Effect of Phototherapy on Sleep Disorders

Effect of Phototherapy on Sleep Disorders In the natural world, the light – dark cycle entrains our rhythm. Light is a very effective ‘Zeitgeber’. In the presences of environmental time cues, sleep-wake physiology, and gene expression continue to exhibit a near-24-hour circadian rhythm regulated by the Suprachiasmatic Nucleus in the Hypothalamus. Phototherapy is an accepted modality for non- pharmacological management of Circadian Disorders such as Delayed Sleep Phase Syndrome, Insomnia etc. This review discusses the physiological principle and highlights evidence based literature of phototherapy and its management in Sleep Disorders. Introduction; Living organism’s exhibit a biological periodicity, this rhythm when occurs on a 24 hour cycle is known as ‘Circadian Rhythm’. A rhythmic biological cycle that displays an endogenous entrainable oscillation of less than 24 hours in known as ultradian rhythm. and that last for more than 24 hours is known as Infradian rhythms. Circadian Rhythms generate rhythmic cycling of sleep patterns, food intake, sexual behavior, core body temperature and secretion release of hormones such as ACTH, Prolactin, Gonadotorophin and Melatonin. Circadian Rhythms are generated by the Suprachiasmatic Nucleus (SCN) of the Anterobasal Hypothalamus. Pineal gland regulates the rhythmic production and release of melatonin. The duration, phase and amplitude of melatonin and cortisol secretion, are influenced by changes in light-dark cycles. The plasma levels are low during day time and are high at night. This rhythm is maintained by the SCN and is entrained by the light-dark cycle. Low light intensities like 100 to 500 lux also have been shown to suppressed levels of melatonin. Phototherapy or light therapy utilizes light boxes which are typically LED square bright lights, ranging from 8-12 x 12-24 inches that emit 10,000 Lux (highest Lux) light, cool color temperature light acts as natural sunlight without the harmful effect of UV rays. This mode of entraining the sleep wake cycle is an accepted modality and mainstay treatment in the non-pharmacotherpeutic management of Circadian Rhythm Disorders. Principles of Phototherapy The goal of the Circadian Rhythm is to maintain a bridge between sleep patterns and the internal clock that is set at a optimally synchronized time. This results in a normal sleep-wake pattern. The Biological Model-Phase response curve The Phase Response curve is modulated by two efficacious modalities i.e. light and melatonin, both of which are exploited to entrain the circadian cycle. Bright light is very helpful in synchronizing the human rhythms and the melatonin serves as a ‘‘dark pulse’’ helping to induce night-time behaviors. Bright morning light advances circadian rhythms; bright evening light delays them. Melatonin in the evening advances circadian rhythms; melatonin in the morning delays them. Circadian Disturbances and Insulin Resistance Type 2 Diabetes Mellitus is a multifactorial disorder, of which Circadian Disturbances is one of the lifestyle factors that contribute to it. Sleepdisturbances including sleep insufficiency, sleep loss, sleep fragmentation, are connected to abnormal Glucose Metabolism and thus, increase the risk of Type 2 Diabetes Mellitus. Studies in rodent models suggest that disruption of Circadian Rhythms leads to impaired glucose homeostasis and beta-cell failure, culminating in increased susceptibility to Type 2DM. Disturbed Circadian Rhythm is causative factor in the recent epidemic â€Å"Obesity†. In controlled clinical studies, acute 1-3 week circadian misalignment (alone) or in combination with sleep restriction results in dysregulation of glucose homeostasis and consequent glucose intolerance attributed in part to loss of beta-cell function as well as decline in insulin sensitivity. CIRCADIAN RHYTHM PROBLEM CONTRIBUTES TO INFLAMMATORY DISEASES. Inflammatory bowel disease (IBD), including ulcerative colitis (UC) and Crohns disease (CD), is a chronic and recurrent inflammatory disorder of the intestinal tract. Study says that sleep disturbances are one of the main reasons of pathogenesis of the patients with IBD. In addition melatonin plays a vital role in regulation of inflammation as well as immune system and antioxidant system in the intestinal disorders. (16, 17) CIRCADIAN RHYTHM and visually Impaired Bright light has been shown to suppress Melatonin secretion even in visually impaired subjects which substantiates the fact that non-visual photoreceptors in the eye mediate the Circadian Rhythm regulating effects of light CIRCADIAN RHYTHM AND IMMUNITY Sleep restriction and sleep deficit increase your vulnerability to disease. The immune system is connected to the sleep regulatory system and actions of the immune system to fight disease.Sleep is regulated partly by immune system components called cytokines. Blood counts of T-cells and levels of proinflammatory cytokines are high during the night while leukocytes and the anti-inflammatory cytokine IL-10 go up during daytime. Changes in the immune system seem associated with the onset of narcolepsy, which has a neurological cause (brain cell death) inflammatory diseases increase cytokine levels and make people feel fatigued. This is a good thing during a short-term injury or illness, as it drives the person to rest. For those with chronic inflammation, however, the immune system keeps them tired for long periods, which may explain symptoms of fibromyalgia and chronic fatigue disorder. The trouble in sleeping that people with those conditions experience is not due to just the discomforts of the illnesses, but because the sleep regulation system is affected. The different phases of sleep are responsible for different functions within our bodies. The first and second phases involve settling in, resulting in rhythmic breathing and a lowered body temperature. The third and fourth stages are when our bodies are working to restore themselves. During this time our muscles relax and the blood supply going to them increases. Our bodies use this time to repair tissue damage and grow new tissue. Important hormones are released and our energy is renewed. These stages appear to be a critical factor in maintaining a healthy immune system and any sleep disturbance that impacts them, impacts our health. It is becoming increasingly evident that disruption of daily rhythms, such as from sleep deprivation, affects the immune response. Toll-like receptor 9 (TLR9), is an immune system protein that can sense bacterial and viral DNA Role of Phototherapy Cognitive Impact Light intensity has a direct impact on cognitive performance and alertness and on the subjective feeling of sleepiness. The researchers found that volunteers subjected to higher light intensity during the afternoon were more alert all the way into the early evening than those who were not. But when subjected to light intensity 10 times weaker, they showed signs of sleepiness and obtained lower scores on the memory tests. Artificial light is used to phase shift circadian rhythm and help improve performance, sleep, and well-being during shiftwork simulations , this was proved in study designed for NASA personals during t he prelaunch week. The treated subjects were self exposed to 10, 000 Lux. The treated personnel showed a positive result reporting better sleep, performance, and physical and emotional well-being than control subjects and rated the treatment as highly effective for promoting adjustment to their work schedules for the study. Nocturnal alertness, performance, and daytime sleep could be improved by light exposure of tolerable intensity and duration in a real work place. This was proved in a cross-over design study conducted on 12 night Shift nurses with three different treatment procedures: Room Light (RL) exposure in the night followed by a 1hr sunlight or 10,000 lux light next morning(08:30 to 09:30), Bright Light (BL) a 4-hour nocturnal light exposure of 4,000-6,000 lux (from 01:00 to 05:00) and Bright Light with Sunglasses (BL/S) the same nocturnal light exposure as in BL was done with light attenuation in the morning. Nocturnal alertness was measured by a visual analog scale. Daytime sleep was recorded with actigraphy. Nocturnal alertness was the highest in the BL/S. The improvement was maximized by attenuating morning light. Sun-Downing phenomenon Sundowning is a clinical phenomenon characterized by the emergence or increment of neuropsychiatric symptoms such as confusion, disorientation, anxiety, agitation, aggression, pacing, wandering, resistance to redirect screaming, yelling and so forth observed late afternoon, evening or at night and occurs among cognitively impaired, demented, or institutionalized elderly patients. In a 6-week, double-blind, placebo-controlled, cross-over trial the effects of bright light therapy combined with melatonin on motor restless behavior in demented patients had been evaluated. This study concluded that bright light therapy (10,000 lux bright light) has a positive effect on motor restlessness in subjects with dementia. Mood disturbances Manic-Depressive Illness (MDP): MDP is recurrent illness in which episodes of Mania and Depression occur and remit spontaneously. Several clinical studies say that disturbance in the Circadian Rhythms play a crucial role in its pathophysiology. Melatonin secretion shows abnormal levels in some bipolar patients (MDP). Patients with MDP exhibit circadian sleep wake rhythm in which patients spent one complete sleepless night in between two nights of normal sleep. In a study, 143 patients with a major depressive episode in the course of bipolar disorder (DSM-IV criteria) treatment with 3 consecutive totalsleepdeprivation cycle (each composed of a period of 36 hours awake followed by recovery sleep), light therapy, and lithium rapidly decreased the depressive suicidality and prompt antidepressant response in patients with drug-resistant major depression in the course of bipolar disorder. Borderline personality disorder (BPD) is typically characterized by instability and impaired behaviour , affectivity, interpersonal relations and lifestyle. This open study assessed 13 female patients for the effectiveness of the application of bright light (10,000 lux, 6:30 to 7:30 a.m. for 6 weeks) added to SSRIs in drug-resistant depressed patients with comorbid BPD who did not show any improvement to 6-week administration of antidepressants. The participants were regularly evaluated using the CGI, HAMD and MADRS scales and the BDI and BDI self-report inventories. All the assessments proved that the application of Bright light leads to a significant improvement. SAD: Phototherapy acts through Retinal Melatonin or Rhodopsin, which regulates Dopamine release in the eye where it acts as the main neurotransmitter. The retina-SCNvpineal gland forms a link, which is disturbed in SAD. By suppressing retinal Melatonin, Phototherapy has been suggested to correct the underlying biochemical abnormality seen in SAD and thereby inducing clinical remission.In Non- Demented people, light therapy is an accepted and validated treatment for seasonal affective disorder, but has also been reported to be effective in Non –Seasonal Depression (15). Recently it has been noted that exposure of SAD patients to natural sunlight in the morning hours resulted in complete remission of depressive symptoms. In the study, N=24(12 SAD patients and 12 controls) were exposed to morning light therapy in the winter and the melatonin profiles being sensitive to light were measured before and after treatment. The SAD Patients showed a phase advance of melatonin rhythms in response to phototherapy which showed an association between phase position and phase shift in the SAD patients. This instability may be secondary to impaired serotoninergic function in the afferent pathways to the suprachiasmatic nuclei. This seems to be a significant advancement in the etiology of SAD that links light with Mood Disorders. In Seasonal Affective Disorder (SAD) is common when vitamin D stores are typically low. wavelengths between 280-320 nm which are Broad-spectrum light therapy that allow the skin to produce vitamin D. In a prospective, randomized controlled trial was conducted N=15 subjects with SAD (8 subjects-100,000 I.U. of vitamin D and 7 subjects–phototherapy). At the onset of treatment and after 1 month of therapy subjects different depression scale were administered. Vitamin D status improved in both groups (74% vitamin D group, p ADHD Morning bright light therapy is associated helps reduce both subjective and objective measures of core ADHD pathology, improves mood symptoms, and phase advance in circadian preference. Multiple regressions showed that the shift toward an earlier circadian preference with LT was the strongest predictor of improvement on both subjective and objective ADHD measures. In the Elderly The risk of developing depression increases with old age. The occurrence of a major depressive episode in Alzheimer’s disease is as high as 20-25%and minor depressive symptoms occur in an additional 20-30% (9, 10). In a randomized double-blind placebo-controlled trial, patients with early Alzheimer’s Disease (AD), Mild Cognitive Impairment (MCI) and Subjective Memory Complaints (SMC)(N=79, Age = between 50 75). Patients were exposed to ~10,000 lux for two years, the active condition or ~300 lux in the placebo condition, daily, for two half-hour sessions at fixed times in the morning and evening. Neuropsychological, behavioral, physiological and endocrine measures are assessed at baseline and follow-up every five to six months. The evaluation showed long-term daily bright light prevented worsening of sleep-wake rhythms and depressive symptoms in elderly people with memory complaints. Elderly experience increased difficulties with sleeping, and thus could be one of the contributing factor for mood problems.(11) Factors contributing in Aging process Aging process | | Impaired Ocular light transmission due to age related eye deficiencies | | Requires high demand of light intensities inorder to maintain a sufficient input to SCN | | Diminished SCN input | | Arrhythmia in the Sleep Wake cycle Studies report that it is possible to reactivate the SCN and improve ‘Sleep –Wake Rhythm’ by applying extra light. Light therapy provides a safe treatment option (13).It’s reported that, bright light therapy is decreasing common health issues (14). In 10 Alzheimers patients with sundowning behavior and sleep disturbances were studied for a week who received 2 hours/day of exposure to bright light between 7:00 p.m. and 9:00 p.m. The results showed that the proportion of total daily activity occurring during the nighttime decreased during the light-treatment week. The relative amplitude of the circadian locomotor activity rhythm, a measure of its stability, increased during the light-treatment week. This kind of effect mediated through a chronobiological mechanism. Artificial light is used to phase shift circadian rhythm and help improve performance, sleep, and well-being during shiftwork simulations , this was proved in study designed for NASA personals during t he prelaunch week. The treated subjects were self exposed to 10, 000 Lux. The treated personnel showed a positive result reporting better sleep, performance, and physical and emotional well-being than control subjects and rated the treatment as highly effective for promoting adjustment to their work schedules for the study. In study bright light exposure improved sleep quality in 7-18% subjects, the study consisted of 13 interventional studies with 1154 participants. Jet lag causes distress to the number of travelers impairing sleep, mood and cognitive performance. Timed exposure to bright light and melatonin administration can help to reduce symptoms. Specific recommendations using bright light and melatonin for eastward and westward travel before and after departure are provided for time zone changes of up to 6, 7–9 and 10 or more hours. Timed bright light and melatonin administration, by helping to adjust underlying circadian rhythms to the new time zone, can serve to mitigate the symptoms of jet lag. Reducingthe symptoms of jet lag by this methods can lessen the mood, cognitive and behavioral symptoms resulting from these desynchronized rhythms.(

Succubus on Top CHAPTER 11

When I went inside to relay this to Bastien a few minutes later, he took Dana's presence on the proposed shopping trip much better than I had. â€Å"That's fantastic! More time for – â€Å" â€Å"So help me, if you say ‘reconnaissance,' I'm going to smack you. I'm only in this for the clothes.† â€Å"Fair enough. But this is a golden opportunity, and you know it. You can feel her out. Put in a good word for me, maybe. Something. Anything. I need this. But,† he added, â€Å"don't do it at the cost of being†¦detrimental.† â€Å"Give me some credit here, all right? I understand the situation's gravity. I'll help you.† His roguish smile lit up his face, or rather, Mitch's face, which was kind of weird. â€Å"While you're at it, maybe you can brush up on your female bonding.† â€Å"What's that supposed to mean?† â€Å"Do a count of all your closest friends someday. I don't think you like female competition.† I made a face at him just as Jody and Dana showed up. They took me to some astonishing shopping nexus a couple of miles away. I couldn't believe that much retail space could be crammed indoors. We had a few enclosed shopping centers in Seattle, but nothing like this. Browsing stores with Dana was about as horrible as I could have imagined. She eyed scantily dressed teenagers askance and spoke to a black saleswoman like an underling. Still, despite my distaste, I remembered my duty and attempted friendliness. Over and over, I tried to bolster Bastien's reputation. â€Å"He's so into what your group's doing. He'd like to get more involved. Maybe you could come talk to him about it sometime.† Fortunately for â€Å"Mitch,† these comments did elicit a warm response from her. Yes, she'd be happy to give Mitch some one-on-one time. Anything for the cause. How nice that he cared. Truly, he was a smart and compassionate man. Blah, blah, blah. She always enjoyed spending time with him. Yet, despite this fleeting progress, her demeanor remained stiff, and her attention always shifted back to me. She peppered me with all sorts of questions, as if she were specifically probing for some key piece of information. She wanted to know what I did for a living. How close Bastien and I were. Where my â€Å"relationship† with Seth was going. What my take on the CPFV was. What my values – race, sexual orientation, etc. – were. I felt like I was being grilled, but she pushed on in that honeyed voice of hers. Despite her aloofness, she always managed to sound friendly and nonthreatening. I could see why she so enthralled her fans. This isn't just curiosity, I realized. She doesn't trust me. Dana knew something was going on with Bastien and me, and now she was trying to figure it out. That was probably why he wasn't really getting anywhere; she was on to him. True, she probably didn't suspect a covert plan featuring an incubus, but I'm sure she had her share of more mundane enemies. She was on guard for such things, hence her skepticism about our cover stories. Bastien had no idea what he'd gotten us into. So, I worked hard to maintain our innocence, answering her queries as best I could. My usual charm still wasn't working on her here, but I performed better than in previous encounters – except for the questions about Seth. The reality with him was weird enough without having to live another version of it via Tabitha Hunter, and I found myself stuttering and blushing when she brought him up. When Dana left us at the Christian Dior counter of Nordstrom to go look for slips, I nearly sagged in relief. â€Å"What about this one?† Jody held out a tester of pale pink lip gloss that would look great on Tabitha, less so on Georgina. I opened it and studied the color. â€Å"Too light. Besides, it'd probably come off with one sip of something.† She gave me a mischievous grin. â€Å"Or in other activities.† I rewarded her with a look of mock astonishment. It wasn't hard to do; she was full of surprises, it seemed. Fun ones. â€Å"Why, Jody. Here I thought you were a respectable married woman.† â€Å"Are you kidding? Marriage only makes you less respectable. Gives you a lot of time to invent new things.† Grinning back, I swapped the pink lip gloss for a red one. â€Å"Better not let Dana hear you talking like that. I got the third degree about my boyfriend, as it is.† Jody's mirth dimmed a bit, though she held her smile. â€Å"It may feel like the third degree, but she's just curious about you, that's all.† â€Å"Yeah, I guess. No other reason, I suppose.† Best not to mention my theory that Dana suspected Bastien and me of duplicity. To my surprise, Jody looked back down at the eye shadow display, pointedly avoiding my eyes. I was reminded of that day in the yard when I'd had the sense she wanted to tell me something about Dana. Something bad. â€Å"Jody,† I murmured, setting down the lip gloss, â€Å"what is it? What's wrong?† She shook her head. â€Å"Nothing. Forget about it.† Dana returned just then, and the moment was gone. â€Å"They don't have what I need. Let's check Victoria's Secret.† I perked up. That was the best thing I'd heard ail day, aside from another possible insight from Jody. We entered what had to be one of my top five favorite stores. We split up, Jody going to pajamas and Dana looking for some slip that would undoubtedly match that god-awful underwear of hers. As for me, I promptly sought outrisquelingerie sets – once I'd ascertained the other two women were occupied. No way was I having a repeat of the swimsuit incident. Unfortunately, the store had a more outstanding selection than usual, and what I'd intended to be a mere browse turned into a full-fledged mission when I found a few sets I simply had to try on. Dana and Jody were still deeply engrossed with their own wares, so I inconspicuously slipped into the dressing-room line, hoping to be in and out before either of them could investigate what sweet, innocent Tabitha was into. I had just made it to the head of the line when both of them squeezed in next to me. â€Å"What a crowd,† Jody said. â€Å"Mind if we just share your room? They're huge here.† I felt the blood drain from my face as I tried to think up some reason to decline. An idea for a contagious, flesh-eating disease was forming in my mind when the sales associate ushered us into a room that was indeed more than big enough to hold the three of us. Dana only had two skirt slips to try on, and she pulled off her slacks with unconcerned efficiency. I winced upon seeing the granny panties again. Meanwhile, Jody tried on a set of cute flannel pajamas. When I made no moves of any kind, Dana asked me if I was all right. Swallowing, I slowly began removing my clothing. She watched with narrowed eyes. The first bra and panty set I tried on was made of ivory lace decorated with black bows. The second consisted of deep magenta satin and was cut so racily it was barely a few scraps of fabric. When I got to the third one – sheer black mesh decorated with embroidered pink flowers – I wanted to die. Jody and Dana had finished and were waiting for me. Jody's face was pleasant and casual. Dana maintained a look of neutrality, but still radiated disapproval. Great. I could feel myself blushing furiously. Bastien would kill me if he found out I'd not only damaged the wholesome image, I'd completely destroyed it. While Dana stayed stone-faced, Jody cocked her head at me curiously. â€Å"I think you have the wrong bra size, Tabitha. They all look too big.† Of course they were too big. Tabitha Hunter didn't wear a 34C. Georgina Kincaid did. I'd intended to shape-shift to my preferred body when I was alone in here. â€Å"Oh,† I said stupidly, feeling like the whore Dana thought I was. Make that a dumb whore. â€Å"Well. I lost some weight recently.† I tried on the last one – red with glittering silver flowers – and even in the wrong size, it was stunning. â€Å"That looks great,† Jody said, echoing my thoughts. â€Å"I wish I was brave enough to wear something like that.† Dana studied me thoroughly. â€Å"That bra offers no support whatsoever. It has no purpose.† â€Å"She doesn't need the support. Besides, that's the point. It doesn't have to be functional. She just wants to be pretty.† â€Å"Pretty for who? And why? She isn't married.† â€Å"So what? It's none of our business.† Dana glared daggers at the other woman. â€Å"None of our business? Humanity is our business.† She must have read Dickens recently. Icy silence filled our little room. I felt invisible, regardless of the fact that I was half naked. â€Å"Hey guys? Maybe we should go. I'll just take this off.† â€Å"No,† said Jody sternly, eyes locked with Dana's in a battle of wills. â€Å"It's beautiful, Tabitha. You have nothing to be ashamed of.† â€Å"She is beautiful,† concurred Dana smoothly, â€Å"but that outfit would be better suited to a married woman.† Her tone suggested that even that was questionable. I was on the verge of just leaving the room as is, but seeing Jody defy Dana like that kindled something warm and fuzzy inside of me. Bastien would kill me, but I couldn't keep myself from joining the fight. â€Å"You know,† I remarked to Dana, making sure she noticed my blatant examination of my backside, â€Å"if that's the case, then maybe you should try this one on. It's just your color. Kind of Christmasy too. I'd love to see it on you. And I bet Bill would really dig it. â€Å" Dana just stared at me, biting her lip again as she held my challenging gaze. She looked like she might snap back but instead simply pursed those lips together in a hard, straight line. Without another word, she left the dressing room, door banging loudly behind her. Jody stood there uncertainly for a moment. â€Å"It looks great,† she reiterated before following Dana out. By myself, I decided I might as well use the alone time to shape-shift and try on the lingerie in the body they'd been intended for. As expected, they looked pretty hot, so I bought them all. I figured I deserved to salvage something from this disaster. â€Å"So how'd it go?† asked Bastien when Jody and Dana dropped me off at his place later on. â€Å"Fine,† I said, having already stuffed the illicit purchases in my car, lest they raise questions from him. â€Å"Just fine. Well†¦sort of.† I told him about Dana's interrogation and my theory that she might suspect us of something insidious, even if it wasn't what we actually planned. His face grew grimmer and grimmer as I spoke, and I knew he thought I had a point. When I finished, I leaned my head against his shoulder, hating to see him so miserable. â€Å"Hey, don't worry. We'll get through this. I mean, look on the bright side: Dana and I did a lot of bonding today. I think we had a real†¦breakthrough.† I knew doubts still plagued him, but he had cheered up by the time we – no longer as Mitch and Tabitha – arrived back in Seattle later that day. We picked up Seth on the way to Peter's apartment, promptly ensuring that neither man spoke to me for the rest of the car ride. Once again, Jerome chose not to grace us with his presence, but everyone else had turned out for more good food and poker: Peter, Cody, Hugh, and Carter. Carter seemed quietly intrigued by Seth's presence while the others greeted him like a long-lost brother. Considering how often he came up in conversation among us, I think the other immortals regarded him as one of our inner circle already. He stuck close to me for most of the night, but turned out to be a pretty damned good poker player. I think his quiet, placid nature fooled others into forgetting he was there. Amusingly, he seemed pretty pleased about his winnings too, albeit in a mild, Seth sort of way. It made me happy to see this side of him, happier still to know he was enjoying himself with my friends. I didn't really know what side of me he saw that night. My friends sure didn't pull any punches when it came to teasing me about my various idiosyncrasies, and Bastien seemed to think it was Memory Lane Night. He kept telling all sorts of stones from my past, trying to lure me into inside jokes no one else knew about. I stayed away from that path as much as possible without offending him. My priority was still making things work with Seth, and as I held his hand all night and only gave polite smiles to Bastien, I think it became clear to the incubus where my loyalties lay. He didn't seem too thrilled. Halfway through the game, I received a joint call from Mei and Grace. â€Å"Hello, Georgina,† said Grace. â€Å"It's us,† said Mei. â€Å"Did you find out anything?† â€Å"No matches,† Mei told me. â€Å"Oh.† So much for that avenue. â€Å"But that may not mean much,† said Grace. â€Å"We always miss some.† â€Å"And it doesn't really matter,† said Mei. â€Å"They're not a problem if they don't meddle in our affairs.† â€Å"And most don't?† I had run into countless immortals over the years, from all sorts of cultures and powers, but I had not paid much attention to how they operated with each other in a political sense. I had always been content to worry about my job and my job alone, safe in the knowledge that the authorities I answered to wielded enough power to deal with anyone else. â€Å"Most don't,† the demonesses agreed in unison. The poker players regarded me curiously when I hung up. â€Å"Who was that?† asked Peter. â€Å"Grace and Mei.† Hugh made a face. â€Å"Ack. The crazy-bitch-dyke twins.† â€Å"Hey, that's uncalled for. They've been very helpful.† â€Å"Yeah? Well, just wait,† he warned. â€Å"Next thing you know, they'll be wanting to cut your hair and dress you in black too. â€Å" Cody smiled at my outrage. â€Å"Why do I get the feeling there's another illicit Georgina investigation afoot?† â€Å"It's not so illicit.† â€Å"Illicit enough,† remarked Bastien with a yawn. â€Å"You and your mortals.† He pocketed the money he had left, downed his bourbon, and thanked Peter again for another fabulous evening. â€Å"Leaving so soon?† I asked. â€Å"Off to find fairer company. No offense to you, Fleur .†He leaned down to me and brushed a kiss over my lips that lingered a breath too long for friendship. â€Å"Good night.† His departure spurred a new round of the Bastien Fan Club as they all speculated what sexual escapade he was about to embark on now. â€Å"How does he do it?† asked Peter. â€Å"I wish I was that good,† added Cody. â€Å"Hey,† I complained, â€Å"pursuing women isn't any harder than men. Sometimes it's easier. â€Å" â€Å"That guy's amazing.† Hugh acted like I hadn't even spoken. † Going after a new one tonight when he's still sporting a glow that can't even be a day old. I wish I got lucky that often.† Seth didn't like to speak much with this group – or any group for that matter – but like my other friends, he was in awe of the incubus. Hugh's comment especially piqued his interest. â€Å"What do you mean by ‘glow?' Like an afterglow?† Hugh grinned at him. â€Å"Sort of†¦you must know what I'm talking about. The post-sex thing? The glamour?† â€Å"Whose deal is it?† I asked sharply, not liking the conversation's new direction. Seth turned thoughtful. â€Å"Well, then it is like an afterglow. I mean, everyone sort of has something like that after sex.† â€Å"Yes, but it's different for an incubus or a succubus,† explained Peter professorially. Unless I was mistaken, he was starting to pick up a British accent. Too much exposure to Bastien. â€Å"In their case, it's more of a literal glow – to other immortals at least. When they've had sex, they take that person's life. Life force is alluring. To an immortal, a just-laid incubus or succubus will almost – â€Å" â€Å"Glitter,† suggested Cody. â€Å"Or sparkle. And yet†¦not. It's kind of hard to explain. Hasn't Georgina told you all this?† â€Å"Not this,† said Seth. â€Å"So I†¦er, mortals don't see it?† â€Å"Are we playing or not?† I asked impatiently, raising my voice. Carter caught my eye. â€Å"Not like we do,† continued Peter. â€Å"But they – you – feel it. Or maybe ‘sense' is a better word. It pulls you in. It's very attractive. â€Å" I sunk lower into my seat, trying to decide if anyone would notice if I suddenly turned invisible. I might as well have been since no one was listening to my protests anyway. â€Å"You must have noticed it,† pointed out Hugh, taking a swig of whiskey. â€Å"There must be days when you see Georgina and practically can't control yourself because of how hot she is. You can only stare. Of course, it's probably hard to tell the difference since she's always so hot, huh?† Everyone except Carter, Seth, and I laughed. I knew the imp had meant that last part as a compliment, but I wanted to throw my gimlet glass at him nonetheless. The hilarity soon died down, and we returned to cards. But the damage was done. Seth and I hardly spoke for the rest of the night, not that anyone – save Carter, I suspected – even noticed. When Seth and I left, I knew something bad was coming. I dropped him off at his place, and he invited me inside to eat Rocky Road ice cream. He was a big ice cream fan. I should have just turned around and left, but Rocky Road has supernatural powers. Plus, I remembered what Seth and I had discussed after the recent make-out session in bed – how we had to communicate about issues, rather than ignore them. I still believed that to be true, but theory and practice were two completely different things. He made up two bowls for us, and we ate the ice cream in silence for a while. When he finished, Seth played with his spoon, not looking at me. â€Å"So,† he asked, â€Å"is it true?† â€Å"Is what true?† Like I didn't know. â€Å"Come on, don't make me spell it out,† he said gently. â€Å"I just want to hear your version, that's all.† I opened my mouth to speak, to find some way to neutralize all this, but my tongue felt thick and useless. No coherent words formed. â€Å"Is it true?† repeated Seth. When I still didn't answer, he continued, â€Å"When I see you sometimes†¦when I see you – like that one night – and can barely even breathe because you are so beautiful†¦so beautiful that I can do nothing but act like an idiot, does that mean that you've just†¦slept with someone? But, of course, I don't actually mean, um, ‘sleep'†¦Ã¢â‚¬  Damn, this communication thing really did suck.

Blooming Of Progress Worldview - 1347 Words

Blooming in Progress: Worldview in my Vocation As a believer, I believe in Creationism and that the universe was created by God ex-nihilo, or from nothing. Moreover, when God created man, he gifted him with vocation. He was given wisdom, understanding, and knowledge to replenish, subdue, and rule over the other living things. (Genesis 1:28, King James Version) It is important to note that even in all that man was ordained to do, that God also blessed him with rest. It is reassuring to know that God wants us to be diligent and faithful in our work and that he desires to bless us with rest. For some that is a difficult concept, many employees work six days a week or overtime in excess of twelve hours a day for financial gain. Not every†¦show more content†¦Jesus paid the price that we could not pay for our sins to redeem us from death and being eternally separated from him. No matter our shortcomings and our stubbornness, God still chooses to work in us and through us despite ourselves. (Veith G. E., 2002) This is exemplified by God allowing us to serve and be served by people from all walks of life. I think it is to remind us of our dependence on Him. Just as we realize that we cannot make it in life without God’s help, we cannot make it in life without the people around us, the everyday ordinary people. â€Å"God, who pours out his generosity on the just and the unjust, believer and unbeliever alike, hides himself in the ordinary social functions and stations of life, even the most humble†. (Veith G. , 1999) Our service would not be possible if Christ had not done for us what we could not do for ourselves. As a matter of vocations, I serve many roles. I am a mother, a daughter, a sister, a cousin, a friend, a niece, a granddaughter, a neighbor, an aunt, a wife, a student, and an employee. My calling in each of these areas is different, yet they share something in common. My duty to serve remains constant. I do not often think of myself as a citizen, yet, I am. Usually, unless I am traveling, it is not something that I give a second thought. Yet, I am a Tennessee native, a Texas resident, a member of the Tomball community. My list keeps getting longer. It is

The Things They Carried Vietnam Essay - 1571 Words

How Society Influences Man: Tim O Brien in Vietnam Tim O Brien s novel The Things They Carried is meant to display the effects of Vietnam on both American soldiers as well as the boys they once were. Vietnam is a society where human decency is left behind, and death is embraced as either a joke or an escape--where the horrors of reality are turned comical and exaggerated in order to keep going. Tim O Brien shows how Vietnam turns him from a boy unknowing of death, to a young man unwilling to face it, to a soldier laughing in the face of it, to a veteran unwilling to leave it behind, and finally, to an author left to make sense of it all. Before describing the effects of Vietnam, first it is necessary to know how Tim O Brien was†¦show more content†¦By this point, he is a different person than he was as a child, a college graduate with a distaste for the Vietnam war like many other American citizens of the time. He believes himself to be too smart, too compassionate, too everything for the war (O Brien 26). By being forced to war by a draft board, he rages against having no options and the unfairness of it all---he revels in his righteousness, his feeling of being wronged, and uses this to help convince himself that he has every right to run from Vietnam. O Brien convinces himself he has every right to run from death, yet still managed to be divided when it came to actually getting up to run. Thus, when he abandons his little town to flee to Canada and escape the war, his constant juggle between doing what was expected of him and doing what would keep him alive is the conflict between the young boy clinging t o Linda alive and healthy and the soldier he will soon have to become. In the end, his fear of facing the disappoint of his family and peers is too great, and he returns home to face the war. While this decision is what gets him to Vietnam, however, it is not the decision that alters him forever. No, it is Vietnam that sheds away both the little boy O Brien once was and the righteous college graduate who feared his town s judgement. Vietnam, in a way, is much like a person, and how it adapts to affect individuals is beneficial to understanding how it changed O BrienShow MoreRelatedComparison of the Vietnam War and in The Things They Carried Essay1792 Words   |  8 PagesIn the twentieth century many young adults and many other men were chosen/ drafted to enter the war. The Vietnam War started during the time period of 1959 and this brutal war ended on 1975. It started with the United States sending aid and military advisors to the Southern part Vietnam. The U.S helped the southerners of Vietnam because the northern part of Viet was a communist state so the south wanted to end Communism up in the north. Also, this war was said to be one of the bloodiest wars thatRead MoreThe Vietnam War in The Things They Carried by Tim O ´brien Essay796 Words   |  4 PagesThe Vietnam War. A war that many Americans believed unfair and unnecessary. â€Å"Why am I being sent off to fight in a war I don’t know anythin g about? Will I ever return again?† Many draftees asked themselves these questions hoping to find comfort in the answers. But there was little to no hope, and they knew it. They were being drafted and they could do absolutely nothing about it, only hope that at the end they would be returning to the enlightened faces of their loved ones, something that not manyRead MoreEssay about The Things they Carried Symbolism772 Words   |  4 Pages The Things They Carried: Essay Prompt Two Tim O’Brien writes about both the physical objects they carry as well as their emotional burdens. The objects that these soldiers carry serve as a symbolism for what they are carrying in their hearts and minds. The soldiers carry items varying from pantyhose, medicine, tanning oil, and pictures. Jimmy Cross is an inexperienced sophomore in college, he signs up for the Reserve Officers Training Camp because his friends are doing the course. Jimmy Cross doesn’tRead MoreAnalysis Of Sweetheart Of The Song Tra Bong In Things They Carried889 Words   |  4 PagesThings They Carried Essay Anything can change a person if they are not ready for that change. The short story Sweetheart of The Song Tra Bong, in Things They Carried, by Tim O’Brien represents this by showing change in Mary Anne, who is a character the reader probably would not expect to see in a book about the Vietnam War. There are many parts show the change in her from the average high school girl she used to be into a predatory killer, but there is only one reason for her change, and that isRead MorePersuasive Essay : The Things They Carried Essay1189 Words   |  5 Pages11/29/16 Persuasive Essay: The Things They Carried Are moral standards in the eye of the beholder? According to one author, â€Å"we’ve seriously lost our way†, going on to state, â€Å"we are like mean adrift at sea without a compass† (Hulme). In literature as in biology, the mantra of form fits function applies and heightens a reader’s appreciation of a writer’s choice and how they contribute to a work of literature. In Tim O’Brien’s collection of short stories, The Things They Carried, the narrative,Read MoreThe Things They Carried By Tim O Brien1377 Words   |  6 PagesTyler Nooney Trafford P.6 The Things They Carried Essay The central theme and true meaning of courage is shown vividly in numerous instances throughout Tim O’Brien’s classic novel The Things They Carried. O’Brien’s novel begins with the courage of coming of age, along with the author’s loss of his innocence. Tim, the protagonist of this novel, goes through an incredible change in belief when he must choose to either run away from the Vietnam War or unwillingly join the bloody battle, of which heRead MoreForeignness in Vietnam: The Things They Carried by Tim O’Brien 566 Words   |  3 PagesForeignness in Vietnam When you think of what is foreign to the common soldier in the vietnam war you usually think of the vietnamese people or the terrain. In the book The Things They Carried, Tim O’Brien twists the idea of what is foreign to the common soldier in Vietnam. The opposite happens too, what was so familiar not too long ago back home seems almost completely unknown to them now. O’Brien even shows similarities between the American soldiers and the Viet-Cong. In the Vignette the â€Å"ManRead MoreWhen is war justified715 Words   |  3 Pageslook back at themself and wonder, â€Å"Was it worth all the lives we lost in battle?† The Vietnam War is a common reminder of a Humanitarian War that caused many people to look back and wonder if it was worth it. Imagine if you were chosen to fight in the Vietnam War. The thought of losing your life in a war that was fought out of national liberation would be terrifying to most. In the book, The Things They Carried, the chapter â€Å"On the Rainy River† is the perfect examination of a young man who has beenRead MoreAnalysis Of The Book The Things They Carried 1409 Words   |  6 PagesDenali Dickson Butler July 22, 2014 Long Form I. The Author and His Times: 1. Birth- October 1, 1946 to present 2. The Things They Carried was published January 1, 1990. This novel discusses stories from the Vietnam War, written many years afterwards. The book shares stories from several different people during the war and shares the truth as they remember it. 3. The factor that influenced the author in his decision to publish this novel was his desire to share his stories with the world. StoriesRead MoreAnalysis Of Tim O Brien s The Things They Carried Essay997 Words   |  4 PagesXizhao Liu(Amber) American Literature Essay #3 Nov. 11, 2016 Male love in The Things They Carried The Things They Carried by Tim O’Brien is a fictional book consisting of different stories from Vietnam war. Tim O’Brien was trying to convey the real perspectives of the war to his readers by telling facts and stories through his personal memories he got from the war, and how things effect them and their life after the war. In order to express the tension in the war, O’Brien depicts the experience of