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When there is the only way for a spiritual sin behind a disease erectile dysfunction joliet discount levitra with dapoxetine 40/60mg without a prescription, no doctor or any form of medicine will be complete healing to come able to do anything more than merely manage the disease with prescripis by going through the tion drugs that often complicate the disease with side effects erectile dysfunction pre diabetes buy 40/60mg levitra with dapoxetine with amex. It also brings right doorway to get it and in occultism and sorcery which is another block to healing erectile dysfunction pills cvs order 40/60 mg levitra with dapoxetine otc. The only way for the disease to be totally eradicated and for complete healing to come that is repentance and sanctification of the heart online doctor erectile dysfunction cheap 40/60mg levitra with dapoxetine with amex. Even Jesus was not able to heal people in His own town because of doubt and unbelief: Mark 6 v 5 ­ 6: "5And He was not able to do even one work of power there, except that He laid hands on a few sickly people [and] cured them. These people will come to me because they are sick, but in their hearts they are saying, "If what you teach is really from God then do something. An attitude like this will hinder your healing because you are not to look to me or to man ­ you are to look to God and the « 722 » Specific Diseases sanctifying work of the Holy Spirit and His Word. The devil also tempted Jesus to "do something" when He was fasting for 40 days in the desert: Matthew 4 v 1 ­ 7: "1Then Jesus was led (guided) by the [Holy] Spirit into the wilderness (desert) to be tempted (tested and tried) by the devil. Jesus said that an evil and adulterous nation seeks a sign: John 4 v 46 ­ 48: "46So Jesus came to Cana of Galilee, where He had turned the water into wine. But He replied to them, An evil and adulterous generation (a generation morally unfaithful to God) seeks and demands a sign; but no sign shall be given to it except the sign of the prophet Jonah. We are to seek God and believe His Word, not the signs and wonders as the foundation of our faith. The key is faith in God and His Word on the basis of an intimate relationship with Him, not on the basis of signs and wonders. Looking to the Symptoms Instead of the Healer - Letting Fear Enter Your Heart atthew 14 v 22 ­ 31: "22Then He directed the disciples to get into the boat and go before Him to the other side, while He sent away the crowds. If you are waiting for your symptoms to go away before you will believe, you are going to be waiting a long time. If you are waiting for your healing before you look to the Healer, you are going to be waiting for your If you look at your healing for a long time! You see, the symptoms of your disease are just the fruit of symptoms rather the problem. Get to the root ­ get into the Word and get sanctified from the sin than the Healer you behind the disease. Get your are going to sink into eyes back on the Lord and His Word and keep them there! When your eyes are on your symptoms and your disease ­ you will sink into fear and unbelief. Pride and Expecting God to Heal You Your Way I f you read all the miraculous healings that Jesus performed in the Bible, He never did exactly the same thing twice. Sometimes we get our own ideas of exactly how God should heal us and we try to put Him in a box. Elisha sent a message with a servant telling Naaman to go and wash in the river Jordan seven times and then he would be healed. Healing begins with sanctification of the heart, which is getting rid of sin in our thoughts and life. However repentance has to start with acknowledging that the sin is there in the first place. Some people are too blinded by their own self righteousness and are too proud to admit to any sin in their life. This makes them appear holy when they are not and it is an existence that is fraudulent. I said, I will confess my transgressions to the Lord [continually unfolding the past till all is told] ­ then You [instantly] forgave me the guilt and iniquity of my sin. Proverbs 16 v 18: "Pride goes before destruction and a haughty spirit before a fall. If you want to be set free from your disease, you have got to confess your faults. James 5 v 16: "Confess to one another therefore your faults (your slips, your false steps, your offenses, your sins) and pray [also] for one another, that you may be healed and restored [to a spiritual tone of mind and heart]. A Hardened Heart here are people who are blinded by their own self righteousness or are too proud to admit that they have sin in their life. The only way that these people will receive their healing is to humble themselves before God, with deep conviction and heartfelt repentance.

You will not be able to remove bitterness from your life until you deal with un-forgiveness erectile dysfunction medication levitra discount levitra with dapoxetine 40/60mg without a prescription, resentment erectile dysfunction test cheap levitra with dapoxetine 40/60 mg with mastercard, retaliation erectile dysfunction and diabetes type 1 purchase levitra with dapoxetine us, anger erectile dysfunction treatment in trivandrum buy 40/60 mg levitra with dapoxetine fast delivery, hatred, violence and murder behind it. This [peace, righteousness, security and triumph over opposition] is the heritage of the servants of the Lord [those in whom the ideal Servant of the Lord is reproduced]; this is the righteousness or the vindication which they obtain from Me [this is that which I impart to them as their justification], says the Lord. Forgiveness ­ the Missing Link ark 11 v 22 - 24: "22And Jesus, replying, said to them, Have faith in God [constantly], 23Truly I tell you, whoever says to this mountain, Be lifted up and thrown into the sea! There are so many Christians who have become so confused and disillusioned with the faith messages and name it and claim it teachings because it is still not working. When the person in this church circus is not receiving the object of their belief, they are simply told that they did not have enough faith. If you want to understand the intent of the author you have got to read Mark 11 v 22 24 in context. If you are going to apply the Word of God, apply the whole Word of God, not just the part that feels good. What has happened to us in the healing ministry is we have hung our hat on a few scriptures to the exclusion of the rest of the Truth in the Word. Well I hope by this point in your journey through this book that you are beginning to understand why. Without mastering this issue of forgiveness, I am wasting my time trying to help you get well from your biological and psychological diseases. The promise of healing and divine health is yours as a child of God (Isaiah 53 v 5). I explained to you in the chapter "Essential background knowledge of disease from a Biblical Perspective" that the condition for healing is repentance. When you repent to God for serving the sin that caused your disease, do you think He will forgive you and heal you? The Bible tells you very clearly that you cannot ask God to forgive you, if you are not prepared to forgive all those who have hurt you and wronged you. Unforgiveness is a major block to healing and it is one of the reasons why our churches are filled with disease. Jesus said in Matthew 6 v 14-15: "For if you forgive people their Forgiveness is a big trespasses [their wreckless and willful sins, leaving them, letting them go, and giving up resentment], your Heavenly Father will also forgive missing link in healing. You would be cut off from a relationship with Him and everything in your life would be a miserable mess of poverty and disease ­ spiritually, mentally, emotionally, financially and physically. We like to think that we can stay angry with other people and yet go to God and receive forgiveness for our sins. Jesus taught us how to pray in Mathew 6 v 12: "Father forgive us our debts, as we have also forgiven (left remitted and let go of the debts and have given up resentment against) our debtors. Henry Wright teaches that as a believer you will not get anything from Heaven that you are not prepared to give away to others. How many times have you done the same wrong thing at least seventy times seven, and God still forgave you for it? We are often willing to keep receiving and receiving forgiveness from God, but it is amazing how little we want to extend forgiveness to others. We freely accept mercy, yet it is surprising how rigid, legalistic and merciless we can be toward others, especially if they have wronged or hurt us in some way. Yet the Bible says that the debt we owe God is much greater than any debt anyone may owe us. Matthew 18 v 23 ­ 35: "23Therefore the kingdom of heaven is like a human king who wished to settle accounts with his attendants. I forgave you and cancelled all that [great] debt of yours because you begged me to . It makes your flesh feel good at the time, but it will literally destroy you spiritually and physically. If you want to hold onto your offense, resentment and un-forgiveness ­ you must also be prepared to hold on to and live with your illness. They have fasted and prayed but the harder they try the more bondage they find themselves. Their prayers seem to be hitting a brick wall and the skies of heaven seem to be closed to their prayers. She could hardly live with herself for the itchiness and discomfort of it and it had been there for over 2 months.

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Medications for diastolic failure depend on the underlying condition erectile dysfunction pain medication order 40/60mg levitra with dapoxetine otc, such as hypertension (see Chap erectile dysfunction tampa discount levitra with dapoxetine 40/60 mg. However erectile dysfunction statistics india purchase 40/60 mg levitra with dapoxetine with visa, it is recommended to start at a low dose and increase every 2 weeks until the optimal dose is achieved and the patient is hemodynamically stable psychological erectile dysfunction wiki buy levitra with dapoxetine 40/60mg amex. Oxygen therapy is based on the degree of pulmonary congestion and resulting hypoxia. When to observe for these effects and for how long depends on the onset, peak, and duration of the medication. However, patients receiving potassiumsparing diuretics (which do not cause potassium loss with diuresis) must be carefully monitored for hyperkalemia, an increased level of potassium in the blood. However, the cough could also indicate a worsening of ventricular function and failure. Nitrates (eg, isosorbide dinitrate) cause ve- nous dilation, which reduces the amount of blood return to the heart and lowers preload. Because of the side effects, betablockers are initiated only after stabilizing the patient and ensuring a euvolemic (normal volume) state. They are titrated slowly (every 2 weeks), with close monitoring at each increase in dose. An important nursing role during titration is educating the patient about the potential worsening of symptoms during the early phase of treatment, and that improvement may take several weeks. It is very important that nurses provide support to patients going through this symptom-provoking phase of treatment. Because beta-blockade can cause bronchiole constriction, a beta1-selective beta-blocker (ie, one that primarily blocks the beta-adrenergic receptor sites in the heart), such as metoprolol (Lopressor, Toprol), is recommended for patients with well-controlled, mild to moderate asthma. However, these patients need to be monitored closely for increased asthma symptoms. Any type of beta-blocker is contraindicated in patients with severe or uncontrolled asthma. Teach patient to change positions gradually and to report signs of dizziness or lethargy. Instruct patient to weigh self daily and to report rapid weight gain and significant feet and hand swelling. Diuretics are medications used to increase the rate of urine production and the removal of excess extracellular fluid from the body. These medications are classified according to their site of action in the kidney and their effects on renal electrolyte excretion and reabsorption. Thiazide diuretics, such as metolazone (Mykrox, Zaroxolyn), inhibit sodium and chloride reabsorption mainly in the early distal tubules. Loop diuretics, such as furosemide (Lasix), inhibit sodium and chloride reabsorption mainly in the ascending loop of Henle. Patients with signs and symptoms of fluid overload should be started on a diuretic, a thiazide for those with mild symptoms or a loop diuretic for patients with more severe symptoms or with renal insufficiency (Brater, 1998). These medications may not be necessary if the patient responds to activity recommendations, avoidance of excessive fluid intake (<2 quarts/day), and a lowsodium diet (eg, <2 g/day). Spironolactone (Aldactone) is a potassium-sparing diuretic that inhibits sodium reabsorption in the late distal tubule and collecting duct. Serum creatinine and potassium levels are monitored frequently (eg, within the first week and then every 4 weeks) when this medication is first administered. Side effects of diuretics include electrolyte imbalances, symptomatic hypotension (especially with overdiuresis), hyperuricemia (causing gout), and ototoxicity. Dosages depend on the indications, patient age, clinical signs and symptoms, and renal function. Careful patient monitoring and dose adjustments are necessary to balance the effectiveness with the side effects of therapy. The effect of a given dose of medication depends on the state of the myocardium, electrolyte and fluid balance, and renal and hepatic function. Chart 30-3 summarizes the actions and uses of digitalis along with the nursing surveillance required when it is administered. Monitor serum potassium levels in patients receiving digoxin, especially those receiving both digoxin and diuretics. An undetected, uncorrected potassium imbalance predisposes patients to digoxin toxicity and dysrhythmias. Assess for symptoms of electrolyte depletion: lassitude, apathy, mental confusion, anorexia, decreasing urinary output, azotemia.

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Medical Management Treatment depends on the underlying cause of respiratory alkalosis (Foster et al erectile dysfunction treatment clinics purchase levitra with dapoxetine overnight delivery. Treatment for other causes of respiratory alkalosis is directed at correcting the underlying problem diabetes erectile dysfunction wiki generic levitra with dapoxetine 40/60 mg overnight delivery. Electrolyte solutions are considered isotonic if the total electrolyte content (anions + cations) is approximately 310 mEq/L erectile dysfunction pills gnc cheap levitra with dapoxetine 40/60 mg visa. They are considered hypotonic if the total electrolyte content is less than 250 mEq/L and hypertonic if the total electrolyte content exceeds 375 mEq/L erectile dysfunction drugs best buy cheap levitra with dapoxetine line. For example, a 10% dextrose solution has an osmolality of approximately 505 mOsm/L. Bicarbonate is the basic or alkaline side of the "carbonic acid­bicarbonate buffer system. If it is moving in the same direction as the primary value, compensation is underway. Arterial Blood Gases the following steps are recommended to evaluate arterial blood gas values. A compensated imbalance is one in which the body has been able to correct the pH by either respiratory or metabolic changes (depending on the primary problem). If the compensatory mechanism is able to restore the bicarbonate to carbonic acid ratio back to 20:1, full compensation (and thus normal pH) will be achieved. The dextrose is quickly metabolized, however, and only the isotonic solution remains. Similarly, with hypotonic multipleelectrolyte solutions containing 5% dextrose, once the dextrose is metabolized, these solutions disperse as hypotonic fluids. Higher concentrations of dextrose, such as 50% dextrose in water, are administered to help meet caloric requirements. These solutions are strongly hypertonic and must be administered into central veins so that they can be diluted by rapid blood flow. If administered rapidly or in large quantity, they may cause an extracellular volume excess and precipitate circulatory overload and dehydration. As a result, these solutions must be administered cautiously and usually only when the serum osmolality has decreased to dangerously low levels. For the same reason, 3 L of isotonic fluid is needed to replace 1 L of blood loss. Because these fluids expand the intravascular space, patients with hypertension and heart failure should be carefully monitored for signs of fluid overload. Once administered, the glucose is rapidly metabolized, and this initially isotonic solution then disperses as a hypotonic fluid, one-third extracellular and two-thirds intracellular. It is essential to consider this action of D5W, especially if the patient is at risk for increased intracranial pressure. During fluid resuscitation, this solution should not be used because it can cause hyperglycemia. Therefore, D5W is used mainly to supply water and to correct an increased serum osmolality. For this reason, normal saline solution is often used to correct an extracellular volume deficit. It is used with administration of blood transfusions and to replace large sodium losses, as in burn injuries. It is not used for heart failure, pulmonary edema, renal impairment, or sodium retention. Parenteral solutions may include high concentrations of glucose, protein, or fat to meet nutritional requirements. The parenteral route may also be used to administer colloids, plasma expanders, and blood products. Examples of blood products include whole blood, packed red blood cells, albumin, and cryoprecipitate; these are discussed in more detail in Chapter 33.

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