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I have a female pt who is taking labetalol 100 mg bid. She used to take either HCTZ or chlorthalidone, but switched to labetalol when she was trying to become pregnant. She ended up not getting pregnant and then continued to take the labetalol since then. So I want to switch her to HCTZ. Beta blockers should not be abruptly discontinued because that can cause rebound HTN. So I will decrease her labetalol to 100 mg daily x1 week while at the same time taking HCTZ 12.5 mg a week. I never learned any specific way to taper off a beta blocker, but a quick search does say to decrease the dose by 25 to 50% 1 week at a time, so I think this is a good taper regimen.
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Crescent Saturn
NGC 2359, Thor's Helmet
French subjunctive verbal triggers
I. Intent, desire, preference
aimer (que)Â â to like that
aimer mieux (que)Â â to prefer that
commander (que)Â â to order that
dĂŠfendre (que)Â â to forbid that
demander (que)Â â to ask that
dĂŠsirer (que)Â â to desire that
empĂŞcher (que)Â â to prevent (from)
exiger (que)Â â to demand that
interdire (que)Â â to forbid that
ordonner (que)Â â to order that
permettre (que)Â â to permit that
prĂŠfĂŠrer (que)Â â to prefer that
proposer (que)Â â to propose that
recommander (que)Â â to recommend that
souhaiter (que)Â â to wish that
suggĂŠrer (que)Â â to suggest that
tenir Ă (ce que)Â â to insist that
vouloir (que)Â â to want that
II. Emotion, feeling
adorer (que)Â â to love that
avoir honte (que)Â â to be ashamed that
avoir peur (que) â to be afraid that (+ ne explĂŠtif)
craindre (que) â to fear that (+ ne explĂŠtif)
dĂŠtester (que)Â â to hate that
ĂŞtre content / heureux (que)Â â to be happy that
ĂŞtre dĂŠsolĂŠ (que)Â â to be sorry that
ĂŞtre ĂŠtonnĂŠ (que)Â â to be surprised that
ĂŞtre fâchĂŠ (que) â to be angry that
ĂŞtre fier (que)Â â to be proud that
ĂŞtre furieux (que)Â â to be furious that
ĂŞtre inquiet (que)Â â to be worried that
ĂŞtre ravi (que)Â â to be delighted that
ĂŞtre reconnaissant (que)Â â to be grateful that
ĂŞtre satisfait (que)Â â to be satisfied that
ĂŞtre surpris (que)Â â to be surprised that
ĂŞtre triste (que)Â â to be sad that
il est bizarre (que)Â â it is odd that
il est dommage (que)Â â it is a shame that
il est ĂŠtonnant (que)Â â it is surprising that
il est ĂŠtrange (que)Â â it is strange that
il est heureux (que)Â â it is fortunate that
il est incroyable (que)Â â it is incredible that
il est irritant (que)Â â it is irritating that
il est navrant (que)Â â it is distressing that
il est regrettable (que)Â â it is regrettable that
il est surprenant (que)Â â it is surprising that
il est triste (que)Â â it is sad that
redouter (que) â to dread that (+ ne explĂŠtif)
regretter (que)Â â to regret that
III. Doubt, uncertainty, denial
contester (que)Â â to challenge/contest that
douter (que)Â â to doubt that
il est douteux (que)Â â it is doubtful that
il est faux (que)Â â it is false that
il est impossible (que)Â â it is impossible that
il est improbable (que)Â â it is improbable that
il est incertain (que)Â â it is uncertain that
il n'est pas clair (que)Â â it is not clear that
il n'est pas ĂŠvident (que)Â â it is not obvious that
il n'est pas probable (que)Â â it is not likely that
il n'est pas sĂťr (que)Â â it is not certain that
il n'est pas vrai (que)Â â it is not true that
nier (que)Â â to deny that (might use indicative if affirming a fact)
IV. Opinion, judgment, necessity
il est absurde (que)Â â it is absurd that
il est avantageux (que)Â â it is advantageous that
il est bon (que)Â â it is good that
il est capital (que)Â â it is crucial that
il est convenable (que)Â â it is proper that
il est curieux (que)Â â it is curious that
il est dĂŠcevant (que)Â â it is disappointing that
il est dĂŠplorable (que)Â â it is deplorable that
il est difficile (que)Â â it is unlikely that
il est essentiel (que)Â â it is essential that
il est facile (que)Â â it is easy that (rare, often indicative)
il est important (que)Â â it is important that
il est indispensable (que)Â â it is indispensable that
il est injuste (que)Â â it is unfair that
il est inutile (que)Â â it is useless that
il est juste (que)Â â it is right/just that
il est logique (que)Â â it is logical that
il est naturel (que)Â â it is natural that
il est nĂŠcessaire (que)Â â it is necessary that
il est normal (que)Â â it is normal that
il est obligatoire (que)Â â it is obligatory that
il est prĂŠfĂŠrable (que)Â â it is preferable that
il est rare (que)Â â it is rare that
il est souhaitable (que)Â â it is desirable that
il est temps (que)Â â it is time that
il est urgent (que)Â â it is urgent that
il faut (que)Â â it is necessary that (must)
il se peut (que)Â â it may be that
il vaut mieux (que)Â â it is better that
V. Conjunctions
Ă condition (que)Â â provided that
Ă moins (que)... (ne)Â â unless
afin (que)Â â so that
ainsi (que)Â â just as, so that (literary)
avant (que)... (ne)Â â before
bien (que)Â â although
de crainte (que)... (ne)Â â for fear that
de façon (que) â so that (result)
de manière (que) â so that (result)
de peur (que)... (ne)Â â for fear that
en attendant (que)Â â while, until
jusqu'Ă ce (que)Â â until
pour (que)Â â so that
pourvu (que)Â â provided that
quoique â although
sans (que)Â â without
soit (que)... soit (que)Â â whether... or
VI. Other important verbal structures
accepter (que)Â â to accept that
chercher... (qui)Â â to look for someone who
comprendre (que)Â â to understand that (emotional)
se dĂŠsoler (que)Â â to be dismayed that
dire (que)Â â to say that (only in negative/interrogative)
ĂŠviter (que)... (ne)Â â to avoid (that)
faire en sorte (que)Â â to arrange it so that
il s'en faut (que)Â â it is far from being the case that
mĂŠriter (que)Â â to deserve that
penser (que)Â â to think that (only in negative/interrogative)
refuser (que)Â â to refuse that
se rĂŠjouir (que)Â â to be delighted that
supporter (que)Â â to bear, stand that
trouver (que) â to find that (in Il est troublant que... or negative/interrogative of opinion)
voir (que)Â â to see that (in negative/interrogative of perception)
Read more: subjunctive mood, expletive ne
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Ghost Season
Youâd call me sometimesâ¨just to leave silence on the line.
And Iâd listen anyway.
There are things Iâll never tell you:
like how your name became a weather pattern in me.â¨Or when I started measuring timeâ¨by the distance between your headlightsâ¨and my driveway.
How hope hereâ¨feels less like a flameâ¨and more like rotââ¨slow, hidden, alive.
The woods behind my childhood duplexâ¨are full of fallen things standing upright.
I think about that oftenââ¨how something deadâ¨can keep pretendingâ¨through winter.
You said onceâ¨that leaving doesnât make a person new.
I laughed too hard at that.
Because we had driven county roads at ungodly hours,â¨with both hands white on the wheel,â¨begging the dark to alter us.
But every gas station,â¨every frozen river,â¨every tired little churchâ¨keeps handing me back to myself.
And youâ
you move through my lifeâ¨like smoke through old floorboards.
Never staying.â¨Never gone.
Some nights I still imagineâ¨your hand brushing mine by accident,â¨both of us too afraidâ¨to call it what it was.
But most nightsâ¨I think the tragedy is not that you didnât love meâ
itâs that I almost loved you.
Outside,â¨the frost climbs the windows slowly,â¨quiet as forgiveness.
That all-encompassing world,â¨whitening at the edges.
Please stay,
I'd like to surrenderâ¨when impossible things whisper.
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đśnever wanted to dance with nobody, but you wouldnât take no for an answerđś
To the Church in Sardis
3 âTo the angel[a] of the church in Sardis write:
These are the words of him who holds the seven spirits[b] of God and the seven stars. I know your deeds; you have a reputation of being alive, but you are dead.2 Wake up! Strengthen what remains and is about to die, for I have found your deeds unfinished in the sight of my God. 3 Remember, therefore, what you have received and heard; hold it fast, and repent. But if you do not wake up, I will come like a thief, and you will not know at what time I will come to you.
4 Yet you have a few people in Sardis who have not soiled their clothes. They will walk with me, dressed in white, for they are worthy. 5 The one who is victoriouswill, like them, be dressed in white. I will never blot out the name of that person from the book of life, but will acknowledge that name before my Father and his angels. 6 Whoever has ears, let them hear what the Spirit says to the churches.