Mother Goose and Gear

lace cardigan

2011-05-10T10:53:00.000-07:00

How to: Storage Baskets

2011-04-26T10:15:00.000-07:00

Storage Basket

How-to provided by www.jcarolinecreative.com

Fabric is Peapod and Leaflet from the Modern Flora Collection. Baskets are lined with Herb.
Materials Needed for Large Storage Basket (finished size 12" wide x 16" deep x 10" high). Materials needed for Small Basket (finished size 8" x 8" x 12") are shown in parantheses if different.: 1 yard of exterior fabric (1/2 yard for smaller basket) 1/2 yard of interior lining fabric scrap of fabric for label holder 1 yard heavy stabilizer (1/2 yard for smaller basket) (I had the best luck with Super Heavy Stabilizer B0509, but you could also usePeltex 70 or Timtex. If you are unhappy with the stiffness of your basket after the basic shape is sewn, the instructions include a way to fix it with some additional interfacing.) 12" x 16" piece of closed cell foam¹ for bottom (8" x 12" for smaller basket) 22" of webbing for handles (I used 1 1/4" heavy duty cotton for baskets shown above) 12" of 3/8" Heat 'n Bond Ultrahold (for the label holder). Glue to affix inside bottom to basket (I used Tacky Glue.)
Step 1: Cut fabric and interfacing. Large Basket Exterior Fabric Cut 2 pieces 13" wide x 13" high for front and back Cut 1 piece 17" wide x 37" high for bottom and sides (If fabric is a one-way design e.g. has a definite "up" direction, like Leaflet shown above, cut 2 pieces 17" wide x 19" high.) Interior Fabric Cut 2 pieces 13" wide x 9 1/2" high for front and back Cut 2 pieces 17" wide x 9 1/2" high for sides Cut 1 piece 15" wide x 19" high for bottom. Interfacing Cut 2 pieces 13" wide x 13" high for front and back Cut 1 piece for bottom and sides 17" wide x 37" high. Small Basket Exterior Fabric Cut 2 pieces 9" wide x 10 1/2" high for front and back Cut 1 piece 13" wide x 28" high for bottom and sides (If fabric is a one-way design e.g. has a definite "up" direction, like Leaflet shown above, cut 2 pieces 13" wide x 14 1/2" high.) Interior Fabric Cut 2 pieces 9" wide x 8 1/2" high for front and back Cut 2 pieces 13" wide x 8 1/2" high for sides Cut 1 piece 11" wide x 15" high for bottom. Interfacing Cut 2 pieces 9" wide x 10 1/2" high for front and back Cut 1 piece for bottom and sides 13" wide x 28" high.
Step 2: Print label holder pattern here. Cut out the paper pattern and trace onto the back side of the fabric for your label holder. Cut out the fabric 1/4" larger than the pattern on the inside and outside. On the inside, clip towards all four corners.
Step 3: Using 3/8" Heat 'n Bond Ultrahold, press the tape along all four sides of the label holder. Remove the backing from the Heat 'n Bond. Carefully fold in the center raw edges and press down with your iron. Then fold down the outer edges and press. (If you don't have an adhesive tape, use a glue stick.)
Step 4: Stitch the top edge and the inside edges of your label holder, as close to the edge as possible.
Step 5: Position the label holder on the front piece. Remember that you will be turning down 2 1/2" of the front piece for the facing (2" for the small basket), so if you want it 2" from the top of the basket, place it 4 1/2" below the fabric edge. I used scotch tape to hold it in place while sewing and it seemed to work pretty well (it was too bulky to pin). Stitch the label holder to the front along the outer unstitched edges, as close to the edge as possible.
Step 6: If your exterior fabric has a design that runs one way, sew the two bottom/side pieces together at their bottoms using a 1/2" seam allowance and press open the seam. (Check the direction of the print before you sew.)
Step 7: Take your pieces of interfacing and trim them down about 3/8" on the top and side. Place the exterior fabric pieces right side down on a flat surface and center the interfacing on its corresponding piece of fabric. Pin in place around the sides. Baste (the longest stitch on your machine) the interfacing and fabric together with your sewing machine within the 1/2" seam allowance. Keep the fabric layer against the feed dogs (bottom of your machine) and you'll find the fabric is less likely to gunch up on you. Repeat for the other two exterior pieces.
Step 8: Mark the center of the long edge of the side/bottom piece (18 1/2" is center for the large basket, 14" for the small). Mark the other edge as well. (I mark it with a nip of the scissors within the seam allowance.)
Step 9: Find and mark the center of the bottom edge of the front and back pieces. (6 1/2" is center for the large, 4 1/2" for the small) The bottom edge is only different from the top edge if your fabric is a one way design.
Step 10: Pin the front and back piece to the bottom/side piece, right sides together, matching the center marks you made in the last step. Mark 1/2" from each side edge of the front and back pieces.
Step 11: Stitch between your marks on the front piece, using a 1/2" seam allowance. Repeat for the back piece.
Step 12: Clip the side/bottom piece where the stitching begins and ends. Be careful to clip just up to the seam. Repeat for the other side.
Step 13: Starting where you finished stitching in the last step, pin the side of the front piece to what will become the side piece. Stitch from the bottom up. Repeat for the other three seams.
Step 14: Trim the seam allowance of all four seams to 1/4" or less. (It helps reduce the bulk when you are sewing around the top.)
Step 15: Cut your webbing or other material you are using for the handles to 11" long. Position the handle on the right side of the front piece, matching the raw edges and centering the handle. The outside edges of the webbing should be 4" - 5" apart. Pin in place and stitch. Repeat with the other handle on the back piece.
Step 16: Sew your front lining piece to the two side lining pieces, with right sides together. Do the same with the back lining piece.
Step 17: Turn the lining right side out. Pin the top of the lining to the top of the basket, matching the four side seams. Stitch around the top of the basket. I opened the seam allowance of the lining, but I didn't worry about opening up the seam allowance of the exterior fabric. I think it actually is less bulky to just let the seam turn in the direction you are sewing.
Step 18: Turn the basket right side out. Don't worry, the stiff interfacing will make it difficult, but just beat it into submission. Use your finger or a narrow object (but not too pointy- you don't want to poke a hole) to push out the corners.
Step 19: Turn down the top of the basket to create a 2" facing (1 1/2" on the smaller basket). You can usually do this with your fingers, but press with an iron if it helps. Pin around the top. If your basket isn't perfect (gasp!), adjust the amount of facing you are turning down to make the basket the same height all the way around.
Step 20: If you feel like your basket is a little too flimsy on the sides, now you have a chance to add some bulk. Cut a piece of heavy interfacing to fit the side plus add 1" to the length. (16" wide x 11" tall). Unpin the top of the basket and stick the interfacing up under the lining into the facing. Pin in place. Fold the extra 1" in interfacing length at a right angle, so it sits on the bottom of the basket. If you want to be extra sure it doesn't flop around, glue that edge to the bottom.
Step 21: Top stitch around the top of the basket about 1/4" from the top.
Step 22: Place the bottom lining face down on a flat surface. Center the foam on the fabric piece. Apply glue 1" all around the edge of the foam piece. Fold the fabric onto the glue and clip with clothes pins until dry.
Step 23: Once the bottom piece is dry, apply glue to the entire bottom of the foam piece. Carefully place the bottom, fabric side up, into the basket. It's easy to get glue on the lining, but use a wet rag to wipe any off. Make sure the lining sides are tucked under the foam piece. Put the basket on a flat surface and place something weighty in the bottom of the basket until the bottom dries.
Step 24: Cut a piece of cardstock 3" x 2" inches and insert it into your label holder.
¹ Closed cell foam is a dense, thin foam that doesn't compress much. It is usually black, blue or white. It is not the cushy yellowish foam you find in your seat cushions. Where do you find closed cell foam? The easiest solution if you want just a little is to buy Foamies or another brand of foam sheets at a craft store and glue them together to get a thickness of a 1/4" or so. If you want closed cell foam in bulk, find a marine or auto upholstery business. If you're lucky, maybe they will give you a small piece to play with before you commit to a 10 yard roll! I'm sure you could also find it on the internet, but it is bulky (and thus expensive) to ship. If you can't find any closed cell foam, your next best option is chair cushion foam or cardboard. The disadvantage of chair cushion foam is it has to be thicker (like 1") to provide any rigidity. The disadvantage of cardboard is if it gets crushed or bent, it doesn't recover. It also disintegrates when wet.
copyright 2008 j. caroline designs, l.p. Feel free to use this pattern and instructions for personal or commercial use. Please do not reprint these instructions without permission. You may link to this page from your website without requesting permission.

Prada inspired dress from Tshirts

2011-04-26T10:08:00.000-07:00

Found over at Craft Magazine on Burdastyle!

http://www.burdastyle.com/blog/celebrate-earth-day-by-recycling-those-fabric-scraps

Illustrations by Daniela Uhlig

2011-04-24T03:52:00.000-07:00

Absolutely love these!
Found over at designerscouch: http://designerscouch.org/view-log/Illustrations-by-Daniela-Uhlig-1386

Be my Penguin?

2011-04-24T03:21:00.001-07:00

Beautiful Sea Cow

2011-04-24T03:13:00.000-07:00

skull vomit

2011-04-09T14:46:00.000-07:00

http://streetanatomy.com/wp-content/uploads/2010/12/TYPOE_CONFETTI-DEATH_1_900px.jpg

great spoken word

2011-04-09T14:27:00.000-07:00

Shake the dust from Anis Mojgani on Vimeo.

Everyday items for fantastic fixes!

2011-04-09T13:08:00.000-07:00

Tickle My Fancy Treasury

2010-10-30T09:15:00.000-07:00

http://www.etsy.com/treasury/4ccc448ecb2a8eefcaff0ebd/tickle-my-fancy

Everything I love.... treasury

Curiouser & Curiouser Treasury

2010-10-30T08:28:00.000-07:00

http://www.etsy.com/treasury/4ccc357ecb2a8eefaf490bbd/curiouser-curiouser

A FUN and FUNKY treasury!

National How to Forgive Yourself Day + Treasury

2010-10-30T06:14:00.000-07:00

Forgiving yourself can be much harder than forgiving someone else. When you're carrying around a sense of blame for something that has happened in the past, this bundle of negativity burrowing deep into yourself can cause a never-ending, pervasive sense of unhappiness. Forgiving yourself is an important act of moving forward and releasing yourself from the past. It's also a way of protecting your health and general well-being. Here are some suggestions on how to forgive yourself.

How to Forgive Yourself - wikiHow

Namaste Treasury on Etsy: http://www.etsy.com/treasury/4ccc27acaf026d91dbc30e36/namaste

Self Meditation and...craft tip!

2010-10-30T06:05:00.000-07:00

Whenever walking in kinhin, keep your mind totally focused on your environment, not on the thoughts that try to distract you.
Power breath: Begin by going for a walk, preferably alone and outside. Inhale, silently saying "Om" to the count of two. Mentally see that the oxygen coming into your body is filled with life-force energy and hold the breath in your mouth. As you force the air against your cheeks, let them fill to capacity and bulge out. Keep pressing the air into your cheeks as long as you can, without creating discomfort. Then exhale to the count of seven. Repeat this twelve times. Try doing this twice a day, gradually increasing to hold your breath for five counts and exhale for ten counts, then hold your breath outside for five counts.
Breathing in, be aware of the activities of your mind being calm and at peace. Breathing out, be aware of the activities of your mind being calm and at peace.

www.thingstobehappyabout.com

Craft Tip:

If you have a paper shredder you can use it to shred left over bits of wrapping paper to make fun and festive bag filler.

Capitol Weekly: 22 disability protestors arrested outside Capitol

2010-08-19T13:35:00.000-07:00

Capitol Weekly: 22 disability protestors arrested outside Capitol

This article makes me so sick for the people suffering in this economy. Release some non-threatening drug offenders from our penitentiaries and save a few thousand lives, programs, and jobs!!

Belated National Dance Day Routine

2010-08-16T19:13:00.001-07:00

Deer Visits Cat Every Morning

2010-08-15T12:11:00.000-07:00

There is nothing more wonderful than animals.
A cat in Harrisburg has a friend that visits every morning.
the owner finally took pics.

"When the power of love overcomes the love of power, the world will know peace."

Be at ease

2010-07-04T13:53:00.000-07:00

In meditation, be at ease, be as natural and spacious as possible.
Slip quietly out of the noose of your habitual anxious self,
release all grasping, and relax into your true nature.

Sogyal Rinpoche

Unicorn After Wisdom Teeth

2010-06-28T15:53:00.000-07:00

Everything exists according to its own nature - our individual perceptions of worth, correctness, beauty, size and value exist inside our heads, not outside them.

Dharma

And Laugh a Little...

See more funny videos and funny pictures at CollegeHumor.

keeping all of my ideas in one place

2010-06-28T15:13:00.000-07:00

I am needing a place for feedback while I write my memoir. Now that I am married and have the wedding day parade behind me and now as a not so distant magical memory, I have A LOT more spare time. I will be posting pictures of the wedding and sharing all of my DIY projects that went into making every detail special and personalized.

I have promised myself that the majority of my spare time will be spent writing the long awaited memoir of Rachel Goldmark (now Lewis) and the many personalities that have all of their own stories to tell. From being dragged to the depths of hell by illness and insanity to the path of addiction and recovery. Then another lifetime of finding out that my previous path was a lie of misdiagnosed labels and being given a new illness- Lyme Disease. The cause of all of my previous ailments that everyone had failed to catch when labeling me as clinically insane. I have overcome my addiction, married my true soul mate, followed the path of helping others like me, and am currently trying to recover from a chronic, horrific and stealthy disease.

It feels like I am to fit 3 life times into 1 book. Maybe I will just have to write 3 books! Who knows. I am embarking on quite a journey to recover my past enough to piece together a coherent story.

I just might need a little help from my friends :)

Amazing Pictures/Art

2009-09-21T13:29:00.000-07:00

Click on Photos to view artist and orgin!

The Eight Irresistible Principles of Fun

2009-09-21T13:02:00.001-07:00

The Eight Irresistible Principles of Fun

Shared via AddThis

Martha Stewarts adorable halloween costumes

2009-08-28T15:25:00.001-07:00

Frog and Princess

Flapper

Pillowcase Pumpkin

3 Peas in a Pod

DIY Kid

2009-08-28T13:57:00.001-07:00

Awesome play kitchen for under $10 over at childhood 101

DIY Kid part one
DIY Kids Kitchen for under $10 - Part 2 part 2

Walk to Fight Against Lyme Disease

2009-08-26T11:56:00.001-07:00

EVENT DETAILS:

Saturday, November 7th, 2009

Shoreline Park, Mountain View, California

Distance - 2k/4k

Registration begins at 10am, walk begins at 11am

Family Fun Event - kids and strollers welcome! (sorry, no pets allowed at Shoreline)

See www.mylymemission.com for more information

Hope to see you there!!

Dear Family and Friends,

On Saturday, November 7 my family, friends and I will be joining Turn the Corner Foundation to Create Footprints™ in the fight Against Lyme Disease at Shoreline Park in Mountain View, CA. This walkathon will raise much-needed funds for the support of research, education, awareness and innovative treatments for Lyme disease and other tick-borne diseases.

As you may know, I have a very personal connection with this cause. I have been ill with lyme disease for over twenty years, but was not correctly diagnosed until two years ago. The years that were wasted while I desperately searched for the cause of my health problems, going undiagnosed and misdiagnosed for so long, turned what should have been a relatively straightforward disease to treat into a late-stage, chronic illness, which is proving to be incredibly difficult to get under control, and has affected my life and the life of my family immeasurably. It has been a very difficult road for me, but finally having answers for my health problems, and a path to treatment has been both a huge relief, and the start of a new journey for me, still very difficult, but one that gives me hope of eventually regaining my health. I want to do whatever I can to make sure that no-one else has to suffer for years without diagnosis and treatment, and to help get the word out about this misunderstood disease.

Lyme disease is a debilitating illness, and can affect so many different body systems, causing neurologic issues, cardiac problems, joint pain and muscle weakness, cognitive difficulty, vision problems, and many other symptoms. Because it affects people so differently, it can be very hard to diagnose, which is compounded by the fact that the current tests available miss nearly half of all lyme cases. Lyme is commonly misdiagnosed as other illnesses, including MS, fibromyalgia, CFS, ALS, lupus, rheumatoid arthritis and a host of others, and is a growing problem across the US and here in California. Funds for innovative research to develop accurate testing, and more effective treatments, as well as physician training, and raising public awareness are desperately needed.

We have organized this walkathon in order to help fund much needed research programs in the fight against Lyme disease through Turn The Corner Foundation – please check out their website at http://www.turnthecorner.org to learn more about the grants and initiatives that they are funding. It is our hope that participating in this walkathon will help put an end to the pain and suffering that this disease inflicts upon millions of people.

To accomplish my goal of raising as much money as possible for this very worthy cause, I am asking each of you to join our team, start a team of your own, or donate to the cause.

You can help!

1. Make a generous contribution in support of Turn The Corner Foundation – you can easily donate online at http://www.firstgiving.com/kcs or alternately you can send a check made out to Turn The Corner Foundation to me at P.O. Box 421, Los Gatos, CA 95031-0421. Any amount is welcome and very much appreciated. Turn The Corner Foundation is a 501(c)(3) not-for-profit public charity, so your donation is tax deductible. Many employers have matching programs where you can double your donation, so it is worth checking to see if your employer offers that.

2. Come walk and be an active participant of our team – Team Squishy! You can register online at http://www.firstgiving.com/createfootprintsttc and you will be given the option to set up a fundraising page to collect money from folks you know, and then join us for a fun day at the walkathon. Or start your own team and recruit your family, friends and coworkers to walk with you.

3. You can join our cheering section by attending the walkathon, but not actually walking.

4. Lastly, please forward this e-mail on to your friends, family, and co-workers, and encourage them to participate as well.

I greatly appreciate your consideration and support of this worthy cause, I am looking forward to having as many people as possible join us for this fun family event. Even if you can't join us at the walkathon, we appreciate any and all donations made to our team as part of our overall fundraising. If you have any questions about the walkathon, please feel free to e-mail me at k@squishymatter.com, and there are more specifics about the walkathon available at http://www.mylymemission.com. Thank you so much for your generous support of Team Squishy and Turn The Corner Foundation.

Very truly yours,

Karen Carlo Salinger

2009-08-18T11:02:00.000-07:00

If you have a dog ... PLEASE read this and send it on. If you don't have a dog, please pass along to friends who do.

Written by:
Laurinda Morris, DVM
Danville Veterinary Clinic
Danville , OH

This week I had the first case in history of raisin toxicity ever seen at MedVet. My patient was a 56-pound, 5 yr old male neutered lab mix that ate half a canister of raisins sometime
between 7:30 AM and 4:30 PM on Tuesday. He started with vomiting, diarrhea and shaking about 1 AM on Wednesday but the owner didn't call my emergency service until 7 AM. I had heard somewhere about raisins AND grapes causing acute Renal failure but hadn't seen any formal paper on the subject. We

had her bring the dog in immediately. In the meantime, I called the ER service at MedVet, and the doctor there was like me - had heard something about it, but... Anyway, we contacted the ASPCA National Animal Poison Control Center and they said to give IV fluids at 1 & 1/2 times maintenance and watch the kidney values for the next 48-72 hours.

The dog's BUN (blood urea nitrogen level) was already at 32 (normal less than 27) and creatinine over 5 (1.9 is the high end of normal). Both are monitors of kidney function in the bloodstream. We placed an IV catheter and started the fluids. Rechecked the renal values at 5 PM and the BUN was over 40 and creatinine over 7 with no urine production after a liter of
fluids. At that point I felt the dog was in acute renal failure and sent him on to MedVet for a urinary catheter to monitor urine output overnight as well as overnight care.
He started vomiting again overnight at MedVet and his renal values continued to increase daily. He produced urine when given lasix as a diuretic. He was on 3 different anti-vomiting
medications and they still couldn't control his vomiting. Today is urine output decreased again, his BUN was over 120, his creatinine was
at 10, his phosphorus was very elevated and his blood pressure, which had been staying around 150, skyrocketed to 220 ... He continued to vomit and the owners elected to Euthanize.

This is a very sad case - great dog, great owners who had no idea raisins could be a toxin. Please alert everyone you know who has a dog of this very serious risk.
Poison control said as few as 7 raisins or grapes could
be toxic. Many people I know give their dogs grapes or raisins as treats including our ex-handler's. Any exposure should give rise to immediate concern.

Onions, chocolate, cocoa, avocados and macadamia nuts can be fatal, too

Even if you don't have a dog, you might have friends who do. This is worth passing on to them. Confirmation from Snopes about the above ....

http://www.snopes.com/critters/crusader/raisins.asp

Shepherdess bride

2009-08-18T10:36:00.001-07:00

Shepherdess bride marries in stunning dress made of wool from her own flock!

I so love how she incorporated her 2nd love of her prized sheep into her wedding! The dress, which cost £1,500, took a spinner and dressmaker 67 hours to make. But it was worth it, as her husband said he was 'blown away' when she walked down the aisle.

Follow my blog with bloglovin

2009-08-17T13:30:00.000-07:00

blog lovin

Joined the Blog Lovin

2009-08-17T13:27:00.001-07:00

Follow my blog with bloglovin

Rockabilly refashion and rainbow canapies

2009-07-14T10:10:00.001-07:00

Refrigerator Chalkboard!
Such a great idea! From the Crafty Brain of Martha Stuart.

Make a Rainbow Canopy for Your Child's Room - More DIY How To Projects

I am so excited to make this and hang it on my ugly fences in the back yard. Now it can have somewhat of a lovely purpose!

VERTICAL VEGETABLES: "Grow up" in a small garden and confound the cats! - More DIY How To Projects

Such a cute swimsuit and skirt. My only hope is that I will look just as good in them as the lovely Threadbanger model.

make your own sunscreen

2009-07-02T07:32:00.000-07:00

I always hate buying sunscreen even though I know how necessary it is when you live in Sacramento, CA where it has been a horrible weather week as the temperature stayed at 105 degrees! I think I will be even more encouraged to put it on if I made it. It will be great- a feeling of accomplishment and no sunburns!!

Homemade Sunscreen - More cool how to projects

make your own stickers

2009-07-02T07:10:00.000-07:00

Homemade Stickers - More cool how to projects

I am really excited to try this because I cant afford one of those xyron machines. I'm off to crafty business...

Altoid tin games

2009-06-29T17:21:00.000-07:00

Altoids Tin Travel Games - Pocket Size Fun - More DIY How To Projects

I am in love with these mini travel game sets!
I want to see how many games I can come up with that will fit in a travel size tin!

Amy Tan on Lyme Disease

2009-06-29T16:21:00.000-07:00

Amy Tan on Lyme Disease

I have late-stage neuroborreliosis. I have had this disease since 1999.

My case is in many ways typical. Like many, I had little awareness of Lyme disease, for I did not live in what was considered the tick-infested hotbeds on the East Coast. I am a Californian -that’s where I file my taxes- and I live among the hills of San Francisco with its tick-free, concrete sidewalks. For a good long while it did not seem significant that I also have a home in New York, that I weekend in the country, and my main form of exercise is hiking. In addition to trekking in the woodlands of Mendocino, Sonoma, and Santa Cruz counties in California, I have also sojourned to leafy spots in Connecticut and upstate New York. I once loved to sit in the tall grass next to the river, and lean my back against a shady oak tree.

I passed off my early symptoms -a stiff neck, insomnia, a constant headache, and a bad back followed by a frozen shoulder- as the unpleasant aftermath of too much airplane travel.

Click Here to read the rest of her story

With This Burger, I Thee Wed - NYTimes.com

2009-06-29T16:15:00.001-07:00

Down-Home Celebrations - With This Burger, I Thee Wed - NYTimes.com

Birthing a baby Giraffe

2009-06-22T18:45:00.001-07:00

nature never ceases to amaze me...

How to Create Embroidery from Pictures

2009-06-20T21:33:00.000-07:00

Crafter Dolin O'Shea of Lulu Bliss shows us how to create an embroidery pattern from a photo, in this case a photo of her cute dog Mikey. Dolin's 101 on Embroidery article is in the current issue of CRAFT:06.

Dolin and I have been friends for over 10 years now and she's one of the craftiest people I know personally. Over the years she's taught me so much about embroidery and also introduced me to the Sublime Stitching patterns by Jenny Hart back in 2000.

To get some carbon transfer paper when working with dark fabric as mentioned in the video, visit the Sublime Stitching store.

From the pages of CRAFT: 06:

CRAFT: 06 - "101: Embroidery, Learn to paint pictures with floss and fabric", pgs 132-137. You can preview the article in our Digital Edition.

Subscribe to CRAFT Magazine and get 4 quarterly issues delivered to your door for only $34.95 (US).

Posted by Natalie Zee Drieu | Mar 21, 2008 01:30 PM on Craft

Love

2009-06-19T18:22:00.001-07:00

How to Sew Your Own Produce Bags - CraftStylish

How to Upcycle a T-Shirt into a Cardigan - CraftStylish

Dress Up Your Bike with a Crocheted Seat Cover - CraftStylish

Crafty Inspiration: Plastic Bottle Purse - CraftStylish

Check Out This Butterfly! - CraftStylish

2009-06-16T14:37:00.000-07:00

Learn how to make Wall-e out of recycled materials on Filth Wizardry's Blog! It is so 100% awesome!

Orange-Coconut Macaroons

Orange-Coconut Macaroons and more delicious recipes, smart cooking tips, and video demonstrations on marthastewart.com

These delectable one-bowl wonders mix up in a matter of minutes.

3 days until execution date

2009-06-15T22:36:00.000-07:00

Please Cross Post!!!
Contact Arnold Schwarzenegger
(916)-445-2841

pal_95945@yahoo.com wrote:

Please call Gov Schwarzenegger at (916) 445-2841 and politely tell him you oppose cutting funds for animal shelters. He plans to limit the time animals are kept in California shelters from 6 days to 3 days. This is devastating news. Please call today. That's all you have to say when the person picks up the phone. It's easy and will help a lot!

If you prefer to send an email, go to www.gov.ca.gov

, then click on the "Interact" tab and send a message that way.

If you want to add anything to your message, you could suggest that he look at the breeders. Currently they pay no taxes, have to get no permits and pay no fines because they have no oversight. There would be millions of dollars in revenue right there.

Thank you and please forward to everyone you know in California.

Lyme misdiagnosed as psychiatric illness

2009-06-15T22:12:00.000-07:00

For those of you trying to document your diagnosis, or trying to prove disability, the article below may be helpful to you. It is from a 2002 Psychiatry textbook, written by Dr. Brian Fallon of Columbia University Medical Center. It also highlights other infectious diseases that may cause psychiatric symptoms, often misdiagnosed as a psychiatric disorder rather than the function of a disease process.

Shadock's 2002 Comprehensive Textbook of Psychiatry

CHAPTER 2. NEUROPSYCHIATRY AND BEHAVIORAL NEUROLOGY 2.9 NEUROPSYCHIATRIC ASPECTS OF OTHER INFECTIOUS DISEASES

BRIAN ANTHONY FALLON, M.D., M.P.H. http://www.columbia-lyme.org

Spirochetal Diseases

Non-HIV Viral Infections of the Central Nervous System

Subacute Spongiform Encephalopathies

Other Infectious Causes of Neuropsychiatric Disorders

Emerging Areas of Investigation

Suggested Cross-References

Ever since the link between severe neuropsychiatric disorders and infectious disease was established in the early 1900s by the identification of the cause of syphilis, questions have been asked about the role of other infectious organisms in the etiology of neuropsychiatric disorders. At times the link between an infectious agent and a neuropsychiatric disorder is obvious, as in the case of neurosyphilis, the viral influenza outbreak of the 1920s, and the current human immunodeficiency virus (HIV) and Lyme disease epidemics. At other times the link is less clear but strongly suspected, as has been true for chronic fatigue syndrome or in the search for bacterial or viral etiologies of obsessive-compulsive and psychotic disorders. Psychopathology may emerge as a result of direct invasion of the central nervous system (CNS) by neurotropic agents or by an indirect host-determined cellular, humoral, or cytokine immune response to infectious organisms that inadvertently damages host tissue. In its effort to protect, the immune response may thereby provoke neuropsychiatric disorders.

This section focuses on selected infectious diseases other than HIV disease that invade the CNS and that have been directly associated with neuropsychiatric syndromes. Particular attention will be paid to the neuropsychiatric aspects of Lyme disease because it has spread rapidly since the 1970s in various parts of the world and has been associated with a plethora of neuropsychological and neurobehavioral problems in both children and adults. In addition, the concluding portion of this section will briefly address a few areas of recent investigation on the overlap of infectious disease and neuropsychiatry.

SPIROCHETAL DISEASES

Under the umbrella of the order of spirochetes are three agents that are known to invade the CNS. These include borrelia, treponema, and leptospira. Borrelia, which require an arthropod vector and a mammalian or bird reservoir, are commonly known to cause relapsing fever and Lyme disease. Treponema, which are spread person to person and do not use an arthropod vector, are the spirochetes responsible for syphilis. Leptospira, which are spread by contaminated water, are the agents of Weil's disease, which can have CNS manifestations.

Lyme Disease Lyme disease (Lyme borreliosis), transmitted by the bite of an infected Ixodes tick, can cause a vast array of neuropsychiatric disorders, ranging from mild mood changes to psychosis and severe memory loss. Lyme disease has been reported throughout the United States and in many countries throughout the world. The causative agent of Lyme disease, Borrelia burgdorferi, is initially inoculated into the skin by an infected tick, typically inducing a local rash, known as erythema migrans, which is reported by approximately two thirds of infected patients. Rapidly disseminated by the bloodstream through the body, B. burgdorferi has been found in the CNS as soon as 3 weeks after initial skin infection. Known to be neurotropic, B. burgdorferi may reside in the cerebrospinal fluid (CSF) or adhere to glial cells or other brain tissue. Like its spirochetal counterpart, Treponema pallidum, B. burgdorferi may remain latent, causing illness months to years later. Partly because of this latency in disease expression, patients may be unable to recall the initial tick bite or rash. Antigenic variability, which refers to the ability to express different surface antigens and to thus evade the immune response, is a feature of borrelial organisms that B. burgdorferi shares.

Diagnosis The epidemiological surveillance criteria for the diagnosis of Lyme disease in the United States require a history of exposure to an area endemic for Lyme disease and either a physician-diagnosed erythema migrans rash or serological evidence of exposure to B. burgdorferi and at least one of the following three clinical features: (1) arthritis; (2) neurologic symptoms (cranial or peripheral neuropathy, meningitis, encephalomyelitis, or encephalitis with evidence of intrathecal antibody production); or (3) cardiac conduction defects. Although useful for epidemiological monitoring, these criteria are unduly restrictive and should not be used for clinical purposes, because these criteria exclude patients who might have Lyme disease, such as seropositive patients who have diffuse arthralgias but not frank arthritis or patients who have encephalopathy without objective CSF abnormalities. Further complicating the diagnosis is the unreliability of the serologic tests. False-positive results might result because of cross-reactivity with other spirochetal organisms.

False-negative results may occur because the patient is tested too soon after infection and before an appropriate antibody response is mounted or because the patient's immune response has been abrogated as can occur when a patient is given antibiotic shortly after initial infection. It is not uncommon for a patient with Lyme disease to have negative or equivocal test results in one laboratory, but positive ones in another or for a patient to have negative test results initially but positive ones several months later after antibiotic treatment has been initiated. For these reasons a rational approach to the diagnosis of Lyme disease must be based upon the primary clinical presentation, followed by the supportive evidence of laboratory test results. Laboratory tests that can be helpful include indirect tests such as the enzyme-linked immunosorbent assay (ELISA) and Western blot analysis and direct tests such as the polymerase chain reaction (PCR) assay for borrelial deoxyribonucleic acid (DNA) or antigen detection assay. When Lyme disease is suspected, the clinician should order both an ELISA and a Western blot, as some patients may have a negative ELISA result but a positive Western blot result.

Bands of particular significance on the Western blot include the ones identified by the Centers for Disease Control as being most frequent and specific, as well as the 31kD (OspA) and 34 kD (OspB) bands. Although highly specific for B. burgdorferi DNA, the PCR assay has low sensitivity. Although laboratory testing is a valuable component of the diagnostic assessment, negative test results cannot be used to exclude Lyme disease in a patient with typical clinical features and a history of exposure to a Lyme disease endemic area.

Clinical Features The erythema migrans rash is the hallmark feature of early Lyme disease; antibiotic treatment at this stage often results in cure. Although typically the rash has a bull's eye, rounded appearance, it may also have a triangular, elongated, or other shape. Because patients may not recall seeing the rash, the flu-like symptoms that often occur shortly after the rash may be ignored, only to be followed several months to years later by the emergence of a multisystem disease affecting the joints, the heart, the eyes, and the peripheral or central nervous system; 15 to 40 percent of patients may have neurologic signs as their presenting feature. Headaches may be followed by meningitis, cranial neuritis, motor or sensory radiculitis, or an encephalitis characterized by mood lability and disturbances of memory or sleep. Although suggestive of Lyme disease, Bell's palsy may occur in only 5 to 10 percent of a sample of patients with neurologic Lyme disease. Symptoms of radiculoneuropathy or peripheral nerve involvement include sharp stabbing or deep boring pains that may radiate from the spine into an extremity of the trunk; areas of numbness, burning, or tingling; weakness; and fasciculations. In later stages of Lyme disease a minority of patients may develop a chronic meningoencephalomyelitis characterized by somnolence, confusion, poor concentration, impaired memory, myoclonus, apraxia, ataxia, paraparesis, dysarthria, dysphasia, seizures, or bladder abnormalities. Some of these patients may be misdiagnosed as having multiple sclerosis because of a relapsing and remitting course and the concurrence of spinal motor signs, ataxia, bladder dysfunction, and, less often, optic neuritis.

The profile of neuropsychiatric Lyme disease typically includes disturbances of cognition and mood. On formal neuropsychological testing, more than 50 percent of patients with chronic neurologic Lyme disease will show impairment in short-term memory, processing speed, or attention. This cognitive impairment, although worsened by marked pain or mood disorders, exists independently of the physical symptoms or the severity of concurrent depression. Typical cognitive symptoms include word-finding problems, word-substitutions, new-onset dyslexia, transient episodes of geographic disorientation, marked inattention and distractibility, difficulty with organization, and the sensation that one's brain is in a fog. Less commonly, the severity of the cognitive disturbance causes a global impairment, suggestive of a new-onset dementia.

Although the full spectrum of psychiatric disorders has been associated with B. burgdorferi infection, by far the most frequent are disturbances of mood, characterized by irritability, mood swings, and sleep loss. The majority of controlled studies in which patients with Lyme disease are compared to healthy controls or to patients with other illnesses reveal that depression occurs more frequently in the group with Lyme disease. Children with neurological Lyme disease typically present with complaints of headaches as the most common symptom, followed by behavioral, cognitive, or mood disturbance as the next most prevalent symptom. Behavioral problems include falling asleep in class, agitation, and poor school performance; common cognitive problems include attentional and short-term memory and visospatial deficits; common mood problems include irritability and new-onset anxiety. Other less common neuropsychiatric aspects associated with Lyme disease in adults and children include panic attacks, transient paranoia, illusions or hallucinations (visual, olfactory, auditory), anorexia, depersonalization, violent outbursts, obsessive-compulsive disorder, agitated mania, hyperacute sensitivity to light or sound, and what appears to be personality change. Because of the multisystem involvement in Lyme disease and the frequent concurrence of anxiety and depression, patients may be mistakenly diagnosed as having a primary psychiatric or a somatoform disorder before Lyme disease is even considered. If Lyme disease is considered but serological tests are equivocal despite the presence of a clinical profile typical of Lyme disease, the somatoform label may once again be mistakenly applied.

A 22-year-old previously healthy college graduate in his first few months of law school developed joint and muscle pains. A medical workup was negative, but the symptoms persisted and worsened, accompanied by fatigue so severe that he was unable to go to class or to study. Referral to a psychiatrist resulted in treatment with a selective serotonin reuptake inhibitor (SSRI) for possible depression without much benefit. Further medical workup revealed a positive result for Lyme disease ELISA with an equivocal Western blot analysis result. The diagnosis of probable Lyme disease was made and the patient was given a 6-week course of oral antibiotics, with a marked improvement in symptoms. Over the following 4 months his prior symptoms returned accompanied by headaches, word-finding problems, paresthesias, shooting and stabbing pains, and hypersensitivity to light and sound. Several consulting doctors gave conflicting opinions, with some firmly stating that this could not be persistent Lyme disease as it had been adequately treated and others stating that persistent infection was indeed possible and that additional treatment with antibiotics was warranted. The Lyme tests remained equivocal and a brain magnetic resonance imaging (MRI) revealed no abnormalities. Three additional months of oral antibiotics resulted in some improvement of arthritic symptoms, but the fatigue and cognitive problems remained. Several months later, the patient developed paranoid delusions followed by a manic episode for which he was hospitalized. Without further testing such as a spinal tap or electroencephalogram (EEG), his doctors dismissed Lyme disease as a possible cause for his new-onset mania. The patient was discharged on antipsychotic agents and lithium, with only a partial improvement in his mood lability. An outpatient internist then checked the patient's spinal fluid, which showed white blood count of 7 × 109 per liter 7 (white blood count [WBC]) and evidence of B. burgdorferi antibodies in both his serum and cerebral spinal fluid (CSF). The diagnosis of neuroborreliosis was made and the patient was placed on a 3-month course of intravenous antibiotics. Although the mood lability, mania, and cognitive problems dramatically resolved with long-term antibiotic treatment, 3 years later the patient had not yet returned to school because of problems with persistent fatigue. At that point, because a PCR assay of his plasma was positive for Lyme disease and a brain single photon emission computed tomography (SPECT) scan revealed global heterogeneous hypoperfusion, the patient was once again treated with antibiotics.

This case highlights the diagnostic difficulties of Lyme disease: the confusion triggered by equivocal results on serological tests, the need to consider B. burgdorferi as the cause for new-onset mania, the inadequate response to standard psychiatric medications, the initially robust but subsequently partial response to antibiotic regimens, and the persistence of the DNA of the organism despite aggressive antibiotic therapy.

Tests for CNS Lyme Disease Examination of the CSF is crucial to rule out other possible causes of CNS disease and to identify the presence of Lyme meningitis or encephalitis. In early neurologic Lyme disease, a spinal tap may reveal lymphocytic pleocytosis, mildly increased protein, and, in some cases, an elevated immunoglobulin G (IgG) index or the presence of oligoclonal bands. In later-stage neurological Lyme disease, however, the CSF may appear normal. MRI studies may reveal punctate white matter lesions on T2-weighted images, suggestive of a demyelinating disorder such as multiple sclerosis. EEG studies are generally normal, although diffuse slowing or epileptiform discharges may be seen. SPECT and positron emission tomography (PET) studies may be particularly helpful in late-stage Lyme disease. Recent reports indicate that many patients with Lyme encephalopathy have a pattern of either global or heterogeneous hypoperfusion, which in some cases improves after antibiotic treatment (Fig. 2.9-1). Given the difficulties facing the clinician attempting to determine whether the fatigue, mood lability, and cognitive tracking problems are caused by primary depression or by an underlying systemic disease, functional imaging studies are a valuable tool to assist in the differential diagnosis.

FIGURE 2.9-1 Transverse views obtained with Technetium-99m HMPAO SPECT. The two views on the left are of the brain of an adolescent with Lyme encephalopathy and demonstrate moderate heterogeneous hypoperfusion. The views on the right are of the brain of an adolescent without encephalopathy and demonstrate a normally perfused scan. The color spectrum scale, from purple to white, represents low to normal perfusion. (See color Plate 2.)

Differential Diagnosis In considering the diagnosis of Lyme disease, it is important to ask the patient about exposure to a Lyme disease-endemic area, history of a tick bite or unusual rash, and the presence of multisystemic involvement. Called the "new great imitator" (after the original great imitator, syphilis), the broad spectrum of atypical neurological manifestations of Lyme disease include strokes, Guillain-Barré syndrome, cerebellar syndromes, seizures, pseudotumor-like syndrome in children, spastic paraparesis, multiple–sclerosis–like illnesses, and progressive dementias. Similarly, other diseases that may look like neuropsychiatric Lyme disease need to be excluded, such as major depression with somatic preoccupation, panic disorder, systemic lupus erythematosus or other connective tissue diseases, chronic fatigue syndrome, endocrinological disorders, vitamin deficiencies, other infectious illnesses, vascular dementias, and other neurodegenerative disorders.

Treatment For early Lyme disease without CNS involvement, 3 to 4 weeks of oral doxycycline (Vibramycin) (100 mg twice a day), amoxicillin (Amoxil) (500 mg three times a day), or cefuroxime (Ceftin) (500 mg twice a day) is recommended. For Lyme disease with CNS involvement, an initial course of 4 to 6 weeks of intravenous ceftriaxone (Rocephin) (2 grams/day) or cefotaxime (Claforan) (2 grams/8 hours) is recommended. Symptoms may worsen during the first week of antibiotic treatment, much like the Jarisch-Herxheimer reaction during the treatment of syphilis. For patients who relapse, longer and repeated courses of antibiotics are often helpful. Failure to treat Lyme disease early in its course or for a sufficiently long duration may lead to a chronic illness characterized by persistent waxing and waning neuropsychiatric disturbances, arthralgias, myalgias, sensory-hyperacuities, and severe fatigue. In some patients these symptoms reflect the effects of persistent infection while in others the symptoms may reflect a residual postinfectious syndrome. Because the laboratory tests for chronic Lyme disease are not sufficiently reliable to document the presence or absence of persistent infection, decisions regarding treatment should be based primarily upon the physician's clinical judgment. Given the emerging literature that indicates that B. burgdorferi is capable of remarkable persistence in the human host despite standard courses of antibiotic treatment and clinical reports documenting improvement in chronic Lyme disease among some patients treated with long courses of antibiotics, many community physicians are now willing to treat such patients more aggressively. Other physicians, wary of the risks associated with long-term antibiotic treatment, choose not to treat these patients. Until well-controlled studies are conducted of patients with chronic symptoms, the debate on the proper antibiotic treatment for chronic Lyme disease will continue. A vaccine for Lyme disease was introduced in 1999; however, it is only effective in about 50 to 75 percent of cases.

Neurosyphilis The cause of syphilis, Treponema pallidum, was identified in 1905. Because of the cognitive loss and neuropsychiatric disturbances associated with tertiary neurosyphilis, these patients accounted for 5 to 15 percent of psychiatric hospital admissions and were diagnosed as having general paresis, general paralysis of the insane, or dementia paralytica. With penicillin treatment of primary and secondary syphilis, neurosyphilis is now an uncommon cause of hospital admissions.

Primary syphilis is manifest by a syphilitic ulcer, the chancre, at the site of inoculation. Secondary syphilis, a result of hematogenous dissemination of the spirochete, is characterized by flu-like symptoms followed by a skin rash, generalized lymphadenopathy, and mucosal lesions. Left untreated, both primary and secondary syphilis resolve on their own, after which the patient enters a latent period during which infection is present but clinical symptoms are not manifest. After months to years, about one third of patients with untreated latent syphilis develop tertiary syphilis that affects the brain or heart.

As in neuroborreliosis, invasion of the CNS by Treponema pallidum occurs early in the disease and may be asymptomatic for months to years prior to clinical expression.

Clinical neurosyphilis can be divided into four types: syphilitic meningitis, meningovascular syphilis, parenchymatous neurosyphilis, and gummatous neurosyphilis. Syphilitic meningitis, the result of direct meningeal inflammation, rarely has focal findings. Meningovascular syphilis results from the ischemic changes caused by proliferative endarteritis, resulting in permanent CNS damage. In parenchymatous neurosyphilis (general paresis or tabes dorsalis), which generally starts 10 to 20 years after infection, there is direct neural destruction resulting in diminished neuron concentration, demyelination, and gliosis (Fig. 2.9-2). In gummatous neurosyphilis, the mass effect causes neurological symptoms.

FIGURE 2.9-2 Tabes dorsalis. Degeneration of the posterior column in the sacral and thoracic cord (myelin sheath stain). Reprinted with permission from Merritt HH, Adams RD, Solomon

HC: Neurosyphilis. Oxford University Press, New York, 1946.)

General paresis often starts with subtle cognitive and emotional changes, such as problems with concentration and irritability; if untreated, it can lead to memory loss, confabulation, anomia, apraxia, or pseudobulbar palsy. The disease may mimic any other psychiatric disorders as well. Half of the patients with neurosyphilis will manifest dementia of whom one quarter will have prominent psychiatric manifestations such as depression, paranoia, psychosis, or mania. A worsening of symptoms during the first 24 hours after the initiation of antibiotic treatment has been termed the Jarisch-Herxheimer reaction; in rare cases, psychosis may emerge shortly after antibiotics are started. With disease progression there is loss of muscle tone and fine motor control and seizures, spasticity, and eventually paralysis and death occur. Focal neurological findings are rare, consistent with the generalized pathophysiology. Tabes dorsalis on the other hand develops somewhat later than general paresis, 15 to 20 years after infection, and causes a more characteristic clinical picture of lancinating pains, attacks of abdominal pain, and paresthesias. Because of progressive loss of proprioception and sensation, patients compensate by walking with a broad-based, shuffling gait. Unlike patients with general paresis, not all patients with tabes will have CSF abnormalities.

Tests T. pallidum is difficult to demonstrate in the CSF and difficult to culture. Although PCR techniques are being developed to detect the genetic material of the spirochete, this method is currently only available in research laboratories. Clinicians must rely upon serological tests in the context of a careful history and physical examination. Serological tests for syphilis include the nontreponemal Veneral Disease Research Laboratory (VDRI) and rapid plasma reagin (RPR) tests and, for confirmatory purposes, the fluorescent treponemal antibody-absorption (FTA-ABS) test. CSF studies are useful to confirm the diagnosis of neurosyphilis if clinical findings are suggestive, to diagnose asymptomatic involvement so that treatment can be started, and to follow treatment efficacy. These CSF studies are limited by the low specificity of the typical abnormalities of elevated protein, g-globulin, and leukocyte count and the low sensitivity (but high specificity) of the VDRL test. The CSF FTA-ABS test on the other hand is thought to have excellent sensitivity but less specificity than the CSF VDRL test.

Neuroradiological studies of neurosyphilis report the presence of cortical atrophy, most commonly affecting the frontal and temporal lobes.

Treatment The goal in clinical neurosyphilis is to reverse the manifestations or arrest the disease progression, although in some patients antibiotic therapy may not be able to achieve these goals. Standard courses consist of intravenous aqueous penicillin G, 12 to 24 million units daily in divided doses at 4-hour intervals for 2 weeks, or intramuscular weekly injections of 2.4 to 4.8 million units of penicillin G benzathine for 3 weeks or intramuscular injections of 2.4 million units of penicillin G procaine four times daily for 2 weeks. The likelihood of marked improvement for patients with general paresis is less than that for patients with syphilitic meningitis or meningovascular syphilis, reflecting the pathological process, which in the former is irreversible neuron damage and in the latter is CNS inflammation. During the first year after treatment, the serum and CSF should be regularly monitored for the reemergence of reactivity so that treatment can be reinitiated if necessary. Certain conditions, such as comorbid HIV infection, may place patients at greater risk for persistence of treponemal infection after antibiotic treatment. However, most neurosyphilis patients, when treated, will show improvement in the cognitive, psychiatric, and functional domains.

NON-HIV VIRAL INFECTIONS OF THE CENTRAL NERVOUS SYSTEM

Numerous viruses are invasive and neurotropic, with the extent of consequent neuronal dysfunction varying widely depending upon the virulence of the virus and the immunological response of the host. This section will focus upon agents known to cause striking neuropsychiatric diseases: herpes simplex, rabies, measles, and subacute sclerosing panencephalitis; Table 2.9-1 presents other infectious causes of neuropsychiatric disorders.

Table 2.9-1 Selected Infectious Causes of Neuropsychiatric Disorders

Herpes Viruses Included under the spectrum of herpesviruses are human herpesvirus 1 (HHV-1), that is, herpes simplex virus 1; HHV-2, that is, herpes simplex virus 2, varicella-zoster virus, Epstein-Barr virus (EBV), cytomegalovirus (CMV), HHV-6, HHV-7, and Kaposi's sarcoma herpesvirus.

Herpes Simplex Herpes simplex encephalitis is a dramatic disorder, characterized by the abrupt onset of fever, personality change, and headaches, followed by cognitive changes and focal neurological signs, such as aphasia, visual field deficits, hemiparesis, or partial seizures. Although focality is an important feature of herpes simplex encephalitis, other viruses, such as the LaCrosse virus or the nonpolio enteroviruses, may also cause focal signs. Neurobehavioral aspects of herpes simplex encephalitis such as hallucinations, memory loss, or behavioral disturbances may be the primary clinical feature, a consequence of the predilection of the virus for the temporal lobes. Although the course of illness is typically rapidly progressive, resulting in refractory seizures, coma, and death within 2 weeks, occasionally the progression may be slower with varied neuropsychiatric features.

HSV-1 is usually transmitted orally entering the CNS through sensory nerves, particularly the trigeminal ganglia. HSV-2 is transmitted genitally and may seed the sacral ganglia or disseminate hematogenously. Herpes simplex viruses typically produce a lytic infection with neuronal necrosis and tissue destruction, and intranuclear inclusion bodies in the neurons and glia. Patients who survive herpes simplex encephalitis may exhibit postencephalitic symptoms, such as amnesia, aphasia, and less commonly, the Klüver-Bucy syndrome or dementia.

Routine serological studies are of little value in suspected herpes simplex encephalitis. The CSF usually demonstrates leukocytosis (approximately 100 cells/mm3), a moderate protein elevation, and a normal or depressed glucose content. PCR analysis of the CSF to detect HSV DNA is at present the diagnostic procedure of choice because the PCR assay has high sensitivity and specificity. Recent studies indicate that approximately 80 percent of patients with biopsy-proven herpes simplex encephalitis will have focal EEG abnormalities consisting of slowing or repetitive epileptiform discharges in the frontotemporal area. MRI studies in early stages of herpes simplex encephalitis may reveal T2 prolongation in the insular cortex and cingulate gyrus. SPECT or PET imaging may show reduced blood flow in the orbitofrontal and temporal regions. Brain biopsy can be helpful in cases that are difficult to diagnose, although the complication rate is approximately 3 percent.

If untreated, 40 to 70 percent of patients with herpes simplex encephalitis will die. Antiviral therapies include acyclovir (zovirax) and vidarbine (Vira-A); however, even with acyclovir treatment fewer than 40 percent of patients survive with minimal or no sequelae (Fig. 2.9-3).

FIGURE 2.9-3 Herpes encephalitis. A, Contrast-enhanced axial CT scan shows diffuse

decreased density of the left temporal lobe with minimal hypodensity of the medial right

temporal lobe. An abnormal CT scan is usually not seen until day 6 to 7 after the onset of

manifestations. Eventually, a majority of scans show gyral enhancement in the sylvian fissure area.

These findings should raise the suspicion of an underlying infectious lesion such as herpes, early

infarction from emboli or vasculitis, or metastatic tumors. B, T2-weighted axial MRI scan shows diffuse

increased signal intensity along the left temporal lobe cortex as well as the posteromedial left temporal

lobe. Both medial frontal lobes are involved as well. An abnormal MRI scan is usually seen by day 1 or 2

after the onset of manifestations. The patient was treated for herpes encephalitis and responded to

acyclovir therapy. (Reprinted with permission from Jubelt B, Miller JR: Viral infections. In Meritt's

Textbook of Neurology, ed 9, LP Rowland, editor. Williams & Wilkins, Baltimore, 1995.)

Epstein-Barr Virus Most adults have evidence of past exposure to EBV, with approximately 50 percent

seropositivity among children over age 5. Infection in childhood is generally mild, whereas in

adolescence and young adulthood it may result in infectious mononucleosis or, rarely, a fulminant

life-threatening disease. EBV enters the body by infecting oral mucosal epithelial cells. The clinical

symptoms of infectious mononucleosis of sore throat, headache, malaise, and fatigue are largely a

result of the vigorous cellular immune response to EBV infection rather than direct cytotoxic effects.

Significant neurological complications of EBV infection are rare, occurring in less than 0.5 percent of

cases of infectious mononucleosis.

EBV encephalitis occurs usually within 1 to 3 weeks after the onset of clinical infectious

mononucleosis. Patients with EBV encephalitis may present with cerebellar ataxia, personality

changes, psychosis, transient global amnesia, perceptual distortions of size and space, focal

neurological findings, seizures, or coma. EEG usually reveals generalized slowing with occasional

sharp-wave activity. The diagnosis of an EBV neuropsychiatric syndrome requires an appropriate clinical

history in the setting of serological evidence of acute or, rarely, chronic active infection. In cases of EBV

encephalitis commonly there is a lymphocytic pleocytosis (atypical lymphocytes are particularly

suggestive) with elevated protein. In most cases EBV encephalitis is self-limited, with recovery occurring

within weeks to months; rarely, acute EBV infection may result in a relapsing or chronic encephalitis.

Treatment is generally supportive.

Other Herpes Viruses With herpes zoster, neuropsychiatric complications occur most frequently in immunocompromised patients, resulting in encephalitis, myelitis, or leukoencephalitis. With CMV infection, encephalitis may also occur because CMV is tropic for the CNS; however, only in rare exceptions has CMV encephalitis occurred in non–HIV-infected immunocompromised individuals.

Rabies Although most cases of human rabies occur after animal bites, other sources of rabies infection include aerosols (risk for spelunkers) and person-to-person transmission following corneal transplants. The virus replicates locally at the site of inoculation and subsequently spreads to the CNS by retrograde axonal transport, infecting the lower areas of the brain most prominently, particularly the limbic system, hippocampus, brainstem, and cerebellum. Limbic system involvement may result in aberrant sexual behavior and behavioral dyscontrol, whereas brainstem involvement typically results in alterations of body temperature and respiratory control. The site and amount of inoculation is associated with morbidity. For example, multiple dog bites to the face may result in a 60 percent mortality rate without prophylactic intervention whereas multiple bites to the hand are associated with lower mortality rates of about 15 percent. The incubation period prior to symptomatic expression ranges from a few days to several years. Once symptoms emerge, the course is rapidly fatal. Most patients get the furious form characterized by agitation, hallucinations, odd behaviors, extreme excitability, and in some cases, hydrophobia. Diagnosis is based on the history of an animal bite in a patient with unexplained encephalitis that has been confirmed by the demonstration of rabies antigen on a skin biopsy of the patient or from a putatively infected animal. There is no treatment for rabies virus infection. Disease prevention is critical, aided by preexposure vaccination in high-risk individuals and postexposure prophylaxis with rabies immunoglobulin and rabies vaccine (Fig. 2.9-4).

FIGURE 2.9-4 Rabies. Inclusion bodies (Negri bodies) in cytoplasm of ganglion cell of cerebral cortex. (Reprinted with permission from Jubelt B, Miller JR: Viral infections. In Merritt's Textbook of Neurology, ed 9, LP Rowland, editor. Williams & Wilkins, Baltimore, 1995.)

Subacute Sclerosing Panencephalitis Subacute sclerosing panencephalitis is a very rare slow infection with measles virus that causes progressive inflammation and sclerosis of the brain. Primarily affecting children and young adults, the rate of subacute sclerosing panencephalitis decreased markedly after 1960 as a result of widespread measles vaccination, with a current rate in the United States of only 1 per 100 million people per year. The onset generally occurs 7 to 12 years after measles and is subtle, characterized by gradual changes in behavior and school performance. Neuropsychological testing may demonstrate reduced overall intelligence and problems with reading, writing, and visuospatial processing. Neuropsychiatric symptoms may include hallucinations, apraxia, agnosia, and Balint's syndrome (optic ataxia, simultanagnosia, and sticky fixation). Repetitive myoclonic jerks are common, at times accompanied by movement disorders and cerebellar ataxia. In advanced stages, dementia, mutism, cortical blindness, optic atrophy, stupor, coma, and death occur.

The usual course of the illness is 1 to 3 years, with rare patients surviving up to 10 years.

Serological testing may reveal unusually high titers of antibodies to measles virus. CSF studies typically show high measles antibody titers and a greatly elevated gamma globulin fraction with oligoclonal bands in a CSF with slightly elevated protein concentrations. EEG studies are essential, particularly in the myoclonic stage, when they reveal high-amplitude bilateral and stereotyped complexes that repeat every 3 to 5 seconds. MRI studies may reveal enlarged ventricles and diffuse brain atrophy, with multifocal low-density white matter lesions and lucent areas in the basal ganglia. PET and SPECT studies may reveal early subcortical hypermetabolism followed by global cortical and subcortical hypometabolism.

No treatments are known to reverse the disease, although slightly prolonged survival has been reported with isoprinosine (Inosiplex) and with intraventricular or intrathecal injections of interferon-a.

Progressive Multifocal Leukoencephalopathy This disease affects immunocompromised subjects and is a progressive infection of oligodendroglial cells with the JC papovavirus. Typically the onset is abrupt with focal neurological or neuropsychological signs and the course is almost invariably fatal within 2 to 4 months. Definitive diagnosis requires a brain biopsy. Neuroimaging studies reveal multifocal areas of high signal intensity in the white matter. Functional imaging with PET or SPECT may reveal a heterogeneous pattern of reduced metabolic activity and perfusion.

SUBACUTE SPONGIFORM ENCEPHALOPATHIES

Included in this group are Creutzfeldt-Jakob disease; kuru, a dementing disease of three New Guinea tribes that is most likely spread by ritual cannibalism; Gerstmann-Straüssler syndrome, a familial disorder characterized by dementia and ataxia; and fatal familial insomnia, a disorder causing disturbances of sleep and of motor, autonomic, and endocrine function. These disorders are all slow infections caused by a transmissible agent not yet clearly described that may be a prion, a virino or an atypical virus. Prions are proteinaceous agents devoid of nucleic acid that are crucial in the pathogenesis of the spongiform encephalopathies. A virino is a small molecule (probably a nucleic acid) associated with a host protein. Characteristic of the neuropathology of these disorders is the neuronal vacuolation that leads to spongy degeneration of the cerebral cortical gray matter.

Creutzfeldt-Jakob Disease Invariably fatal, this transmissible, rapidly progressive disorder occurs mainly in middle age or older and is manifest early on by fatigue, flu-like symptoms, and mild cognitive impairment or focal findings such as aphasia or apraxia. Subsequent psychiatric manifestations include mood lability, anxiety, euphoria, depression, delusions, hallucinations, or marked personality changes. Progression of disease occurs over months leading to dementia, akinetic mutism, coma, and death. Other common neurological findings are generalized startle myoclonus, cortical blindness, and extrapyramidal and cerebellar signs.

The rates of Creutzfeldt-Jakob disease range from 0.25 to 2 cases per million persons a year worldwide. The infectious agent self-replicates and can be transmitted to humans by inoculation with infected tissues and sometimes by ingestion in food. Iatrogenic transmission has been reported via transplantation of contaminated cornea or to children via contaminated supplies of human growth hormone. Household contacts are not at greater risk than the general population, unless there is direct inoculation. Because of an epidemic of a newly recognized prion disease, bovine spongiform encephalopathy (mad cow disease), among cattle in the United Kingdom and because of the unexpected recent emergence of cases of an atypical form of Creutzfeldt-Jakob disease among teenagers in the United Kingdom, fears exist that transmission to humans may have occurred as a result of eating infected meat (Fig. 2.9-5).

FIGURE 2.9-5 Creutzfeldt-Jakob disease. Section from cortex showing status spongiosis of the neuropil, loss of neurons, and prominent astrocytosis. (PTAH stain × 120). (Reprinted with permission from Jubelt B, Miller JR: Viral infections. In Merritt's Textbook of Neurology, ed 9, LP Rowland, editor. Williams & Wilkins, Baltimore, 1995.)

Diagnosis requires pathological examination of the cortex, which reveals the classic triad of spongiform vacuolation, loss of neurons, and glial cell proliferation. Genetic susceptibility is a factor in disease risk, indicated by a common polymorphism of the human prion protein. An immunoassay for Creutzfeldt-Jakob disease in the CSF is currently under development, showing promise in supporting the diagnosis of Creutzfeldt-Jakob disease in patients with dementia. EEG abnormalities, although not specific for Creutzfeldt-Jakob disease, are present in nearly all patients: a slow and irregular background rhythm with periodic complex discharges. Computed tomography (CT) and MRI studies may reveal cortical atrophy later in the course of disease; SPECT and PET reveal heterogeneously decreased uptake throughout the cortex. There is no known treatment for Creutzfeldt-Jakob disease.

OTHER INFECTIOUS CAUSES OF NEUROPSYCHIATRIC DISORDERS

A variety of bacterial, mycoplasmal, fungal, and parasitic infections can cause neuropsychiatric disturbances as a result of a chronic meningitis or sequelae from an acute infection (Table 2.9-1).

EMERGING AREAS OF INVESTIGATION

Chronic Fatigue Syndrome Chronic fatigue syndrome, more commonly referred to as myalgic encephalomyelitis in the United Kingdom and Canada, is a multisystem syndrome characterized by 6 months or more of severe, debilitating fatigue, often accompanied by myalgia, headaches, pharyngitis, low-grade fever, cognitive complaints, gastrointestinal symptoms, and tender lymph nodes. The search for an infectious cause of chronic fatigue syndrome has been active because of the high percentage of patients who report abrupt onset after a severe flu-like illness. In the mid-1980s chronic fatigue syndrome was linked to infection with Epstein-Barr virus. After EBV was shown in controlled studies to have no specific role in the etiology of chronic fatigue syndrome, reports have linked chronic fatigue syndrome to a variety of other agents, including enteroviruses, retroviruses, and new lymphotropic herpesviruses but these reports have not been consistently replicated in well-designed studies. Certain organisms, however, such as B. burgdorferi (which causes Lyme disease), can result in a chronic fatigue syndrome-like picture; however, most cases of CFS are not linked to Lyme disease. Evidence of immune dysregulation has been frequently reported among patients with chronic fatigue syndrome, but the data are not consistent across studies nor are they reflective of illness severity. Various studies have found high rates (15 to 54 percent) of depressive disorders among patients with chronic fatigue syndrome. In addition, recent research has shown that patients who are most likely to be plagued by persistent fatigue after an acute viral illness are patients with preexisting or comorbid psychiatric problems. However, other research has shown that the cognitive impairment in chronic fatigue syndrome exists even in the absence of preexisting or comorbid psychiatric disorders, thus leading to the conclusion that psychiatric disorders alone cannot account for chronic fatigue syndrome. At present, chronic fatigue syndrome is best conceptualized as a heterogeneous syndrome of uncertain etiology, most likely involving an interplay of psychiatric, infectious, neuroendocrine, and immunological factors.

Group A b-Hemolytic Streptococci Poststreptococcal autoimmunity has been postulated to be a cause of certain types of childhood-onset obsessive-compulsive disorders and Tourette's disorder based on the observation that children who develop Sydenham's chorea are often observed to have tics or obsessive-compulsive symptoms prior to the onset of the chorea. These pediatric autoimmune neuropsychiatric disorders are characterized by abrupt and dramatic symptom exacerbations that are temporally related to group A b-hemolytic streptococcal infections. Recent research has identified a genetic marker in pediatric autoimmune neuropsychiatric disorders that has previously been shown to be both highly specific and sensitive in identifying individuals with rheumatic fever. In one study 85 percent of children who developed streptococcal-related obsessive-compulsive disorder or tics and 89 percent of children with Sydenham's chorea carried the D8/17 monoclonal antibody marker on DR+ cells in the peripheral circulation, whereas only 17 percent of healthy controls carried this marker. Investigations are currently underway to determine whether treatments that modulate the immune response (e.g., intravenous g-globulin or plasmapheresis) are effective in eliminating obsessive-compulsive disorder and tic disorders among children with pediatric autoimmune neuropsychiatric disorders.

Borna Disease Virus Borna disease virus (BDV) is a small neurotropic ribonucleic acid (RNA) virus that infects various domestic animal species, causing disturbances in behavior and cognition and, rarely, death. Researchers have found that BDV targets cells of the limbic system in animals and compromises their neuronal function without causing direct damage. BDV has recently been linked to a wide array of neuropsychiatric disorders in humans. Evidence suggestive of BDV infection in humans has been accumulating from several research centers. One research group recently identified serum antibodies to BDV in 9.6 percent of 416 people with schizophrenia, major depressive disorders, bipolar I disorder, and other neuropsychiatric disease whereas these serum antibodies were found in only 1.5 percent of 203 healthy controls. Reverse transcriptase-PCR identified BDV RNA sequences in 13 of a subset of 26 psychiatric patients but in none of 23 healthy controls. Other reports have identified BDV antibodies in 6.8 percent of patients with psychiatric illnesses versus 3 percent of surgical controls. These studies represent provocative preliminary findings that suggest a possible role for BDV in a subset of human neuropsychiatric diseases; well-controlled microbiological and epidemiological studies are needed to determine the significance of these reports.

SUGGESTED CROSS-REFERENCES

Acquired immune deficiency syndrome is discussed in Section 2.8; interactions of the immune system and the CNS are discussed in Section 1.12; neuropsychological testing is discussed in Section 7.4; and neuroimaging is discussed in Section 2.13. Obsessive-compulsive disorder and schizophrenia are discussed in Chapter 15 and Chapter 12, respectively.

SECTION REFERENCES

Ackerman R, Rehse-Kupper B, Gollmer E, Schmidt R: Chronic neurologic manifestations of erythema migrans borreliosis. Ann NY Acad Sci 64:506, 1988.

Ancar B, Yalaz K, Oktem F, Köse G: Long-term follow-up of patients with subacute sclerosing panencephalitis treated with intraventricular alpha-interferon. Neurology 48:526, 1997.

Bates DW, Buchwald D, Lee J, Kith P, Doolittle T, Rutherford C, Churchill H, Schur P, Wener M, Wybenga D, Winkelman J, Komaroff AL: Clinical laboratory test findings in patients with chronic fatigue syndrome. Arch Intern Med 155:97, 1995.

Bode L, Zimmermann W, Ferszt R, Steinbach F, Ludwig H: Borna disease virus genome transcribed and expressed in psychiatric patients. Nat Med 1:232, 1995.

Bloom BJ, Wyckoff PM, Meissner HC, Steere AC. Neurocognitive abnormalities in children after classic manifestations of Lyme disease. Pediatr Infect Dis J 17:189, 1998.

Brown P, Cathala F, Castaigne P, Gajdusek DC: Creutzfeldt-Jakob disease: Clinical analysis of a consecutive series of 230 neuropathologically verified cases. Ann Neurol 20:597, 1986.

*Burrascano JJ: Lyme disease. In Conn's Current Therapy, Rakel RE, editor. Saunders, Philadelphia, 1997.

Collinge J: New diagnostic tests for prion diseases. N Engl J Med 335:963, 1996.

Coyle PK: Neurologic Lyme disease. Semin Neurol 12:200, 1992.

Coyle PK, Schutzer SE, Deng Z, Krupp LB, Belman AL, Benach JL, Luft BJ: Detection of Borrelia burgdorferi-specific antigen in antibody-negative cerebrospinal fluid in neurologic Lyme disease. Neurology 45:2010, 1995.

DeLuca J, Johnson SK, Ellis SP, Natelson BH: Cognitive functioning is impaired in patients with chronic fatigue syndrome devoid of psychiatric disease. J Neurol Neurosurg Psychiatry 62:151, 1997.

*Demitrack MA, Abbey SE, editors: Chronic Fatigue Syndrome. Guilford Publications, New York, 1996.

Fallon BA, Nields JA, Burrascano JJ, Liegner K, DelBene D, Liebowitz MR: The neuropsychiatric manifestions of Lyme borreliosis. Psychiatric Q 63:95, 1992.

*Fallon BA, Nields JA: Lyme disease: A neuropsychiatric illness. Am J Psychiatry 151:1571, 1994.

Fallon BA, Das S, Plutchok JJ, Tager F, Liegner K, Van Heertum R: Functional brain imaging and neuropsychological testing in Lyme disease. Clin Infect Dis 24(Suppl): S57-63, 1997.

Haywood AM: Transmissible spongiform encephalopathies. N Engl J Med 337:1821, 1997.

Heegaard ED, Hornsleth A: Parvovirus: The expanding spectrum of disease. Acta Paediatr 84:109, 1995.

Hendler N, Leahy W: Psychiatric and neurologic sequelae of infectious mononucleosis. Am J Psychiatry 135:842, 1978.

Hooshmand H, Escobar MR, Kopf SW: Neurosyphilis: A study of 241 patients. JAMA 219:726, 1972.

*Huang C, Chatterjee NK, Grady LJ: Diagnosis of viral infections of the central nervous system. N Engl Med 340:483, 1999.

*Huisman TA, Wohlab G, Nadal D, Boltshauser E, Martin E: Unusual presentations of neuroborreliosis (Lyme disease) in childhood. J Comput Assist Tomogr 23:39, 1999.

Krupp LB, Masur D, Schwartz J, Coyle PK, Langenbach LJ, Fernouist SK, Jandorf L, Halperin JJ: Cognitive functioning in late Lyme borreliosis. Arch Neurol 48:1125, 1991.

Lawrence C, Lipton RB, Lowy FD, Coyle PK: Seronegative chronic relapsing neuroborreliosis. Eur Neurol 35:113, 1995.

Lecour H, Miranda M, Magro C, Rocha A, Goncalves V: Human leptospirosis—a review of 50 cases. Infection 17:10, 1989.

Logigian EL, Kaplan R, Steere AC: Chronic neurologic manifestations of Lyme disease. N Engl J Med 323:1438, 1990.

Jones KJ, Garada BM, Holman BL, Steere AC: Reversible cerebral hypoperfusion in Lyme encephalopathy. Neurology 1997; 49:1661, 1997.

Oksi J, Kalimo H, Marttila RJ, Marjamaki M, Sonninen P, Nikoskelainen J, Viljanen MK: Inflammatory brain changes in Lyme borreliosis. Brain 119:2143, 1996.

Pachner AR: Borrelia burgdorferi in the nervous system: The new "Great Imitator." In Lyme Disease and Related Disorders. Ann N Y Acad Sci 539:56, 1988.

Sauder C, Muller A, Cubitt B, Mayer J, Steinmetz J, Trabert W, Ziegler, Wanke K, Mueller-Lantzsch N, de la Torre JC, Grasser FA: Detection of borna disease virus (BDV) antibodies and BDV RNA in psychiatric patients: Evidence for high sequence conservation of human blood-derived BDV RNA. J Virol 70:7713, 1996.

*Scheld WM, Whitley RJ, Durack DT, editors: Infections of the Central Nervous System. Lippincott-Raven, New York, 1997.

Swedo SE, Leonard HL, Mittleman BB, Allen AJ, Rapoport JL, Dow SP, Kanter ME, Chapman F, Zabriskie J: Identification of children with pediatric autoimmune neuropsychiatric disorders associated with streptococcal infections by a marker associated with rheumatic fever. Am J Psychiatry 154:110, 1997.

Swedo SE: Sydenham's chorea: A model for childhood autoimmune neuropsychiatric disorders. JAMA 272:1788, 1994.

Thomas EW: Syphilis: Its course and management. MacMillan, New York, 1949.

Waltrip RW, Buchanan RW, Summerflet A, Breier A, Carpenter WT, Bryant NL, Rubin SA, Carbone KM: Borna disease virus and schizophrenia. Psychiatry Res 56:33, 1995.

Wessely S, Chalder T, Hirsch S, Pawlikowska T, Wallace P, Wright DJM: Postinfectious fatigue: Prospective cohort study in primary care. Lancet 345:1333, 1995.

*Yolken RH, Torrey EF: Viruses, schizophrenia, and bipolar disorder. Clin Microbiol Rev 8:131, 1995.

Books@Ovid

Harold I. Kaplan, M.D, Benjamin J. Sadock, M.D and Virginia A. Sadock, M.D.

Kaplan & Sadock's Comprehensive Textbook of Psychiatry

Free Pintable and Lyme experience

2009-06-15T17:25:00.000-07:00

Ice Cream Fill In Words Game. Using this picture on the game to figure out the six words that fill in the boxes of the game. All six words are related to ice cream and available on page two of the game which is the answer key. Great for summer kids activity or children’s birthday party.

>>> Ice Cream Fill In Words Game. pdf

TOUCHED BY LYME: Is having Lyme-induced MCS a criminal offense?

Some people with Lyme disease develop a host of related problems, like extreme sensitivity to light, sound, and various chemicals in the environment. (This last condition is called multiple chemical sensitivity, or MCS. For people who have it, being around gasoline fumes, cologne, and even clothes washed in certain detergents, can literally be life-threatening.)

Eighteen-year-old Makayla Berndt has all of the above-mentioned health issues and more. She’s also the founder of a Yahoo group for teens and young adults with Lyme disease, a published writer, and a frequent contributor to many Lyme-related internet discussion groups.

Her health problems recently led to a harrowing encounter with the police in Williams, a small town near Interstate 5 in northern California.

She gave me permission to excerpt one of her recent yahoo postings:

So last night around 9:15 p.m. my mom and I were coming back from a doctor’s appointment trip, and the car needed gas. With my MCS, I can't be in the car when my mom is fueling up without getting a huge reaction which affects my airways. So my mom dropped me off at a park, which was down the street from the gas station....you can see the gas station and park from each other. She wanted me to take our pepper spray with me, for protection. I had my sunglasses, earplugs and mask on.

So I am waiting for my mom, and a police car drives up. Two policemen come out of the car, and ask me what I am doing. I told them that my mom was down the street getting gas and that I have MCS... I can't handle the fumes from the gas. One of the policemen says "Right" with the tone of "Yeah, Right"—didn't believe me. Then they pointed their flashlight at me and I flinched...light sensitivity. And then of course they have fragrance on them, so I was reacting and my lungs were burning and I was having a hard time breathing.

So I told them that I was about to step back, because I was reacting to their laundry soap. And the police man says again "Right" in the same tone as before...so I stepped back, and they stepped forward. Then I showed them the pepper spray that I had in my hand, like you can see it if you want. And he asked why I had it, I told him 1) that my over-protective mom told me to carry it and 2) because I am sick, I have Lyme and I needed to protect myself if something happened. He then says “Right" again. Then he asked if I was from around the area, and I said, "No, I am traveling home from a doctor’s appointment, and my mom and I are on our way home." So then one of the men asked if I had ID, and I don't drive so I don't have one. So he asked me for all my information, and I gave it to him.

At this point, Makayla’s mom returned, saw her daughter being questioned by the police, and came barreling out of the car yelling, “If you have cologne on, you are causing her damage!” After she verified what Makayla had already told the police, they finally let them go. Legs still trembling from her scary encounter, Makayla turned on her oxygen to help her breathe better, and “took all the detox agents that I had.”

In our phone conversation, Makayla said she doesn’t necessarily blame the police for stopping to talk to her. (Yes, she must have looked a bit odd with her sunglasses, carbon filter face mask, and earplugs, standing at the edge of the park at nine o’clock at night.)

But, she says, the cops obviously didn’t believe what she was saying, and when she tried to step back to protect herself from their harmful fragrance, they kept coming closer. She said her body was already reacting to just being around them in the open air. If they had put her in the enclosed environment of the police car, she fears she might have passed out or stopped breathing.

At this point, Makayla recommends that people in her situation carry a note from their doctor in their wallet or purse, explaining why they need to wear protective gear. Or perhaps a Medic-Alert bracelet.

Here’s my two cents worth: This is one more example of why we need increased public awareness of Lyme disease and related ills. Police officers are trained to respond to any number of unusual circumstances. The idea of encountering someone with MCS shouldn’t be a foreign concept to them. MCS is, after all, a protected condition under the Americans with Disabilities Act. This protection should include not having your life unwittingly imperiled by policemen who happen along while your mom is filling up the gas tank.

Please Rescue me

2009-06-15T17:17:00.000-07:00

Please save this girl and let her know there are kind people in the world who will not starve her! I want to pull her out; this is just so sad. Can someone foster her! PLEASE. We will pay for vet bills and food? She will need TLC. I will start looking for a home for her. Am Staff mix female. VERY emaciated, a seizure from owner now released for rescue. A very nice girl who did not deserve to be treated like this. She was out in the play yard with several small dogs and paid no attention to them.

Please cross post!!!! Her time is up! If you unable to help, please Kindly consider donation, so she can be kenned. Our rescue just received over 10K vet bills for 2 dogs.

You can make donation via website:http://www.scooterspals.org/

Or sending check:Scooter's Pals -228 Commercial Street, Nevada City, CA 95959 Let me know ASAP; the transport is coming this Monday and I want her out of the shelter. Thank you! Marianna 916-508-9418

Merced shelter!

Holistic Pregnancy and Crafty Crochet

2009-06-15T13:36:00.000-07:00

Cristen Andrews of shares with us her plastic bag crafts and shows us how to get started with crocheting plastic bags.

Breastfeeding Benefits to Mother and Child

Unsung Benefits of Breastfeeding
by: Philip J. Goscienski, M.D.

From the Stone Age until just a few generations ago, human infants’ only sustenance was mother’s milk, but modern infant formula seems to be an adequate substitute. After all, infant mortality in Western societies is at historic lows and growth patterns are normal. But is that all there is to it? Could there be other advantages to breastfeeding, both to the mother and to the infant?

Post-delivery stress discomfort.
All those hours of labor may be natural, but they are exhausting and stressful for mom. It’s not so easy on baby, either! First, that cushion of fluid suddenly vanishes in a big gush as labor begins. Then comes the big squeeze as the infant is mashed against the opening of the uterus, and through a birth canal that is so narrow that the baby’s skull elongates just to fit through. It takes a day or so before a newborn’s head gets its normal rounded shape back.

Read the story »

These thin chocolate cookies with ganache icing dipped into grated coconut make the perfect nests for two or three miniature chocolate eggs.
Bird's Nest Cookies and more delicious recipes, smart cooking tips, and video demonstrations on marthastewart.com

Free Fathers Day Printables

2009-06-12T14:13:00.000-07:00

Free printable Fathers Day Cookout coloring sheet is free to printout as many copies as you would like. Fun kids activity for a father’s day cookout so each kid can color the picture for their dad.

Print Daddy's Little Monkey Card from Mom's Break

Kids Activity Fathers Day Card Making - Cut out the bear card on dotted line then have child write their own message in the white belly box to make a Father's Day card. This is a great card making craft for kids to do for Father's Day.- From Mom's Break

Orange Bear. jpg
Yellow Bear. jpg
Pink Bear. jpg
Blue Bear. jpg
Red Bear. jpg
Purple Bear. jpg
Brown Bear. jpg
Green Bear. jpg
White Bear for coloring. jpg

The “# 1 DAD” design prints at approximately height of six and half inches and width of five and half inches (printer may vary) so it will fit on most shirts. Below is an example image of what a shirt would look like after the shirt is made into a Fathers Day gift. Colors may vary by the color of shirts and iron-on transfer paper you use. This is not reverses (mirror) so if your iron on transfer paper instructions you to reverse (mirror) the image before printing then you will need to pick that setting on your printer options however most new types of iron on transfer paper do not require mirroring.
*** Important - Follow the directions of the iron on transfer paper you choose to make the “#1 DAD” Father's Day gift.

>>> Number One Dad Iron-on Transfer or Craft .pdf

To Donate To Mom's Break Please Click Here

LymeLife and lyme in Canada

2009-06-11T06:22:00.000-07:00

Disarray And Disenchantment, Amid The Deer Ticks

Enlarge

Amid a Lyme disease outbreak, Scott's mother (Jill Hennessy) worries about his safety — even on the front porch. Screen Media Films

Lymelife

Director: Derick Martini
Genre: Family comedy-drama
Running time: 94 minutes

Rated R: profanity, sexual situations, fist fights, gun threats

Enlarge

Scott's developer father (Alec Baldwin) shows his dubious family a dream house. Screen Media Films

NPR.org, April 9, 2009 · Midway though Lymelife, an unhappily drunk suburban mom drops the family's Monopoly set, and little green plastic houses scatter.

And because the movie has already offered vignettes of tract homes, not to mention close-ups of miniature abodes in a real estate office, there's just one conclusion to be drawn: Cookie-cutter houses are the problem.

Longtime couples drifting apart? Sexual awakening a drag? Teenagers growing to hate their parents? Blame it on the mini-mansions.

Director Derick Martini does present some other suburban afflictions, notably the one mentioned in the film's title: Lyme disease threatens late-'70s Long Island, where Brenda (Jill Hennessy) tapes shut the cuffs of 15-year-old son Scott (Rory Culkin), and where their neighbor Charlie (Timothy Hutton) suffers long-term consequences after a tick bite.

Charlie is also enduring unemployment and depression, and perhaps hallucinations. (Is he the only one who sees that ominous deer prowling the neighborhood, possibly carrying Lyme-diseased ticks?)

Plus, Charlie knows that his wife, Melissa (Cynthia Nixon), is having an affair with her boss, the ambitious residential-property developer named Mickey (Alec Baldwin) who is Brenda's husband. Mickey tells his sons that Long Island real estate will soon make him a millionaire; Brenda can't stop recalling how much happier they were back in Queens.

Martini scripted this proficient but mostly unsurprising movie with his brother Steven, and the two have acknowledged that it's autobiographical. So naturally the story turns on the younger generation — especially on Scott.

Regularly bullied at school, Scott takes lessons in macho from his obnoxious father and his older brother Jim (Kieran Culkin), who is home for a visit before beginning a stint in the military. But Scott is tormented less by other guys than by his seemingly hopeless love for longtime friend Adrianna (Emma Roberts), who lives next door. She is, of course, the daughter of Melissa and Charlie.

Sly Adrianna looks out for bland Scott, but she tells him she prefers to date older boys. Still, the two have a crucial bond: the emotional wreckage strewn by their parents' entanglements.

While the movie focuses on Scott and his idealized crush, Hutton and Baldwin give the most colorful performances. Charlie and Mickey's near-confrontation in a bar shows how much more compelling Lymelife could have been if the Martinis had downplayed the coming-of-age-kids stuff.

Conventionally, the director sets the period with TV reports (the seizure of the U.S. Embassy in Tehran) and pop-culture fandom (Scott wants to be Han Solo). The music, which ranges from Boston and Bad Company to Frank Sinatra, is less chronologically specific, and sometimes kind of confusing.

The movie concludes with tracking shots of homes, and a foreboding reflection in a new house's glass exterior. Yet for all its emphasis on suburbia and its discontents, Lymelife never quite convinces that its story's environs are essential — or even all that interesting.

The emergence of Lyme disease in Canada
Nicholas H. Ogden, DPhil, L. Robbin Lindsay, PhD, Muhammad Morshed, PhD,
Paul N. Sockett, PhD and Harvey Artsob, PhD

Canadian Medical Association Journal, 2009 Jun 9;180(12):1221-4.
Free, full text here:
http://www.cmaj.ca/cgi/content/full/180/12/1221

http://dx.doi.org/10.1503/cmaj.080148

Review

Lyme disease, caused by the bacterium Borrelia burgdorferi and
transmitted by tick vectors, is the most commonly reported vector-borne
disease in the temperate zone. More than 20 000 cases are recorded
annually in the United States. In about 80% of cases, early Lyme disease
is characterized by a skin lesion, erythema migrans, which expands to a
diameter of more than 5 cm from the site of the tick bite. If left
untreated, the disease can progress to early disseminated Lyme disease
with neurologic (facial palsy, meningitis and meningoradiculoneuritis,
also known as Bannwarth syndrome) and cardiac (usually atrioventricular
block, sometimes with myopericarditis) involvement, and then to late
disseminated Lyme disease with neurologic manifestations (peripheral
neuropathy or encephalomyelitis) and Lyme arthritis.

B. burgdorferi is transmitted by ticks, which feed on wildlife reservoir
hosts of the pathogen, particularly rodents and birds. Ixodes
scapularis, the blacklegged tick (Figure 1), is the main vector in
eastern and central North America. Ixodes pacificus, the western
blacklegged tick, is the main vector west of the Rocky Mountains. Both
tick species are indiscriminate in their choice of host and will feed on
humans; as such, they can transmit pathogens from wildlife to humans.

Recent studies have suggested that the risk of exposure to Lyme disease
is emerging in Canada because the range of I. scapularis is expanding, a
process that is predicted to accelerate with climate change. Here we
review the available and emerging surveillance information and discuss
its relevance to the early diagnosis and prevention of Lyme disease. We
based this review on a search of the MEDLINE database using the key
words "Lyme," "Ixodes " and "Canada."

Altoid kits and saucy stitches

2009-06-11T06:09:00.000-07:00

Oh the things we can do.. with an altoid box

Bicycle Survival Kit ! - More cool how to projects

altoids clock - More DIY How To Projects

Altoids Tin Pocket-Sized Watercolor Box - More DIY How To Projects

Altoids Tin Guitar - More DIY How To Projects

Teal peacock Silk-lined clutch bag

- I had to share this clutch. It is so chic, I absolutely love it

By redrubyrose, $75.
View Item| View Shop

FREE PATTERN ON FLICKR

FATHER'S DAY COMING UuuuUUP (embroidered ties, anyone?)

(Want to know where this image came from? Read about it here!

Sublime Stitching is also having a 10% OFF sale on ANY SILLY THING YOU WANT!
Stitchable Eco Tote: 14 Bucks!

(plus 10% off through Monday)

Floral Fantasy Stitchable Tote: also 14 Bucks!

(plus 10% off through Monday)

Lyme Disease

2009-06-08T18:56:00.000-07:00

Lyme Life: Young victims of the most common vector-borne disease
By Mandy Feder, News Editor, Lake County Record-Bee, Lakeport, California

http://www.record-bee.com/ci_12532953

June 5, 2009

They've been called lazy and crazy. That is what these two young people,
Miranda Rae Hunt, 20, from Clear Lake Riviera and Nick Farrar, 16, of
Paradise have in common. They've also been called spoiled, indulged and
been misunderstood.

Miranda loved to play basketball; she played for Lower Lake High School.
She also ran cross country and she volunteered at the Alzheimer Day
Care. That was before she got sick, really sick. These days she says,
"Naps are cool. I like to sleep. I think I'm part cat." She smiles
sweetly and speaks quietly.

"The Lyme disease makes me hesitant to start a conversation. I think,
what if I can't find the words and I embarrass myself," she said. She
agreed to tell her story, "If I can remember it," she laughed and said,
"That was cognitive Lyme humor." Everyday and moment is dictated by Lyme
disease and has been for about more than seven years. Miranda was not
diagnosed with Lyme until she was 17.

Nick contracted Lyme before he could verbally express the pain. He was 8
months old.

Full story and comments:
http://www.record-bee.com/ci_12532953

New items but not on etsy yet

2009-06-08T18:42:00.001-07:00

Molly Bear is one of my new clothing models. Isn't she adorable? She is modeling a new pajama outfit with woodland creature fabric and an owl applique. So cute and cozy!

This yellow striped onesie is appliqued with an "I'm with the band," patch and paired with yellow polka dot bottoms. The bottoms have an applique reading "run!"

This one has actually been posted on etsy. It is a haind painted sailor onesie. Super cute!

I have a lot more items made but am having a hard time concentrating long enough to put them online. Will post them as soon as I can!

Great Story- Rehabilitated pit bull becomes state champ

2009-06-08T16:20:00.001-07:00

KSTP TV - Minneapolis and St. Paul - Rehabilitated pit bull becomes state champ

Shared via AddThis

The following dogs are in danger of being euthanized at the Merced shelter due to the amount of time they have been there and the shelter is very crowded. If you can help anyone, please let me know asap at this e-mail address or by phone at (209) 606-3045.

We will be happy to transport them and all will be fully vaccinated when they go to rescue, including rabies vaccination.

There are some extremely nice dogs on this list, please save them....

Thanks,

Dana

Susan Hayward - Am Staff female. 4 yrs., 50 lbs. SPECIAL NEEDS as she has a cloudy spot in one of her eyes...possibly from an old injury? Susan is a real sweetheart who loves to give kisses.

Gina Davis - Am Staff female. 4 yrs., 55 lbs. I think her teeth look younger than 4 yrs. in the pics. Gina is a very nice girl and loves people, but does not always get along well with all of the dogs she has been introduced to by staff. A very pretty girl.

Lou Cotton - Shepherd mix male. 1 yr., 45 lbs. Lou has a docked tail and is a very pretty dog. He is a bit on the shy side but warms up quickly. Is very friendly and loves attention.

Lenny Flag - Shepherd mix male. 1 yr., 35 lbs. What a great dog! Lenny is a real sweetheart with a fun and playful personality.

Audrey Harding - Terrier mix female. 3 yrs., 45 lbs. Audrey is a nice girl and a staff favorite. They love this girl! She is very sweet and very loving, and likes to talk to you when you are petting her.

John Hooker - Am Staff male. 1 yr., 45 lbs. John is a gerat dog. He is super happy with a fun personality. He loves to lean up against you to be petted.

Ruth Fields - Dobie/Am Staff mix female. 4 mos. old, 20 lbs. Ruth is the sister of Bobby Fields. She is a great pup with a fabulous personality.

Bobby Fields - Am Staff mix male. 4 mos., 20 lbs. Bobby is the brother of Ruth Fields. He is also a great pup, and a good personality. He is described by the volunteers as a real character!

Nellie Spinner - Border Collie mix female. 10 mos., 20 lbs. Nellie is a lively little girl with a very happy personality. She has a great smile!

Curt Keeler - Catahoula/Am Staff mix male. 2 yrs., 45 lbs. What a beautfiful combination! Curt is a bit on the shy side but warms up quickly. He is very friendly with a nice demeanor.

Lady Mae - Am Staff mix female. 3 yrs., 40 lbs. Lady is a very pretty girl who is friendly but is definitely shy when she first meets someone.

Dwayne Johnson - Pit male. 2 yrs., 70 lbs. Someone did a home crop job on this poor boy's ears. He is a very nice dog in spite of having an owner who did this to this dog.

Tyra Banks. Am Staff female. 5 mos., 20 lbs. Tyra is friendly and sweet and loves to have her tummy rubbed. Hopefully someone will look and that sweet face and save this nice girl.

Michelle Branch - Shepherd mix female. 1 yr., 25 lbs. Michelle is a bit overwhelmed at the shelter, but wams up quite nicely in a couple of minutes. She is friendly and loves to have someone pay attention to her and pet her.

How to give a cat a pill

2009-06-03T21:00:00.000-07:00

How to Give a Cat A Pill

1. Pick up cat and cradle it in the crook of your left arm as if holding a baby. Position right forefinger and thumb on either side of cat's mouth and gently apply pressure to cheeks while holding pill in right hand. As cat opens mouth, pop pill into mouth. Allow cat to close mouth and swallow.

2. Retrieve pill from floor and cat from behind sofa. Cradle cat in left arm and repeat process.

3. Retrieve cat from bedroom, and throw soggy pill away.

4. Take new pill from foil wrap, cradle cat in left arm, holding rear paws tightly with left hand. Force jaws open and push pill to back of mouth with right forefinger. Hold mouth shut for a count of ten.

5. Retrieve pill from goldfish bowl and cat from top of wardrobe. Call spouse from garden.

6. Kneel on floor with cat wedged firmly between knees, hold front and rear paws. Ignore low growls emitted by cat. Get spouse to hold head firmly with one hand while forcing wooden ruler into mouth. Drop pill down ruler and rub cat's throat vigorously.

7. Retrieve cat from curtain rail, get another pill from foil wrap. Make note to buy new ruler and repair curtains. Carefully sweep shattered figurines and vases from hearth and set to one side for gluing later.

8. Wrap cat in large towel and get spouse to lie on cat with head just visible from below armpit. Put pill in end of drinking straw, force mouth open with pencil and blow down drinking straw.

9. Check label to make sure pill not harmful to humans, drink 1 beer to take taste away. Apply Band-Aid to spouse's forearm and remove blood from carpet with cold water and soap.

10. Retrieve cat from neighbor's shed. Get another pill. Open another beer. Place cat in cupboard, and close door onto neck, to leave head showing. Force mouth open with dessert spoon. Flick pill down throat with elastic band.

11. Fetch screwdriver from garage and put cupboard door back on hinges. Drink beer. Fetch bottle of scotch. Pour a shot, drink. Apply cold compress to cheek, and check records for date of last tetanus shot. Apply whiskey compress to cheek to disinfect. Toss back another shot. Throw Tee shirt away and fetch new one from bedroom.

12. Call fire department to retrieve the damn cat from across the road. Apologize to neighbor who crashed into fence while swerving to avoid cat. Take last pill from foil wrap.

13. Tie the little sucker's front paws to rear paws with garden twine and bind tightly to leg of dining table, find heavy-duty pruning gloves from shed. Push pill into mouth followed by large piece of filet steak. Be rough about it. Hold head vertically and pour 2 pints
of water down throat to wash pill down.

14. Consume remainder of scotch. Get spouse to drive you to the emergency room, sit quietly while doctor stitches fingers and forearm and removes pill remnants from right eye. Call furniture shop on way home to order new table.

15. Arrange for RSPCA to collect mutant cat from hell and call local pet shop to see if they have any hamsters.

How To Give A Dog A Pill.....

1. Wrap it in bacon.

2. Toss it in the air.

Award Winning Blog

2009-06-03T10:49:00.000-07:00

Mother Goose and Gear is now an award winning blog thanks to ByCoco's Art for Everyday Enjoyment. She recieved the award from Studio618. That blog received this award from MandiBeads who received it from from Anna of Life, Craftiness, and Everything Else who received it from Leslie of Shrimp Salad Circus... You get the idea...

I am super excited! I have never gotten an award and would never have expected to get one for my blog. Thank you so much for the recognition.

I am almost as excited to pass this award onto some of my favorite blogs as the One Lovely Blog Award fairy. I have come to enjoy many blogs as I have ventured into blog land so it is hard to choose from the many blogs that I follow.

And the awards go to... drum roll please...

Design*Sponge
Lovinthemommyhood
Etsy Stalker
How About Orange
The Etsy Trashion Street Team
Forty-two Roads
Four Dog Day
ExtremelyCrafty
Knock Knocking
Lenox Knits
That Unreliable Girl
Happy Flying Buttons
Swish and Swanky

Creature Comforts
Sweetie Pie Pumpkin Noodle
Made By Girl

ByCoco creates beautiful stained glass suncatchers and heirloom wooden boxes that are so beautiful that I would love to pass them down to my children and would hope they would pass it on the theirs.

One of her boxes that absolutely caught my eye is so stunning. It is a Golden Berchtesgadener Wedding Schachtel and is Heirloom Quality with Hand Painted designs on a Shaker Style Wood box.

Another item I would love to show off from her etsy store is this beautiful stained glass tulip suncatcher. It is so simple but would be so refreshing hanging in my kitchen window. Plus, it is a win-win since tulips are one of my favorite flowers.

ByCoco has so many beautiful items in her shop. You should stop by and check it out!

Queer Animal Kingdom

2009-05-08T15:45:00.000-07:00

Had to share this. I thought it was so awesome, innovative and creative. A perfect way to make a statement.

Nicole Georges 5/1/09 from cat on Vimeo.

Loving Zebra Print by Nicole J. Georges

http://spinstersummer.etsy.com

Support American Heart Association

2009-05-08T13:47:00.000-07:00

Etsy Angels support the American Heart Association during month of May. These are some of the shops that are donation a percentage of their proceeds to the American Heart Association. Help support a wonderful cause plus receive super adorable stuff!

Myminimoc's adorable hip hop - - 4 Sizes Infant to Toddler - Soft Sole Baby Shoes - Genuine Leather Shoes. 10% of all of Myminimoc's proceeds from May sales will go towards the American Heart Association. Please check it out and help support a wonderful cause!!

Peaceful Kingdom - Limited Edition Fine Art Print - Art for Children
By NovusArt would be so perfect in a child's room or a nursery. Plus NovusArt will be donating 35% of ALL proceeds from May Sales to the American ♥ Association. Check it out and support a wonderful cause!

Noah's Ark Playset for Toddlers...
By Ozarknana's shop is so incrediably adorable. This would make a great gift for any toddler even made from organic bamboo fabric. Ozarknana will be donating 50% of each Etsy Angel's, Prim Kitty, Kitty for the American Heart Association and 10% of everything else in her shop Support the cause and get something adorable in the process!

Old school baby tricks and comfortable baby sling

2009-05-08T10:18:00.000-07:00

How to carry your baby African style - More DIY How To Projects

I am currently working on making some baby slings and I saw this on instructables and thought it was great. I was also watching a movie series the other day called Into the West.. I'm not a huge western fan but really enjoyed it. One of the Indian women was carrying her baby in a basket type thing on her back, similar to an odd version of a backpack.
It looked super comfortable so I am going to try to figure out how to make one. We'll see, I might bring back really old school, eco-friendly baby backpacks!!

Another old indian trick- swaddling! Here is a good tutorial of how to use a simple baby blanket. I am also going to be coming out with easy velcro swaddling blankets soon!!

Help Your Baby To Sleep .......... - Funny bloopers R us

Sew behind... posting a ton of new things in my shop!!

2009-05-06T23:04:00.000-07:00

I was super busy with the Sacramento Indie Craft Fair and now it is over and realized how far behind I am on EVERYTHING. I made a ton of new things for the craft fair but didn't sell very much because it ended up pouring almost the whole day. I was super proud of myself and all the vendors that showed up and still set everything up. There was actually a fair amount of foot traffic even for a VERY rainy day. I had some AMAZING help from some wonderful friends. I could not have done it without them. In the next couple of days I will be posting many more blogs (lost touch with you guys since April 10)... which i cant believe, I will put up a lot more items in my etsy shop and will share a couple of things I have been working on. I have also be trying to stay healthy as well. This month is Lyme Disease awareness month and I will be posting a lot of new and items on Lyme Disease. It is so horrible that so many people dont know about it and myself and so many people suffer terribly on a daily basis because of it. Well... I need to head to bed in order to get all of this stuff done tomorrow and the next day and the next...
Matt, my fiance is coming home soon! Hopefully on Sunday or Monday evening. He has been in Southern California for a month playing war games for the Army. I can't wait to see him. I have missed him so much. Also, when he gets home we have to start wedding planning!! May 29th, 2010!! Since it is Memorial Day Weekend everything will book up really fast. ok, ok.. off to bed. Good Night.

coolest video ever!

2009-05-06T16:56:00.000-07:00

This blows my mind...

carrot cake cookies

2009-05-06T16:34:00.001-07:00

These look so amazing. I am going to try and make these this week! thanks martha stewart!!

From:

Send Me a Free
Preview Issue Now!

Before being filled, the cookies can be kept in an airtight container at room temperature for up to 3 days. The filling can be made ahead and chilled for up to 5 days.

Prep: 30 minutes
Total: 1 hour 15 minutes

Ingredients

Makes 18

FOR THE FILLING:
2 ounces bar cream cheese, room temperature
2 ounces unsalted butter, room temperature
1/4 cup confectioners' sugar
1 teaspoon fresh lemon juice
FOR THE COOKIES:
1/2 cup (1 stick) unsalted butter, melted
1/2 cup packed light-brown sugar
1/4 cup granulated sugar
1 large egg yolk
3/4 cup all-purpose flour
1 teaspoon ground ginger
1/2 teaspoon salt
1 cup rolled oats
3/4 cup packed, finely grated, peeled carrots
1/3 cup dried currants

Directions

Preheat oven to 350 degrees. Line two baking sheets with parchment paper. Make filling: With an electric mixer, beat cream cheese and butter until smooth. Add sugar and lemon juice; beat until combined. Cover; chill until firm, at least 30 minutes.
Meanwhile, make cookies: In a large bowl, whisk together butter, sugars, and egg yolk. In a medium bowl, whisk together flour, ginger, and salt. Add flour mixture to butter mixture; stir until combined. Mix in oats, carrots, and currants.
Drop dough by level tablespoons, 2 inches apart, onto prepared baking sheets. Flatten with the palm of your hand. Bake until edges are crisp, rotating baking sheets halfway through, 15 to 18 minutes. Transfer cookies to a wire rack to cool.
Turn half the cookies over, bottom side up; dollop each with about 1 teaspoon chilled cream-cheese filling. Top with remaining cookies, pressing gently to spread filling to edges. Serve immediately.

Tips for the day and your daily spoon full of sugar

2009-04-10T11:39:00.000-07:00

If you can't drink and drive why do you need a driver's license to buy liquor, and why do bars have parking lots?

Citrus Market Linocut Print on Vintage Newspaper by peaseblossomstudio

Awesome Newspaper Classifieds

Washer. Owned by clean bachelor who seldom washed -- $100.

Snow blower for sale. Only used on snowy days.

Found: dirty white dog. Looks like a rat. Been out for a while. Better be reward.

Free puppies. Part German Shepherd, part dog.

Cows, calves never bred. Also, one gay bull for sale.

Free puppies: part Cocker Spaniel, part sneaky neighbor's dog

Full-sized mattress. 20-year warranty. Like new. Slight urine smell.

Nice parachute. Never opened. Used once. Slightly stained.

Free Yorkshire Terrier. Eight years old. Unpleasant little dog.

Tired of working for only $9.75 per hour? We offer profit sharing and flexible hours. Starting
pay: $7 - $9 per hour.

Craft Tip: Do you have left over tiles from a home improvement project? Use them to make accessories like mosaic flower pots, coasters, trivits. They are also good for placing beneath hot glue guns to protect your work surface.

Tips for Job Hunting
When hunting for a job, do not confine yourself to the newspapers, or online ads, as less than 30% of the available jobs are ever posted there. One of the reasons for this is the cost, and another is the time that would have to be wasted screening applicants. By Shari from Greer, SC

Daily Meditation

2009-04-10T11:31:00.000-07:00

Kindness is the oil that reduces the friction of life.

Self-Meditation

Let what you think pass through your consciousness like clouds through the sky.

In walking meditation: notice the thought, return to the walking, notice the thought, return to the walking.

Your goal is to live in a simple, direct way - without cluttering up the mind with wanting things, hating things, judging, taking too much, worrying, or doubting.

When the mind is constantly bombarded by stimuli, it becomes overloaded and exhausted. We may be unaware that we are doing it, but by thinking and worrying we are using up tremendous amounts of energy. The tension put on the mind by worries, whether real or imagined, can use more energy than physical work. When worries get out of hand, energy resources are strained. Mental fatigue sets in, often resulting in wear and tear on the physical body as well. It is important to set aside some time each day for the mind to unwind and recoup its energies.
Whenever you experience mental tension, try breathing slowly and rhythmically for a few minutes while you concentrate on the breath. Yogic breathing exercises will may take conscious effort, but develop your ability to calm the mind using your own thought power. This leads to an experience of inner peace,with physical relaxation following the mental relaxation.

Contributor: Kems
From: Brooklyn, NY
Referenced from: http://yoga.org.nz/what-is-yoga/yoga_relaxation.htm

My Book

2009-04-09T23:03:00.000-07:00

my memoir... my life.

I am not really sure if I want to start posting pieces of my book here on my blog. It has been a long road for me but if it could help parent's understand their kids a little better or mental illness than I guess it is worth it.

I havn't written in it for a while. I have put it on hold while I start up my little craft business. Since I am on disability I try to keep myself busy with my crafts and business since it is really one of my only income sources (and not a sucessful one...yet). I have been spending almost every waking moment trying to market myself and put myself out there to see. My name is Rachel, but you know me by Mother Goose and Gear.

I guess I will start posting tid-bits and see what kind of response I get. Thank you to my followers. The 7 of you are super awesome. Maybe if I start posting some of my story it will inspire me to keep writing until I have written about my life thus far which is a long way from where I was a year ago when I stopped writing.

Here it goes...

Survive Together or Die Alone
A Memoir by Rachel Goldmark

This is a memoir of a woman named Rachel Goldmark; her life as she remembers. Her story is about coping with a variety of mental and physical illnesses. She tells about home life, drug addiction, coping with life, mental institutions, recovery and life outside of mental institutions while continuing to deal with mental illness in her daily life. Included in her story are clips from her journals, poetry, and art when she was in treatment and in mental institutions. She still deals with mental illness; it is a life long process to cope. With the help of doctors and medication and continual self-observation she is currently successful in life.

“Introductions aren’t always boring, this one is actually pretty entertaining”

I was standing inside a hollow tree with its roots firmly planted into the ground. The tree started shaking and the roots were unleashing themselves from the firm ground and it started lifting me into the sky. It was like a magical elevator that could take above the clouds into nothingness. We traveled back down to the clouds and I stepped out of the tree onto a pink puffy cloud and rays of sunlight seemed to shine through the clouds to the busy world beneath us. I sat there for awhile and then all of a sudden the cloud turn grey and I fell dramatically into the busy streets of New York City. Cars were whizzing passed me and I had no control I was frozen, I couldn’t move. The was loud honking noises coming from the cars. I let out a rumbling scream and then all of a sudden I was curled up in the fetal position inside my mothers womb. I hadn’t been born yet. I was just taking in the nutrition from my mother to grow. I didn’t want to leave this warm, safe place because somehow I knew how terrifying those busy streets were, but nothing is ever been normal in my life. Nothing is as planned. I came out of my mother’s womb a month early. The interesting part now is that I can return to my mothers safe, warm womb when ever I get panicked. How do you ask? Well, It a long story and you are about to read it.

All rights to this post can not be copied
Rights belong to Rachel Goldmark 2009

Mother Nature Team

2009-04-09T20:36:00.000-07:00

In celebration of Earth Day, all team members of Mother Nature Team are offering free shipping and recycled packaging until April 22nd. Search under "Mother Earth Team " for more great deals like this one.

Some more items and members of Mother Nature Team:

Chenille A-Line Dress Size 8/10 EARTH DAY SALE EVENT by Regal Cottage

Silver and concrete peas in a pod by lulubugjewelry

SALE-Needle felted bunnies-mother and child handmade

of natural materials in needle felt soft sculpture by oritdotanddolls

Craft tip and Old Ladies

2009-04-09T07:48:00.001-07:00

Small Organic Quilting Remnants by Picky

To keep your work surface clean, when doing crafts that generate large amounts of scraps, try taping a small bag to the table and just swipe your scraps into it as you go.

I just forgot what I was forgetting Button by Mindseyecards

Getting Forgetful

from Joke of the Day

Three old ladies sit in a diner, discussing their health. One lady says, "You know, I'm getting really forgetful. This morning, I was standing at the top of the stairs, and I couldn't remember whether I had just come up or was about to go down."
The second lady says, "You think that's bad? The other day, I was sitting on the edge of my bed, and I couldn't remember whether I was going to sleep or had just woken up!"
The third lady smiles smugly. "Well, my memory is just as good as it's always been, knock on wood," she says as she raps on the table. Then with a startled look on her face, she asks, "Who's there?

Self-meditation

2009-04-09T07:16:00.001-07:00

Self- Meditation

Find something that has been a toy for you that you can part with now. Give it away. See what it is like to be without it. Do that with yet another toy when you are ready. Give them away, one at a time. Note how you feel and what your life is Simplifying your life doesn't necessarily mean doing without. It might, but it doesn't have to. Rather, the prevailing philosophy of today's voluntary simplicity movement is not to live without possessions or to live in frugality, but to slow down and live a more balanced, deliberate, and thoughtful life. And as research increasingly shows, a healthier life as well.without them.
Be liberated by these two: examination and analysis.
Both in times of formal practice and everyday life, practice distinguishing the level of consciousness.

I won the blog give-away!!!

2009-04-08T21:16:00.000-07:00

I am so excited!! I have never won anything in my life but have now won the most adorable little snuggle bunny ever!!

And the winner is....

I simply can't wait to announce the winner of last week's blog giveaway from Rose's Handmade Menagerie .

So, drum roll please.....The winner is MOTHER GOOSE AND GEAR!

Here is a picture of the most adorable bunny ever! My good friend is in labor as we speak and I know Mr. Snuggle Bunny will have a wonderful home with baby girl or boy 'little Stu'.

Thank you so much Rose!!
And a shout out to Diary of a Mad Crafter for hosting the give away!

Relaxation tip

2009-04-08T11:09:00.001-07:00

GO TO THE GYM Recycled Felt Applique Pillow by alexandraferguson

Use Up Anger By Physical Activity. (Channel your anger into a job that needs doing or take a long walk or even play a game). *Physical exercise is a great way of removing pent up aggression. Please walk away from a potential flash point. It never solves anything and only intensifies your loss as you lose either friends, family or even both. I know it is difficult but self-discipline is the only real option here.

Referenced from: ptsd.org.uk

Take the Stairs

Stairs by angel110 on etsy

Most of us have sedentary jobs. Work takes up a significant part of the day. What can you do to increase your physical activity during the work day? Why not...:Brainstorm project ideas with a co-worker while taking a walk. - Stand while talking on the telephone. - Walk down the hall to speak with someone rather than using the telephone. - Take the stairs instead of the elevator. Or get off a few floors early and take the stairs the rest of the way. - Join a fitness center or Y near your job. Work out before or after work to avoid rush-hour traffic, or drop by for a noon workout. - Get off the bus a few blocks early and walk the rest of the way to work or home.

Beautiful yoga pose

2009-04-08T11:06:00.001-07:00

The beauty and complexity of the human body always amazes me.

Daily Laugh

2009-04-08T11:05:00.001-07:00

Buddhist thought for today

2009-04-08T10:52:00.001-07:00

A brahmin once asked The Blessed One: "Are you a God?" "No, brahmin" said The Blessed One. "Are you a saint?" "No, brahmin" said The Blessed One. "Are you a magician?" "No, brahmin" said The Blessed One. "What are you then?" "I am awake."

Craft tip of the day

2009-04-07T08:24:00.000-07:00

Cul de Sac by Richard Thomson

Use a toothpick or small wooden skewer to apply small dabs of glue to small projects. It makes it easier to use smaller amounts and place it just where you want it.

Meditation of the day

2009-04-07T07:53:00.000-07:00

We are one Multi-purpose Hemp Clip by ButterflyMoon

The word "meditation" and the word "medicine" come from the same root.
Medicine means that which heals the physical,
and meditation means that which heals the spiritual.
Both are healing powers.
-Osho

Self-meditation tips

Take pleasure in the perfection of things in their places.
When you get used to including sensations, thoughts, and feelings in your meditation, you can open your awareness wider and welcome whatever arises - without judgment or resistance. Imagine that your mind is like the sky and your experiences are floating through the sky like clouds.
Whenever you see a judgment is coming, immediately exhale - as if you are throwing the judgment out with the exhalation.

Adventures of baby photography

2009-04-05T18:46:00.000-07:00

I went over to my soon-to-be sister/brother-in-law's house last night to take pictures of their adorable little baby, Geran. When I got there he was asleep and woke up very hungry! His schedule has been off after he got his immunization shots... poor guy. He refused to be my model until he gt some wonderfully, delicious milk from mommy. When he decided he was full he was almost willing to be a patient model. The first outfit he was a little cranky but looked so amazingly cute in the 'Lost Bo-peep' set. which is now on sale in my etsy shop (there is my shameless self-promotion).

He was such a little trooper! We got through almost 5 outfit changes!! Although, all of the pieces will need to be washed because of baby Geran's yummy milk left overs that didn't come out during the first burping session end up on every single piece of clothing he modeled. Now you know that they are baby tested, mother approved an will withstand everyday baby wear and tear *smile*.

Geran even passed as a lovely little girl when he modeled the pink and yellow ruffled onesie. Don't tell dad, but he looked great!!
Most of the pictures turned out blurry but at least I got enough to post for the listings on my shop with a few pictures of the items not on little Geran.
Thank you Geran for being such an adorable baby; you will definitely be a super-star on my etsy page/blog and will return when I need you to model more outfits. Special thanks to Susan for letting be photograph Geran after such a long shopping day.

Check out my shop! There are a lot more items not shown on my blog.

Tips for the day

2009-04-05T10:06:00.000-07:00

Idle Moment? Antique Pocket Watch Eco Unisex Sweater by Vital!

Thrifty Tip: Make a "What To Do" List for Idle Moments
Have you ever wondered how some people get more done than others? I have always believed that wasting time is as bad as wasting resources or money. I started taking stock of how much time I spend waiting for something, and the numbers will astound you! Example: I spend 30 hours a year waiting for my coffee to brew! If you spend 5 minutes a day, that comes out to be just about 30 hours per year! I spend about twice that waiting for a bus! And don't even get my started on the 20 minutes per hour that is nothing but commercials on each and every show I watch! So, I compiled a list of what I do while I wait. I hope this will help you not only in your time management, but perhaps even help you eliminate some things you may be doing that you don't even like! By Sandra from Salem, OR

Craft Tip: When using oil based paints, avoid exposure to dangerous solvents. Instead, clean your brushes with baby oil and then use soap.

"Alone we can do so little;
together we can do so much."
- Helen Keller

First sale on Etsy!

2009-04-04T17:00:00.000-07:00

Tooting my own horn! I am sooooo excited!!!! Yayyyyyyyyyyyyyyyyy!! Thank you czmonkey aka Sarah!! Hope the soon to be mama loves the forest onesie and sparrow dress!You are held close in my heart for being my 1st customer!

Craft addiction

2009-04-04T16:46:00.000-07:00

I have to admit that my name is Rachel, and I am a total craft junky. I just bought 3 patterns from buggabug. They are so amazingly cute I can hardly stand it!! I am super excited to make the baby basket, cinammon rolls, and the tea set! I will keep you updated! They will for sure be in my shop in the near future!

So great...

2009-04-04T13:43:00.000-07:00

definitely describes the real world couple after a baby is born...

Rose's Give away!!

2009-04-03T16:38:00.000-07:00

The inaugural BrigaBauble BLOG GIVEAWAY, courtesy of Rose’s Handmade Menagerie!

Come and visit Brigabauble's Blog for all of the details. Come join the fun and enter for the give away!!

cutest little snuggley bunny prize ever!

Entry deadline is April 8th.

Meditation of the day

2009-04-03T15:54:00.000-07:00

Meditation does not belong to any religion, and meditation is not a belief.
It is a pure science of the inner.
Learning to be silent, learning to be watchful, learning to be a witness;
learning that you are not the mind, but something beyond --
the consciousness -- will prepare you to receive truth.

Osho

The bubble jester

2009-04-02T11:43:00.000-07:00

I took one on my sketches and scanned it on my printer and printed it on transfer paper!! It turned out very cute ironed on the back of a onesie. Another drawing is ironed on the front. I will try to take a picture of it. *mental note.

Lesson learned: color on the sketch and not the transfer after it is ironed.
It work ok putting the color on after but if looks a little rushed in putting it together. I drew the bubbles up and over the shoulder to connect the two drawings. I am so happy with how it turned out!

Yay!! I finally got my clothing labels!!! They are very cute! Big shout out to
mommiemadeit.et sy.com. turned out great!!

Super Productive

2009-04-02T10:00:00.000-07:00

I said I would post again a couple of days ago but I have been working on some adorable projects. I found this little onesie in a thrift store and a friend of mine gave me a little baby cardigan to use and they work great together! I added the yellow and white trim and ta da! it looks like I bought them together!
Sticking with the mother goose theme... the lamb lost Bo-peep! How is he to find her??
I was super excited that my aunt bought me a sizzix machine for x-mas and then I realize that the dies are sold seperately! So I had to wait until I had a little extra money to buy some. Here is a cute little lamb die I got! I gave him some detail with fabric markers. So cute!!

I added two snaps to the jacket and realized AFTERWARD how thin the fabric is! I reinforced the snap the second time... lesson learned! I then used fabric glue to put the little flower/pearl embellishments on and used clear thread to secure them!
I realized how much easier it is to use the clear thread! It would have been such a pain to try and hide the thread with the transparent flowers!
Ta Da- cute little Bo-peep "Easter" outfit!!

First Post!

2009-03-29T01:09:00.001-07:00

Everyone has been telling me that blogging can be as therapeutic as my crafting but I'm not so sure. They also say that it is useful to let people know what I am up to and updates about my shop that I just opened up at mothergooseandgear.etsy.com. I have been working so hard at getting this whole thing up and running. It has been very difficult to find time. I was diagnosed with Lyme disease last August and treatment has been horrendous. I am more sick treating the lyme than when I didnt know I had it. I am constantly sick but my motivation is to get this business going and my fiance, Matt. He is so encouraging and sees how much happier I am when I am creating my masterpeices.

I will post more later because it is getting very late. Please check out my shop. I have a lot more items to add and descriptions to type but it is now in progress!