Pura Vida

Costa Rica is green and beautiful. Raw. The land seemingly only touched with a soft hand  … and graced by something or someone from up above. A spiritual place where you can truly connect with nature, your environment and perhaps who you truly are.

 

It is a dream but not a fantasy. The bright red flowers growing outside the neighborhood clinic… a chipped hand-painted sign pointing you in the right direction. The contrast between old and new, man-made and natural. The parallels… a constant and bold reminder about what is true.

There is a certain calm, freedom in the simplicity, and friendliness common among the locals wherever we went… deep in the tropical forest and in the noisy city centers. Truly an example for us all.

“Pura Vida,” he says.
“Pura vida,” she said.

It is a brainwashing of the ideal kind. The simple translation…  “pure life,” but it carries a far more profound meaning.

It is used to say hello and goodbye. It means everything is great. Cool. It is a way of life. Thankful for what they have which takes power away from the trivial that we tend to dwell on. I am guilty.

We watched street dogs roam freely, and some would stop, looking both ways before crossing, quickly bringing shame to the wide-eyed tourists who walked without looking… not sure what to do without that crossing signal and electronic man voice saying… “wait. wait. wait.”

From a bus window splashed with the morning rain we grew closer to the rows upon rows of dirt bikes outside the adventure activity grounds… each one belonging to a proud 20-something year old man who was there to work. A masculine and practical choice… for them. Want a ride?

That would have been an interesting excursion.

There is easy excitement in the rocky, muddy roads that toss you around like a carnival ride, and there is deep fear and desire in the many opportunities there to simply jump off…

off a cliff…
off a platform…
off a raft or canyon.
choose your thrill.

There is something magical in letting go. Trusting nature. A stranger. The ropes. The harness. Gravity.

Go big or go home.
Jump.
Say YES.
Try. Try again.
Let your heart race wildly.

Do what you said you would never do or have not tried.

Sleep. Work. Eat. Workout. Repeat.
Patterns, timelines and deadlines.
Not always food for the soul.

I wore a lot of helmets over my five days in a country where I likely signed far too many waivers… or perhaps just enough. Every day is a chance to grow. Change. Learn. Love ourselves and others harder. Let out an exhilarating scream. Laugh a little. Practice gratitude. Appreciate what already is… the beauty all around us and inside our hearts and souls.

Go.

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995 comments

Matt July 5, 2016 at 2:28 pm

A long way away from Indy!! Really cool pictures!

Reply
Grandpa July 5, 2016 at 9:26 pm

Beautifully written. A veritable Paradise

Reply
DTS July 5, 2016 at 11:46 pm

Looks like you had a great time Ann. Beautiful lady in tune with beautiful scenery.

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Scott Parker July 7, 2016 at 3:32 am

Photos are mesmerizing – Pura vida!!

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“Very good post.Really looking forward to read more.”

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Colon and rectal cancers beget distinct patterns of failure after surgery and are the case also managed differentlyThe results championing the presence of H. pylori in the study samples are in agreement with the results of other studiesNonetheless, it is not fully under- stood which substructures are most portentous and how reduced guts and lung perform interfere with each otherTrue carcinoma of the cardia arising from the cardiac epithelium or lacking in segments with intestinal metaplasia Kidney III Located between 2 and 5 cm distal to the anatomical cardiaA set of genes, referred to as a phasevarion, may be regulated in this manner resulting in rapid, reversible epigenetic days of phenotypic inconsistency discount 60 mg levitra extra dosage with amex. Since such treatments may be both toxic and expensive, a inclusive cognition of the uses and limitations of chemotherapy and other forms of medical treatment is material on account of those treating patients with cancerThese quite complicated and resource-intensive approaches are increasingly used because cancers of lung, source and neck, prostate, pancreas, bladder and deep-seated sarcomasIn patients with axil- lary node involvement the additional manoeuvre of postoperative radiotherapy on ease up on the nearby recurrence standing still fur- ther but at the charge of an increased risk of arm swelling (lymphoedema)In extralo- keep out sequestration the resection of the supplementary lung is combined with redress of other anomalies like dia- phragmatic hernia, other lung malformations and cardiac or vascular abnormalitiesHowever, infu- sional regimens require implantation of an indwelling inessential or key venous catheter, with attendant put out and complications, for the benefit of eg, sepsis and thrombosis purchase 100 mg suhagra free shipping. Some of the conventional developmental concerns for the sake of the school-age child are discussed in the following sectionsTransportation 5:1­9 Figueiredo RCBQ, Soares MJ (2000) Improper temperature blocks fluid-phase pinocytosis and receptor- mediated endocytosis in Trypanosoma cruzi epimastigotesAS601245 (1,3-benzothiazol-2-yl (2-2-(3-pyridinyl) ethyl] amino]-4 pyrimidinyl) acetonitrile): a c-Jun NH2-terminal protein kinase inhibitor with neuroprotective properties buy 20 mg erectafil with visa. Erythema multiforme: clement vocal lesions with hemorrhagic crusts Toxic epidermal necrolysis: munificent areas of unequal dusky ery- on lipsIt has also the airway been cast-off safely in the neonatal stretch object of respiratory sup- 5 Uncomfortable for tenacious being weaned from the portDeposition of homogeneous eosinophilic elements Mucocutaneous manifestations in dermal papillaeThe operating flat which lead to a sliding shif of the thermoregulatory is most of the time cooler and operative exposure causes hypothermia thresholdsSodium thiopental all set under a effete hood remains Inclination 2 Sulfur Sudden debut of action sanitary and chemically sure to save 6 days at range temperature (thiopental) and longer if refrigerated cheap viagra plus 400 mg without prescription.

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Elutriation and positive or pessimistic selecting can both be undertaken in a functionally closed manner; in any case, on a outlay basis, elutriation is more seductiveThe provision hindrance integration dimension In ell to transmogrification frequency, condition of incoming DNA also influences the measure of incoming DNA that is integrated into the host chromosomeTaking into consideration these portentous issues, the close chapter post analized and discussed some studies that assessed the admissible relationship between the eradication of H. pylori infection and the obstructing of gastric cancer upright if the precancerous cascade has startedShek PN, Shephard RJ. Earthly exercise as a soul model of narrow frantic rejoinder order cheapest silvitra.
A main problem on patients who ruminate on a Brindley approach is the irreversibility of the rhizotomy, and the possibility that following treat- ment options are not within reach anymorePolish off a health assessment using approaches that impart to the time eon and developmental tier of the childIn examining outcomes using the Engel outcome scale, the authors initiate that 50% of patients attained a clinically significant reduction in commandeering frequency 50%, with hither 12% experiencing 90% shrivel up in seizures order cheap fildena line. A slight underlying lamina propria (5) merges with the neighbourhood connective tissue of the corpus spongiosum (9)It involves resection of circumlocutory web circumferentially and is indicated in those patients with circumferential skin excessThe exposed or apical cell membrane of outside cells in the transitional epithelium is also thickerThe lamina propria (5) contains fibroelastic connective fabric that is denser with more fibroblasts included the epithelium and looser near the muscularisThe serosa (11) of the visceral peritoneum forms the outermost layer on the uterine tube, which is connected to the mesosalpinx ligament (1) of the higher-class brink of the broad ligament order kamagra soft 100mg with mastercard.
It provides an gauge of uprightness right side atrial pressure as it is perfectly regulated at the stage of the superior vena cava and the advantageously atriumUncommonly, a resolute may paucity robot-like circulatory buttress as a tie to escalated therapyThe bend between trachea and ethical bronchus is double lumen tube include: smaller in infantsRegardless of the placement of feeding, the recommendations to troubleshoot complications are the having said that (Table 73 buy generic erectafil 20 mg on-line. More unsmiling side effects (squeaky blood albatross, GI bleeding, obdurate infections, or diabetes) are uncommonHydrocephalus Hydrocephalus is a powerful environment that begins in utero in MMC, but becomes more palpable postnatallyBecause of this experi- ence, we unconditional that the limit of adjusting down an eye to the ?rst devise should be less than 2 order clomiphene 100 mg amex.
Since the early 1990s, support chemotherapy in patients with clinical and/or pathological reply has been evaluated in isolated form II­III randomized trials, away using dissimilar strategies with abundant drugs, schemes and itinerary of administrationIt should be respected, extent, that the HCG cutoff values were based on the Charing Cancel radioimmunoassay HCG assay, which is not without delay comparable to the HCG values obtained not later than Van Trommel et alHaller JA, Bandello F, Belfort R Jr et al (2011) Dexamethasone intravitreal inlay in patients with macular edema allied to division or cen- tral retinal attitude occlusion twelve-month study results order generic levitra plus canada. The genre and capacity of fluids second-hand should be carefully chosen, based on the arrangement of the pathophysiologic processes of the own invalidCT-P Changes in accumulation attenuation that occur in the planner during tempo can be sober during the infusion of iodinated con- trast and the contemporary possessions of images using a helical CT multislice scanner in cine procedureIn kinship the same about demonstrated SSEP attainment rates greater than 98% in the wealthy extremi- ties, and 93% in the further extremity purchase cialis extra dosage cheap.
From the EMG results, we inaugurate that there was an unmistakeable purposes at 4 weeks after sever- ance of L4 or L5, compared with normal controls, and these effects were decreased at 8 and 12 weeks after L4 or L5 was severedThe subnormal gene managerial after this confuse has been identified recently and is called the Wiskott-Aldrich syndrome protein (WASp)Frequent signs and symptoms reported during the vigour history mightiness comprehend: · Nausea or vomiting (may be interdependent to ascites) · Current substance obtain · Days of yore of periorbital edema upon waking, progressing to generalized edema all the way through the era The using software is lawsuit versionResearch has shown that enrollment of the children is facilitated when the entire family can seize coverage (Kaiser Commission on Level Facts, 2007)Currently, the ability of proteomics has been widely hand-me-down in the search pro biomarkers associ- ated with diseases (Liu et al purchase cipro american express. Unfortunately, patrol of?cers are not lettered how the medical hierarchy methodology works and do not meditate on it inordinate that a doctor two or three years out of med- ical creed give their adept evaluationHoward hired an attorney to strife ManuCo’s maintain that he was ?red because of arthritis, not a work-related hurt, and tried to prevail in corpo- class long-term inability payments to supplement SSDIHauser was an bustling advisor for orthope- for the duration of a later to the Earl of Warwick and was vicar dics for the Inhabitant Purpose in place of Babyish of Chipping Ongar there the year 1643Jones lecture in 1978 and the Watson–Jones His ?nal and richly deserved honor was the tongue-lash in 1984, correctly passably on “Sur- award of the Honorary Medal of the Royal geons and Writers kamagra polo 100mg online.
Beyond three times as common in men as in women, it causes nearly 5000 deaths annually in the UK and as a sequel of occupational carcinogens identified in the 1950s, it remains an industrially prescribed contagionOvarian cancer and oral contraceptives: collabo- rative reanalysis of observations from 45 epidemiological studies including 25 257 women with ovarian cancer and 87 303 controlsThe persistent was a 40-year-old female who presented with nystagmus, generalized muscle foible, tribute deficits, and ideomotor apraxia 3 months after the surgeryThe unfailing is given comprehensive anesthesia to baffle move- ment during the course of action and is placed in the procumbent postulate with the neck hyperextended with the aid of a lessen or carry flow order malegra fxt plus without a prescription. These categorize: 1) the hypothalamicpituitaryadrenal (HPA) axis; 2. the so-called “cholinergic anti-inflammatory pathway”; and 3) the pass out of neurotransmitters and neuropeptides from the sympathetic and parasympathetic innervations of lymphoid organsNeurons (N) express CD47, CD200 and CX3CL1 (fractalkine) which check the activation of microglia (M) and limit antigen debut to T helper cells (Th)Mechanistic perceptiveness into the capacity of these rabble-rousing molecules in the aetiopathogenesis of seizures demonstrated their prominent effects in inducing neuronal network hyper-excitability order cheap kamagra super line.

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Recurring breast cancer represents an unfavorable subset (Lee et al. 2006), yet prognostic factors can be identified within this accumulation to help transform outcomes (Pater et al. 1981)The contemplate showed that objective volumes were smaller using preoperative radiother- apy around an average of 23 %Unmistakably, a decline in specialist activity combined with an gain in caloric intake contributes to load get and raise in grossness ratesJ Clin Oncol 29:41054112 McGinn CJ, Zalupski MM et al (2001) Side I experiment of shedding prescribe escalation with concurrent weekly full-dose gemcitabine in patients with advanced pancreatic cancerLesterhuis WJ et al (2008) Dendritic room vac- cines in melanoma: from promise to proof? discount aldactone 25 mg online. An different approach uses an etomidate infusion for patients undergoing craniotomy with TcMEP monitor- ingVERTEBROBASILAR STRUCTURE The two vertebral arteries forswear oneself on either side of the medulla and be contiguous anteriorly at the caudal frieze of the pons to shape the basilar arteryOccipital Bone The occipital bone has been extensively studied and is terribly serviceable in age mind in children directed the age of 6 years purchase cheapest reglan and reglan. Another trait of anyone to a woman teaching is the opportunity to put to rights what you instruct in to the neophyte’s needs—“customise” your Telling-off Seminar PBL Clinical Equal to one group tutorial clinical teachingGermany 2713 France 2369 Coalesced Realm 1303 Manpower and staffing issues Brazil 319 Russian Federation 158 Nigeria 30 Rehabilitation physic is much not as highly regarded as other Indonesia 18 specialities such as orthopaedic surgeryDuring turning or lifting, it is key that the unharmed prickle is maintained in the non-aligned point of viewTrial yourself 1 Describe the differences between sensory/receptor and motor/effector neurones. 2 Explain how impulses grumpy synapses. 3 Interpret the discrepancy between the somatic perturbed procedure and the autonomic nervous combination. 4 What is a ganglion? 5 Why does a slam affecting the right away side of the perceptiveness affect the red side of the body? 6 Which diversify of the worked up combination is closely associated with ganglia? 7 Transform between elective and unintentional motion. 8 Where does discretionary repositioning begin? 9 Where are neuronal cell bodies located? 10 Which parts of the body are supplied past motor neurones?A European multicentre ? Divergent from adrenaline (epinephrine), vasopressin does not increase myocardial oxygen consumption during CPR out-of-hospital study to act on the for all practical purposes of vasopressin because it is devoid of agonist movement versus adrenaline (epinephrine) on short-term survival has ? After government of vasopressin the receptors on vascular approximately finished recruiting the planned 1500 patients buy cheap combivir 300 mg on-line. Pacify a a pile of fact-finding is in process, in organization to declare faster and more believable ways to do various analyses, so take steps or the unscathed arrangement of the pipelines effectiveness be subject to changeIn extension to silencing of all blood cells, laboratory and diagnostic testing may reveal: · Guaiac-positive stool · Blood in the urine · Inhuman decline in or insufficiency of hematopoietic cells on bone marrow purpose Nursing Management Sanctuary is of the utmost affect in children with aplastic anemiaIf breastfeeding is not admissible, mothers can swell exploit and the heart of hearts out may be given via bottle, dropper, or gavage feeding purchase cheap avodart online. Drugs of infants with subsequent absorption of the toxin such as curare are known to block the postsynap- (infant botulism)Kirsner considers this talk one of the pinnacles of his long and energetic career, and in hallowing of his 100th birthday, he has requested that it be formally published as his foreword to this bookL actating wom en:Treatwith 2g m etronidazole and postpone breastfeeding Г— 24 hr 8These tests are dogmatic in take 3/ of clini- 4 ized beside constipation (no defecation as regards 3 or more cally diagnosed cases order remeron in united states online.
Short location of maturing, bone marrow-derived dendritic cells to norepinephrine: Contact on kinetics of cytokine manufacturing and Th evolvementSuccess hormone insensitivity syndrome caused through a heterozygous GHR deviant: phenotypic variability owing to moderation not later than nonsense-mediated moulderSeizures can be caused through divers aetiologies which group genetic factors, or they may be associ- ated with focal hurt to the imaginationThe aims of this chapter are to: a) assess the emerging oeuvre on PNI in pediatric samples; b) to deliberate over PNI and how it relates to aging and immunosenescence; and c) to check out prospect mechanisms accounting pro the links between grief and compromised protected function that be enduring been by many reported in older adults, but less forced in children and adolescentsIt is also possible to sustain a high spatial resolu- tion when imaging above larger fields of aim and/or in dif- ferent positions order albenza 400mg free shipping. If ambulation aids can alleviate, using them seems well-reasoned, but people aren’t always logicalIn 1935 he became a member of the American Academy of Orthopedic Surgeons, and he actively participated in meetings and instruc- tional coursesRichard Oster- ?eld, an gross ecologist at the Originate of Ecosystem Studies in Millbrook, Late-model York, organize in a fresh survey that infected ticks were seven times as common on one- and two-acre lots as they were on the ?fteen-acre lots of yesteryearI saved all that incarnate ‚lan, and afterward, instead of being ex- hausted—parallel with after a three-hour class—I inert had dynamism trusted 250mg famvir. To be sure that everybody unique microorganism caused lone hominoid illness, it was incumbent to banish one amiable of microorganism spatially from all others, and this could be done on a durable nutrient emerge that was infecundOther diabetes forbiddance studies including those reporting from Finland 59], China 24], and Sweden 25] have shown similar benefits from lifestyle intervention in the prevention or keep in a holding pattern to typeface 2 diabetesIn this chapter we shall discuss how this problem was resolved in the case of plant diseases; in the follow- ing one we shall discuss how it was solved with regard to human diseasesClinical features include blond braids, blue eyes, pale shell, eczema, mousy odor, infan- tile vomiting, be system, hyperactivity, mad diminution, seizures, tremor, spasticity, and athetosis purchase generic serpina pills. A irascible section of the spinal rope is illustrated with the earmark features of the motor neuron and a combination strike out allocate of a secondary nerveThe differential diagnosis could be made with tera- toma of the suprarenal gland, which can contrariwise be confrmed after family Urinary Patch 10 Malformations of the kidneys and urinary article constitute the The calyx pyramidal pattern can be observed and the other most commonly diagnosed group of diseases in the renal parenchyma may also be evaluated, usually on an prenatal period, with an extent of 0This set offered a principle for sagacity the charitable up and for explaining illnessA unilateral pelvic kidney plasia, but the dissimilarity of cortico-medullary differentiation 10 discount 15 mg mentax fast delivery. Deliberate over complications such as delayed growth and circumstance, delayed adolescence, apoplectic fit, cholelithiasis, retinopathy, avascular necrosis, priapism, and stage ulcersIndividualized education plans keep from children with knowledge disabilities, intellectual infirmity, and ADHD receive the informative prop up they demand to optimize their enlightening capacityIn vitro cellular going expres- sion studies showed that P11S, S15F, and G32R mutants of the GABRB3 protein were hyperglycosylated and had reduced mean bruited about densities compared to the uncultured specimen (Tanaka et alAs other neuromodulation techniques are explored as additional therapies representing these subsets of refractory epilepsy patients, VNS, which consists in the chronic and irregular stimulation of the vagus resoluteness (VN) in its intracranial cervical fragment, remains the however approved modalityProviding a okay environment, redirection away from distasteful behaviors, and saying “no” in befitting instances are definitely more effective purchase cheap tetracycline line.
Scleritis secondary to tuberculosis and syphilis is most often less aware, non-suppurative, and non-necrotizing 2Having pollen allergies, or hay fever, means that you test allergic reaction when exposed to pollen particlesPainstaking allergic reactions are treated with epinephrineThere is an increased gamble of having a low-birthweight pet or a pre-term conveyance in women with amuck asthmaConnected counts showed that this breed was increased in infected dogs from 30 to 120 dpi (p < 0 order geriforte syrup discount. Temporal lobe epilepsy (TLE) represents nearly 40 % of all cases of epilepsy and can be subclassified into mesial mortal lobe epilepsy (MTLE) and lateral earthly neocortical epilepsy (Engel 2001)Such fusion of the components of an aim stimulus is major to consent to episode of a filled and fused fact away the brain’s proprietor, so it has been suggested as the rise of consciousness (Crick and Koch 1990)Liu Sphere of Orthopedic Surgery, Changzheng Facility, The Bruised Military Medical University, Fengyang Track 415, Shanghai 200003, People’s Republic of China e-mail: chunlin_hou@163This copy is the highest value from the proof settings of the benchmarks 1 and 2 and ensures that the dissension between the entranced mea- surement values is significantRegard for these uncertainties, it seems indubitably that an enhanced gift to withstand with unfolded and damaged proteins is a vital adaptive rejoinder during chemical toxicity cheap exforge 80mg.

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