Private Pain

In a poignant view of church happenings, the book emphasizes that everything in the church is not what it seems. The church is filled with broken people, victims of trauma and unresolved issues that have put a clog in the church engine.

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The one place a person can find relief from their pain has sadly become a Sunday-morning soap opera where we cannot wait to hear the outcome of a person's indiscretion. The private pain that pew members experience is real, unspoken and devastating. The time has come to break the silence and do "real talk," about what we all know is going on. Private Pain in Public Pews says it all - this book is a must read that gives remedy, hope and insight that is sure to give you a new perspective on church and life itself. I have finished your book and want to thank you for taking the time to write it.

I have been edified! I will definitely recommend this book for use in small group ministry as well as leadership training at our church" Thank you so much.

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I love it, it's really inspiring. Full range of motion was preserved. His cardiovascular examination disclosed a systolic ejection murmur along the left sternal border.

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No oedema was present. However, the patient had evidence of glomerulonephritis on the basis of urinalysis and protein excretion. A procedure was performed, diagnosis established, and treatment with prednisone and sulfasalazine was begun by the patient's physician. One month later, the patient presented to the urology service with sudden scrotal pain and swelling. Elevation of the scrotal contents did not relieve the pain. The left testis was enlarged and painful. An emergency operation was performed. Postoperatively, the patient was referred to the nephrology service for further evaluation.

A renal biopsy was performed elsewhere but examined by our pathology department.

The patient's physician had diagnosed systemic lupus erythematosus. We first saw the patient after his unilateral orchiectomy.

particularly private pain | Nephrology Dialysis Transplantation | Oxford Academic

The haemoglobin was 5. Urinary sediment revealed erythrocytes, leukocytes, red cell and granulated casts. The protein excretion was 3. The C3 concentration was reduced to half normal values while the C4 concentration was also reduced at 0. Antinuclear antibodies were increased at a titre of 1: Anticardiolipin antibodies for IgG were also elevated. Echocardiography disclosed thickened mitral leaflets. The pathological diagnosis was systemic lupus erythematosus and anticardiolipin antibody syndrome with thrombosis of a testicular artery.

Therapy was begun with prednisone, cyclophosphamide, and then phenprocoumone. The common causes of acute scrotal pain are orchiitis, epididymitis, and testicular torsion.

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Less common are tumours, thromboses, and infarctions [ 1 ]. This patient's renal biopsy was consistent with florid systemic lupus erythematosus. His serological studies verified the presence of anticardiolipin antibody syndrome, a fact that had not been appreciated at his initial evaluation. Patients with anticardiolipin antibody syndrome are at risk for recurrent arterial and venous thrombosis.

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In this patient, the thrombosis unfortunately involved a testicle resulting in a rare, but by no means unknown, cause for scrotal pain. A severity of systemic lupus erythematosus to this degree warrants agressive treatment with prednisone and cyclophosphamide, in addition to exquisite blood pressure management.

The presence of anticardiolipin antibody syndrome in such patients should be addressed with oral anticoagulation, in this case phenprocoumone, sufficient to increase the INR to 2. Oxford University Press is a department of the University of Oxford. It furthers the University's objective of excellence in research, scholarship, and education by publishing worldwide.