JINSI YA KUGUNDUA MAAMBUKIZI KWENYE UZAZI (DIAGNOSIS OF PID)

Kama tulivyokwisha kusoma wiki iliyopita katika safu hii dalili za maambukizi kwenye viungo vya uzazi kwa mwanamke kama vile kutokwa uchafu sehemu za siri, homa, maumivu chini ya kitovu, kutokwa na hedhi bila mpangilio, maumivu wakati wa tendo la ndoa na maumivu wakati wa kutoka hedhi na nyinginezo, hivyo basi ili kugundua ugonjwa wa PID ni lazima kuchukua historia vizuri ya mgonjwa.

Daktari atampima tumbo mama ili kugundua maumivu ya tumbo kama yapo sehemu gani na pia kufanyia vipimo kama vile kupima uchafu kutoka ukeni na vipimo vingine kama Ultrasound.

Magonjwa mengine yanayofanana na PID: Hayo ni kama kidole tumbo (appenditis), mimba kutunga nje ya mji wa mimba hasa ikitungwa kwenye mirija na kupasuka (ruptured actopic pregnance), kupasuka uvimbe kwenye mfuko wa mayai (reptured ovarian mass) au maambukizi ya vidudu kwenye mkojo (urinary tract infection).

MADHARA YA PID
Madhara ya haraka (immediate complication) ni magonjwa yanayoweza kusababishwa na maambukizi kwenye mji wa mimba, vijidudu huweza kusambaa na kuingia kwenye utumbo (peritonitis) au wadudu kuingia kwenye mfuko wa damu (septichemia) ambapo huweza kuathiri viungo kama magoti na mgonjwa kupata ugonjwa wa arthritis na moyo (myocarditis).

Madhara ya muda mrefu ni kama maumivu wakati wa tendo la ndoa (Dyspareunia), kukosa kupata mimba (infertity), maambukizi kuwa sugu (chronic imflammatory diseases) na uwezekano wa mimba kutunga nje ya mji wa mimba yaani ectopic pregnance.

MATIBABU
Mgonjwa atapatiwa tiba kwa muda usiopungua siku 14 dawa zinazotumika ni kama levoflaxacin ikichanganywa na metronidozole.

Pia dawa zingine kama cefriaxone, dnycyline hutumika kwa kipindi cha siku 14. Matibabu haya hutumika kwa wagonjwa wa nje (out patient), wagonjwa watahitaji kuonwa na daktari baada ya siku 2 baada ya kumaliza dawa. Itaendelea wiki ijayo.global publishers

JUA KWA UNDANI KUHUSU SARATANI YA TEZI DUME

TAFADHAL TEMBELEA HOSPITALINI NA ZUNGUMZA NA DOKTA KUHUSU SUALA HILI

Truvada yatumika kuzuia Ukimwi badala ya kondomu, soma upate kufahamu maajabu ya hizi dawa

Wanawake wanaofanya biashara ya kuuza miili na wanaume wanaofanya mapenzi ya jinsia moja sasa wanatumia dawa za kufubaza makali ya Virusi vya Ukimwi aina ya Truvada kwa ajili ya kuzuia maambukizi ya ugonjwa huo badala ya kutumia mipira ya kondomu.Picha na Maktaba 

Dar es Salaam. Wanawake wanaofanya biashara ya kuuza miili na wanaume wanaofanya mapenzi ya jinsia moja sasa wanatumia dawa za kufubaza makali ya Virusi vya Ukimwi aina ya Truvada kwa ajili ya kuzuia maambukizi ya ugonjwa huo badala ya kutumia mipira ya kondomu.


Mwananchi lilizungumza na baadhi ya wafanyabiashara ya ngono jijini katika maeneo ya Mwananyamala Hospitali, Komakoma na Vingunguti ambao walisema kuwa wanatumia dawa hizo kwa ajili ya kuzuia maambukizi ya VVU ili kuwaridhisha wateja wasiopendelea mipira hiyo.


Baadhi ya wafanyabiashara hao walidai kuwa wanatumia Truvada kuzuia maambukizi pindi wanapokutana na wanaume wakware ambao huwabaka au kuwalazimisha kufanya mapenzi bila kinga.


“Hizi dawa tunazipata katika hospitali na wakati mwingine katika maduka makubwa ya dawa. Kwa sababu zinazuia maambukizi ya Ukimwi na sisi ni watu ambao tunafanya kazi katika mazingira hatarishi,” anasema Leyla Musa, mmoja wa wanawake hao.


Si hivyo tu, kwa kuwa hii ni biashara baadhi yao hukubali kufanya mapenzi bila mipira ili kupata fedha nyingi kutoka kwa wanaume.


Wengine hukimbilia huduma ya PEP


Baadhi ya wanawake hao wanasema kuwa baada ya kufanya mapenzi na wanaume kadhaa asubuhi huenda katika kliniki zinazotoa huduma za ARV na kudanganya kuwa wamebakwa na kisha hupewa huduma za dharura za ARV zinazoitwa kwa kitaalamu Post-exposure prophylaxis.


Kwa kawaida mtu aliyebakwa au kujikata hupewa dawa aina ya Lamivudine, Zerophidine au Truvada kulingana na uzito wa tatizo.


“Tunatumia hizi dawa mara kwa mara lakini tunafanya hivyo katika kliniki tofauti ili tusigundulike,” alisema mmoja wao, mkazi wa Mwananyamala, Mariam Leshaniki.


Kwa maelezo ya Dk Rachel Baggaley, mtaalamu wa masuala ya Ukimwi wa Shirika la Afya Duniani anasema dawa za PEP zipo maeneo mengi duniani kwa sasa na zinafanya kazi kwa ufanisi pia hazina madhara kwa mwanamke.


“Dawa hizi siyo sumu mwilini, zinaingia kwenye mfumo wako wa damu kabla virusi havijajizatiti na inavizuia ili mradi uzitumie ndani ya saa 72,” anasema Dk Baggaley. Dawa ya Truvada, ambayo ina mchanganyiko wa dawa aina ya Tenovofir na Emtricitabine, imethibitishwa kuwa salama kwa kupunguza makali ya VVU pia kuzuia maambukizi mapya. Dawa hizi zinazotengenezwa nchini India, zimekuwa msaada mkubwa wa tiba kwenye nchi zinazoendelea endelea page2

Mambo ya Kuzingatia wakati wa kujifungua

Tangu mimba inatungwa na kipindi chote cha ujauzito ni wakati muhimu mno kwa mjamzito, lakini wakati muhimu zaidi ni wakati wa kujifungua.


Yapo mambo muhimu ambayo yanapaswa kufanyika mara mama mjamzito anapofikishwa kwenye chumba cha kujifungulia. Jina la kituo lazima liandikwe kwenye sehemu yake kwenye kadi ya kliniki.


Tarehe na muda alioanza kupata uchungu na kulazwa, chupa kupasuka au hapana. Umri wa mimba na kimo chake kwa wiki, mlalo na kitangulizi cha mtoto pamoja na upimaji wa nyonga ni baadhi ya mambo muhimu ya kuzingatia.


Upimaji sahihi wa nyonga hutoa taswira ya mwelekeo wa kujifungua kwa kulinganisha na makadirio ya ukubwa wa mtoto.


Ndani ya chumba cha kujifungulia ni lazima viashiria vyote vya hatari wakati wa ujauzito vijulikane kwa anayemhudumia mama wakati wa kumlaza kwa ajili ya kujifungua.


Viashiria hivi ni kidokezo A au B katika ujauzito kama tulivyoona kwenye makala zilizotangulia, chupa kupasuka bila uchungu, uchungu kabla ya wiki 34, saa 12 kupita tangu uchungu kuanza, damu kutoka, mapigo ya moyo ya mtoto kuwa juu ya 160 au chini ya 120 kwa dakika pamoja na kubadilikabadilika, kifafa cha mimba au presha kuwa zaidi ya 140/90 na upungufu wa damu chini ya gramu 8.5 kwa desilita na homa juu ya kiwango cha 38 sentigredi.


Mambo haya yanapogundulika kwenye kituo kidogo cha afya, mhudumu anapaswa kumpeleka kituo kikubwa au hospitali na daktari kupewa taarifa mara moja.


Ndani ya chumba cha kujifungulia, maendeleo ya uchungu husimamiwa kwa grafu maalumu (partogram).


Matumizi sahihi ya grafu hii ni njia mojawapo ya kupata matokeo mazuri kwa uzazi salama kwani huonyesha kama mama anaendelea vizuri au kuna viashiria vya hatari vinajitokeza, hivyo kutoa nafasi kwa mhudumu kuchukua hatua mapema kabla madhara hayajatokea.


Grafu hii huratibu mambo makuu matano amabyo ni mapigo ya moyo wa mtoto aliyeko tumboni, kufunguka kwa njia ya uzazi sehemu ya shingo (cervix) ili kuruhusu mtoto kupita, kushuka kwa mtoto hadi kutoka, kiwango cha maumivu ya uchungu kila baada ya dakika 10 na hali ya afya ya mama kwa ujumla.


Uratibu wa mambo haya makuu hufanywa kwa pamoja au kwa mpangilio kutegemea na hali ya kujifungua aliyokuja nayo mzazi mtarajiwa.


Mzazi anaweza kupokelewa wakati uchungu haujakazana wala njia kufunguka au uchungu umekolea na njia kufunguka zaidi ya sentimita tatu.

Apple grabs biosensor specialists for wearables drive

Apple has added two medical wearables specialists to its team, reigniting speculation that the upcoming "iWatch" could track health issues as well as provide a wrist-worn window to your iPhone. Former medical device specialists from Vital Connect and Sano Intelligence each quietly joined Apple in December, 9 to 5 Mac spotted, bringing expertise in biosensors, minimally-invasive blood monitoring, and more.



For instance, Nancy Dougherty, formerly of Sano Intelligence and now a "hardware engineer" at Apple, was responsible for developing a system of micro-needles which can be worn as an adhesive patch. According to details shared with Fast Company, that patch has a texture like sandpaper and is battery powered and wireless, with Sano Intelligence predicting it will eventually be able to track glucose, potassium, and electrolyte levels, not to mention kidney functions.

Vital Connect, meanwhile, developed a disposable wireless health monitor we tried last year which tracks ECG, temperature, and movement for up to three days from its onboard battery. That data is squirted to a nearby smartphone or tablet via Bluetooth LE, delivering insights not only on ongoing wellbeing but being able to monitor things like trips and falls for elderly or disabled wearers, notifying a remote caregiver accordingly.

From the startup, which could begin selling its sensors in Verizon stores this year under the carrier's mHealth banner, Apple has snatched R&D VP Ravi Narasimhan. He was responsible for sensor processing, not to mention involved in operating Vital Connect's clinical trials, essential if products are to achieve regulatory approval as medical devices.

Neither new employee has detailed exactly what they're doing at Apple, nor the team on which they're working, though their individual backgrounds in medical devices and biosensors does make it seem likely that they'll be involved in the Cupertino firm's oft-discussed wearable plans.




Although those plans - and the many rumors around them - have centered for the most part on the "iWatch", a smartwatch-style companion device for the iPhone and iPad, it's entirely possible that Apple has more than one iron in the body-worn gadget fire. Fitness and health have long been associated with the iPhone and iPod lines - such as their inbuilt Nike+ functionality - and a range of new sensors that extend that could allow Apple to tap into what's predicted to be a growing and lucrative market in personal health.

It won't be the only firm aiming to do that, of course. Google made the surprise announcement yesterday that it was developing smart contact lenses that can track glucose levels for diabetics, while signs of a "fitness API" were spotted in Android code earlier this week.

Meanwhile, Apple is also said to be investigating iris scanning systems, 9 to 5 Mac's sources claim, with work taking place around whether other sensors already in smartphones could be used to improve the accuracy of face recognition. Earlier in the month, a Samsung executive suggested the Korean company was looking into its own iris scanning tech, with whispers that it could show up as soon as the Galaxy S5 expected later this year. How soon Apple's wearable products will arrive is still a mystery. During CES, reports surfaced that the company was weighing a change in display technology for the iWatch so as to reduce power consumption and prolong battery life

Temporary Tattoos—Prequel to the Mark of the Beast?

Dr. Todd Coleman

Now folks who struggle to remember passwords or those who have to carry access cards can avoid this hassle and wear a temporary tattoo on their forearm or wrist.

These “epidermal electronics” allow users to take advantage of an incredibly resilient patch of digital sensors. A tiny patch allows them to be a walking “authentication token”.

These tiny tattoos are also capable of detecting health data such as heart activity, muscle movements, hydration levels and body temperature. And get this: when the tattoo is applied to the throat, the highly intricate sensors can detect muscle movement and speech—potentially allowing the tattoos to become a wireless hands-free tool.

Dr. Todd Coleman

Studies on larger digital tattoos have shown that brain signals can be picked up by the patch and “mind-controlled” commands such as flying a remote-control plane or drone can be completed.

Researchers are hoping to replicate this “mind-control” in the smaller tattoo versions. Just imagine the possibilities. Motorola (owned by Google) is still waiting to release these wearable tattoos but financial backers are coming around because of the amazing potential for so many possibilities in a tiny, temporary tattoo. Perhaps that’s what is so alarming—all the amazing possibilities and no one overly concerned about who might really be controlling the tattoo and the person wearing it
SEE MORE http://www.slashgear.com

EFFECTS AND TREATMENTS OF LOW T (LOW TESTOSTERONE)

Drop in Energy

Fatigue is a common effect of low testosterone. You might feel like you just don't have the energy that you're used to. Or you might be incredibly tired.

But many other things can sap your energy, too, including normal aging and depression.

Getting enough sleep may help raise your energy levels. Try to get at least 7 to 8 hours each night.

See your doctor for more help with unusual fatigue.
 



Changes in Sex Life

A drop in your sex drive can be due to low T. So can erectile dysfunction.

Low testosterone alone is rarely the only reason for weaker and fewer erections. Other medical problems can be to blame, such as heart disease or diabetes.

Check with your doctor. If you have low testosterone levels, your sex drive may get better with treatment.


Fuzzy Thinking

Low testosterone can hurt your mental focus and memory. You may forget what you planned to do and have trouble concentrating. This happens more often when testosterone levels are extremely low. To help, take steps to ease stress. Try meditation, yoga, exercise, or massage. The more stress hormones your body makes, the less testosterone it can make

Changes in Mood

Low testosterone can get you down -- a little or to the point of depression.

Some men really see a change in personality. Nothing seems to make them happy anymore and they don't want to do things they used to enjoy. When testosterone levels are back to normal, men often say they feel like themselves again


Muscle Changes

Because testosterone helps build muscle, when it gets low, so does your muscle mass and strength. When you work out you don't see the results that you would normally expect from exercise. Regular exercise can help boost your testosterone levels. Be sure to work large groups of muscles when you exercise and do some weight lifting, to

More Body Fat

Not only can you lose muscles with low testosterone, you can also gain fat. If you're not building muscle with the calories you take in and the physical activity you do, then your body turns the calories into fat. Eat a healthy diet. When you start to lose weight and extra body fat from dieting, you may lose some muscle. If you are overweight or obese, your body may make more testosterone as you lose weight. This will help you gain lost muscle mas


Thinning Body Hair

Low testosterone can cause you to lose some facial hair, pubic hair, and hair on your arms and lower legs. But it doesn't usually affect the hair on your head.

But one thing you should know. There's a link between testosterone therapy and male-pattern balding. Your doctor can talk to you about any side effects of testosterone treatment.


Loss of Bone Mass

Low testosterone has been linked to osteoporosis, a disease that weakens bones. But there are other causes of osteoporosis too, so check with your doctor. To keep your bones healthy, don't smoke, and cut back on alcohol. Also get regular exercise, including weight-bearing exercise

Trouble Sleeping

When your testosterone levels are low, you might have trouble with insomnia and restlessness at night.

To help get a good night's sleep, have a relaxing bedtime routine. Go to bed and wake up at the same time, even on weekends. Make your bedroom dark, quiet, and comfortable, and only use it for sleep and sex.

10 Ways to Slow the Aging Process

If you’re in your 20s or 30s, it’s prime time to prevent the signs of aging. If you’re older, there’s still hope!


“What you do for your skin or against your skin will have ramifications as you age,” dermatologist Heidi Waldorf, MD, says.

Two of the best things you can do for your skin are not to tan or smoke. Don’t count on quitting either habit later; that won’t protect your skin from what’s happening now. “Unfortunately, younger women are still smoking,” dermatologist Doris Day, MD, says. “It’s one of the worst things — after sun — you can do to your skin.”

Signs of aging may still be subtle in your thirties, Day says. “But it’s a nice time to start to address it because a little bit goes a long way.”
10 Anti-Aging Tips

Keep your skin looking youthful every decade with these tips from top dermatologists.

1. Wear sunscreen every day. Rain or shine, in every season, wearing sunscreen should be an automatic part of your daily routine, like brushing your teeth.

The American Academy of Dermatology recommends wearing a sunscreen that has an SPF of at least 30 and says “broad-spectrum” on the label. That means it protects against the sun’s UVA and UVB rays. The sunscreen should also offer some water resistance. The UVA rays cause the sun’s aging effects, Waldorf says. To get UVA protection, check the ingredients list for avobenzone, mexoryl, zinc oxide, or titanium dioxide.

Reapply the sunscreen as directed on the label. Most people don’t put on enough, so be liberal when you apply it, and reapply it every one to three hours, depending on the amount of sweating, swimming, or direct sun exposure you get. “Nothing is going to work if you don’t put on enough and use it often enough,” Waldorf says. Don’t forget your neck, hands, and arms.

2. Avoid tanning, both indoors and outdoors.

Tanning is one of the biggest skin mistakes that younger women make, Waldorf says. “Damaging your skin with ultraviolet radiation will make it look worse.” And too much sun, she says, can also cause skin discoloration and damage to elastin and collagen.

If you want a tanned look, Day recommends you use sunless tanners. They come in sprays, gels, creams, lotions, and wipes. Just remember, they don’t protect you against sunburn, Day says. “You still need to wear sunscreen every day, all year round.”

3. Wear sunglasses.

They will you protect your eyes from the sun and also the delicate skin surrounding them. Plus, you won’t be creating more wrinkles by squinting all the time.

4. Wear hats, visors, and sun-protective clothing.

Wear them along with sunscreen. Hats with a broad brim are a good choice, Day says. You could even rock a parasol to keep sun off your skin. If you’re outdoors a lot, you might consider buying sun protection clothing. They look the same as regular clothes, but, Day says, they have been treated to provide at least SPF 30 protection against UVB and UVA all day. “Not only is the practice good for your health, but it’s a very smart anti-aging move,” she says.

5. Don’t smoke.

Smoking is bad news for every part of you. In your skin, it speeds up the breakdown of collagen and constricts blood vessels that carry oxygen and nutrients to your skin. Smokers are more likely to wrinkle early. In time, their nails and fingertips will turn yellow.

Day, a former smoker herself, strongly urges smokers to quit. The prospect of wrinkles could be the last bit of motivation you need. You may need to try several times to quit for good, but it’s more than worth it.

6. Avoid too much alcohol.

Having a drink with a friend or savoring a glass of wine with dinner is fine, Day says. But drinking too much alcohol dehydrates your skin and dilates your blood vessels. If you drink too much, you could develop broken blood vessels and rosacea, a skin disorder marked by redness and tiny pimples.

7. Avoid yo-yo dieting, and get help for eating disorders.

Eating disorders, such as anorexia and bulimia, stress and damage your whole body, including your skin, hair, and nails. These are serious — even life-threatening — disorders, so seek professional help for them immediately.

Many women in their twenties and thirties also go through periods of “yo-yo” dieting, without having an eating disorder. Day says that repeatedly gaining and losing weight can stretch the skin and make it sag.

“At a certain point,” Waldorf says, “your skin does not bounce back when your weight changes.”

That’s all the more reason to work on reaching, and keeping, a healthy weight.

8. Use retinoids or retinols.

Retinoids are prescription face medications, such as Retin-A, Renova, and Tazorac, that can help skin look younger. Retinols are a weaker form sold without a prescription.

If you’re pregnant or are planning to get pregnant, ask your doctor about whether they’re safe to use.

Women who aren’t planning to become pregnant can start using retinoids at any age, even their early twenties, Waldorf says. Day recommends that women begin using a retinol (an over-the-counter, weaker form of a retinoid called tretinoin) in their twenties as an anti-aging strategy.

If you don’t have a lot of sun damage by your twenties or thirties, you can wait. Waldorf didn’t have much sun damage from her earlier years, so she held off on retinoids until her forties. “How necessary it is and how much difference a retinoid is going to make will depend on your baseline skin,” she says.

9. Consider antioxidants and peptides.

For women in their twenties, the most basic skin care routine is washing with a gentle cleanser and using a moisturizer at night, with a retinoid if needed, Waldorf says.

Day also likes serums that contain peptides and antioxidants –such as grape seed extract, resveratrol, green tea, and vitamins A, C, and E.

If you use skin products with antioxidants, Waldorf recommends applying them in the morning before using a sunscreen moisturizer. Both products may work in tandem to protect skin from damage.

10. Consider treatments for youthful skin damage.

If you have a lot of sun damage or acne scars, microdermabrasion, light peels, or laser treatments may help. These procedures can improve skin more than facials can, Waldorf says.

Also, if you have acne, don’t pick at it. Scars will look like wrinkles as you age.

Turns Out His Blood Runs Green

I never wanted to write about the Irish.

When I got out of the Marine Corps in 1972, I was invited to a lunch of Irish-American writers. At a table of perhaps 10, I was conspicuously underaccomplished. I’d been brought along by my old professor Terry Moran (he was perhaps 37), because I was a poet. At the table, among others, were James T. Farrell and Jimmy Breslin. Farrell had 50 books to his credit, including, most famously, the Studs Lonigan trilogy. Breslin had reinvented blue-collar New York and maybe journalism.

I had a good time. Breslin held forth about Nixon. Around dessert, Farrell, who had downed several brandies, burst into tears, pointed at me, and said, “He’s the one we should be helping.” I tried to look less in need.

A waiter appeared. There was a call. It was my then wife, Joan. I’d just gotten an acceptance letter. Two of my poems were going to be published. I was 22.

Heading home on the F train to Brooklyn, I thought about what I wanted to do, big picture. And I decided right then, I didn’t want to be helped, and I didn’t want to be labeled an Irish-American writer. I wanted to be a writer. I wanted to write about everybody. And for the next 30 years I did. I became a playwright and screenwriter. Italian-Americans were my particular specialty. I liked the way they talked. There was something free in it. This attraction resulted in plays and films with titles like “Italian American Reconciliation” and “Moonstruck,” and not a lot of jobs for Irish-American actors.

Launch media viewer John Patrick Shanley, author of the new “Outside Mullingar,” on a relative’s farmland in Ireland. Doug Hughes

I always knew I’d have to come home eventually. I’m Irish as hell: Kelly on one side, Shanley on the other. My father had been born on a farm in the Irish Midlands. He and his brothers had been shepherds there, cattle and sheep, back in the early 1920s. I grew up surrounded by brogues and Irish music, but stayed away from the old country till I was over 40. I just couldn’t own being Irish.

Something in me hated being confined by an ethnic identity, by any family. In addition, I have often found procrastination to be an enriching exercise. Not saying increases what I have to say. Not writing about the Irish was building up a hell of a lot of pressure to do just that.

When I finally went to Ireland, I had to go. It was 1993. My father was finally too old to travel alone, and he asked me to take him home. When an old man asks you to take him home, you have to do it.

When I sat with my father in that farm kitchen, the one that he had grown up in, and listened to my Irish family talk, I recognized that this was my Atlantis, the lost and beautiful world of my poet’s heart. There was no way to write about the farm, yet I had to write about it. I listened to the amazing language these folks were speaking as if it were normal conversation, and I knew this was my territory. But it was new to me. It was a time to listen, not to write.

It took about 20 years. When I turned 60 and flipped out (the number, the guy in the mirror with gray hair), I felt I had nothing left to say or do. I wanted to go on vacation some place warm for the rest of my life. I was miserable, dead barren and solitary. I moved to an apartment in Williamsburg where I could see the sun and the river. My parents were dead now. It was just me and the river and the sun and time. A year went by. One quiet day, I sat down without a thought in my head and wrote a play about the farm.

Launch media viewer From left , Peter Maloney, Brian F. O’Byrne and Dearbhla Molloy on Broadway in John Patrick Shanley’s “Outside Mullingar.” Sara Krulwich/The New York Times
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The farm had become a place in my imagination where I had stored up so many things. My love for my father was there. Feelings of grief. My romantic hunger, my frustration with this unpoetic world. I had held back much for a long time, and I kind of erupted with language. I felt free suddenly, free to be Irish. Family stories, family names, changed by dreaming, mixed with my own long longings for love, and impossible happiness unfurled across the page. I had turned 60, and the knife at my throat woke me to the beauty of my own people, the fleeting opportunities of life, the farce of caution. I wanted to write a love story. I wanted to find all the words I had not been able to find because what I have been unable to express has caused me anguish, even as what I have given adequate voice has lent me peace.

I found a strange relief in the play. I called it “Outside Mullingar,” a prosaic title perhaps to balance the poetry it contained. The script was a refuge and a consolation for me. Manhattan Theater Club signed on to do it, and we put a team together.

I decided to return to the farm and bring my son Nick. He drove me, as I had driven my father. He was taking me home now. And then the director, Doug Hughes, said, “I’m going to Ireland, too.” And the designer, John Lee Beatty, said, “I’m coming as well, and bringing my partner.” I announced I would make a documentary. (I always go too far.) My son, who’s a photography major at Parsons, was drafted as cinematographer. And, of course, we never got around to that, but that’s O.K.

My cousin Anthony was not perfectly delighted that I had written a play set on his farm and that the main character was named Anthony. And he was openly terrified when all these theater folk piled out of a couple of cars to photograph his home and him. But his good manners got the best of him, and he made us tea. Doug, exhibiting his considerable social skills, talked Anthony into a state of relative comfort, and we had a good chat. After, we went into the fields where my father had grown to manhood among the cattle, in the quietly overwhelming green fields.

Launch media viewer From left, Anthony Shanley (the playwright’s Irish cousin), with the director Doug Hughes and John Patrick Shanley, in County Westmeath. Scott Laule

I knew I was imposing. That is the artist’s way. We take the real and refashion it to our purpose. The desire is strong, and reality must give way. Anthony, me, my father, the farm, all of these things, my Uncle Tony, my Aunt Mary, all things animate and otherwise, existed only as materials for my use. I had a home being born in me, and I had to build it before the dream faded. I had written the play, but now, being on the farm, I held the script like tracing paper over the real and looked for gold in the differences. There was gold.

It was a strange week. Nothing was real to me, not the play nor this world as it is. I stumbled forward with a kind of double vision. The Irish side of my family is a patient lot and endured my interviews with grace. They trusted me, and they didn’t. They knew I wouldn’t be telling the truth about them. I’d be telling my own truth, using them. They watched as my designers photographed their stoves and sheds, their cattle and mangers.

I came back to New York and went into rehearsal. As the actors and director took the play, I watched the world I’d created leave me and felt the supreme loneliness of that. For a moment though, through the spell of storytelling, I had a home. I was Irish. And then the moment faded. That’s how it is with writers. We keep getting evicted from our own imaginations. We are wanderers, dreaming, and then our dreams become real and push us out.

The play opens in New York shortly. The lights will rise on a farmhouse kitchen in rural Ireland. If things go well, my longtime traveling companions, the audience, will share with me something of my Uncle Tony, my Aunt Mary and my cousin Anthony. I’m glad.

 

 

CHRISTMAS WITH AN EATING DISORDER

Every Christmas, the number of people reaching out for help with an eating disorder rises. This season, if you feel like you are struggling, don’t worry, you aren’t alone. Whether you suffer from Anorexia, Bulimia or EDNOS (eating disorder not otherwise specified), Cosmo has partnered with Beat to bring you the best tips and advice to cope with the Christmas period.

“Christmas is always a particularly difficult time for individuals and families affected by eating disorders whether they’re missing a loved one at the table or struggling to cope with the pressures Christmas brings around food.

Here at Beat we often see the focus of the contact with our service users during the festive period change to how to cope during these times and our calls peak in January and February when people feel alone after Christmas, want to talk about a really difficult experience they had over the holidays or have made a New Years’ resolution to beat their eating disorder.”

Seeing others enjoying themselves and the fear of food, at this time of year can spark of a lot of emotions and leave you feeling lonely, depressed or hurt.

However you can pull through and you don’t have to be alone.

· Try talking to someone; phone a friend or a relative. You could also talk to one of your family members and tell them how you are feeling.

· Write down how you’re feeling,

· Take a few minutes break from everyone, go for a walk, listen to music, read a book, or anything else you enjoy.

· If you feel the need to binge, try to turn to someone rather than food.

· If you do happen to binge don’t feel bad or punish yourself, it doesn’t mean you have failed.

Remember that you can recover so never give up hope.

Check out some tips on how to survive the Christmas period from sufferers:

“I practice saying "No, thank you" for weeks before I go to any parties so I don't feel like I have to eat everything offered to me."

“I give up any idea of weight loss over the holidays. It puts too much pressure on me and I don't enjoy the holidays."

"I find that if I go to a party hungry, I eat everything in sight. The calories I 'saved' by starving for the day usually are wasted, plus some. So I eat regularly for the day, and moderately at the party."

"I tell myself ahead of time that I can eat a small amount of whatever I want. Whenever I tell myself something is 'off-limits', I usually end up bingeing because I feel deprived."

"I practice relaxation techniques such as yoga and deep breathing to deal with holiday stress."

"I take a lot of hot bubble baths. I can't eat in there!"

"I decide ahead of time how long I can tolerate a family party. At the end of that time period, l leave and feel good about taking care of myself."

“I always help out at parties, washing dishes, setting the table. That way I don't feel so awkward and don't just stand around eating."

“I reward myself with small non-food items, such as a pair of earrings, a movie or a bike ride every time I resist bingeing."

“I stay away from alcohol at parties. It's laden with calories and just makes me eat more."

“I bring my toothbrush to parties and brush right after I've eaten. The clean taste cuts my desire to eat more."

"My friend and I arrange to call each other often so that we both know we have an ally. It helps just to know I have someone on my side."

If you think you need help, then contact Beat:

Understnd Why Girls’ Brains Mature Faster Than Boys’ Brains

It’s always been conventional wisdom that girls reach maturity more quickly than boys, but now scientists have provided some proof.

In new research published in the journal Cerebral Cortex, an international group of researchers led by a team from Newcastle University in England found that girls’ brains march through the reorganization and pruning typical of normal brain development earlier than boys’ brains. In the study, in which 121 people between ages 4 to 40 were scanned using MRIs, the scientists documented the ebb and flow of new neural connections, and found that some brain fibers that bridged far-flung regions of the brain tended to remain stable, while shorter connections, many of which were redundant, were edited away. And the entire reorganization seemed to occur sooner in girls’ brains than in boys’ brains.

Females also tended to have more connections across the two hemispheres of the brain. The researchers believe that the earlier reorganization in girls makes the brain work more efficiently, and therefore reach a more mature state for processing the environment. What drives the gender-based difference in timing isn’t clear from the current study, but the results suggest that may be a question worth investigating.