Mais la polymyxine n'est pas du tout absorbée dans le sang du système gastro-intestinal et n'a d'effet que dans l'intestin et est utile pour le traitement des infections intestinales azithromycine prix Internet en y faisant des achats permettant d’économiser jusqu'à soixante-dix pour cent, tout en étant sûr de la qualité des produits pharmaceutiques.
Rosh hashanah morning 577
Shanah tovah u‘metukah – a sweet and good year. My friend, Marisa1 has been married for three years. All of a sudden people she works with started to approach her and make statements like, ―Mazal tov. When are you due?‖ or ―How are you feeling? You look really great‖ or ―We‘ve been waiting for this. We‘re so happy for you and your husband.‖ Marisa is not pregnant. These painful comments were really an unfortunate reminder that she had gained a few extra pounds. I don‘t know when or if Marisa will have children and it isn‘t my business. I do know that over the summer she has been working out and has lost over ten pounds. All of a sudden the comments are back though pointed in a different direction. ―I didn‘t know if I should share that I was worried about you‖ and ―oh, you look good. I thought maybe…‖ or ―Is everything okay with you and your husband?‖ We need to remember to think before we speak. What if she had been pregnant? What if she had a miscarriage? What if there was a story she wasn‘t ready, or willing, to share? Too often we forget to be sensitive or forget to use our common sense at all. There‘s no better time to start remembering than today. The first day of the year, the day we celebrate the birth of the world. As a society we presume that everyone who wants to can bare children. When couples have been married for ‗some time,‘ we, their family and friends, expect to hear news of a baby on the way. Those couples that do not wish to have children for whatever reason are an anomaly. Meanwhile, couples may struggle in silence. In the 21st century, families are presented with choices unlike those from any other time in history. When to have children, if to have children and even how to have children are the types of questions individuals and couples grapple with. What seems like something so easy is not. When individuals or couples decide to be conscientious about trying to reproduce suddenly it isn‘t as easy as it seemed when we learned about the birds and the bees. ―A fifth to a quarter of all first-time pregnancies yield to loss instead of life. Tens of thousands more women cannot begin or hold a pregnancy without medical intervention.‖2 These are the realities. And no one seems to want to talk about them.
Infertility is stigmatized in our society. It affects at least one in six couples. As a community we forget to be sensitive. It can‘t possibly happen to someone that we know. It can‘t happen to us. We live in an era of complete openness. People post on the Internet what were once intimate details of life. However, it is so painful to speak of infertility that many choose not to and in turn, suffer in silence. At the very moment a person or a couple needs support, to know they are not alone there is no means of communicating pain.
For all of our discomfort, our unease, in discussing fertility issues, our Torah is rife with such stories. Abraham is aware of his own lack of virility. Sarah, our matriarch, turns first to
1 Name changed to protect identity. 2 Cardin, Tears of Sorrow, Seeds of Hope
, p. 14.
surrogacy. Rebecca struggles to maintain a pregnancy. And Rachel, Rachel might have been on the IVF roller-coaster, if that existed in Biblical times. The theology of infertility is clear. ―The Torah uses barren couples as a literary device to demonstrate the miraculous nature of the conception of the patriarchs and the beneficence of God.‖3 A midrash asks the obvious question—why do all of these matriarchs
struggle to conceive? Rabbi Levi answers: Because the Holy Blessed One desired their prayers. In the Torah, there is only one solution to infertility: God intervenes directly with the childless. We have something that or biblical ancestors couldn‘t conceive of. Modern medicine. In 2009 the World Health Organization classified infertility as a ―disease of the reproductive system defined by the failure to achieve a clinical pregnancy after 12 months or more of regular unprotected sexual intercourse.‖' There are a lot of options to combat infertility thanks to medical science. Surrogacy, in vitro fertilization treatments, various fertility drugs and a myriad of other options exist and science is advancing everyday. The challenge is, as Peggy Orenstein documents, ―the descent into the world of infertility is incremental. Those early steps seems innocuous, even quaint…‖5 Abraham, laments his own lack of virility when he makes the brit, the covenant, with God. He cries out, ―O Eternal God, what can You give me, seeing that I shall die childless, and the one in charge of my household is [my servant] Eliezer … Since You have granted me no offspring, my steward will be my heir.‖6 When God hears Abraham‘s cry for offspring. Remember, this is the first time we hear of Abraham‘s desire for an heir, God sends Abraham outside of his tent and promises that his offspring shall be as plentiful as the stars in the sky. Sarah, our foremother is infertile. Her own answer to her struggles is to use her maidservant, Hagar. ―… Sarah said to Abraham,
Look, the Eternal has kept me from bearing. Consort with my maid; perhaps I shall have a son through her.‖ And Abraham heeded Sarah‘s request. So Sarah, Abraham‘s wife, took her maid, Hagar the Egyptian … and gave her to her husband Abraham as concubine. He cohabited with Hagar and she conceived; and when she saw that she had conceived, her mistress was lowered in her esteem.7
Sarah gives Abraham a child the only way she knows how, through surrogacy. In our 21st century world, surrogacy is an important option. For women with reproductive challenges and for same-sex couples that want children as a part of their family, surrogacy is a means to that end.
3 Lieber, Valerie. ―Contemporary Reflections‖ Parshat Toldot. A Women’s Torah Commentary
, 152. August 19, 2010. 5 Ibid. Location 1042. 6 Gen. 15:2-3. 7 Gen. 16:1-4
What must it have been like for the biblical Rachel? She is the beloved wife of Jacob yet she is barren while her sister Leah has successful pregnancy after successful pregnancy. Anita Diamant describes in The Red Tent
that ―Rachel miscarried again and again … she no longer hated Leah with the full force of the past, Rachel could not smile at her sister while her own body remained fruitless … Rachel tried every remedy, every potion, every rumored cure. She wore only red and yellow—the colors of life‘s blood and the talisman for healthy menstruation … Whenever she saw running water, she lay down in it, hoping for the life of the river to inspire life within her.‖8 When she complains to Jacob, he says to her, ―Can I take the place of God, who has denied you fruit of the womb?‖9 Rachel masks her own pain and sends her maidservant to lie with Jacob. Bilhah bares two children. Peggy Orenstein was a happily married 35-year-old when she decided she wanted to have a baby. While she knew it might not be easy (she had only one ovary and was heading into her late 30s), she had no idea of the troubles she'd face. First, she was diagnosed with breast cancer, fortunately treatable. After waiting the recommended recovery period, she miscarried with a dangerous "partial molar pregnancy," so she had to avoid becoming pregnant for at least six months. Soon she was riding the infertility roller coaster full-time, trying everything from acupuncture to IVF and egg donation. She endured depression and more miscarriages while spending untold thousands of dollars. Even her very understanding husband was beginning to lose patience, when, surprisingly, she got pregnant with her daughter, Daisy.
She documents her initial desire not to have children and that shift which her husband supported. She writes in Waiting for Daisy
―Without form, there is no content. So even in this era of compulsive confession, women don‘t speak openly of their losses. It was only now that I‘d become one of them, that I‘d begun to hear the stories, spoken in confidence, almost whispered. There were so many. My aunt. My grandmother. My sister-in-law. My friends. My editors. Women I‘d known for years—sometimes my whole life—who had had this happen sometimes over and over and over again but felt they couldn‘t, or shouldn‘t mention it. My shock and despair were, in part, a function of improved technology and medical care.10
Rebecca our Biblical mother, Isaac‘s beloved, is barren. Isaac ―pleaded with the Eternal on behalf of his wife, because she was barren; and the Eternal responded to his plea, and his wife Rebekah conceived. But the children struggled in her womb…‖11 This is an early reference to the difficulty of pregnancy. Rebecca is bemoaning her physical pain. According to Ibn Ezra, a biblical commentator, when Rebecca inquired of other women if they experienced such pains these women all said no.12 I believe Rebecca‘s turmoil in this pregnancy is illustrative of what the reality in one of five pregnancies is: miscarriage.
8 Diamant, Anita. The Red Tent.
Picador USA, 1997. 46-47. 9Gen. 30:12 10 Ibid. Location 2000. 11Gen 25:21-22. 12 My understanding of Ibn Ezra on Gen. 25:22.
Anywhere between 10-25% of pregnancies spontaneously end before 20 weeks gestation reports a leading College of Obstetricians and Gynecology.13 With something so surprisingly common, we don‘t often hear about it and when individuals or couples go through this painful physical and emotional process they do it alone. Orenstein writes, ―many of us choose to bear this sorrow alone. Perhaps because we do not trust our neighbors and community with our most tender feelings. Perhaps because we fear political misuse our mourning over a child that is not yet a child. Perhaps because we fear what will happen if we dare to open the gates of our bulging reservoir of pain.‖14 For the ancient rabbis, it is a woman who teaches them what it means to open those gates. Hannah, whose words and story we read today, becomes a model for spontaneous prayer. And what inspires her? Her own fertility struggles. Though her husband loves her more than his other wife, the Eternal closed her womb, or so says the text. Hannah was completely distraught. During the annual pilgrimage to Shiloh she couldn‘t eat or drink of the sacred meal. ―In her wretchedness, she prayed to the Eternal, weeping all the while. And she made this vow: Adonai Tz‘vaot, if You will look upon the suffering of Your maidservant, and will remember me and not forget Your maidservant, and if You will grant Your maidservant a male child, I will dedicate him to the Eternal for all the days of his life…‖15 It isn‘t only God who takes note of Hannah. Eli the priest, watched Hannah‘s mouth. Hannah‘s lips moved but he could hear no sound. Making his own assumptions, Eli takes Hannah for a drunkard. He called out to her, ―How long will you make a drunken spectacle of yourself? Sober up!‖16 Hannah turns to the priest, the man of God, ―Oh no, my lord! I am a very unhappy woman. I have drunk no wine or other strong drink, but I have been pouring out my heart to the Eternal. Do not take your maidservant for a worthless woman; I have only been speaking all this time out of my great anguish and distress.‖17 Eli is impressed with Hannah. He begs her to go in peace and wishes her prayers be answered. She conceives and bares a son who becomes the prophet Samuel. Let us not be naïve. Not everyone who battles infertility gets to know fertility. While the success stories are widely available in books, magazines, online, and from friends the reality is not so. However it is described, defeat, reframing, or plan b, it is never easy to accept a new reality and come to peace with it. In The Motherlode Blog,
Shelagh Little writes,
Almost two years ago, I resolved to accept that I would never have children. I was 37 and had just learned my IVF procedure had failed. Our eight-year struggle with infertility included six rounds of artificial insemination, clomid pills, hormone injections, a surgery, and countless (and sometimes painful) diagnostic procedures. Every new test and treatment carried with it the hope that this time, it would work. What I had to show for it all: a
13http://www.americanpregnancy.org/pregnancycomplications/miscarriage.html 14Cardin, 14-15. 151 Sam. 1:10-11. 161 Sam. 1:14. 171 Sam. 1:15-16.
picture of three sad little clumps of cells — the embryos that didn‘t implant — and no real explanation of why I couldn‘t get pregnant. Every woman facing infertility has to decide when she‘s had enough, when she has reached her ethical, emotional, and/or financial edge. My sense of self- efficacy dictated that if I researched all the options, sought support from the right professionals and followed their instructions, I‘d get what I wanted. I did all of these things to the point of obsession, but our options were running out. my main reason for calling it quits was that I was tired of feeling frustrated and desperate. I needed to stop trying so I could get back to living.18
No one is less of a man or a woman because he or she is infertile just as the couple that does not want children is no less valid as a family. We get to choose our family. That is the reality today. Hannah reminds us how to pray and travel deep into the depths of our own desire. It is okay to subscribe to the idea that God interceded on her behalf and to hope that God will do the same for us. It is also clear that for our Biblical women calling out to God is the only prescription to combat infertility. We turn to prayer, and we also turn to science to answer our prayers and relieve our pain. We also need to turn to our communities and our families of origin and choice because the journey through infertility is not one that any couple should face alone. And we those families need to remember to view everyone with compassion. Hannah serves as a model of prayer for our ancient rabbis, though it is doubtful that they imagined—or wanted to imagine—the depth of her pain. The story of Hannah reminds us that too often women‘s experience is absent from the stories and rituals that comprise our tradition. Today, women and men need Jewish acknowledgement of the sometimes painful path to parenthood, need Jewish language to mourn dreams and hopes, need Jewish ritual to mark endings and new beginnings. These newer rituals are based on our rich textual tradition and include things like immersion in the mikveh, prayers, and transition ceremonies in a circle of loving friends and family acknowledging the loss. These ritual innovations are a direct result of the need for to mark this experience in a sacred way. I know I speak on behalf of the entire Temple Sinai family, especially our clergy, when I say that we are here. No one needs to go through any of this alone. ―Ribono Shel Olam, Creator of the World, You answered the prayers of our matriarchs Sarah, Rachel, and Hannah during this month of Tishrei. You listened to their pleas and opened their wombs, helped them conceive and brought them to a healthy birth. So may You respond to the cry of all those who call out to You today. On this, the day that celebrates the birth of the world, remember us. Our God and God of our ancestors, be compassionate. Let those who so desire conceive this year, and let the children who comes forth be endowed with a soul of gentleness and holiness. For those who desire to bring a child into their family through the adoption process, may their child-by-choice come into their family at the right time and in the right way. May
18 Shelagh Little, ―Life After Infertility Treatments Fail,‖ Motherlode Blog, The New York Times
, Sept. 10, 2009.
Your compassion ease the transition as their families expand overnight. May You teach compassion to those of us who are childless, teaching us to forgive our bodies and ourselves and to find comfort in the relationships we determine to be holy. God, remind us to guard our tongues from evil and hurtful questions. Let us know holiness and wholeness. So may it be Your will.‖ Ken y‘hi ratzon. May this be God‘s will.
International Office WELCOME PROGRAMME ACADEMIC YEAR Spring Semester International Office Tuesday, 31st January Place Aula Magna (Conference Hall) Julián Romea, 23 – 1st Floor 10:00 h. PRESENTATION OF CEU SAN PABLO UNIVERSITY PROF. JOSÉ LUIS PIÑAR MAÑAS Vice-Rector of International Relations PRESENTATION OF INTERNATIONAL OFFICE MRS. CARMEN FER
Are our services in safe hands? - 10-29-2013 by DBenson - Dennis Benson - http://dennisbenson.net Are our services in safe hands? by DBenson - Tuesday, October 29, 2013 Whatever happened to our national sense of humour? One of the positive aspects of our chicken-breedingco-operative is that humour is very much in evidence, if it is true that laughter is the best medicine we should all liv