizing Care in Inflammatory Bowel Disease

I attended this webinar 21 May 22 for 1.5 hrs. I can’t really claim the hours because I am not a physician but I attended because as a psychotherapist people come to me with physical complications as well, so it doesn’t hurt to accept an invitation if it helps any of my clients. The speaker was Dr Anita Afzali MD. MPH etc…….She has quite a few interesting initials. She talked about this in detail but I will give you the tid bit version. Crohn’s Disease is a progressive disease. The longer you have it, the more the chance of needing surgery. If you have one surgery, chances again increase for another. She stated, “we need to do a better job.” Up to 80% of patients will have a progressive disease. Colitis is less understood. Dr Afzali suggested never acting on a single elevation. Supplemental vitamins can elevate. Octave Clinical Program U.C. 65 years of age is the risk factor for the drug, 1/3 above age 65. With Upadacitinib there is improvement the next day. For moderate to severe Crohn Disease - Patient - treatment option - choose one biologic medication and be on it for 10 years. One patient (six months ago) had six inches of her stomach removed. Continued biologic after one month off. Tailor and individualize - these are the options. Looking at everything - this is the best treatment choice. High risk - have to do something biological. Low risk - have more time. Week 12 - response to medication. Need more data for combining. That is all the notes I have for now. I have lots to catch up with once again. I don’t know who invited me to attend, but thank you. Any errors written here are my own and not Dr Afzali.

Live Video Address | President Volodymyr Zelenskyy at University of Toro...

Sex - interesting article from Couple and Family Magazine

I have been saving this article for you since I last wrote about sex. This is from the Family Therapy Magazine Jan/Feb 22 pp 44-47. They are going to stop sending me the magazines and I’ll have to read on line so I won’t be reading them as much anymore due to too much time on the internet. I like to read my magazines at my own leisure away from the computer. According to this article 42% of American women have low libido or desire, pain and or elusive orgasms. Many more lack emotional connection with their partners. Issues such as body shame (Brown, 2012), negative conditioning and or lack of ability to relax is common. The clitoris is similar in size to a penis, with 95% below the surface (Aswell, 2018). There are half dozen types of orgasms to experience. Trauma may cause a body to feel desensitized or numb. Growing up, women may receive negative messages about their sexuality, bodies and desires which may cause lasting shame, confusion and guilt. Parts of the female anatomy need 20-40 minutes of attention, yet the average sex act is over in about six minutes (do you see a problem?). A great sex life needs priority and time. Sex with deep emotional connection is often the ultimate goal. What I usually suggest to women who have body shame is to look at themselves in a full length mirror and tell themselves they are beautiful. This is difficult and requires time. Do it every day if you feel shame, until you believe it. Communicate with your partner what it is you like once you find out what it is. Relationships require communication and listening. However, both need to be comfortable and nothing should ever be forced. Have a good weekend. Sex is important in a relationship——connection. What do you think?

My Sympathies to the Families and Survivors of the Mass shootings at Highland Park, Illinois

CNN reported that there have been 309 mass shooting across the U.S.A. this year alone. These tragic deaths and injuries causes so much grief and terror. Lives are forever changed. At this point I just want to say, Sorry. We should all be able to enjoy the holidays, feeling safe in our own countries.

The Internet Murders continues..........

Cory was in his office on Bay Street. He couldn’t stop thinking of the girl. What was his problem? Maybe his buddies were right. He needed a life. Cory thought that Corporate was not making him happy. He would tell his father today. He needed to do something more with his life. Cory walked down the hall and stood in front of the grand double doors. He walked inside without knocking. The older man sat at the desk, behind him a breathtaking view of the city. They were high enough to see the lake. “You should knock, Cory. I could have been with someone.” “Dad, I want to talk to you.” Cory’s father looked up at his beautiful son who showed so much promise. Already his son was making more money than he ever did at his age. Of course Cory did have it easier because of his own station in life; however he was smart and earned every bit he was making. “Sit down, son.” Cory sat on the designer sofa, made to impress rather than comfort. The entire room spelled luxury. It wasn’t really a room. It was the size of an entire apartment, bar and all. It also had a separate area, for a king size bed, where his father would sleep many nights. Cory was sure that his father always slept here alone, regardless of the size of his bed. Everything his father did was grand. His mistress was money. He was no longer happy making mere millions. Cory wondered if his father was ever really capable of loving anyone. He was sure that his father wanted Cory to join him to help maximize his empire. He knew that he didn’t trust anyone except for him and his mother. Cory wondered whether his father placed so much importance on money because of his humble beginnings. His mother was happy being host to everyone at a moment’s notice. She didn’t mind him being away because he seemed absent when he was home. When he did come home, he would spend most of his time in his home office, and many nights Cory would awaken to hear his father speaking to someone in China or Japan or someone in Europe during their own time zones. It was probably more relaxing when his father was at the office. He looked out at the view of the city. It was beautiful. He could see the CN Tower, which you could hardly see now from street level, because there was a new high-rise being built on every parking lot. The growth was exciting for his father, who profited by this expansion. “Dad, I want to leave the company.” Excerpt From: Silva Redigonda. “The Internet Murders.

Happy Canada Day (belated) and Happy Jul 4th

I spent the weekend quietly enjoying gardens, roses and pets. It is not too often that I get to spend such a tranquil weekend, but I did. Canada Day for me is enjoying my country and celebration in fun. It is a day when only positivity fits in. I spent two Jul 4th's in the States, one being my Happy place - Disney World. We are hitting a seventh wave in my city of the pandemic and so I am still careful and normally participate in outdoor activities where it is not busy. That is easier said than done. Most of my hideout places have been discovered and is slowly becoming busy as well. However, I still have a few spots. This was the first time that my pets did not get too anxious about the fireworks, mainly because it was raining and so the neighbourhood scaled it down. I wish you a healthy time. Thank you for reading my blogs. What are your thoughts?

Care for those who are dying. End of Life Issues - Theology notes

Three-Font Principle How we judge for someone morale or imoral. 1. Intention 2. Act in itself. 3 Circumstances (proportionality). Drive to Totality. Eg. Act of killing is wrong. Now circumstances. If defence, Church can kill. But if we kill when we do not have to? -Modern medical approaches (gift and difficulty) -Fear that death will no longer be a “serene moment.” -Our unability to talk about death and dying. Natural fear of the unknown. Changes in our families and society. For Catholics - often mistaken understanding of our teaching. The Dignity of a person “ The dignity of the human being must be recognized from conception to natural death. This fundamental principle expresses a great “yes” to human life and must be at the centre of ethical reflection. Bioethical issues (Dignitas Personae, 2008). Image of God. This principal has even greater importance in today’s world. “A cultural of death”, “a consistent ethic of life”. Normally one is held to use ordinary means according to circumstances of persons, places, times and culture - that is to say, means that do not involve any grave burden for one suffering or another. A more strict obligation would be burdensome for most people and would render the attainment of the higher, more important (God) good too difficult Pope Pius X11 (Nov 24, 1952). When there is a reasonable hope of benefit that can be obtained and used without excessive pain or other serious inconvenience (Jehovah Witness refusing provision of blood and therefore die). Persons receiving care are not obliged to such treatment when it is no benefit etc…moral law means natural law. We have lost integration, the integration of moral theology and spirituality. We have moved away from old theology to relationship. Richard Gueller indicated that what leads us to be moral is gratitude (celebrate life). We celebrate what is. Attitude of gratitude - gives us a sense of humility - never assuming that something is. Image of God as desire. Need to understand that notion of incarnation. Scripture is one of the sources of moral theology. Love: agape - God loves in that love completely? From gratitude - disinterest - Disinterested in self (lack of ego - for something for myself - letting go the ego - of me, myself and I - not my interest. Eros - sexual. Philia - love that is affirming, we with each other. Our purpose is to call one another to greatness? I call that person indifferent, to what it may mean to me. Sense of calling to growth is another gratitude. Calling to conversion, that interested presence to grow. Must be generous? Notion of gift we need to explore too. We must move beyond established identity and well defined relationships, not denying, taking care of primary self, self care; part self care. Ecology is challenging the structure of ecology. The science of ecology is first most - relationships. The rest, the world would be better without us but we cannot do without it. Incarnation - the very substance of God’s son is the earth. We are not superior to but equal to and responsible for God’s relationship. We are in interrelationship. God added other species so God’s image could be viewed more accurately. Three Principles of the universe: Subjectivity/interiority - tree is tree; human - human; pig is pig. Diversity: In that diversity is communion (the third). Without these principles live crisis to exist. The individual is important in relationship. Balance of individual and common good. Diversity therefore calls us to respect life. We gain the facts through interrelations. Calls us to move forward. That that tree from its roots, knowing it and loving it. It moves us from the past of sin, its a breath of relationships (all relationships). Primary made in the image of God. God of Trinity. Three persons, one God in relationship. All creation is reflected by God who is in creation and beyond creation. Ok - next in theology notes is Eschatology