"An Angel in the book of life wrote down my baby's birth. And whispered as she closed the book "too beautiful for earth."

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Hello all! I just though I would send out an update! Thank you all for the sweet messages of concern and prayer. Please keep them coming as they are very needed these next few weeks especially! 


I started my Lupron shots on the 26th and other than the actual medicine stinging like crazy and a few crying spells, and an allergic reaction on my arms, I haven't noticed any side effects (lol, I love to be complicated).  I will do my best to explain what the meds do since I have people ask me constantly. Lupron in a nutshell causes a "flare effect". The flare effect of Lupron can be used at the beginning of a fresh IVF cycle to help stimulate the development and maturation of eggs. Lupron is given for a few days and then injectable fertility medications are started.  It essentially acts by suppressing the pituitary gland (the gland which is normally responsible for triggering ovulation). However, before suppression occurs, Lupron will briefly stimulate the pituitary causing an increase in the pituitary hormones LH (luteinizing hormone) and FSH (follicle stimulating hormone).

Two days later I started Gonal F injections. Gonal FSH increases the number of growing follicles and stimulates their development. Within the follicles are the developing eggs. FSH also increases the production of oestrogen, and under the influence of this hormone, the largest follicle continues to develop. This medicine is used to stimulate the development of follicles and eggs in women who are having difficulties getting pregnant due to problems with ovulation. 

So the side effects of both of these are:

• Pain, bruising and inflammation at the injection site in men and women.
• Headache in women.
• Ovarian cysts

• Mild to moderate over-stimulation of the ovaries (ovarian hyper stimulation), causing the production of many eggs.
• Disturbances of the gut, such as nausea, vomiting, diarrhoea, abdominal cramps and bloating in women.
• Breast enlargement, weight gain, acne and swelling of the veins in the scrotum in men.

I am experiencing every one of them except the scrotal swelling which if Steven doesn't play his cards right...he may experience! (lololol! crack myself up again).
I have this entire week off which is a God send because I am going to need a lot of sleep I do believe. 
Please pray for me this week. As if the hormones are not atrocious enough, this would have been my week to deliver nugget #1! November 6 would have been my first babies due date (at least by my calculations) and anybody that has ever had a miscarriage knows, a mommy never forgets that date. I cannot dwell on the past, however I do feel like that baby deserves some remembrance and I won't ever stop thinking about it! It was my only "first child"! Hopefully I'll be adding a sister or brother to the mix here shortly! 
Enough about that (sniff, sniff)...I go back to the doctor to see my new babies again this Friday. At that point they will assess how the medicines are working and at what stage the eggs are in order to plan their retrieval. November 10 is the tentative date for removing those bad boys. They will put me to sleep and use a very large needle to poke through my uterus and into my ovaries and get each individual egg out of it's nest! How cool is that?! Then we will put them together with Steven contribution to the process, and wait..... 
Somewhere around November 13-15 they will take the good embryos and implant the two best ones back in and WAIT...
All of this is assuming they have enough eggs to harvest and that they survive this process. I am praying and believing that I will produce more than enough and that they will be exceptionally gorgeous! (ha)At this point, if they are ugly PLEASE DON'T TELL ME! I will dress them cute anyway.
Many prayers needed for my health, sanity and marriage over the next month please! 
Here is a sweet reminder of my first angel that I won't ever forget! XOXO sweet fetus!


                       Nothing will ever out do this I don't believe! 
Have a great week!

Raise hell, Your mamma did!

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This sucks! It just totally sucks. No joke! My infertility highlights the fact that seemingly every other woman in the world is pregnant. Kinda like when you buy a car, you never notice how many of them are on the road until you drive one!  It often seems to me that every thing, every comment, seems to draw attention to my infertility and conspire to make me feel inadequate and a failure. No matter how much I try, I begin to take things personally. Feeling like a less than anything but normal is hard.Reading articles that emphasize the bond between mother and child and even see that freaking Kim Kardashian is pregnant only serve to accomplish one thing in my life: they make me feel that my circumstances have condemned to be less than ideal. No matter what I do, I can never have a full life, and that I can never fulfill the requirements of an ordinary wife and woman.  They scream to me that I should just suck it up and know that I may never know true love and true bonding, that no matter how hard I try. The thought that I will never measure up and never feel this love is devastating at very least!While these thoughts run over and over in my head, I make a conscious effort to remember that I don't have to reconcile myself to this destiny. Even writing this I have to hold back the lump in my throat and push away the "control freak" in me that wants to DO SOMETHING...ANYTHING! Again last week I had another miscarriage. I didn't go to the doctor and I won't ever know if that is truly what happened, however I know in my heart that it was. Same circumstances as the last time. Only this time, I am much more numb. My expectations are so much less. If it's possible, I am becoming much more crass to the loss of life, and potential life. What a horrible feeling. Well my lack of fertility is based on a world view, not based on what I know, but based on my circumstances. My dad always says "spiritual things can only be caught and understood my spirit. They cannot be explained or understood with natural minds". My circumstances are surreptitious and can influence even my best-intentioned Christian thoughts.  What makes it so seductive is how transparent it seems on the surface.  After all, what can be more pure than motherhood?  What can be more perfect than the bond between a woman and a child? It’s an illusion, a distraction, from the ultimate truth.  It’s Satan’s subtle way of saying, It’s a beautiful feeling, so it must be right.  By focusing my thoughts on childbearing as the ultimate and ideal , the true Ultimate and Ideal is overshadowed: God. My circumstances place childbearing above my knowledge that my creator wants good things for me. That my earthly father wants me to have a baby, why wouldn't God want that?Even in our modern society the idea stands that motherhood is the highest calling of women.  While I agree that being a mother cannot be paralleled in any since, the ultimate reason for my existence was not to be a mother. For those of us who are precluded from the fulfillment of motherhood, the lie serves as sharp and bitter sword that separates us from finding our true worth and purpose as women and as human beings. This in and of itself is almost impossible to bare. I have to remind myself, when my circumstances tell me that I’m less than the ideal expression of womanhood, that God tells me that that I am the ultimate expression of Him! He had a reason that He created me, it was to have relationship with Him.  That the ideal expression of my person hood, above all, is to be Christ’s ambassador on this earth, to be like Christ. This is the reason that this mission trip is so important to me. I finally, after three long years am coming to grips with the ultimate lesson in this "journey"! Again I will say, my reasons for wanting a baby are so polar opposite than they were three years ago that it baffles me to think what kind of mother I would have made back then! (Not that I have it all together now, clearly that is the understatement of the decade)By no means am I trying to understate the importance of being a mother. It is after all what I desire the most in life. Hopefully I have not offended anyone with this blog. I want to give credit where credit is due. No ONE could ever take the place of a mother. It is truly the hardest job you could ever love. My point is not at all to disregard or minimize that, only to point out that being a mother isn't going to "complete me" (thank you Tom Cruise! if i didn't want to hit him then, the couch thing did me in...freak). That being said, I am so excited to go and find my true calling and hopefully fulfill the desires in my heart. I realize that a week long trip won't take the insatiable need for a baby away. However I know it will further change me, and Steven for the better! While my aspiration is to change the world I am counting on the world to change me!!!I couldn't resist this! It's so me! In my old life I used to say "Raise hell, your mamma did"! And she did. I intend on being a "Hell raiser"! lol. God is my Ideal and my Ultimate.




Acts 20: 24  

But I do not account my life of any value nor as precious to myself, if only I may finish my course and the ministry that I received from the Lord Jesus, to testify to the gospel of the grace of God.**My friends Gene and Bronwyn Dougherty have started an apparel company called Only Happy in the Sun or OHITS! I have included a link to their site! For every tee shirt sold they will donate 5 dollars for our missions trip! Go over and check out their adorable tees and hats!**http://www.ohitsapparel.com or follow the link on my page!http://amazon-mission.org/
donate tab and add Jessica and Steven Elliott to the paypal note! 

Thanks again! =)

Top 5 Things You Can Do With an Associate's Degree

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You may think that an associate's degree can't open up as many doors for you as a bachelor's degree.



Think again.



Truth be told, there's a lot you can do with an associate's degree these days. It can a faster, less expensive way to start a one of 2010's top careers, start a rewarding vocational career, or work towards a four-year degree.



Here are our 5 favorite things an associate's degree can do for you:



1. Start a Vocational Career
If you don't want to spend your weekdays locked in a cubicle, there are a lot of fantastic, high-paying vocational careers out there for you to explore. From cosmetology careers to automotive careers, these options can help you to turn your favorite hobby into a paycheck.



To start these careers, you'll need highly-specialized skills. That's where the associate's degree comes in. Many community, junior and technical colleges offer associate's degrees for a variety of vocational careers, which provide the skills and technical know-how you need to get started.



That means the minute you have your degree in hand, you'll be ready to join the workforce. No unpaid internships required.



2. Start a Career You Can Advance In
Who doesn't want a career that you can start fast, advance in, and make a good paycheck? Associate's degrees are often the keys that can unlock these kinds of career options.



Take nursing, for example. You can become a registered nurse by earning your Associate's of Science in Nursing. In approximately two years, this degree will have you working in a hospital, treating patients and helping doctors.



While you're working as an RN, you can take the next steps by earning a Bachelor's of Science in Nursing online. This will give you more career options, and the chance to eventually earn a Master's of Science in Nursing (MSN). The MSN allows you to become a nurse practitioner and enter a whole range of specialties, some of which pay a higher salary than a doctor's.



And it all starts with the associate's degree.



3. Work Towards a Bachelor's Degree
If you want a bachelor's degree, or know you'll need one to eventually advance in your career, but can't commit to a four-year program just yet, an associate's degree is a great place to start.



The associate's degree will allow you to complete your prerequisites and preliminary coursework, many of which will count towards a four-year bachelor's degree program when you're ready to enroll.



(An added bonus: associate's programs tend to be less expensive per credit hour than bachelor's programs, which will allow you to save some serious cash on your first two years of school.)



4. Make a Career Change
Let's say you're already working on a particular career path. One day, you wake up and realize you hate your job and what you really want to do is start a cupcake delivery business. (When you do, feel free to put the myFootpath corporate office address on your delivery route. Thanks.)



But while you need to get some business classes under your belt, you already have a bachelor's degree in accounting, and you don't want to start another four-year program. So what are you to do?



Enter the associate's degree. A specialized associate's degree can build on the education you already have, and provide the knowledge you need to make that career change.



5. Start One of Today's Best Careers
You don't need a PhD in rocket science to land one of today's top careers. These days, an associate's degree is the key to entering one of the 2010 top careers, including veterinary technician careers, dental hygienist careers, physical therapist assistant careers, and more

Just a 'Lil' Encouragement 3 - Strength

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Video Request: What's in my nursing bag?

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Get Competent for Journalism Work opportunities in London - Professions - Recruitment

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Who would not want to land a job in London? It offers of the world's most appropriate excellent of dwelling, plenty of career chances, and superb employment environments. With all these and even more to present, you'll find it no surprise that acquiring a job in London is on top rated of nearly every jobseeker's priority checklist.

Journalism is a exceedingly competitive subject in London and a person of the most interesting as properly. If you have a passion for to collect useful data, analyzing and reporting them and disseminating them to the common manifeste, then a journalism career is for you. Journalism work opportunities in London are in demand as media businesses and publishing properties are always on the lookout for new journalists.

Journalism work opportunities in London vary but the most well liked consist of working in a newspaper or broadcasting station. Entry degree positions for new graduates are available in the market in these job sectors. Once you've got obtained go through or had taken advance classes in journalism, you can land considerably better work opportunities as a reporter, commentator, sports and weathercaster, and anchor. Other people grow to be information writers, columnists, and correspondents.

Educational Specifications

Journalists will need to possess exemplary education and ability in the English language. They have to be proficient in both equally drafted and oral communication. As these types of, they will need to have a diploma in English or Journalism and acquire classes in record, sociology, political science, economics, and other associated spots. Other people who pursued a assorted diploma can acquire advance classes in journalism from respected universities or exercise facilities.

Apart from the academic demands, journalism work opportunities also will need ability in the fields of photography, term processing, and desktop publishing. Meanwhile, there are also master's and Ph.D. systems in journalism featured by academic institutions. They are ideally suited for journalists attempting to get specialist improvement and want to land higher caliber journalism work opportunities in London and internationally.

Relevant Experience

If you utilized to publish for your school's paper or employment in your school's regional radio or Television station, you have considerably better probabilities of acquiring hired. The majority of employers favor people who currently have go through in the subject of journalism due to the fact they currently possess the primary background associated to the job even if they are only new graduates.

Expectations

Journalism work opportunities are not as uncomplicated as they start looking. As a issue of reality, they are a person of the hazardous work opportunities approximately. Not all journalists employment in the business office composing stories and content pieces or anchoring the most up-to-date information. Some of them have to possibility their lives by covering worthwhile gatherings like war, political rallies, peace negotiations, hearth, and even crimes.

Meanwhile, you happen to be anticipated to employment late nights and even while in weekends. You also will want to deal with a whole lot of pressure due to the fact there are instances when you have to go over stories as they transpire or publish press releases in an instant.

There's a exceedingly constructive outlook for journalism work opportunities in London. Inspite of the arrival of technological innovation, a great number of nevertheless like studying printed components like newspapers and publications. Vast majority of the populace are nevertheless watching tv especially in updating themselves with regard to information and present gatherings. This is why a great number of media and publishing businesses are nevertheless in London irrespective of the economic situations that affected the total world.

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Know The Best Way On Make Money On-line - Business - Business Ideas

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Working from home has claimed an area from the new trends of everyday living with a lot more individuals interested in it. The better they were into it greater they'll profit. These individuals would be the versions, that's created desire and has now researched read more about the ways of how to earn money on line has provided the thought of executing freelancing performs to generate income. This is a vogue announcing they are a freelance worker which is making money from the. They can't commit anything but obtain a unwanted fat repay.

The internet efforts are of number and can not be stated because very best should there be particular specifics that they can will need preference from lots more people. But they might be stated appropriately to give the new man or women who would like to know how to earn money online and provide a most effective way of picking the best profession that fits them.

These efforts are brand new show sustained but this doesn't suggest that these bankruptcies are not that much suitable sufficient to handle essential income wants for yourself. The first one is definitely the freelancing fat loss persons like to do them mainly the kids who've additional information in all the regions and are generally efficient at way with words-at all.

The next essential one happens when you own a website give additional adverts upon them and earn an excellent profit outside of individuals adverts. Then you can definitely carry out the affiliate marketing online and also the ways of increasing the recommendations for promotion together with the essential competencies you require preparation your marketing plan.

Freelancing efforts are merely performs which most of the corporations use outside agencies for with regards to profit as they do not will need long-lasting organisations for these particular requirements on it's own. While they have the joy of becoming accustomed to the practice of the freelancing many people like doing its job the self employed.These careers have no sort of contract in any respect the job may very well be. These careers predominantly are similar to article writing, content articles writing, website making, pr release writing, details entrance careers, and many others, which are simpler to use just internet and some desire.

The free-lance efforts are best way to give your skills while using the dialect and knowledge about the present-day problems and to generate money from them. These are the most effective way of income at home because they're the choices to who doesn't like promotion and business.

They might require lots of endurance look previous to writing content or web content and they're going to also assist you to uncover more points by internet. These free-lance efforts are the best goal from the scores on how to earn money on line options all over the web.

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Make money on the net ? news you need to use - Finance - PersonalFinance

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On-line job is having very famous full-time work opportunities. One particular obtains to be able to function starting from house and easy. Anybody of all age groups class will find on-line work opportunities, over common work opportunities. Net isn't any extra a spot of enjoyment only. Persons of the hundred years have selected familiarity with how to use the world-wide-web for other intent and earn money on-line. Any person doesn't need to position significantly work to discover employment, which suits their educative and professional backdrop completely. If you can submit an application your cleverness completely and opt for the right career, you need to use world-wide-web to be a income generating technology.

Uncomplicated process: If you are searching for a fun way to generate income on-line or researching how earn money on-line with virtually no the fear of hoaxes, in which case you must try this simple process. While searching on-line, you will find quite a few mini career- web pages. Go with a well-known website and checklist the jobs within your inclination, which you wish to do in the market host to that particular website. Potential customers scan these formal internet sites so they can employ the ready man or women to do the work regarding the clientele to be a short-term or article writing career. A lot of the on-line clientele possess the track record to pay in time as a result of on-line cost procedure like pay pal. Nothing else option is as eye-catching and rewarding simply because this to generate large quantities, utilizing world-wide-web.

Blogging: Blogging is easily the most favored way to generate income on-line. Here we will explore in a nutshell what blogging and site-building is and earn money on-line in this way career. Blogging would be the only on-line career, which brings in more money in return of fewer work. There are plenty of alternatives to generate income from a web site and produce on-line. If you are planning to generate income on-line by using blogging and site-building, don't go with sites that allow free of charge blogging and site-building. Generally go with the compensated web pages, which can provide quite a few blogging and site-building screenplays (Phrase click one example is) inside the client's cp.

Once you setup the website, the next step practices with getting started with a Ad-sense. You will get quite a few Web addresses, which provide a choice to try to get a regular membership. To acheive accepted, your web site must comprise high quality written content and educational written content. Once you grow written content, the next thing you could do is that you simply work hard to develop website traffic for your site. Without correct website traffic, your member's program is not going to remain good for many years. When investing in the recognition, paste the limitations inside the sites to get started on gaining on the website traffic.

Support companies: This is yet another good solution to generate income on-line. If you want to study the procedure earn money on-line by carrying out live answering services company work opportunities, it is essential to opt for the organizations who offer instruction skills on this type of work opportunities.

A lot of the on-line job is component-time work opportunities, that happen to be either entertaining and money producing in addition. So, appreciate performing and gaining by deciding on the best career.

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Tips On How To Study Online Trading within 1 week - Finance

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Ever thought how folk have had the oppertunity to maximize the inventory marketplaces making destroying from the results for their ventures with simply a press of the computer mouse button? Will you be Environmentally friendly with are jealous of simply because you might be Environmentally friendly to online trading and have not been creating your money be good enough? What if another person emerged your choice and stated that you can also make money as with any the traders and traders you've heard a lot about (and perhaps even been green with envy of), and you can be able to do so within 1 week? Sounds also superior really was, don't you think?

The simple truth is, now and again, it likely is. Especially if these are suggesting that you pay back excessive volumes for instructions you could in all probability obtain totally free on the net. Of course, as long as they state they are this sort of industry experts on being profitable through dealing and are generally previously allegedly making a destroying around the marketplaces, why the requirement to ask for for fundamental information? Much better inside of reason behind industry experts with the deal to ask for a tiny payment for innovative instructions, you could find out the fundamental information sufficient to begin with your web dealing employment by web looking for the appropriate facts. The truth that you might be reading this report reveals that you might have previously consumed the first step in beginning your web dealing employment.

Just one terrific rule in learning online trading would be to begin small. You shouldn't be lured by individuals that are betting their homes with a deal. If you're at ease sufficient to get started on dealing straight away, do smaller investments 1st. The advantage of starting off smaller is the fact with web dealing, there isn't a purchase or sell sequence that may be not big enough. So if you've got the some capital but don't have the self-confidence of a big deal, take care of the tiny investments as education for on your own just before shifting on larger investments. Of course, you will need to be able to wander before you can be able to run.

Obtained close friends while in the deal? Fantastic. Grow from them, do what they are carrying out on the market, darkness them. With that you can be exposed to loads of information to help you with your quest to understand. Supply graphs, performance signs, shifting earnings, cracking open selling price, concluding selling price, everywhere deal price ranges these are just some of the terminologies you have to get informed about, and what better way than 1st-give encounter? Also, by following their every move what others can be carrying out, you are free to understand deal techniques that other individuals have experienced success or have achieved disappointments with. Having said that, bearing that at heart, it is quite probable pertaining to a reduction just as easily as you've made a cash in on darkness dealing, especially if you do not know your work. So if you're only starting, maintain the 1st rule at heart when beginning darkness dealing: begin small.

If you're entirely not comfortable with facing potential losses at this time, and will want to have just about every dime of your dollars function confidently for yourself, then you should try to attend at simulators dealing. Similar to darkness dealing, you are always dealing and learning the ropes the only real difference is the fact no real money is involved. All you might be carrying out is following their every move the market industry by online trading, and you will then still get all the enthusiasm of the actual deal, but it might be just a simulators. No losses, no obtain. Just one advantage of simulators dealing is that you will have gain access to (whole or minimal, depending on your origin) to a range of online trading plans, software you will want to get to know just before starting a actual deal.

Of course there are other approaches ways to understand online trading within 1 week, and all you have to do is find them on the net the way you identified this post. But remember that while you are free to understand the basic principles of online trading within 1 week, online trading is actually a continual process of do-it-yourself-knowledge, since good results will depend on how good-advised looking the market industry.

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Is Very early Retirement life A Fantasy? - Professions

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When living or doing the job conditions turn out to be difficult, some people fantasise about earlier pension as some sort of get away from. Earlier pension can be a reality in case you have taken actions early on to ready for this. If you have the understanding as well as self-control to get absent benefits from a occupation revenue and spent them correctly, maybe you take a position a good chance to try and do whatever you want to do every time you want to do it. For individuals that delight in their job, compulsory requirement to retire in the specific time is probably not anticipated. They worry the morning every time they will surely have to cease visiting function in a normal plan, fraternizing because of their colleagues and essentially preserving on their own completely filled. An additional group are satisfied because of their former living period as staff members and enjoy moving on their next phase of pension. In conclusion, people take to pension differently.

A small section of folks get going because of their pension from them first payroll check. Quite a few individuals do not get going for pension right up until it is a very little already happening. Individuals that began earlier with protecting and investing for pension, usually can enjoy relaxed pension. If you're unprepared, they will make it through their pension outside of pure luck - monetary gift from dad and mom with kicked the bucket or funds from an insurance agreed payment as a consequence of earlier dying of your respective significant other. For everyone in addition who is unprepared, living is going to be fairly tough in their pension. They'll have to drastically restriction their selections with regard to quality of overnight accommodation, activities like vacation and potentially even the sort of food items absorbed.

Usually Do Not Dream Of Your Pension Get Ready For It

If you wish to benefit from the freedom to try and do what you wish upon your pension, you should plan it by protecting and investing correctly in line with economic approach. You could want to get out of bed if you wish. You should spend more time with your neighbors and friends. Choices time using your grand kids watching them develop. You would like to are employed in your garden or take very long sleeps. You could make amends for your chosen Television programs or shows. The fact is, your pleasurable options are countless. The important thing proviso is basically that you contain the financial indicates for this. So applied a pension approach early.

There are numerous who worry pension, given that they neglect the experience of get when they were young from occupation. They don't have any certain passions or likes and dislikes. They might not make friends easily. They merely do not can deal with on their own with all the current time they have got from pension. A number of them will take on an additional employment post-pension. A job that may not demand from customers considerably with regard to skills or actual strength. This type of person pleased to figure after they can and don't enjoy their pension.

Pension Attempts Are Increasingly Becoming Available

The difficulty of pension work may seem really strange to many, but the fact is that not everyone is able to manage to retire. In developed countries, the 2 main problems with a getting smaller population as a result of less little ones getting created and a growing old population lifestyle in the evening former life-time rates means retired persons who want work generally find them. Considering that lots more people can get to reside in longer, they need to acquire this extended endurance in pension financial organizing. For a lot of insect activity . very little already happening, so they will grudgingly have got to contemplate doing the job longer. Quite a few health systems all over the world happen to be methodically elevating the required retirement throughout the last few decades.

Chances For Pension Jobs In Asking

Quite a few experts currently can get new careers in pension by offering their services as experts while in the job areas in which they have expertise and from where they retired. This makes it possible for relax in the employees without worrying about difficulties of day by day employment requires. Most will work with a in your free time foundation and the like will work as building contractors, doing the job only when there is function, abandoning plenty of time for passions as well as other likes and dislikes.

Those people fortunate enough to have money-making piece-time visiting pension work contain the high-class of doing the job completely abbreviated intervals during a period, while the pliability to spend the rest of their time on other stuff like passions and interpersonal support. Quite a few retired persons who elect to function often accomplish that by using a robust function mentality. Organizations may gain advantage substantially from presenting these charged-up, determined and effective retired persons.

There's a excellent period of pension work designed for the retiree who is seeking ideal function. Some may be simple and undemanding are employed at stores like takeaway food joints and coffee shops, bookstores to substantial-end consultancy jobs. If pension work give retired persons some a feeling of reason along with other tangible added benefits, then modern society as a whole added benefits way too. Country's well being solutions do not always be above-mired.

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Video Request: What's in my nursing bag?

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Top 5 Things You Can Do With an Associate's Degree

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You may think that an associate's degree can't open up as many doors for you as a bachelor's degree.



Think again.



Truth be told, there's a lot you can do with an associate's degree these days. It can a faster, less expensive way to start a one of 2010's top careers, start a rewarding vocational career, or work towards a four-year degree.



Here are our 5 favorite things an associate's degree can do for you:



1. Start a Vocational Career
If you don't want to spend your weekdays locked in a cubicle, there are a lot of fantastic, high-paying vocational careers out there for you to explore. From cosmetology careers to automotive careers, these options can help you to turn your favorite hobby into a paycheck.



To start these careers, you'll need highly-specialized skills. That's where the associate's degree comes in. Many community, junior and technical colleges offer associate's degrees for a variety of vocational careers, which provide the skills and technical know-how you need to get started.



That means the minute you have your degree in hand, you'll be ready to join the workforce. No unpaid internships required.



2. Start a Career You Can Advance In
Who doesn't want a career that you can start fast, advance in, and make a good paycheck? Associate's degrees are often the keys that can unlock these kinds of career options.



Take nursing, for example. You can become a registered nurse by earning your Associate's of Science in Nursing. In approximately two years, this degree will have you working in a hospital, treating patients and helping doctors.



While you're working as an RN, you can take the next steps by earning a Bachelor's of Science in Nursing online. This will give you more career options, and the chance to eventually earn a Master's of Science in Nursing (MSN). The MSN allows you to become a nurse practitioner and enter a whole range of specialties, some of which pay a higher salary than a doctor's.



And it all starts with the associate's degree.



3. Work Towards a Bachelor's Degree
If you want a bachelor's degree, or know you'll need one to eventually advance in your career, but can't commit to a four-year program just yet, an associate's degree is a great place to start.



The associate's degree will allow you to complete your prerequisites and preliminary coursework, many of which will count towards a four-year bachelor's degree program when you're ready to enroll.



(An added bonus: associate's programs tend to be less expensive per credit hour than bachelor's programs, which will allow you to save some serious cash on your first two years of school.)



4. Make a Career Change
Let's say you're already working on a particular career path. One day, you wake up and realize you hate your job and what you really want to do is start a cupcake delivery business. (When you do, feel free to put the myFootpath corporate office address on your delivery route. Thanks.)



But while you need to get some business classes under your belt, you already have a bachelor's degree in accounting, and you don't want to start another four-year program. So what are you to do?



Enter the associate's degree. A specialized associate's degree can build on the education you already have, and provide the knowledge you need to make that career change.



5. Start One of Today's Best Careers
You don't need a PhD in rocket science to land one of today's top careers. These days, an associate's degree is the key to entering one of the 2010 top careers, including veterinary technician careers, dental hygienist careers, physical therapist assistant careers, and more

Changing Perceptions: Clozapine no longer a 'last resort'

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(Original Post Date: December 7, 2009)
A thanks to one of my wonderful students, for sending along this article about Clozapine. http://www.currentpsychiatry.com/article_pages.asp?AID=8165 We actually just attend the Yale Master Psychopharmacology conference last week, where the speaker on Advances in Schizophrenia, Dr. Cyril D’Souza, was quite clear in his preference to see patients treated with Clozapine. Interesting to see this publicized in this way, given the initial introduction of this drug with such care. When introduced, it was suggested as the drug for those treatment resistant patients, with I believe the understanding that those not responding to other agents might find benefit in the drug vs. the risk of potentially life threatening agranulocytosis. This was later widened to include those with schizophrenia or schizoaffective disorder who were a suicide risk. Use of the drug has led to individuals being treated with clozapine while closely scrutinized for the development of life-threatening side effects. More recent studies have suggested clozapine has antiaggressive properties(per Krakowski et al, 2006) and offers superior symptom management (per CATIE results).This article suggests thinking more broadly about the use of clozapine, given studies showing its efficacy. As I translate the idea: rather than thinking of it as a 'last resort', we should consider it a ‘second choice’ after a first trial of antipsychotic medication is not effective. It seems to me that clozapine needs a new marketing strategy. Although we should expect that if we begin to use clozapine in a larger proportion of the population we will see its side effect, agranulocytosis, occurring in greater numbers (i.e. it will have the same frequency, but if more of your patients are taking it, the likelihood you will see a case of agranulocytosis will increase.) Whenever we do prescribe clozapine, we must carefully attend to the potential it has for this side effect, and be sure that we monitor individuals closely.
Posted by Joanne at 12:57 PM

And thanks also for the comment, which shows your use of this clinical information!

Joanne, I wanted to share a recent and ongoing clinical case (without going into too much detail) that I have been a part of at my current clinical site in a forensic setting. The article that I forwarded to you I had also forwarded to my clinical preceptor, a psychiatrist. Not more than a week or two after this conference and stumbling upon this article did it come to our attention that one of the inmates, had presented a couple of months ago in the midst of an acute psychotic episode. It is likely paranoid schizophrenia but with a mood component thus our differentials of adding a bipolar diagnosis per history or leaning towards schizoaffective. This inmate, prior to arrival, had been misdiagnosed with mood and anxiety disorders only (as far as we could gather from collateral sources). Nonetheless, we started slowly titrating up on Risperdal. First 1mg BID and so on up to 6mg according to response; we also concurrently followed the antipsychotic with adequate amounts of Cogentin, Amantadine and even some Klonopin to aide with anxiety as well as hoping to prevent and treat some already apparent EPS. Along with this titration we slowly introduced Depakote as well to stabilize mood. As we responded to symptoms with the Risperdal increases, the psychosis almost completely cleared. The turn around was rapid and the medications effective. BUT, of course this was too good to be true and by this time EPS and Parkinsonian symptoms had become too much to bear. The inmate was at times unable to eat or take pills because of shaking so badly. We had of course had “the benefits outweigh the risks” talk prior to administering the medication, but it was at this point that we attempted to back off several of the meds. We switched from Risperdal to Abilify to see if this might help decrease the EPS, but no changes were noted. It struck me as we were sitting pondering this difficult case, "Why not Clozaril!?" With its very good side effect profile (except of course the life-threatening agranulocytosis, ha) it would give the antipsychotic and even mood stabilizing properties without the same high risk for EPS. At first my preceptor and the nurses were very hesitant and questioned this high-risk medication yet soon at least my preceptor was on board and telling me the more consideration, the more sure it might work very well for this particular patient. We began a titration down off all meds and did basically a washout (in the safety of an inpatient setting) while keeping low-dose Klonopin onboard. So, the current status is that some Parkinsonian symptoms seemed to have decreased but the resting tremor remains. We are weekly monitoring WBC levels (for agranulocytosis as Joanne mentioned) and titrating the dose up. So far so good! I’ll try and update to let you all know how things are progressing…..Thanks again Joanne for posting on this topic, it’s really interesting as well as clinically applicable. ☺ (Comment Date: January 13, 2010)

My Thoughts on 'Anti-Energy' Drinks

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Let me be perfectly clear: I am not an expert on nutrition, nor do I research these agents or drinks. I do have an opinion though, which I shared on my blogs Wednesday and I will share today.

I was asked by someone if I knew anything about the effects of anti-energy drinks such as Drank, which just recently started being sold in Connecticut. The product contains three main ingredients: valerian root, rose hips and melatonin. Part of the question was if there was evidence of an effect of these ingredients on stress relief and/or relaxation. In addition I was asked if I know anything about the three main ingredients. I do not have special knowledge to answer these questions with, they are not my areas of study. They are excellent questions!

I do think this is an interesting twist on the use of nutrients and other agents in beverages. In fact I have not researched energy drinks to any great degree, except to look up some of the ingredients. I just have a long standing concern: people think just because something is a ‘natural’ substance (herb or vitamin or mineral) it is ok to take it however they wish. I also don’t think people understand the lack of protections we have, given the lack of required evidence of safety to put products like these on the market. People may also think because it is on the store shelf it must be safe.

Unfortunately the websites available about drinks of these kinds do not have specifics about the amounts of each ingredient. They do not identify specifically the labelling with nutritional information (at least that I could find on the website for Drank). I'll have to go to the store and see what the label says. Despite the ingredients mystery, they are very direct in suggesting this is a fun new way to relax though.

I do not know off-hand of the safety of the ‘anti-energy’ drinks. My concerns about safety would be similar to those of all energy or 'nutritional' drinks. Whenever we begin to use agents in food or beverage that are commonly consumed at meals or other times, we have to wonder about the effects of exposure (i.e. how many of these drinks might you drink in a day? What is the dose of the substance you get over the day?). Is it like water and you can drink as much as you want?. Over long periods of time and with penetration of these products in the marketplace there is increased population exposure. Because they are foods/drinks they are differently regulated. How many people do you know that would take 3 pills a day (valerian, rose hips and melatonin) without considering the safety? Drinking them seems to make them appear safe to people. That is my concern. What if they are on other medication? Could they interact and cause negative effects? Do they check with their health practitioner to be sure it won’t cause a problem?

The other concern is we may have studies of a substance like melatonin for example and consider it safe for some use in some dose, but are there potential interactions between the three substances in this particular drink? Also where is the long term evidence of safety of these substances (individually and combined) in such a common food/drink source? An absence of evidence does not equal an absence of negative effect. It just means we haven’t studied it in this way.

I suspect ‘anti-energy’ drinks will be popular in the marketplace… It makes you wonder whether people will be pumping up on energy drinks all day and then trying to settle down with the anti-energy drinks in the evening. I am sure the beverage industry is very excited about all this… It is like they are the new but unregulated pharma – without having to shoulder the costs of safety research and clinical trials.

I am sure I told you more than you are really interested in. I am not the ‘expert’ on these ingredients. There are many people I am sure who have much more knowledge than I do about these ingredients. (actually you might look at the medline plus search info for supplements from the national library of medicine, if you haven’t already found it). Here is the link to info about melatonin: http://www.nlm.nih.gov/medlineplus/druginfo/natural/patient-melatonin.html I would consider medline plus a trustworthy source of data on ingredients like this.

Of course as Mental Health Clinicians, we should also be inquiring about beverages like this, particularly given the lack of knowledge of amount of ingredient in each drink and that if one doesn't settle me down, maybe I will need a few... Something new to consider in our assessments.

50 worker's lives at risk: The Fukushima 50

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I saw the wife and small child of one of the nuclear power plant workers on the morning news today.  I can only imagine the fears and anxiety associated with having a loved one in this situation.  I am sure many share the same feelings I do in terms of the courage and bravery of these workers, who are daily putting their lives at risk to prevent even greater disaster than has already been experienced. Here is a link to the news story:
http://today.msnbc.msn.com/id/26184891/vp/42207681#42207681 

I imagine these workers have already been exposed to high levels of radioactivity while at work securing these plants.  They are literally risking their lives for those in the area of the plant, as well as society at large.

I always find it disturbing when workers are put in harm's way to earn a paycheck.  Regardless of the fact that they get paid and in some dangerous jobs they may earn extra pay due to the great risk involved, it seems hard to imagine that trade off. I often worry that decisions like this are made without full understanding of the risk.... Or perhaps without other options?

More disturbing is that this man-made industry is of course capable of catastrophic disaster.  Despite systems of safety procedures developed and strict standards and requirements to protect the public.  We only need to consider the 'disaster of the moment' to realize that despite the perception that we can control things with rules and requirements, things do go wrong...earthquakes and tsunami's are possible.  Terrorist attacks (and yes, unfortunately on US soil) are possible.  Terrible mistakes, accidents and weather events are possible.

We would like to think we are civilized and mostly in control of what happens.  Yet we are every so often reminded of our own helplessness and vulnerability.  As with risks of other rare events- we do not think about these risks in a regular way and often are struck by the possibility only when confronted by a one in a million event.

I think each of us identifies with those workers.  We have all had the experience of loyalty or devotion to a job or role.  Or a sense of duty or responsibility for getting a job done.

Do they continue today at work for the paycheck or the extra bonus due to the risk?  I doubt that.  I suspect they sacrifice their own safety for the others they protect outside of the plant walls... The wife and child I watched today, anxiously awaiting their safe return.  I suspect the paycheck is low on their priorities now.  I suspect their employer is also not high on their list either.

To those workers and to all workers who risk their own safety for the greater good... We are all indebted to you.

Most of us have the luxury of allowing work to be 'only a job'.  We are never faced with such decisions.  Hopefully those of us who don't risk our lives aren't part of the reason these workers may pay with their lives.

I consider the individuals reassuring us of safety when there are unanswered questions or they really are not sure.  No one really can be sure of safety in all circumstances.  Do business priorities sometimes encourage risks to be taken or safety standards or concerns to be overlooked?  When faced with a tragedy like this I wonder why didn't we imagine the possibility of a situation like this?  Why didn't we imagine the oil spilling into the gulf last year...  Competing interests sometimes do not result in good decisions for society.  A reason we have standards and oversight and why money or profit as a driver is not always a good thing.

I hope we all very carefully consider the responsibilities we carry out that do affect the health and safety of others. If only we could act as bravely and courageously in protecting society as those 50 workers are.  I would like to believe they would not risk other's safety for profit.

Here is another view on the story...
http://www.telegraph.co.uk/news/worldnews/asia/japan/8393018/Japan-nuclear-crisis-Fukushima-Fifty-cut-off-from-family.html

"An Angel in the book of life wrote down my baby's birth. And whispered as she closed the book "too beautiful for earth."

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Hello all! I just though I would send out an update! Thank you all for the sweet messages of concern and prayer. Please keep them coming as they are very needed these next few weeks especially! 


I started my Lupron shots on the 26th and other than the actual medicine stinging like crazy and a few crying spells, and an allergic reaction on my arms, I haven't noticed any side effects (lol, I love to be complicated).  I will do my best to explain what the meds do since I have people ask me constantly. Lupron in a nutshell causes a "flare effect". The flare effect of Lupron can be used at the beginning of a fresh IVF cycle to help stimulate the development and maturation of eggs. Lupron is given for a few days and then injectable fertility medications are started.  It essentially acts by suppressing the pituitary gland (the gland which is normally responsible for triggering ovulation). However, before suppression occurs, Lupron will briefly stimulate the pituitary causing an increase in the pituitary hormones LH (luteinizing hormone) and FSH (follicle stimulating hormone).

Two days later I started Gonal F injections. Gonal FSH increases the number of growing follicles and stimulates their development. Within the follicles are the developing eggs. FSH also increases the production of oestrogen, and under the influence of this hormone, the largest follicle continues to develop. This medicine is used to stimulate the development of follicles and eggs in women who are having difficulties getting pregnant due to problems with ovulation. 

So the side effects of both of these are:

• Pain, bruising and inflammation at the injection site in men and women.
• Headache in women.
• Ovarian cysts

• Mild to moderate over-stimulation of the ovaries (ovarian hyper stimulation), causing the production of many eggs.
• Disturbances of the gut, such as nausea, vomiting, diarrhoea, abdominal cramps and bloating in women.
• Breast enlargement, weight gain, acne and swelling of the veins in the scrotum in men.

I am experiencing every one of them except the scrotal swelling which if Steven doesn't play his cards right...he may experience! (lololol! crack myself up again).
I have this entire week off which is a God send because I am going to need a lot of sleep I do believe. 
Please pray for me this week. As if the hormones are not atrocious enough, this would have been my week to deliver nugget #1! November 6 would have been my first babies due date (at least by my calculations) and anybody that has ever had a miscarriage knows, a mommy never forgets that date. I cannot dwell on the past, however I do feel like that baby deserves some remembrance and I won't ever stop thinking about it! It was my only "first child"! Hopefully I'll be adding a sister or brother to the mix here shortly! 
Enough about that (sniff, sniff)...I go back to the doctor to see my new babies again this Friday. At that point they will assess how the medicines are working and at what stage the eggs are in order to plan their retrieval. November 10 is the tentative date for removing those bad boys. They will put me to sleep and use a very large needle to poke through my uterus and into my ovaries and get each individual egg out of it's nest! How cool is that?! Then we will put them together with Steven contribution to the process, and wait..... 
Somewhere around November 13-15 they will take the good embryos and implant the two best ones back in and WAIT...
All of this is assuming they have enough eggs to harvest and that they survive this process. I am praying and believing that I will produce more than enough and that they will be exceptionally gorgeous! (ha)At this point, if they are ugly PLEASE DON'T TELL ME! I will dress them cute anyway.
Many prayers needed for my health, sanity and marriage over the next month please! 
Here is a sweet reminder of my first angel that I won't ever forget! XOXO sweet fetus!


                       Nothing will ever out do this I don't believe! 
Have a great week!

Changing Perceptions: Clozapine no longer a 'last resort'

To contact us Click HERE
(Original Post Date: December 7, 2009)
A thanks to one of my wonderful students, for sending along this article about Clozapine. http://www.currentpsychiatry.com/article_pages.asp?AID=8165 We actually just attend the Yale Master Psychopharmacology conference last week, where the speaker on Advances in Schizophrenia, Dr. Cyril D’Souza, was quite clear in his preference to see patients treated with Clozapine. Interesting to see this publicized in this way, given the initial introduction of this drug with such care. When introduced, it was suggested as the drug for those treatment resistant patients, with I believe the understanding that those not responding to other agents might find benefit in the drug vs. the risk of potentially life threatening agranulocytosis. This was later widened to include those with schizophrenia or schizoaffective disorder who were a suicide risk. Use of the drug has led to individuals being treated with clozapine while closely scrutinized for the development of life-threatening side effects. More recent studies have suggested clozapine has antiaggressive properties(per Krakowski et al, 2006) and offers superior symptom management (per CATIE results).This article suggests thinking more broadly about the use of clozapine, given studies showing its efficacy. As I translate the idea: rather than thinking of it as a 'last resort', we should consider it a ‘second choice’ after a first trial of antipsychotic medication is not effective. It seems to me that clozapine needs a new marketing strategy. Although we should expect that if we begin to use clozapine in a larger proportion of the population we will see its side effect, agranulocytosis, occurring in greater numbers (i.e. it will have the same frequency, but if more of your patients are taking it, the likelihood you will see a case of agranulocytosis will increase.) Whenever we do prescribe clozapine, we must carefully attend to the potential it has for this side effect, and be sure that we monitor individuals closely.
Posted by Joanne at 12:57 PM

And thanks also for the comment, which shows your use of this clinical information!

Joanne, I wanted to share a recent and ongoing clinical case (without going into too much detail) that I have been a part of at my current clinical site in a forensic setting. The article that I forwarded to you I had also forwarded to my clinical preceptor, a psychiatrist. Not more than a week or two after this conference and stumbling upon this article did it come to our attention that one of the inmates, had presented a couple of months ago in the midst of an acute psychotic episode. It is likely paranoid schizophrenia but with a mood component thus our differentials of adding a bipolar diagnosis per history or leaning towards schizoaffective. This inmate, prior to arrival, had been misdiagnosed with mood and anxiety disorders only (as far as we could gather from collateral sources). Nonetheless, we started slowly titrating up on Risperdal. First 1mg BID and so on up to 6mg according to response; we also concurrently followed the antipsychotic with adequate amounts of Cogentin, Amantadine and even some Klonopin to aide with anxiety as well as hoping to prevent and treat some already apparent EPS. Along with this titration we slowly introduced Depakote as well to stabilize mood. As we responded to symptoms with the Risperdal increases, the psychosis almost completely cleared. The turn around was rapid and the medications effective. BUT, of course this was too good to be true and by this time EPS and Parkinsonian symptoms had become too much to bear. The inmate was at times unable to eat or take pills because of shaking so badly. We had of course had “the benefits outweigh the risks” talk prior to administering the medication, but it was at this point that we attempted to back off several of the meds. We switched from Risperdal to Abilify to see if this might help decrease the EPS, but no changes were noted. It struck me as we were sitting pondering this difficult case, "Why not Clozaril!?" With its very good side effect profile (except of course the life-threatening agranulocytosis, ha) it would give the antipsychotic and even mood stabilizing properties without the same high risk for EPS. At first my preceptor and the nurses were very hesitant and questioned this high-risk medication yet soon at least my preceptor was on board and telling me the more consideration, the more sure it might work very well for this particular patient. We began a titration down off all meds and did basically a washout (in the safety of an inpatient setting) while keeping low-dose Klonopin onboard. So, the current status is that some Parkinsonian symptoms seemed to have decreased but the resting tremor remains. We are weekly monitoring WBC levels (for agranulocytosis as Joanne mentioned) and titrating the dose up. So far so good! I’ll try and update to let you all know how things are progressing…..Thanks again Joanne for posting on this topic, it’s really interesting as well as clinically applicable. ☺ (Comment Date: January 13, 2010)

My Thoughts on 'Anti-Energy' Drinks

To contact us Click HERE
Let me be perfectly clear: I am not an expert on nutrition, nor do I research these agents or drinks. I do have an opinion though, which I shared on my blogs Wednesday and I will share today.

I was asked by someone if I knew anything about the effects of anti-energy drinks such as Drank, which just recently started being sold in Connecticut. The product contains three main ingredients: valerian root, rose hips and melatonin. Part of the question was if there was evidence of an effect of these ingredients on stress relief and/or relaxation. In addition I was asked if I know anything about the three main ingredients. I do not have special knowledge to answer these questions with, they are not my areas of study. They are excellent questions!

I do think this is an interesting twist on the use of nutrients and other agents in beverages. In fact I have not researched energy drinks to any great degree, except to look up some of the ingredients. I just have a long standing concern: people think just because something is a ‘natural’ substance (herb or vitamin or mineral) it is ok to take it however they wish. I also don’t think people understand the lack of protections we have, given the lack of required evidence of safety to put products like these on the market. People may also think because it is on the store shelf it must be safe.

Unfortunately the websites available about drinks of these kinds do not have specifics about the amounts of each ingredient. They do not identify specifically the labelling with nutritional information (at least that I could find on the website for Drank). I'll have to go to the store and see what the label says. Despite the ingredients mystery, they are very direct in suggesting this is a fun new way to relax though.

I do not know off-hand of the safety of the ‘anti-energy’ drinks. My concerns about safety would be similar to those of all energy or 'nutritional' drinks. Whenever we begin to use agents in food or beverage that are commonly consumed at meals or other times, we have to wonder about the effects of exposure (i.e. how many of these drinks might you drink in a day? What is the dose of the substance you get over the day?). Is it like water and you can drink as much as you want?. Over long periods of time and with penetration of these products in the marketplace there is increased population exposure. Because they are foods/drinks they are differently regulated. How many people do you know that would take 3 pills a day (valerian, rose hips and melatonin) without considering the safety? Drinking them seems to make them appear safe to people. That is my concern. What if they are on other medication? Could they interact and cause negative effects? Do they check with their health practitioner to be sure it won’t cause a problem?

The other concern is we may have studies of a substance like melatonin for example and consider it safe for some use in some dose, but are there potential interactions between the three substances in this particular drink? Also where is the long term evidence of safety of these substances (individually and combined) in such a common food/drink source? An absence of evidence does not equal an absence of negative effect. It just means we haven’t studied it in this way.

I suspect ‘anti-energy’ drinks will be popular in the marketplace… It makes you wonder whether people will be pumping up on energy drinks all day and then trying to settle down with the anti-energy drinks in the evening. I am sure the beverage industry is very excited about all this… It is like they are the new but unregulated pharma – without having to shoulder the costs of safety research and clinical trials.

I am sure I told you more than you are really interested in. I am not the ‘expert’ on these ingredients. There are many people I am sure who have much more knowledge than I do about these ingredients. (actually you might look at the medline plus search info for supplements from the national library of medicine, if you haven’t already found it). Here is the link to info about melatonin: http://www.nlm.nih.gov/medlineplus/druginfo/natural/patient-melatonin.html I would consider medline plus a trustworthy source of data on ingredients like this.

Of course as Mental Health Clinicians, we should also be inquiring about beverages like this, particularly given the lack of knowledge of amount of ingredient in each drink and that if one doesn't settle me down, maybe I will need a few... Something new to consider in our assessments.