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Carefulinspection of abnormal postures is required to determine which muscle is the primaryproblem. Much more detailed information isavailable by echocardiography which can informdecision making on the management of pulmonaryartery pressure and right ventricular function. It broadly de?nes two groups: those that have a largenumber of mutations (which comprise about 16 % of cases) and those that don’t(which are in the majority). Monitoring of the association between cerebral bloodflow velocity and intracranial pressure

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Epidural spinal tumors, par-ticularly metastasis, can also compromise the nerve rootsat any level but are more common in the thoracic spine.Other, less common causes of radiculopathy includeinfections such as herpes zoster, CMV, HIV, Lyme disease,tuberculosis, and syphilis. Berkers CR et al (2013) Metabolic regulation by p53 family members. Miller can put just enough weight on her right leg touse a walker, but is not stable and the pain is too muchto bear weight for any walking distance; needs assistancewith bathing, cooking, and dressing; is not eating verywell and seems to choke easily, especially when she isdrinking, and that she complains frequently of a “drymouth.” Uses bed pads to manage a small amount ofincontinence during the night, and daughter gets her upat 3:00 AM to bedside commode

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In our center, thetotal treatment duration is 3 months. However,this technique must be further evaluated inthis and other settings, in both experimentaland clinical studies. These changes arerecognized clinically by increased peripheral vasoconstriction,tachycardia buy Dilantin using paypal LV remodeling, increased LV wall stress, releaseof brain natriuretic peptide, fluid and sodium retention, tissuecongestion, dilutional hyponatremia, and anemia. In addition buy Dilantin using paypal the nurse can use phy-sician- and nurse-prescribed interventions to minimize thecomplications of these problems. The inspiratory and expiratory trig-gers of these devices may be ?xed or adjustablewith generally different levels of sensitivity. When the force iswithdrawn,the network reverts to the relaxed state as in panel a

When the force iswithdrawn,the network reverts to the relaxed state as in panel a. Although the overallbalance of the literature did not support Hutchinson andFazzini (1996) in suggesting an improvement in motorsymptoms, only a modest proportion of individuals expe-rienced a worsening of parkinsonism

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I’ve written before about the Leatherman’s Loop. It’s a 6.7 mile ‘rite of spring’ run through woods and rivers, sandpits, and mudflats; and it’s been going on for over thirty years, here in Westchester, NY, in the Pound Ridge Reservation. It started with about 50 runners and this year registered 2000.

People love it for the obvious reasons related to any good run, but for something else as well. Yesterday, when I offered a reflection before leading our traditional ‘Celtic-Navajo’ starting blessing, I suggested that this ‘something else’ was all about connection. For it is clear that people feel connected to this event, in all kinds of ways: to the place, to the story of the Leatherman, and to each other.

The Leatherman, by the way, is something of a mystical figure who is part of the lore of these parts: a wanderer who walked a circuit of about 300 miles a month between the Connecticut River and the Hudson River, from around 1857 to 1889. His only possession, when he was found dead – besides his famous handmade leather suit of clothes – was a French prayer book, which gave rise to various stories. For example, one was that he was French and had come to the U.S. as a young man to manage the leather mill of his fiance’s father, partly, it was suggested, as a test of his commitment. It seems he failed to make a success of the task and lost both his job and his finance, which led to his wandering, whether in sorrow or not, we don’t know.

Good story, right? Certainly enough for people to create a little legend around, even if the facts don’t have a lot of foundation! And certainly enough to give a focus to the event.

But there is more. A number of years ago, the founder of the race, my dear friend Tony Godino, invited me to offer a blessing at the start. I can vividly recall the first effort because there was a Nor’Easter that day, with cold, driving rain pelting the exposed bodies of the scantily clad runners, as I stood on a shaky step-ladder with a megaphone in hand and began ee cumming’s famous poem:

i thank You God for most this amazing day…

You could almost feel the less than positive thoughts of the freezing runners, directed like daggers at this strange figure on the ladder: ‘What the…!!’

I continued, a little louder to make myself heard above the wind and the rain:

…for the leaping greenly spirits of trees..

And somebody shouted ‘yeh’, partly out of pity, perhaps, or to keep themselves warm during this ordeal. So I raised the decibel level a little more

and a blue true dream of sky..

A few more voices joined in with a ‘yeh’ response. By the time, I reached the end of the stanza, the crowd had turned the poem into a chant

..and for everything

which is natural which is infinite which is YES…

The following year I created our ‘Celtic-Navajo’ chant and we got a microphone and a speaker. Now, all these years later, this chant-blessing has become a central element of the celebration. And now also, even in the midst of all the excitement and anticipation that is generated before the race, when this part of the process is announced you could hear a pin drop. Into that amazing silence I try to spill a couple of thoughts as a way of drawing out the obvious. And then, the climax of the call-response of the chant explodes with the powerful energy of beautiful men, women and children (and a few dogs) released into the wonderful ritual that is the Leatherman’s Loop.

I say ‘beautiful’ men, women and children, because beauty is the core concept that underpins the chant and, for many, the entire event:

Beauty before me as I run
Beauty behind me as I run
Beauty below me as I run
Beauty above me as I run
Beauty beside me as I run
Beauty within me as I run.


I see beauty all around me:
In beauty may we walk.
In beauty may we see.
In beauty may we all be.

The thoughts that I offered this year were that life is really all about connecting. Whenever we connect – with anything or anyone – we see beauty: the beauty that is intrinsic to whomever or whatever we are able to be present to because of this connection. This, for me, is central, simple and profound: when we connect we see beauty. In our world today, because there is less and less real connection, we don’t see the beauty that is at the heart of everything and everyone, and so often we simply use and more often abuse each other and the world that gives us life.

I sense that we all know this, which is why I said that I try to offer a couple of thoughts that are obvious. They are especially obvious in this setting because people have gone to great lengths to be there. Registration is an expression of intent: the online lottery process in January fills to capacity in a couple of days. So we are all open to something special. And, of course, this expectation has only grown over the years as we experience the beauty that is there more obviously in special times like this Loop-rite-of-spring (even if the day is wet), when the first flowers have appeared and the trees have begun to bud, and the birds are gathered round to join in the celebration, and the peepers (tiny frogs) are keeping up their chorus in the background.

Yesterday, I said, that in the face of the increasing dis-connection that we experience in our everyday world, in all its forms – race, immigration, poverty, violence – we are drawn to the Loop, because the Loop connects us – or perhaps, more accurately, reconnects us – to the beauty in each other, the beauty in the earth-home we share, and the beauty in all the members of our earth family. It’s why we chant: ‘beauty before me…beauty behind me…’

This year the Loop coincided with Earth Day so, before the blessing/chant, I invited us to make this our Connecting Loop. Turn to the people around you, I said, and with a handshake or a hug say something like ‘beauty be with you…’ To be honest, I was a little apprehensive about adding this element, lest it seem too much like church and offend some. But, it was like setting fire to dry grass: all through the big crowd, there was an amazing rush of what I can only describe as ‘communion’. You could feel our collective identity move to another level of excitement and, I would be inclined to add, possibility. It was truly wonderful to behold: to see beauty ripple through the gathering like a wave on the sea.

I added that we could continue this generation of beauty by connecting with the members of our earth family as we ran through the trees and the rivers. And, I suggested, we could use this powerful experience afterwards, to inspire us to connect with our communities – our neighbors and our colleagues at work – and release, as it were, the same beauty. When we see the beauty that is in all of us, I concluded, we will heal the rifts and wounds and the abuses we inflict on ourselves and each other.

So off they went on their beauty pilgrimage. And, judging by the conversations Tony and I had afterwards with tired, muddy runners of all ages, beauty was indeed the energy and the experience. ‘It was like a mantra that kept me going..’ said one runner. ‘I experienced so much more in the run because of the blessing part..’ said another. One woman spoke of how the Loop touched something deep in her that she doesn’t experience anywhere else. An older man said that the two most important days of the year for him now were Christmas and the Leatherman’s Loop.

I don’t wish to exaggerate the experience or make it into something that it is not, for I do realize that my passion and my ever-developing work has been to draw out what is already, innately present in things. The Greek word poiesis reflects this process of making present what was not there before, or at least not in a clear or obvious way. In the medical world it refers to processes like the production of blood cells in the body: hematopoiesis. I wrote recently about my intention to explore what I called an ‘Everybody’s Spirituality’, by which I mean concepts and practices that would be relevant and accessible to our increasingly complex and disconnected world. Many of us have discarded the old spiritual concepts and practices we grew up with because they had ceased to be helpful in this way; many more – particularly in the Millennial generation – have never even experienced them. But, as events like the Leatherman’s Loop demonstrate, I believe, the need – indeed the hunger – for ways to address this (spiritual) dimension of life, remains.

Indeed, the Loop also demonstrates ways in which many are already doing this spontaneously. Whether it is running, cycling, hiking, or music, singing, dancing, or gardening, cooking, eating, or yoga, aerobics or tai chi, the central element is clearly coming together: connecting more deeply than we tend to do at work or even at home. My thought about an ‘everybody’s spirituality’, then, is little more than drawing out what is already there, even if not obvious, in the ordinary things of life. Clearly, there is much that can be drawn out of the Loop experience. In fact, it already has many of the elements of what good – in the sense of relevant or meaningful – spirituality is about: an experience of deeper levels of life; gatherings to share and celebrate this experience; reflections to draw out the meaning and implications of the experience; even an iconic figure who symbolizes the ideal; and so on…

I have a hunch that poiesis is what all the spiritual leaders were about, from Buddha to Jesus: what they described in terms of enlightenment or resurrection. Moreover, these leaders all seemed to suggest that this is something we can – should – all do for ourselves and with each other. The implication, of course, is that we have to do this in the world we live in today and avoid the tendency towards fundamentalism and exclusivity (which seems to be constitutive characteristics of our species). But perhaps that is the subject of another blog.

The heart of the Loop is connection, and it is in connection that we find – and cultivate – the underlying beauty that we knew one time as children and only glimpse occasionally, if at all, as we get older. Let me finish with the piece from ee cummings that was the awkward beginning of this ‘beauty’ dimension of the Loop:

how should tasting touching hearing seeing

breathing any – lifted from the no

of all nothing – human merely being

doubt unimaginable You?

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