In asymptomatic moderate to severe AR with normal LV function—long acting nifedipine.2. Instead, they describe drugs as ‘good’ or ‘terrible’, anindication of the total impact of their treatment and the impact that it has on well-being

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My phone was broken.  Well, actually the phone was fine, but the screen was shattered, so with no way to access the data inside, I took a trip to the Verizon store and got in line.

I stood behind a woman with two daughters:  the younger child was running about the room playing with a ball, and the other was confined to a wheelchair playing with her mother’s car keys.  I didn’t recognize the older child’s disability.  She couldn’t speak, but she was alert and focused on her play.  She held a key ring with a big metal butterfly, a thick electronic car key and a number of regular metal house keys.

We all waited a very long time.  At last the weary mother ahead of me was called to the tech counter, and I sat down on the bench she had occupied.  As I did, an amazing, humbling thing happened.  The older child turned her full attention to me and, in a very methodical way, began to teach me how to play with keys.

I could see her watching me to see if I would get it.   She showed me how to shake the keys and tap them on the metal of the chair to make sound.  “That’s an interesting sound,” I said.  But she wasn’t finished.  There were more games I needed to learn.  She tossed the keys onto the bench to see if she could get them to land just at the edge of her reach, but not so far away that she couldn’t retrieve them.  She showed me how to drop the keys down into the wheel spokes and then roll forward or backward to try to bring them back within reach before the keys fell to the floor.  She seemed to enjoy setting herself a challenge, introducing the element of risk—risk, because if the keys fell on the floor she would need someone else to intervene before the game could continue.

As buy isotretinoin online with mastercard we develop what is known as “theory of mind” by which we attribute intention to the actions of others.  We imagine other minds—what they are thinking, what they know, what they are trying to communicate to us.  It’s how we make sense of a world with other people in it.  It’s how we connect.

I don’t know what made that little girl look at me and risk reaching out.  Why should she think there was a mind in my body when surely many people had assumed there was no mind in hers?   Where did that confidence come from?  And what brought out the teacher in her?  What led her to show me something fun that she understood and I did not?   I was just a tired woman with a broken phone in a long line until a child who could not speak decided to teach me something new.

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So far as I know, my parents have never uttered a profanity or a vulgarity.  So far as I know, neither have my children.  Having never heard them use rough language I can only assume that they do not.  You should also note that I am not delusional.  Instead, these understandings represent the venerable tradition known as the Polite Fiction.

The polite fiction differs from its cousins the White Lie (“Do these pants make me look fat?”  “Heavens, no!”) and Hypocrisy (“The bank has your best interests at heart!”).  For, while the white lie protects someone and hypocrisy acts as a disguise, the polite fiction indicates respect.  It seeks first and foremost to be polite, and is distinct, therefore, from Don’t-Ask-Don’t-Tell which facilitates denial.

Generally speaking, the polite fiction (“All teachers at our school admire one another and the principal”) is suspected or known by all parties to be a fiction, but the statement’s veracity is never pressed.  It acts like the willing suspension of disbelief—allowing all to maintain the personae they have constructed for the purpose of social interaction.

There is a place in this world for the polite fiction, though the practice may seem a bit quaint—like handwritten letters on elegant stationery.  It can also seem like too much effort when we’d rather just be ourselves and let other people deal.  Still, politeness is never out of fashion, and sometimes we are happiest when we don’t reveal how well we know one another.

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The other day I accidentally bought whole bean coffee, which meant I then had to go buy a coffee grinder so I could enjoy my Starbucks at home.  I drove to my friendly neighborhood superstore and from the two available models selected the Mr. Coffee Coffee Grinder with Chamber  Maid ™.   This fabulous invention not only grinds coffee, it “quickly cleans coffee grounds from the walls, and its bowl-scraper ‘buy isotretinoin mexico‘ effectively dislodge coffee from the grinding area.”

It was after I got home and started opening the box that the cognitive dissonance started to set in. While I am happy that my post-coffee cleaning burdens are lightened by the presence of “bowl-scraper fingers,” why did they call this feature the “Chamber Maid?”   Okay sure, it cleans the grinding chamber—and you can call that little bowl a chamber if you want to.  But where can i buy isotretinoin for acne makes me think of French women in skimpy costumes (oo-la-la!) or of unpleasantries like chamber pots (pee-yew!).   Perhaps the oo-la-la image is meant to be a sort of pun on the whole idea of grinding (think “bane of school dance chaperones”), but I’m still not getting to coffee here in my brain.

And what about the gender thing?  Did I accidentally get the guys’ coffee grinder?  Does the ladies’ version come with a muscle-y grime fighter like Mr. Clean?  or a superhero like where can i get isotretinoin without a prescription with a furnace of psionic energy in his chest? (“Because we know you like your coffee HOT!”)  Sometimes the best minds of the advertising industry elude me.   They take you down a path and suddenly you look up and wonder, “How did I get here?!”   Maybe I’ll just think of the Chamber of Commerce—they usually have a pot of coffee going, don’t they?

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In my town, the Texas First State Bank flies a flag so huge that it’s a landmark.  It probably has more square footage than most of the apartments you’ve rented.  So when the bank took down that Texas flag  and replaced it with Old Glory, we knew it was time to get serious about the Fourth of July.  Our family headed on over to the city park for live music, funnel cakes, and fireworks.

Texas is good place to celebrate the Fourth.  In Texas you learn to be proud of your school, your state, and your country.   There is no one here too cool for a little flag waving on America’s Birthday–or any other day for that matter.  Besides, the Pay COD for isotretinoin without prescription are upon you, so don’t be giving less than your best.

When they heard I was moving, lots of people warned me that Texans are mighty proud of being Texans.  These people were right.  I’ve never seen any place where  people decorate their isotretinoin buy online with state symbols they way they do in Texas. At the grocery store, you are encouraged to buy products grown or made in the state with a Go Texan! sticker (contrast that with the less boisterous “Virginia’s Finest” or “Maryland’s Best.”) And here you can buy a Texas Edition Silverado, or a Lone Star Ram, whereas I can’t even imagine an Old Dominion F-150 or General Lee SUV.

Still, that famous Texas Pride is not always exactly what you’d expect.  The thing about Texas is that Texas—like California—is America, only more so.   It’s concentrated not diluted.   And while California is isotretinoin 20 mg without prescription, Texas is America at Work.  Texans are not afraid to step up to the plate, to lift heavy objects, to do what needs to be done.  Texans are raised to be leaders.  The message is “Be proud of Texas and make Texas proud of you.”

Maybe that’s why folks really like it here.  76 percent of the folks born in this where to buy isotretinoin state are still living here.  But, unlike the Californians with their “Welcome to California! Now go home”  bumper stickers, Texans will take you in too.  As Lyle Lovett says, ” can you buy isotretinoin in uk, but Texas wants you any way.”   When you get a driver’s license, they say you where is the best place to buy isotretinoin online.  Shoot, Stephen F. Austin and Sam Houston were both born in Virginia; they just ended up in a better place.

Texas takes some getting used to.  It’s a complicated reality.  Not for the shy.  As my husband reminds me, Texas looks to the rest of America the way America looks to the world:  a little too loud, a little too proud, a little too religious, and just a bit crazy.   And most of the people living here wouldn’t trade it for the world.

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This week I was summoned for jury duty.  The case itself wasn’t especially interesting—possession of .02 gram of cocaine in a seedy lounge where the prostitutes hang around out back and a body was found about a month ago.  The cop had one story, the defendant had another, but regardless, a parcel containing a controlled substance was found on the floor.

Though the crime wasn’t the stuff of TV drama, I found the process fascinating.  The control of information was constant, and it was one of the few places I have ever been where the subtext was consistently as loud as what was actually said.  I might as well have had two people speaking to me at once.

The day began with questioning of the jury panel–they call it Voir Dire–but  in this case there was as much teaching as questioning.  Like those “Guess-the-Magic-Word” classes we all remember, nothing was completely straightforward.  Simple explanations were followed by a question to see if you were paying attention:   “The law says that you must prove three things to convict.  Now if only two of those things are proved, how will you have to vote, guilty or not guilty?”   There were questions with extra information included so we would learn things that might move our sympathies:   “Does anyone know the defendent?  Do you know his friends or family sitting over there?  Does anyone know his three children?”  (Ahh, so he’s a father, not just a bad person.)  There were questions with a moral lesson attached:  “Drugs are a serious problem in our community.  Do you have any problem convicting someone who is in possession of an amount smaller than one gram?”

Then came the trial.  During a trial every question is “going somewhere.”  Everyone is trying to steer the bus with their words, and as I sat on the jury I felt I was watching to see where we would all be taken.  Sometimes there were surprises.  Sometimes the person who seemed to be driving lost control for a minute and the testimony took a turn and we wound up in an entirely unexpected section of town, so to speak.  You couldn’t listen without dissecting the spin.  No one could be trusted.  Everyone had an agenda.  “Why are you asking this question, in this way, at this time?  Why are you answering in this way?  What are you not saying and why?  What does it all mean?”

But if the process was fascinating it was also exhausting.  The endless parsing of communication was wearisome.  It played with your mind.  It was irritating.  We ended with a hung jury after a long day.

What a great relief to return to my normal everyday life:  to ask a simple question and have it answered without wondering what was not being said.    I’m glad we have this system of justice, but it is surely a strange way to look for truth.

There was one other thing that made the day a bit surreal.  The isotretinoin purchase overnight delivery is a cheap isotretinoin singapore, over a hundred years old and decorated with eagles, the Greek and Roman goddesses of justice,  and America’s Lady Liberty. Nothing unexpected there, but on the third floor the courtroom door pulls are all Tiki gods—just like the ones you would find on a Polynesian restaurant or Tiki bar.  Try as I might, I just can’t figure that out, but there has to be a story.   Maybe someday I’ll get a chance to ask the judge.

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This summer my daughter conquered her fear of roller coasters.  Two friends each grabbed hold of a cold, sweaty hand, and together the three of them walked onto the Steel Eel and rode it—twice.  It was terrifying.  It was exhilarating.  But after that her life was changed.  Several weeks later she went to another theme park and spent the entire day riding the rides.  And she loved it.

Now I have to admit, I hate roller coasters.  In fact, I pretty much hate any ride that involves a drop or the sensation of falling.  You may call it flying, but to me it always seems like falling—and that is Bad.   It’s a trick of mind that I can’t accomplish.  You have to believe in coasters to enjoy them. You have to believe that that the design is sound, that the technology will not fail, that the maintenance guy really did his job, and that the operator is paying attention.  If you cannot believe, then the ride becomes a nerve-wracking rush of possible failures narrowly averted by sheer good fortune or the grace of God.  You’re falling not flying, no matter what people tell you.   And when it comes to coasters, I simply can’t believe that it will be all right, much less an occasion for fun.

Sometimes I imagine that change feels this way to people who are afraid.  I thought about this while reading a recent review of Richard Holmes’ The Age of Wonder in isotretinoin purchase online uk. Lev Grossman, the reviewer, recounts this anecdote from the book:

The world’s first manned balloon flight took place on Nov. 21, 1783, in Paris. The balloon was blue and gold and 70 ft. (about 20 m) tall. It had no basket. You rode on a kind of circular balcony that hung around the balloon’s neck like a collar. This meant that there had to be two passengers, for balance, and they had to stay on opposite sides of the balloon at all times.  The two men in question were Jean-François Pilâtre de Rozier, a young doctor who was exactly as dashing as he sounds, and the Marquis d’Arlandes, an army major….

They couldn’t see each other because the balloon was between them, so they had to yell back and forth. As the giant aircraft careened wildly over the roofs of Paris and the two men frantically shoveled straw into the fire that kept it flying, the marquis became more and more hysterical. “We must land now!” he yelled. “We must land now!” Pilâtre stayed icy calm. “Look, d’Arlandes,” he said. “Here we are above Paris. There’s no possible danger for you. Are you taking this all in?” But the marquis couldn’t take it in. When a gust of wind jostled the balcony, he screamed, “What are you doing! Stop dancing!

Eventually, after 27 minutes aloft, they landed safely. D’Arlandes — according to his own account — threw himself out onto the grass. Pilâtre just stood there. “We had enough fuel to fly for an hour,” he said sadly.

“What are you doing! Stop dancing!”   I can understand how, when change is jostling you from side to side and everything seems to be rushing at you faster than you can possibly comprehend or control, a person might feel just like I do on a roller coaster:  falling, not flying.   Not having fun.  And a bit angry at the people who seem to think this is no big deal.

Navigating change probably also takes a kind of faith—in technology, in history, in the other people who are trying to get you on board,  in your own abilities to learn and cope.  Faith in the good things that change can bring.  Faith that ultimately it will be okay—maybe even fun.

Belief is a tricky thing to manage.  You can’t convince someone of the logic of faith.  You can’t make yourself believe.  Sometimes you’re not even sure exactly what to believe in.  You may look objectively at whatever evidence is present, but in the end you just have to jump in.  Maybe find a friend to take you by the hand.

Here we are above Paris…. Are you taking this all in?

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The other day as I was listening to isotretinoin online pharmacy, I learned of the death of nonprescription isotretinoin, a pioneer in the study of suicide and founder of one of the nation’s first suicide prevention centers.  Working at a time when the study of suicide was shunned, Schneidman believed that two simple questions — “Where do you hurt?” and “How may I help you?” – could begin to diffuse the impulse to self-destruction.

For me, Schneidman’s insight demonstrates a simple, but enormously powerful truth:   a question is a mysterious thing.  A question is a turn of language indicating an empty space, something unknown and desired.  It reaches out of the self to touch another person or thing—to unlock a door of isolation and pain, to see the past, to explore the present, to search for God.   Questions direct our inquiry, leading us forward like pathways through the underbrush.  Questions inspire us, provoke us, prod us to action.  They are tools, they are weapons, they are instruments of love.  Questions can make us believe that someone wants to know.

People think a great deal about how to phrase questions to facilitate the smooth and effective exchange of information.  How can we learn what we really want to know?  How can we get someone else to say what they really want to tell us?  How do we ask a good question?  A precise question?  An open-ended question?   A pointed question?

But the real mystery is the question itself.   Where does the question come from?  How does it work?  And can it bridge the space from me to you?