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Scope

Stanford University School of Medicine blog

We’ve partnered with Inspire , a company that builds and manages online support communities for patients and caregivers, to launch a patient-focused series here on Scope. Once a month, patients affected by serious and often rare diseases share their unique stories; the latest comes from retired nurse Joan Jahnke.

After 2 ½ years of seeking a definitive diagnosis for my heart disorder, my physician of 14 years told me, "You have been insistent, persistent and consistent each time you presented." She smiled at me as she said this, and I accepted this compliment as a job well done.

I had been diagnosed with cardiac endothelium dysfunction .Iconsidered thediagnosis atriumph of some sort:Standard tests don't always identify the disease, and Ihad gone onquite the journey toidentify the source of my problems.

From the beginning, Ihad stayed focusedon my heart symptoms. When various specialists insisted on blaming other organs (gall bladder, uterus, lungs) for my chest pain, I was insistent that they were off target. As a cardiac nurse, I knew that the mounting conflicting test results were confusing, but I felt confident my heart was the issue.After all, Iknew myself far better than anyone else could.

Within weeks of my symptom onset, I read an interview with Dr. George Sopko, a cardiologist at the National Institutes of Health, who said, "Women, pay attention to your heart symptoms." And so, I did that. I began a very succinct journal documenting the timing, duration and quality of chest pain I was experiencing, and I alsoincluded what I did to relieve the symptoms. It presented a cause-and-effect pattern with details that supplemented my memory.

I persisted in my search for a definitive diagnosis for my symptoms. My sources were not anecdotal stories from Internet blogs, but instead were scientific papers funded by medical universities and research institutions. I copied medical articles, whose content and format would be most familiar to physicians. I sought out the opinions of medical friends and colleagues,and I approached my researchfrom the perspective of a student - notthat ofanemotionally distraught woman whose quality of life was rapidly failing.

I remained consistent in my approach. Mindful of how time-consuming difficult diagnoses can be, I came prepared for appointments. Ibrought with me my ever-present journal, previously prepared questions and medical articles. Many times, my husband would serve as my note-taker, which allowed me to listen closely and concentrate on getting my questions and comments addressed. I offered options for my physicians to consider. I was wrong many times, but never was I rebuffed.

The ancient art of reflexology and acupressure have brought relief from aches and pains to millions of people throughout the ages and around the world. D1’s Tactile Therapy consists of various-sized therapeutic “bumps” that have been grouped together at key acupressure points for the arms, hands, wrists and feet. These bumps stimulate trigger points in these key areas, providing you with an acupressure massage.

The CrystalFX™ lighting system creates a relaxing, colorful experience in your hot tub. Based on Chromotherapy, these brilliant underwater jewels of faceted light captivate and enhance the soft, luxurious interior to create the perfect mood. CrystalFX™ utilizes long-life LEDs and features eight colors and two dynamic light shows, from calm and soothing, to vibrant and rejuvenating, to visually enhance your hot tub soaking experience.

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SPECIFICATIONS

WARRANTY

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Dimension One Spas ® offers the best hot tub warranty with a lifetime guarantee, made possible by our UltraLife™ shell. Our UltraLife™ shell’s surface material is structurally warranted not to leak for the life of the hot tub. All of the D1 ® colored acrylic shells have a warranty of 5 years.

The UltraLife™ shell texture provides a non-skid surface that is not prone to scratching, dulling or crazing like a colored acrylic shell. It is the most durable shell material you can find on the market today with the best hot tub warranty. UltraLife™ white picks up the LED lights in your spa more than a darker acrylic shell, making it safer to enter and exit the hot tub. It reflects D1’s multi-colored LED lights allowing you to make the inside of the spa virtually any color you want.

We promise that both your UltraLife™ shell and will look like new, years after you’ve made your purchase. Because it is resistant to cracking, blistering, discoloration and other wear, you will need to perform very little maintenance, which gives you more time to enjoy your tub!

Dimension One Spas’ beautiful Terracina™ skirting is covered with a 7-year warranty that covers defects and structural integrity. Our exclusive Terracina™ skirting has the look of real wood without the upkeep. This skirting is weather resistant, will not crack or fade and does not require staining.

**Security Protocol Changes - Mitchell Courthouse - Please See General Information**

Melissa J. Monroe , Jury Commissioner Clarence M. Mitchell, Jr. Courthouse 100 North Calvert Street, Room 239 Baltimore, Maryland 21202 (410) 333-3775 (410) 333-0057 (f)

Melissa J. Monroe Jury Commissioner

Received a “Summons and Juror Qualification Form”?

Read both sides of the SUMMONS AND JUROR QUALIFICATION FORM in its entirety. The form tells you if you are being called as a Grand or Trial Juror. You must complete and return the qualification form within (10) days of receipt to ensure that the Jury Office receives your information in time. Be certain to complete items 1 through 24 of Part B – Juror Qualification Form, and return it to the Court with any relevant documentation (refer to the DOCUMENTATION CODE LEGEND noted in Part B).

If you prefer, you may complete the JUROR QUALIFICATION FORM online . In addition to completing the form online, the website also allows you to update your juror profile or to submit a request (one time only) that your service is postponed to a later date. If any of your answers on the form disqualify or exempt you from serving, or if your request for a postponement of service is granted, you will be notified before the date your service is to begin (as shown on the bottom right portion of the summons) and you will not have to attend. It is important that you return the form within ten (10) days as requested.

If you prefer, you may complete the JUROR QUALIFICATION FORM online

Jurors are not to bring/invite visitors or companions with them. Only the person with a jury summons for the day of service will be permitted in jury assembly areas. Therefore, children, spouses, parents, neighbors, friends and other guests may not accompany or visit with a juror in any assembly area.

This notice is to inform Baltimore City residents of a jury scam that has been reported nationwide and to provide guidance on how to proceed if you believe you are being targeted by this scam.

Citizens are being contacted via phone by a scam artist who identifies himself as a staff member of the Jury Division, Sheriff or Police Departments. The scam artist claims that the office needs to verify your personal information AND/OR informs you that a fine has been assessed for failing to appear for jury service. The scammer may even threaten to issue a warrant for your arrest and instruct you to obtain a form of money card, cash advance, etc., to satisfy the fine.

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