Back Pain Causes And Effects Biology Essay

Back Pain Causes And Effects Biology Essay According to the National Institute of Neurological Disorder and Stroke (NINDS) back pain is considered one of the most common disabling conditions, being the second most common neurological disorder after headache in the USA and affecting almost 60% of the general population. The essay discusses in details and aided by the latest studies, the various causes of this disease including obesity, occupational hazards, pregnancy, sports and the natural aging process. Also, utilizing the best diagnostic approaches to reach to the proper cause of the back pain and therefore the appropriate modality of treatment. Finally and to sum the issue, I would like to emphasize on the best line of treatment in back pain which is the prevention, elimination of the potential causes, risk factors and the need of more research and for better management of back pain. Back Pain: Causes and Effects Back pain is considered to be the second most common neurological disorder after headache in the United States of America (USA) according to the National Institute of Neurological Disorder and Stroke (NINDS) in USA (2003). Nearly everybody had experienced the episode of back pain in different severity, timing, age and with variety of associated causes. Prevalence estimates suggests that 70-85 % of adults will experience low back pain during a given year and 30% will seek treatment for this problem. The health institutions are paying a large number of money treating back pain all over the world because of the high incidence of the complains and the various degree of disabilities caused by acute and chronic back pain (Andersson, 1999). To fully understand back pain, a glance of the back anatomy will be of great help. The back is a complex structure consisting of 24 small bones (vertebrae) that support the weight of your upper body and form a protective canal for the spinal cord which carries nerve signals from the brain to the rest of the body. Between each consecutive vertebra are found the shock-absorbing discs (intervertebral discs) that cushion the bones and allow the spines to bend, held all together by Ligaments, Tendons and Muscles. The lower part of the back is known as the lumbar region, which is made up of five vertebrae, known as L1, L2, L3, L4 and L5. The lumbar supports the entire weight of the upper body (plus any extra weight that you are carrying), and it is under constant pressure, particularly when bending, twisting and lifting (Smeltzer, S Bare, B, 2000). Though the presence of huge number of literatures and researches has been conducted to discuss the causes and effects of back pain, there has still been a matter of controversy among medical researchers. However, the causes of back pain were categorized according to the effects with the associated signs and symptoms the victims describe, as well as the physical fitness of the targets. In fact, most back problems are probably the result of a combination of factors. Some factors, such as family history, arent preventable. You can control other factors, such as weight, fitness and flexibility, by changing your lifestyle. This essay will discuss the main causes and effects of back pain, but it will also put on the light on the associated signs and symptoms, as well as the most common treatments used. Obesity is one of the leading causes of back pain. According to the American Obesity Association (AOA), 64.5% of adult Americans (about 127 million) are categorized as being overweight or obese. The unfortunate truth is that obesity is becoming an epidemic affecting adults and children (Silveri). Extra abdominal fat and weight on the pelvis pulls the body forward and puts strain on the lower back muscles. Over time, obesity causes the spine to carry the bodys weight and distribute the loads encountered during rest and activity. When excess weight is carried, the spine is forced to take in the burden, which may lead to structural injuries. Hence, this burden on the spine may lead to poor flexibility and weak muscles in the back, pelvis, and thighs, as well as pain over other regions of the spine for example, the neck. Being overweight poses a lot of health risks associated with back pain. It puts added stress on muscles and joints pain and causes degenerative disc disease, spinal sten osis, osteoporosis, rheumatoid arthritis, hernia, ruptured disc, heavy burden on the spine and unhealthy posture. Many occupations à ¢Ãƒ ¢Ã¢â‚¬Å¡Ã‚ ¬such as nursing, construction and industrial work à ¢Ãƒ ¢Ã¢â‚¬Å¡Ã‚ ¬ may place significant demands on the back. Even routine office work can worsen back pain. The associated factors that may contribute with work load related back pain may be caused by three elements. The first element is the strain and exerting too much force on the back may cause injury. If the job is physical in nature, a person might face injury with frequent lifting or moving of heavy objects. The second element is the posture and position of the employee when sitting, standing or performing a task at work. Sitting for prolonged hours in front of a computer, for example, usually causes occasional pains from sitting still. The third and last element is stress. Pressures at work will increase stress level and lead to muscle tension and tightness, which eventually leads to back pain. The third main cause of back pain is pregnancy. Back pain, unfortunately, is an expected symptom during pregnancy in most of women. In most cases, back pain in pregnancy will cause disturbance of daily living activities, as well as resting time and sleep disturbance. (Palmer, 2001) stated that there are a number of physical reasons for back pain in pregnancy, some of which include: increase of hormones à ¢Ãƒ ¢Ã¢â‚¬Å¡Ã‚ ¬ hormones released during pregnancy allow ligaments in the pelvic area to soften and the joints to become looser in preparation for the birthing process of your baby; this shift in joints and loosening of ligaments may affect the support your back normally experiences. The center of gravity associated with pregnancy will gradually move forward as the uterus and baby grow, which causes the posture of pregnant women to change. Furthermore, additional weight during pregnancy and baby will create additional weight that back must support. Poor posture, excessive standing, and bending over can trigger or escalate the pain. Lastly, stress usually finds the weak spot in the body, and because of the changes in the pelvic area, pregnant women may experience an increase in back pain during stressful periods of pregnancy. Back pain can be a natural part of getting older (Hainline, 2007). Getting older always has degenerative effects on the body. Aging causes minor as well as major backaches. Some pain can be tolerable to some extent, where it causes disabilities in other conditions. Thus, getting older cannot be prevented, but being prepared on the consequences of aging is the key in controlling the age-related back pain. Osteoporosis creates weak and porous bones. Vertebral fractures are a common result of osteoporosis in elderly patients. On the other hand, osteoarthritis can create pain in many areas of the body including the spine. Degenerative disc disease is a normal part of aging. It is often asymptomatic but can create pain in some patients. Spinal Stenosis is common in elderly people. Stenosis may or may not cause pain. Spinal stenosis can also cause neurological impairment. CompressedHYPERLINK http://www.cure-back-pain.org/pinched-nerve.html nerves can be caused by spinal stenosis, spondylol isthesis, bone spurs, or spinal curvature. Adult scoliosis is often a result of aging and osteoporosis. Cauda Equina Syndrome the compression of a bundle of nerve roots that serve the lower back, legs and vital pelvic structures e.g. bowel and bladder, can cause weakness in the legs, numbness in the saddle or groin area, and loss of bowel or bladder control. This syndrome should be recognized due to its devastating neurological impact if not identified and treated promptly. All those factors can be a natural part of getting older. The last main cause is the sport related back pain. Up to 20% of all injuries that occur in sports involve the lower back or neck. Sports that use repetitive impact e.g., running, or weight loading at the end of a range-of-motion e.g., weightlifting are commonly cause damage to the lumbar spine or lower back. Sports that involve contact like football, place the spine at risk of injury, (Hyde, 2000). Thus, Injuries to the lower back can be the result of improper conditioning and warm-up, repetitive loading patterns, excessive sudden loads and twisting activities. With all those causes and effects, the end result pain comes with the classical signs and symptoms. The pain might be intermittent, sudden, gradual, or sometimes without reason. Pain is classified accordingly to severe pain that last for more than a few days without improvement and may require medical attention. Severe pain comes with difficulty passing urine; numbness in the back or genital area; numbness, pins, or weakness and pain in the legs; or unsteadiness when standing. Another type of pain is the localized pain which is often described as aching, tight, stiff, sore, burning, throbbing, or pulling. Localized pain may worsen while bending, sitting, walking, or standing too long in one position. Other signs and symptoms of pain may accompanied with a compressed nerves that cause numbness and weakness in the muscle associated with the nerve. The muscle may atrophy if the compression is not relieved. Diagnostic tests arent usually necessary to confirm the cause of back pain. However, after a thorough physical exam including the range of movements, ability to carry on simple daily tasks and testing reflexes with a reflex hammer, it is the decision of the doctor to either treat conservatively or the need of further investigation to rule out more serious causes of back pain in the form of X-Rays, MRI, Bone scan and Nerve studies.. The NINDS and other institutes of the National Institutes of Health (NIH) conduct pain research in laboratories at the NIH. Currently, researchers are examining the use of different drugs to effectively treat back pain, in particular, chronic pain that has lasted at least 6 months. Other studies are comparing different health care approaches to the management of acute low back pain (Standard medical care versus chiropractic, acupuncture, and acupressure or massage therapy). These studies are measuring symptom relief, restoration of function, and patient satisfaction. Another research is comparing standard surgical treatments to the most commonly used standard nonsurgical treatments to measure changes in health-related quality of life among patients suffering from spinal back pain. In the treatment of back pain, people may decide to choose the alternative treatments than to see a doctor. In many cases, doctors may advise their client to seek for those alternative resources. Acupuncture or acupressure is a type of therapy developed in China. Practitioners believe that people have an energy force. When this force is blocked, person can develop physical illness, such as back pain. Other therapy is using the herbal remedies which may be having side effects that could interfere with a prescribed medicine. Other alternative option of medicine is massage. A massage can help release muscle tension and relieve muscle inflammation and pain. Medical treatment will be focusing on the relive of the pain and treat the possible inflammation, as well as reducing the side effects of this pain. Acetaminophen is a type of medication that has proven to be a good pain reliever. Over-the-counter NSAIDs (non-steroidal anti-inflammatory drugs) will help reduce swelling (or inflammatio n) while relieving the pain; thats how NSAIDs differ from acetaminophen other prescription medications like muscle relaxants if the cause of pain was muscle spasm and opioids in the extreme cases, and only under careful supervision. Lastly the treatment may be by eliminating the causes of the pain, like loosing of extra weight, exercising, physiotherapy and surgery for severe cases. In conclusion, back pain is still considered to be a rich topic for study. Americans spend at least 50 billion dollars each year on low back pain, the most common cause of job-related disability and a leading contributor to missed work (NINDS). Luckily, most types back pain relived within a few days, where other conditions needs more time to cure and may lead to more serious conditions. Most of back pain causes cannot be completely prevented, but thought they can be modified in order to decrease the severity of the effects. Obesity can be modified with regular exercise and consumption of healthy food. Work related back pain as well as sport injuries can be prevented by accurate posturing and stretching of spine and muscles. Good back-strengthening exercises may include walking, swimming, bike riding and yoga could be beneficial to overcome aging back pain, where carful lifting, housekeeping and relaxing exercises will help pregnant women in controlling the incidence of lower back pai n. Signs and symptoms of back pain differ from person to another according to the severity of the injury to the spin and in the most of the cases, seeking for medical advice is important. The type of treatment to choose may be optional for people suffering of pain. Many people may seek to alternative therapy like Acupuncture, herbal medication and massage. On the other hand, many patients will seek for medical treatment for the severe pain by using prescribed pain killers and regular physiotherapy, exercise and weight reduction. Unfortunately, most of the literatures stated that attempts to prevent the occurrence of back pain have been unsuccessful. Proper health education can increase the health awareness of population regarding back pain and its prevention tips might be the key to solve this problem.   

The Twilight Saga 2: New Moon Chapter 1 PARTY

I WAS NINETY-NINE POINT NINE PERCENT SURE I WAS dreaming. The reasons I was so certain were that, first, I was standing in a bright shaft of sunlightthe kind of blinding clear sun that never shone on my drizzly new hometown in Forks, Washingtonand second, I was looking at my Grandma Marie. Gran had been dead for six years now, so that was solid evidence toward the dream theory. Gran hadn't changed much; her face looked just the same as I remembered it. The skin was soft and withered, bent into a thousand tiny creases that clung gently to the bone underneath. Like a dried apricot, but with a puff of thick white hair standing out in a cloud around it. Our mouthshers a wizened pickerspread into the same surprised half-smile at just the same time. Apparently, she hadn't been expecting to see me, either. I was about to ask her a question; I had so manyWhat was she doing here in my cream? What had she been up to in the past six years? Was Pop okay, and had they found each other, wherever they werebut she opened her mouth when I did, so I stopped to let her go first. She paused, too, and then we Goth smiled at the little awkwardness. â€Å"Bella!† It wasn't Gran who called my name, and we both turned to see the addition to our small reunion. I didn't have to look to know who it was; this was a voice I would know anywhereknow, and respond to, whether I was awake or asleep or even dead, I'd bet. The voice I'd walk through fire foror, less dramatically, slosh every day through the cold and endless rain for. Edward. Even though I was always thrilled to see himconscious or otherwiseand even though I was almost positive that I was dreaming, I panicked as Edward walked toward us through the glaring sunlight. I panicked because Gran didn't know that I was in love with a vampirenobody knew thatso how was I supposed to explain the fact that the brilliant sunbeams were shattering off his skin into a thousand rainbow shards like he was made of crystal or diamond? Well, Gran, yon might have noticed that my boyfriend glitters. It's just something he does in the sun. Don't worry about it What was he doing? The whole reason he lived in Forks, the rainiest place in the world, was so that he could be outside in the daytime without exposing his family's secret. Yet here he was, strolling gracefully toward mewith the most beautiful smile on his angel's faceas if I were the only one here. In that second, I wished that I was not the one exception to his mysterious talent; I usually felt grateful that I was the only person whose thoughts he couldn't hear just as clearly as if they were spoken aloud. But now I wished he could hear me, too, so that he could hear the warning I was screaming in my head. I shot a panicked glance back at Gran, and saw that it was too late. She was just turning to stare back at me, her eyes as alarmed as mine. Edwardstill smiling so beautifully that my heart felt like it was going to swell up and burst through my chestput his arm around my shoulder and turned to face my grandmother. Gran's expression surprised me. Instead of looking horrified, she was staring at me sheepishly, as if waiting for a scolding. And she was standing in such a strange positionone arm held awkwardly away from her body, stretched out and then curled around the air. Like she had her arm around someone I couldn't see, someone invisible Only then, as I looked at the bigger picture, did I notice the huge gilt frame that enclosed my grandmother's form. Uncomprehending, I raised the hand that wasn't wrapped around Edward's waist and reached out to touch her. She mimicked the movement exactly, mirrored it. But where our fingers should have met, there was nothing but cold glass With a dizzying jolt, my dream abruptly became a nightmare. There was no Gran. That was me. Me in a mirror. Meancient, creased, and withered. Edward stood beside me, casting no reflection, excruciatingly lovely and forever seventeen. He pressed his icy, perfect lips against my wasted cheek. â€Å"Happy birthday,† he whispered. I woke with a startmy eyelids popping open wideand gasped. Dull gray light, the familiar light of an overcast morning, took the place of the blinding sun in my dream. Just a dream, I told myself. It was only a dream. I took a deep breath, and then jumped again when my alarm went off. The little calendar in the corner of the clock's display informed me that today was September thirteenth. Only a dream, but prophetic enough in one way, at least. Today was my birthday. I was officially eighteen years old. I'd been dreading this day for months. All through the perfect summerthe happiest summer I had ever had, the happiest summer anyone anywhere had ever had, and the rainiest summer in the history of the Olympic Peninsulathis bleak date had lurked in ambush, waiting to spring. And now that it had hit, it was even worse than I'd feared it would be. I could feel itI was older. Every day I got older, but this was different, worse, quantifiable. I was eighteen. And Edward never would be. When I went to brush my teeth, I was almost surprised that the face in the mirror hadn't changed. I stared at myself, looking for some sign of impending wrinkles in my ivory skin. The only creases were the ones on my forehead, though, and I knew that if I could manage to relax, they would disappear. I couldn't. My eyebrows stayed lodged in a worried line over my anxious brown eyes. It was just a dream, I reminded myself again. Just a dream but also my worst nightmare. I skipped breakfast, in a hurry to get out of the house as quickly as possible. I wasn't entirely able to avoid my dad, and so I had to spend a few minutes acting cheerful. I honestly tried to be excited about the gifts I'd asked him not to get me, but every time I had to smile, it felt like I might start crying. I struggled to get a grip on myself as I drove to school. The vision of GranI would not think of it as mewas hard to get out of my head. I couldn't feel anything but despair until I pulled into the familiar parking lot behind Forks High School and spotted Edward leaning motionlessly against his polished silver Volvo, like a marble tribute to some forgotten pagan god of beauty. The dream had not done him justice. And he was waiting there for me, just the same as every other day. Despair momentarily vanished; wonder took its place. Even after half a year with him, I still couldn't believe that I deserved this degree of good fortune. His sister Alice was standing by his side, waiting for me, too. Of course Edward and Alice weren't really related (in Forks the story was that all the Cullen siblings were adopted by Dr. Carlisle Culler and his wife, Esme, both plainly too young to have teenage children), but their skin was precisely the same pale shade, their eyes had the same strange golden tint, with the same deep, bruise-like shadows beneath them. Her face, like his, was also startlingly beautiful. To someone in the knowsomeone like methese similarities marked them for what they were. The sight of Alice waiting thereher tawny eyes brilliant with excitement, and a small silver-wrapped square in her handsmade me frown. I'd told Alice I didn't want anything, anything, not gifts or even attention, for my birthday. Obviously, my wishes were being ignored. I slammed the door of my '53 Chevy trucka shower of rust specks fluttered down to the wet blacktopand walked slowly toward where they waited. Alice skipped forward to meet me, her pixie face glowing under her spiky black hair. â€Å"Happy birthday, Bella!† â€Å"Shh!† I hissed, glancing around the lot to make sure no one had heard her. The last thing I wanted was some kind of celebration of the black event. She ignored me. â€Å"Do you want to open your present now or later?† she asked eagerly as we made our way to where Edward still waited. â€Å"No presents,† I protested in a mumble. She finally seemed to process my mood. â€Å"Okay later, then. Did you like the scrapbook your mom sent you? And the camera from Charlie?† I sighed. Of course she would know what my birthday presents were. Edward wasn't the only member of his family with unusual skills. Alice would have â€Å"seen† what my parents were planning as soon as they'd decided that themselves. â€Å"Yeah. They're great.† â€Å"I think it's a nice idea. You're only a senior once. Might as well document the experience.† â€Å"How many times have you been a senior?† â€Å"That's different.† We reached Edward then, and he held out his hand for mine. I took it eagerly, forgetting, for a moment, my glum mood. His skin was, as always, smooth, hard, and very cold. He gave my fingers a gentle squeeze. I looked into his liquid topa2 eyes, and my heart gave a not-quite-so-gentle squeeze of its own. Hearing the stutter in my heartbeats, he smiled again. He lifted his free hand and traced one cool fingertip around the outside of my lips as he spoke. â€Å"So, as discussed, I am not allowed to wish you a happy birthday, is that correct?† â€Å"Yes. That is correct.† I could never quite mimic the flow of his perfect, formal articulation. It was something that could only be picked up in an earlier century. â€Å"Just checking.† He ran his hand through his tousled bronze hair. â€Å"You might have changed your mind. Most people seem to enjoy things like birthdays and gifts.† Alice laughed, and the sound was all silver, a wind chime. â€Å"Of course you'll enjoy it. Everyone is supposed to be nice to you today and give you your way, Bella. What's the worst that could happen?† She meant it as a rhetorical question. â€Å"Getting older,† I answered anyway, and my voice was not as steady as I wanted it to be. Beside me, Edward's smile tightened into a hard line. â€Å"Eighteen isn't very old,† Alice said. â€Å"Don't women usually wait till they're twenty-nine to get upset over birthdays?† â€Å"It's older than Edward,† I mumbled. He sighed. â€Å"Technically,† she said, keeping her tone light. â€Å"Just by one little year, though.† And I supposed if I could be sure of the future I wanted, sure that I would get to spend forever with Edward, and Alice and the rest of the Cullens (preferably not as a wrinkled little old lady) then a year or two one direction or the other wouldn't matter to me so much. But Edward was dead set against any future that changed me. Any future that made me like himthat made me immortal, too. An impasse, he called it. I couldn't really see Edward's point, to be honest. What was so great about mortality? Being a vampire didn't look like such a terrible thingnot the way the Cullens did it, anyway. â€Å"What time will you be at the house?† Alice continued, changing the subject. From her expression, she was up to exactly the kind of thing I'd been hoping to avoid. â€Å"I didn't know I had plans to be there.† â€Å"Oh, be fair, Bella!† she complained. â€Å"You aren't going to ruin all our fun like that, are you?† â€Å"I thought my birthday was about what I want.† â€Å"I'll get her from Charlie's right after school,† Edward told her, ignoring me altogether. â€Å"I have to work,† I protested. â€Å"You don't, actually,† Alice told me smugly. â€Å"I already spoke to Mrs. Newton about it. She's trading your shifts. She said to tell you ‘Happy Birthday.'† â€Å"II still can't come over,† I stammered, scrambling for an excuse. â€Å"I, well, I haven't watched Romeo and Juliet yet for English.† Alice snorted. â€Å"You have Romeo and Juliet memorized.† â€Å"But Mr. Berty said we needed to see it performed to fully appreciate itthat's how Shakespeare intended it to be presented.† Edward rolled his eyes. â€Å"You've already seen the movie,† Alice accused. â€Å"But not the nineteen-sixties version. Mr. Berty said it was the best.† Finally, Alice lost the smug smile and glared at me. â€Å"This can be easy, or this can be hard, Bella, but one way or the other† Edward interrupted her threat. â€Å"Relax, Alice. If Bella wants to watch a movie, then she can. It's her birthday.† â€Å"So there,† I added. â€Å"I'll bring her over around seven,† he continued. â€Å"That will give you more time to set up.† Alice's laughter chimed again. â€Å"Sounds good. See you tonight, Bella! It'll be fun, you'll see.† She grinnedthe wide smile exposed all her perfect, glistening teeththen pecked me on the cheek and danced off toward her first class before I could respond. â€Å"Edward, please† I started to beg, but he pressed one cool finger to my lips. â€Å"Let's discuss it later. We're going to be late for class.† No one bothered to stare at us as we took our usual seats in the back of the classroom (we had almost every class together nowit was amazing the favors Edward could get the female administrators to do for him). Edward and I had been together too long now to be an object of gossip anymore. Even Mike Newton didn't bother to give me the glum stare that used to make me feel a little guilty. He smiled now instead, and I was glad he seemed to have accepted that we could only be friends. Mike had changed over the summerhis face had lost some of the roundness, making his cheekbones more prominent, and he was wearing his pale blond hair a new way; instead of bristly, it was longer and gelled into a carefully casual disarray. It was easy to see where his inspiration came frombut Edward's look wasn't something that could be achieved through imitation. As the day progressed, I considered ways to get out of whatever was going down at the Cullen house tonight. It would be bad enough to have to celebrate when I was in the mood to mourn. But, worse than that, this was sure to involve attention and gifts. Attention is never a good thing, as any other accident-prone klutz would agree. No one wants a spotlight when they're likely to fall on their face. And I'd very pointedly askedwell, ordered reallythat no one give me any presents this year. It looked like Charlie and Renee weren't the only ones who had decided to overlook that. I'd never had much money, and that had never bothered me. Renee had raised me on a kindergarten teacher's salary. Charlie wasn't getting rich at his job, eitherhe was the police chief here in the tiny town of Forks. My only personal income came from the three days a week I worked at the local sporting goods store. In a town this small, I was lucky to have a job. Every penny I made went into my microscopic college fund. (College was Plan B. I was still hoping for Plan A, but Edward was just so stubborn about leaving me human) Edward had a lot of moneyI didn't even want to think about how much. Money meant next to nothing to Edward or the rest of the Cullens. It was just something that accumulated when you had unlimited time on your hands and a sister who had an uncanny ability to predict trends in the stock market. Edward didn't seem to understand why I objected to him spending money on mewhy it made me uncomfortable if he took me to an expensive restaurant in Seattle, why he wasn't allowed to buy me a car that could reach speeds over fifty-five miles an hour, or why I wouldn't let him pay my college tuition (he was ridiculously enthusiastic about Plan B). Edward thought I was being unnecessarily difficult. But how could I let him give me things when I had nothing to reciprocate with? He, for some unfathomable reason, wanted to be with me. Anything he gave me on top of that just threw us more out of balance. As the day went on, neither Edward nor Alice brought my birthday up again, and I began to relax a little. We sat at our usual table for lunch. A strange kind of truce existed at that table. The three of usEdward, Alice, and Isat on the extreme southern end of the table. Now that the â€Å"older† and somewhat scarier (in Emmett's case, certainly) Cullen siblings had graduated, Alice and Edward did not seem quite so intimidating, and we did not sit here alone. My other friends, Mike and Jessica (who were in the awkward post-breakup friendship phase), Angela and Ben (whose relationship had survived the summer), Eric, Conner, Tyler, and Lauren (though that last one didn't really count in the friend category) all sat at the same table, on the other side of an invisible line. That line dissolved on sunny days when Edward and Alice always skipped school, and then the conversation would swell out effortlessly to include me. Edward and Alice didn't find this minor ostracism odd or hurtful the way I would have. They barely noticed it. People always felt strangely ill at ease with the Cullens, almost afraid for some reason they couldn't explain to themselves. I was a rare exception to that rule. Sometimes it bothered Edward how very comfortable I was with being close to him. He thought he was hazardous to my healthan opinion I rejected vehemently whenever he voiced it. The afternoon passed quickly. School ended, and Edward walked me to my truck as he usually did. But this time, he held the passenger door open for me. Alice must have been taking his car home so that he could keep me from making a run for it. I folded my arms and made no move to get out of the rain. â€Å"It's my birthday, don't I get to drive?† â€Å"I'm pretending it's not your birthday, just as you wished.† â€Å"If it's not my birthday, then I don't have to go to your house tonight† â€Å"All right.† He shut the passenger door and walked past me to open the driver's side. â€Å"Happy birthday.† â€Å"Shh,† I shushed him halfheartedly. I climbed in the opened door, wishing he'd taken the other offer. Edward played with the radio while I drove, shaking his head in disapproval. â€Å"Your radio has horrible reception.† I frowned. I didn't like it when he picked on my truck. The truck was greatit had personality. â€Å"You want a nice stereo? Drive your own car.† I was so nervous about Alice's plans, on top of my already gloomy mood, that the words came out sharper than I'd meant them. I was hardly ever bad-tempered with Edward, and my tone made him press his lips together to keep from smiling. When I parked in front of Charlie's house, he reached over to take my face in his hands. He handled me very carefully, pressing just the tips of his fingers softly against my temples, my cheekbones, my jawline. Like I was especially breakable. Which was exactly the casecompared with him, at least. â€Å"You should be in a good mood, today of all days,† he whispered. His sweet breath fanned across my face. â€Å"And if I don't want to be in a good mood?† I asked, my breathing uneven. His golden eyes smoldered. â€Å"Too bad.† My head was already spinning by the time he leaned closer and pressed his icy lips against mine. As he intended, no doubt, I forgot all about my worries, and concentrated on remembering how to inhale and exhale. His mouth lingered on mine, cold and smooth and gentle, until I wrapped my arms around his neck and threw myself into the kiss with a little too much enthusiasm. I could feel his lips curve upward as he let go of my face and reached back to unlock my grip on him. Edward had drawn many careful lines for our physical relationship, with the intent being to keep me alive. Though I respected the need for maintaining a safe distance between my skin and his razor-sharp, venom-coated teeth, I tended to forget about trivial things like that when he was kissing me. â€Å"Be good, please,† he breathed against my cheek. He pressed his lips gently to mine one more time and then pulled away, folding my arms across my stomach. My pulse was thudding in my ears. I put one hand over my heart. It drummed hyperactively under my palm. â€Å"Do you think I'll ever get better at this?† I wondered, mostly to myself. â€Å"That my heart might someday stop trying to jump out of my chest whenever you touch me?† â€Å"I really hope not,† he said, a bit smug. I rolled my eyes. â€Å"Let's go watch the Capulets and Montagues hack each other up, all right?† â€Å"Your wish, my command.† Edward sprawled across the couch while I started the movie, fast-forwarding through the opening credits. When I perched on the edge of the sofa in front of him, he wrapped his arms around my waist and pulled me against his chest. It wasn't exactly as comfortable as a sofa cushion would be, what with his chest being hard and coldand perfectas an ice sculpture, but it was definitely preferable. He pulled the old afghan off the back of the couch and draped it over me so I wouldn't freeze beside his body. â€Å"You know, I've never had much patience with Romeo,† he commented as the movie started. â€Å"What's wrong with Romeo?† I asked, a little offended. Romeo was one of my favorite fictional characters. Until I'd met Edward, I'd sort of had a thing for him. â€Å"Well, first of all, he's in love with this Rosalinedon't you think it makes him seem a little fickle? And then, a few minutes after their wedding, he kills Juliet's cousin. That's not very brilliant. Mistake after mistake. Could he have destroyed his own happiness any more thoroughly?† I sighed. â€Å"Do you want me to watch this alone?† â€Å"No, I'll mostly be watching you, anyway.† His fingers traced patterns across the skin of my arm, raising goose bumps. â€Å"Will you cry?† â€Å"Probably,† I admitted, â€Å"if I'm paying attention.† â€Å"I won't distract you then.† But I felt his lips on my hair, and it was very distracting. The movie eventually captured my interest, thanks in large part to Edward whispering Romeo's lines in my earhis irresistible, velvet voice made the actor's voice sound weak and coarse by comparison. And I did cry, to his amusement, when Juliet woke and found her new husband dead. â€Å"I'll admit, I do sort of envy him here,† Edward said, drying the tears with a lock of my hair. â€Å"She's very pretty.† He made a disgusted sound. â€Å"I don't envy him the girljust the ease of the suicide,† he clarified in a teasing tone. â€Å"You humans have it so easy! All you have to do is throw down one tiny vial of plant extracts† â€Å"What?† I gasped. â€Å"It's something I had to think about once, and I knew from Carlisle's experience that it wouldn't be simple. I'm not even sure how many ways Carlisle tried to kill himself in the beginning after he realized what he'd become† His voice, which had grown serious, turned light again. â€Å"And he's clearly still in excellent health.† I twisted around so that I could read his face. â€Å"What are you talking about?† I demanded. â€Å"What do you mean, this something you had to think about once?† â€Å"Last spring, when you were nearly killed† He paused to take a deep breath, snuggling to return to his teasing tone. â€Å"Of course I was trying to focus on finding you alive, but part of my mind was making contingency plans. Like I said, it's not as easy for me as it is for a human.† For one second, the memory of my last trip to Phoenix washed through my head and made me feel dizzy. I could see it all so clearlythe blinding sun, the heat waves coming off the concrete as I ran with desperate haste to find the sadistic vampire who wanted to torture me to death. James, waiting in the mirrored room with my mother as his hostageor so I'd thought. I hadn't known it was all a ruse. Just as James hadn't known that Edward was racing to save me; Edward made it in time, but it had been a close one. Unthinkingly, my fingers traced the crescent-shaped scar on my hand that was always just a few degrees cooler than the rest of my skin. I shook my headas if I could shake away the bad memoriesand tried to grasp what Edward meant. My stomach plunged uncomfortably. â€Å"Contingency plans?† I repeated. â€Å"Well, I wasn't going to live without you.† He rolled his eyes as if that fact were childishly obvious. â€Å"But I wasn't sure how to do itI knew Emmett and Jasper would never help so I was thinking maybe I would go to Italy and do something to provoke the Volturi.† I didn't want to believe he was serious, but his golden eyes were brooding, focused on something far away in the distance as he contemplated ways to end his own life. Abruptly, I was furious. â€Å"What is a Volturi?† I demanded. â€Å"The Volturi are a family,† he explained, his eyes still remote. â€Å"A very old, very powerful family of our kind. They are the closest thing our world has to a royal family, I suppose. Carlisle lived with them briefly in his early years, in Italy, before he settled in Americado you remember the story?† â€Å"Of course I remember.† I would never forget the first time I'd gone to his home, the huge white mansion buried deep in the forest beside the river, or the room where CarlisleEdward's father in so many real wayskept a wall of paintings that illustrated his personal history. The most vivid, most wildly colorful canvas there, the largest, was from Carlisle's time in Italy. Of course I remembered the calm quartet of men, each with the exquisite face of a seraph, painted into the highest balcony overlooking the swirling mayhem of color. Though the painting was centuries old, Carlislethe blond angelremained unchanged. And I remembered the three others, Carlisle's early acquaintances. Edward had never used the name Volturi for the beautiful trio, two black-haired, one snow white. He'd called them Aro, Caius, and Marcus, nighttime patrons of the arts â€Å"Anyway, you don't irritate the Volturi,† Edward went on, interrupting ray reverie. â€Å"Not unless you want to dieor whatever it is we do.† His voice was so calm, it made him sound almost bored by the prospect. My anger turned to horror. I took his marble face between my hands and held it very tightly. â€Å"You must never, never, never think of anything like that again!† I said. â€Å"No matter what might ever happen to me, you are not allowed to hurt yourself!† â€Å"I'll never put you in danger again, so it's a moot point.† â€Å"Put me in danger! I thought we'd established that all the bad luck is my fault?† I was getting angrier. â€Å"How dare you even think like that?† The idea of Edward ceasing to exist, even if I were dead, was impossiblypainful. â€Å"What would you do, if the situation were reversed?† he asked. â€Å"That's not the same thing.† He didn't seem to understand the difference. He chuckled. â€Å"What if something did happen to you?† I blanched at the thought. â€Å"Would you want me to go off myself?† A trace of pain touched his perfect features. â€Å"I guess I see your point a little,† he admitted. â€Å"But what would I do without you?† â€Å"Whatever you were doing before I came along and complicated your existence.† He sighed. â€Å"You make that sound so easy.† â€Å"It should be. I'm not really that interesting.† He was about to argue, but then he let it go. â€Å"Moot point,† he reminded me. Abruptly, he pulled himself up into a more formal posture, shifting me to the side so that we were no longer touching. â€Å"Charlie?† I guessed. Edward smiled. After a moment, I heard the sound of the police cruiser pulling into the driveway. I reached out and took his hand firmly. My dad could deal with that much. Charlie came in with a pizza box in his hands. â€Å"Hey, kids.† He grinned at me. â€Å"I thought you'd like a break from cooking and washing dishes for your birthday. Hungry?† â€Å"Sure. Thanks, Dad.† Charlie didn't comment on Edward's apparent lack of appetite. He was used to Edward passing on dinner. â€Å"Do you mind if I borrow Bella for the evening?† Edward asked when Charlie and I were done. I looked at Charlie hopefully. Maybe he had some concept of birthdays as stay-at-home, family affairsthis was my first birthday with him, the first birthday since my mom, Renee, had remarried and gone to live in Florida, so I didn't know what he would expect. â€Å"That's finethe Mariners are playing the Sox tonight,† Charlie explained, and my hope disappeared. â€Å"So I won't be any kind of company Here.† He scooped up the camera he'd gotten me on Renee's suggestion (because I would need pictures to fill up my scrap-book), and threw it to me. He ought to know better than thatI'd always been coordinationally challenged. The camera glanced off the tip of my finger, and tumbled toward the floor. Edward snagged it before it could crash onto the linoleum. â€Å"Nice save,† Charlie noted. â€Å"If they're doing something fun at the Cullens' tonight, Bella, you should take some pictures. You know how your mother getsshe'll be wanting to see the pictures faster than you can take them.† â€Å"Good idea, Charlie,† Edward said, handing me the camera. I turned the camera on Edward, and snapped the first picture. â€Å"It works.† â€Å"That's good. Hey, say hi to Alice for me. She hasn't been over in a while.† Charlie's mouth pulled down at one corner. â€Å"It's been three days, Dad,† I reminded him. Charlie was crazy about Alice. He'd become attached last spring when she'd helped me through my awkward convalescence; Charlie would be fore'ter grateful to her for saving him from the horror of an almost-adult daughter who needed help showering. â€Å"I'll tell her.† â€Å"Okay. You kids have fun tonight.† It was clearly a dismissal. Charlie was already edging toward the living room and the TV. Edward smiled, triumphant, and took my hand to pull me from the kitchen. When we got to the truck, he opened the passenger door for me again, and this time I didn't argue. I still had a hard time finding the obscure turnoff to his house in the dark. Edward drove north through Forks, visibly chafing at the speed limit enforced by my prehistoric Chevy. The engine groaned even louder than usual as he pushed it over fifty. â€Å"Take it easy,† I warned him. â€Å"You know what you would love? A nice little Audi coupe. Very quiet, lots of power† â€Å"There's nothing wrong with my truck. And speaking of expensive nonessentials, if you know what's good for you, you didn't spend any money on birthday presents.† â€Å"Not a dime,† he said virtuously. â€Å"Good.† â€Å"Can you do me a favor?† â€Å"That depends on what it is.† He sighed, his lovely face serious. â€Å"Bella, the last real birthday any of us had was Emmett in 1935. Cut us a little slack, and don't be too difficult tonight. They're all very excited.† It always startled me a little when he brought up things like that. â€Å"Fine, I'll behave.† â€Å"I probably should warn you† â€Å"Please do.† â€Å"When I say they're all excited I do mean all of them.† â€Å"Everyone?† I choked. â€Å"I thought Emmett and Rosalie were in Africa.† The rest of Forks was under the impression that the older Cullens had gone off to college this year, to Dartmouth, but I knew better. â€Å"Emmett wanted to be here.† â€Å"But Rosalie?† â€Å"I know, Bella. Don't worry, she'll be on her best behavior.† I didn't answer. Like I could just not worry, that easy. Unlike Alice, Edward's other â€Å"adopted† sister, the golden blond and exquisite Rosalie, didn't like me much. Actually, the feeling was a little bit stronger than just dislike. As far as Rosalie was concerned, I was an unwelcome intruder into her family's secret life. I felt horribly guilty about the present situation, guessing that Rosalie and Emmett's prolonged absence was my fault, even as I furtively enjoyed not having to see her Emmett, Edward's playful bear of a brother, I did miss. He was in many ways just like the big brother I'd always wanted only much, much more terrifying. Edward decided to change the subject. â€Å"So, if you won't let me get you the Audi, isn't there anything that you'd like for your birthday?† The words came out in a whisper. â€Å"You know what I want.† A deep frown carved creases into his marble forehead. He obviously wished he'd stuck to the subject of Rosalie. It felt like we'd had this argument a lot today. â€Å"Not tonight, Bella. Please.† â€Å"Well, maybe Alice will give me what I want.† Edward growleda deep, menacing sound. â€Å"This isn't going to be your last birthday, Bella,† he vowed. â€Å"That's not fair!† I thought I heard his teeth clench together. We were pulling up to the house now. Bright light shined from every window on the first two floors. A long line of glowing Japanese lanterns hung from the porch eaves, reflecting a soft radiance on the huge cedars that surrounded the house. Big bowls of flowerspink roseslined the wide stairs up to the front doors. I moaned. Edward took a few deep breaths to calm himself. â€Å"This is a party,† he reminded me. â€Å"Try to be a good sport.† â€Å"Sure,† I muttered. He came around to get my door, and offered me his hand. â€Å"I have a question.† He waited warily. â€Å"If I develop this film,† I said, toying with the camera in my hands, â€Å"will you show up in the picture?† Edward started laughing. He helped me out of the car, pulled me up the stairs, and was still laughing as he opened the door for me. They were all waiting in the huge white living room; when I walked through the door, they greeted me with a loud chorus of â€Å"Happy birthday, Bella!† while I blushed and looked down. Alice, I assumed, had covered every flat surface with pink candles and dozens of crystal bowls filled with hundreds of roses. There was a table with a white cloth draped over it next to Edward's grand piano, holding a pink birthday cake, more roses, a stack of glass plates, and a small pile of silver-wrapped presents. It was a hundred times worse than I'd imagined. Edward, sensing my distress, wrapped an encouraging arm around my waist and kissed the top of my head. Edward's parents, Carlisle and Esmeimpossibly youthful and lovely as everwere the closest to the door. Esme hugged me carefully, her soft, caramel-colored hair brushing against my cheek as she kissed my forehead, and then Carlisle put his arm around my shoulders. â€Å"Sorry about this, Bella,† he stage-whispered. â€Å"We couldn't rein Alice in.† Rosalie and Emmett stood behind them. Rosalie didn't smile, but at least she didn't glare. Emmett's face was stretched into a huge grin. It had been months since I'd seen them; I'd forgotten how gloriously beautiful Rosalie wasit almost hurt to look at her. And had Emmett always been so big? â€Å"You haven't changed at all,† Emmett said with mock disappointment. â€Å"I expected a perceptible difference, but here you are, red-faced just like always.† â€Å"Thanks a lot, Emmett,† I said, blushing deeper. He laughed, â€Å"I have to step out for a second†he paused to wink conspicuously at Alice†Don't do anything funny while I'm gone.† â€Å"I'lltry.† Alice let go of Jasper's hand and skipped forward, all her teeth sparkling in the bright light. Jasper smiled, too, but kept his distance. He leaned, long and blond, against the post at the foot of the stairs. During the days we'd had to spend cooped up together in Phoenix, I'd thought he'd gotten over his aversion to me. But he'd gone back to exactly how he'd acted beforeavoiding me as much as possiblethe moment he was free from that temporary obligation to protect me. I knew it wasn't personal, just a precaution, and I tried not to be overly sensitive about it. Jasper had more trouble sticking to the Cullens' diet than the rest of them; the scent of human blood was much harder for him to resist than the othershe hadn't been trying as long. â€Å"Time to open presents,† Alice declared. She put her cool hand under my elbow and towed me to the table with the cake and the shiny packages. I put on my best martyr face. â€Å"Alice, I know I told you I didn't want anything† â€Å"But I didn't listen,† she interrupted, smug. â€Å"Open it.† She took the camera from my hands and replaced it with a big, square silver box. The box was so light that it felt empty. The tag on top said that it was from Emmett, Rosalie, and Jasper. Selfconsciously, I tore the paper off and then stared at the box it concealed. It was something electrical, with lots of numbers in the name. I opened the box, hoping for further illumination. But the box was empty. â€Å"Um thanks.† Rosalie actually cracked a smile. Jasper laughed. â€Å"It's a stereo for your truck,† he explained. â€Å"Emmett's installing it right now so that you can't return it.† Alice was always one step ahead of me. â€Å"Thanks, Jasper, Rosalie,† I told them, grinning as I remembered Edward's complaints about my radio this afternoonall a setup, apparently. â€Å"Thanks, Emmett!† I called more loudly. I heard his booming laugh from my truck, and I couldn't help laughing, too. â€Å"Open mine and Edward's next,† Alice said, so excited her voice was a high-pitched trill. She held a small, flat square in her hand. I turned to give Edward a basilisk glare. â€Å"You promised.† Before he could answer, Emmett bounded through the door. â€Å"Just in time!† he crowed. He pushed in behind Jasper, who had also drifted closer than usual to get a good look. â€Å"I didn't spend a dime,† Edward assured me. He brushed a strand of hair from my face, leaving my skin tingling from his touch. I inhaled deeply and turned to Alice. â€Å"Give it to me,† I sighed. Emmett chuckled with delight. I took the little package, rolling my eyes at Edward while I stuck my finger under the edge of the paper and jerked it under the tape. â€Å"Shoot,† I muttered when the paper sliced my finger; I pulled it out to examine the damage. A single drop of blood oozed from the tiny cut. It all happened very quickly then. â€Å"No!† Edward roared. He threw himself at me, flinging me back across the table. It fell, as I did, scattering the cake and the presents, the flowers and the plates. I landed in the mess of shattered crystal. Jasper slammed into Edward, and the sound was like the crash of boulders in a rock slide. There was another noise, a grisly snarling that seemed to be coming from deep in Jasper's chest. Jasper tried to shove past Edward, snapping his teeth just inches from Edward's face. Emmett grabbed Jasper from behind in the next second, locking him into his massive steel grip, but Jasper struggled on, his wild, empty eyes focused only on me. Beyond the shock, there was also pain. I'd tumbled down to the floor by the piano, with my arms thrown out instinctively to catch my fall, into the jagged shards of glass. Only now did I feel the searing, stinging pain that ran from my wrist to the crease inside my elbow. Dazed and disoriented, I looked up from the bright red blood pulsing out of my arminto the fevered eyes of the six suddenly ravenous vampires.

Things You Should Know About Paper Research

Things You Should Know About Paper Research Accordingly the age criterion isn't mentioned. Dwelling just on the introduction is not a simple job. Sometimes one is extremely busy, or he fails to get the topic well. In case the topic is too narrow, you might find it difficult to locate the appropriate literature. A title page isn't required in a typical MLA report. It should be centered. Linguistics is a complicated field of study and Paper Masters has writers accessible to help students in understanding linguistics. World History Research Papers involve an astounding amount of information. Paper Research: No Longer a Mystery Dissertations and reports produced by students in prior years can help you get a sense of fashions and standards required. In some cases, they simply devise the study and then imagine the possible results that might occur. Many students wind up having documents which are overly generalized and don't narrow down the reach of their topics. College students are anticipated to deliver premium quality research papers that fulfill strict requirement as to contents and form. Needless to say, everything sounds very uncomplicated and interesting, but if you get started working on your research paper, you face a great deal of challenges. A lot of businesses promote workplace diversity. Researching any issue about government or laws can get overwhelming because of the intricacy of the issues and even on account of the wording of some laws. A family company can be both a good prospect for you to live out your passions and ambition, but nevertheless, it may also be a place that's so bound in tradition it can feel completely stifling for a young creative mind. The Paper Research Chronicles Make sure that you review two or three term paper examples before you get started working on your paper. Initially, absolutely free research paper examples were posted on the internet, as a way to help students acquire new knowledge and information concerning the research paper writing, as a portion of the educational practice. At times, excellent research paper topics are just the easiest ones. Without a proper content, they will not make sense. Remember that should you understand what your audience needs a lot of, you will locate a suitable direction and suitable tone for your writing. If you're allowed to freely choose what things to write all on your own, utilize the chance to make something unique. After you have a topic in mind, you will need to seek advice from your instructor with it to make sure you're headed in the proper direction. Beyond picking the best sort of white paper to accomplish your purpose and reach your intended audience, you want an engaging topic. Apparently, there's more than 1 person who'd attempt to use a completely free research paper as original writing. The most essential part of the paper will incorporate a discussion about the present research being done on the subject. A research paper is quite a serious kind of academic writing. A research paper that concerns scientific issues isn't just a free-style essay where you are able to tell readers whatever you desire. 1 thing to be on the lookout for is picking an idea that's either too large or too tiny. Locating a topic for your study can be hard, but there are lots of great tactics to develop intriguing ideas. Otherwise, there are many style guides you can select from. If you can't cope with them yourself, you always have the option to make an application for aid.

William Shakespeare s Jabberwocky And Lear s Limericks...

When everything in our reality seems like unreal, it can be difficult to distinguish between sense and nonsense. Everyday we seem to read another tragic headline about people getting assaulted for being their true selves, countries being torn apart because of hate and intolerance and innocent children getting killed in the crossfire. The frightening part is when these horrors that never make any sense become normal to us. It begs the question, has the world gone mad or have we? Growing up can be a difficult and confusing experience for all. As we grow older and realize the world is more than what is right in front of us. We ask questions to try and make sense of the world as we grow from the simplicity of childhood to the complications of adulthood. As we mature, our perceptions of the world change drastically. A child’s closed off world view is challenged as he begins to ask questions and explore. What seemed simple before is much more intricate now. The use of nonsense in bo th Carroll’s Jabberwocky and Lear’s limericks from The Book of Nonsense force us to challenge nonsensical situations so we can grow and adjust to the harsh realities of our world by realizing that things are not always what they seem. Both authors do this effectively through the absence of meaning and the use of juxtaposition. The absence of meaning in both Carroll and Lear’s poems is significant, even though it may seem like the opposite. When reading these poems for the first time, the reader may be