IVU Preparation and IVU Procedure

IVU Preparation and IVU Procedure What is Intravenous Urography? Intravenous Urography examines is the urinary system by using a special dye (contrast medium) that is injected into one of your veins. The dye travels through the bloodstream and is removed by the kidneys and passed into the ureters and bladder. The dye helps to show up these organs more clearly on X-rays. The test can help find out the cause of urinary problems. It can show kidney and bladder stones, tumours, blood clots or narrowing in the ureters. It is routinely done as an out-patient procedure in the radiology department. The procedure is comprised of two phases. First, it needs a functioning kidney to clean the dye out of the blood into the urine. The time necessary for the dye to come into view on x rays correlate exactly with kidneys function. The second phase gives entire anatomical images of the urinary tract. Within the first few minutes the dye lights up the kidneys, a stage called the nephrogram. Later the pictures follow the dye down the ureters and into the bladder. The final film taken after urinating shows how well the bladder empties. The contrast is removed from the bloodstream through the kidneys. Then contrast media becomes visible on x-rays almost immediately after injection. Attention is paid at the: Kidney Bladder  Ãƒâ€šÃ‚   Tubes that connect them (urethras) Why Intravenous Urography is done? The most common reason an IVU is done is in a condition be the suspected presence of stones in the urinary tract. Other pathology are such as renal failure, myeloma and infancy. The doctor would like to know how the urine is draining from the kidney to the bladder and how the stones have affected your urinary system. This may be used to balance the ultrasound of the kidney to the bladder and how the stones have affected the urinary system and the other wise. IVU uses a dye, also called as a contrast medium. This shows up the soft tissues the urinary system on the x-ray. This will allow the cancer to be seen in any parts of the patients urinary system. The cancer shows up as a blockage or an uneven outline on the wall of the bladder or ureter for an example. It is also used in the investigation of other suspected causes of urine obstruction or blood in the urine. Patient preparation for Intravenous Urography. Patient should be held NPO for 24 hours prior to the radiographic study. Patient should receive a minimum of 2 cleansing enemas prior to study. One enema should be performed the night before the procedure. Patient should receive large-bore catheter prior to examination start time. Patients over 60 lbs should receive 2 large-bore catheters to facilitate contrast administration. Medication Instruction Fasting Instruction Bowel Preparation A) Unless the patient have an asthma or other allergies the medications are not reqiured. Therefore, the suggestion for the examination is reviewed since the patient can develop a reaction towards the contrast media that are used. If the doctor feels the benefits of this procedure will equalize the risks, then the patient may be arranged to prednisolone (a type of steroid medication) tablets for the examination. This would be 40 mg 12 hours and then, 40mg 2 hours prior to the procedure. Sometimes in an urgent examination, the patient may be given an injection of Hydrocortisone 100 mg (another type of steroid) just before the the examination. B) If the IVU procedure is in the afternoon, patient can take light breakfast. Until 4-6 hours before the procedure, the patient can take a small cup of clear fluids per hour such as water, fruit juice, black tea or black coffee. No milk must be taken because it causes indigestion. It is preferable that nothing should be taken for at least 4 hours prior to the procedure. Water is allowed in diabetics, myeloma patients, renal failure and for other conditions where dehydration is contraindicated. C) Low residue vegetable-free diet for 1 day before the examination. A lot of water should be taken during this period before fasting begins. The patient may be given laxatives such as 2 tablets of Dulcolax at 9 pm the night before the examination to increase the peristalsis action. Procedure for Intravenous Urogram. Patient will be asked to lie on an x-ray table where the radiographer will take a preliminary film of their abdomen. The doctor will then give patient an injection of contrast medium into their arm. After this, a series of films will be taken over the next 30 minutes as the dye passes through your renal tract. At one stage of the procedure, a tight band may be placed on patients lower abdomen to help the radiographer to obtain maximum filling of the kidneys before the contrast medium flows down into the bladder. At the end of the examination, patient will be asked to empty your bladder, and then another film will be taken to see the empty bladder. Sometimes the contrast medium takes some time to go through the kidneys and these results in an extended examination time. Contrast medium is a fluid that is opaque to x-rays, is concentrated in the kidneys and goes into the bladder before being passed out in your urine. It is colorless, so the patient cannot see it when you go to the toile t. Aside from the minor sting from the injection as the contrast medium is injected, some people report feeling a warm flush, and sometimes have a metallic taste in their mouth. These things usually disappear within a minute or two, and are no cause for alarm. Incase the patient become itchy or short of breath, let the radiologist know straight away, as they may have a slight reaction to the contrast, which can be eased with antihistamines. If the patient have asthma or severe allergies, the radiologist may suggest them to take a steroid, or use other imaging options. Patient care after Procedure Sometimes, there would be minor (generalised warmth, to rashes) to moderate, asthma and difficulty breathing, a drop in the blood pressure (usually transient) or rarely severe and life threatening (anaphylaxis). Infrequently, there may be severe discomfort/pain when compression is applied, but usually the compression will be released the moment the patient inform the radiographer in charge of your examination. The only severe complication of an IVP is an allergy to the iodine-containing dye that is used. Such an allergy is rare, but it can be fatal. Patient are given and asked to lay on top of draw sheets cause the radiographic may be cold. Pillows are given for comfort. There is usually no special instructions post IVU. The patient may eat and drink unless your referring doctor has another examination or procedure for you after the IVU examination About the Intravenous Urography Examination The procedure takes about 40 to 60 minutes. Patient need to empty their bladder before the test. In a private cubicle, Patient may be asked to remove their clothing and put on a hospital gown. Then patient will be taken to the X-ray room and asked to lie down on the X-ray table. Radiographer will take the first X-ray pictures without the dye. Radiographer will then inject the dye in a vein in their hand or arm, and take more X-rays of your abdomen and pelvis. Patient may be asked to move position and lie on your stomach, or hold their breath for a few seconds while the X-rays are taken. To help improve images of the kidneys, a tight band may be placed across their abdomen. Patient may also be asked to go the toilet to empty your bladder and have another X-ray taken. Results on Intravenous Urography A normal intravenous urogram indicates no visible abnormality in the structure or function of the urinary system. The radiologist looks for a smooth non-lobulated outline of each kidney, no clubbing or other abnormality of the renal calyces (collecting system), and no abnormal fluid collection in the kidneys that could suggest obstruction. The ureters must contain no filling defects (stones) or deviations due to an adjacent tumor. The bladder must have a smooth outline and empty normally as visualized on the post-void film. Abnormal results include hydronephrosis (distension of the renal pelvis and calices due to obstruction) as a result of tumors or calculi (stones). Cysts or abscesses may also be present in the urinary system. A delay in renal function can also indicate renal disease. An abnormal amount of urine in the bladder after voiding may indicate prostate or bladder problems. Intravenous urograms are often done on children to rule out a rapid developing tumor in the kidneys, called a Wilms tumor. Children are also prone to infections of the bladder and kidneys due to urinary reflux (return back-flow of urine). Film For a preliminary film, (35 x 43cm) supine full A.P. abdomen to include lower border of symphysis pubis and diaphragm, abdominal preparation,and for any calcifications overlying the renal tract areas. Additional films to decide position of any opacities.35 ° posterior oblique of the renal regions. Tomogram of the renal areas are at 8-11 cm 4 reasom why we do preminilary Patient preparation The position of kidney (collimation) Exposure factor Instruction For an immediate film (24 x 30cm), AP of the renal areas, the film is exposed 10-14 s after the injection (arm-to-kidney time). It is to show the nephrogram. For a 5 minute film (24 x 30cm) AP of the renal areas, this film is taken to decide if the excretion is equal or if the uptake is poor and is important for assessing the need to adjust the technique. A compression band is now applied around the patients abdomen and the balloon positioned midway between the iliac spines. This can produce better pelvicalyceal distension. Compression should not be used in cases of suspected renal colic, renal trauma or after recent abdominal surgery. In 15 minute AP of the renal areas, there is usually sufficient distension of the pelvicalyceal system with opaque urine by the time. In the release of film the supine AP abdomen, this film is taken to show the whole urinary tract. If the film is good enough, the patient is asked to empty their bladder. The main value of this film is to access bladder emptying to demonstrate a return to normal of the dilated upper tracts with the relief of bladder pressure. In 25 Minute film (24 x 30cm) 15 ° caudal angulations centred 5 cm above the upper border of the symphysis pubis to reveal the swollen bladder. After micturition film, this will be the coned view of the bladder with the tube angled 15 caudad and centred 5cm above the symphysis pubis or the full length abdominal film to show the bladder emptying success and the return of the previously swollen lower ends of urethras to normal. Contrast agents and drugs Common examples for a 70 kg adult with normal blood urea values (2.5 7.5mmol/L.)Contrast media must be warmed to body temperature before injection. High osmolarity of contrast medium (HOCM) or low osmolarity of contrast medium (LOCM) 370 are acceptable but infants and small children, those with renal and cardiac failure, poorly hydrated patients, patients with diabetes, myelomatosis or sickle-cell anaemia and patient who have had a previous severe contrast medium reaction with low osmolarity contrast medium reaction with a strong allergic history have to receive low osmolarity contrast medium. Paediatric dose is 1ml kg/1 Equipment used for Intravenous Urogram Conray 400 ® 1 mL / lb ( 3 mL / kg) In high risk cats or compromised dogs (abnormal BUN / Creatinine), consult with the radiologist about the use of Omnipaque (Iohexol) instead of the Conray. Indwelling catheter preplaced in patient by clinician, student or treatment room techs. Depending on size of the animal or amount of contrast to be injected, 2 catheters might be required. Crash kit should be made available in the case of allergic contrast reaction (ie: vomiting and / or nausea are the most common.) What are the risks on doing Intravenous Urogram? Intravenous urograms are commonly performed and generally safe. However, in order to make an informed decision and give your consent, you need to be aware of the possible side-effects and the risk of complications of this procedure .Patient will be exposed to some X-ray radiation. Level of exposure is about the same as the background radiation that you would receive naturally from the environment over 12 to 14 months. Pregnant women are advised not to have X-rays, as there is a risk the radiation may affect the development of your unborn child. If the patient is, or think you may be pregnant, they must tell their doctor before the appointment. These are the unwanted but mostly temporary effects of a successful procedure. Very rarely, they may sense a warm feeling or get a metallic taste in their mouth after having the contrast. This should last only a minute or two.

Systems Model; Critique

Critique the relevance of the systems model to the study of politics Models, theories and concepts as approaches for analysing policy and decision making have been developed by political and social scientists to guide the study of public policy, to facilitate communication and to suggest possible explanations for policy actions. This essay is a critique of the relevance of the systems model to the study of politics. A model is conceptually defined as a theoretical representation of empirical data that aims to advance understanding through highlighting of significant relationships and interactions. According to Heywood (2007) one of the most influential models in political analysis is the Political system model developed by David Easton (1979, 1981) which aims to explain the entire political process including the functions of the major political actors through what is called systems analysis. A system is an organised and complex whole, a set of interrelated and interdependent parts that form a collective entity. Roskin, Cord, Medeiros & Jones (1997) concur that in the political systems model the politics of a given country worked the same way as a biological system. Here they were trying to emphasise the interrelationships and inter dependence likening it to the biological human body; how the various organs needed or related to each other and likening this to the political system. Systems theory is therefore the theory that treats the political system as a self regulating mechanism responding to inputs (demands and supports) by issuing authoritative decisions or outputs (policies). David Easton’s model illustrated the existence of a linkage between inputs and outputs in a political system(Heywood, 2007). Inputs consist of demands and support from the general public and demands in a political system range from pressure for the need of a higher standard of living, improved employment opportunities, greater protection to minorities, improved social benefits among many. Support on the other hand includes ways in which the public responds to the political system that is by paying taxes, offering compliance to the state through participation in public life and other societal issues. Heywood (ibid) further asserts that outputs on the other and are in the form of laws promulgated by government, consisting of decisions and actions of government that is the passing of laws, the imposition of taxes and most importantly allocation of public funds. The outputs generate feedback which consist of further demands and support from the general public. Further Easton referred to what he called gatekeepers being political parties, church organisations, pressure groups which gatekeepers manage the percep tion of the people and convey their inputs in the form of demands and supports. Outputs from government go back to the people and the cycle goes on and on. He projected that a political system tends to operate at equilibrium as its survival depends on outputs being brought into line with inputs. However, according to Anderson (1997) the usefulness of the systems theory in studying public policy is limited by its highly general and abstract nature. Older studies have devoted little attention to the nature and definition of public problems. It is now conventional wisdom that policy study that does not consider the characteristics and dimensions of the problems that stimulate government action is less than complete. In Easton’s model there is no clarity on the inputs which are the problems of the public. It gives a general picture of society. The importance lies in knowing both why some problems are acted on and others are neglected and why a problem is defined in one way rather than another. It is also important to know the nature of the problem whether it is foreign or domestic, a new item or an outgrowth of an existing policy to determine the ensuing policy making process, issues that the systems model is silent on. According to Jackson & Jackson (2003) the basic argument of systems analysis is that governments are the centre of political systems which involves three stages mainly the effects of the environment on a political system by making multiple demands, as well as providing fundamental support. A demand can be defined as a condition or situation that produces needs or dissatisfaction among people for which relief or redress is sought. For example problems such as air pollution, unwholesome food, abortion, urban congestion, crowded prisons and global warming are conditions that may become problems if they produce sufficient anxiety or dissatisfaction to cause people to seek a remedy. For this to happen people must have some criterion or standard by which the troubling condition is judged to be both unreasonable or unacceptable and appropriate for government to handle Anderson (1997). Conditions do not become public problems unless they are defined as such, articulated by someone or defined as such. The systems model therefore does not explore these highlighted problems. According to Jackson & Jackson (ibid) the systems analysis is criticised often arguing that the model on which it is based does not help discern which part of a political system are essential or influential. It is further argued that it is impossible to predict how or even whether a change in one part of the system will affect another part. Furthermore political systems are not as closely related as the model implies. Political systems are not as static as the model implies Another criticism of the systems theory is that it does not acknowledge the changes that occur with time. According to Roskin (et al) systems change over time with the rise of new powers, new technologies and new alliances. It does not even recognise the existence of bigger entities with many components for example countries or groups of countries that interact with each other forming international systems. To some the fall of the Soviet empire in the 1990’s marked the end of the cold war and the bipolar system. But some argue that the bipolar system did not end with the collapse of the Soviet Union, but rather a multi polar economics race emerged. As Moscow gave up the East European nations and no longer posed any invasion threat to Western Europe which moved closer to unity in the European Union (EU). All barriers among the fifteen members disappeared, producing a single economy if not a single political entity. The United States on the other hand had some economic problems, massive trade deficits following massive budget deficits making it the biggest debtor. It could no longer call the tune and get alliance from allies in Europe and Asia. Countries of the Eastern bloc consolidated their political system significantly. The systems model is limited in this sense in that its diagrammatic representation is only limited to small entities. According to Anderson (ibid) a condition to be turned into a problem, must be seen as an appropriate topic for governmental action and further, as something for which there is a possible governmental remedy or solution. The systems model does not articulate the inputs fed into gate keepers, neither does it clarify the difference between conditions and problems. Those who oppose government action to ban smoking in public places may argue that tobacco smoke is not harmful, or that smoke is a matter of individual choice and should not be regulated. Professor Wildavsky contends that officials are unlikely to deal with a problem unless it is coupled with a solution. He thus, states that ‘a problem is a problem only if something can be done about it’,(Anderson, ibid). Thus in Easton’s model there is no emphasis on the nature of the inputs. Power distribution in the systems model is not adequately explored in the graphical representation. In today’s world for example the American system, political power is fragmented and dispersed by constitutional prescription and political practice. Many points of official decision making exist and a multitude of officials share in the exercise of political power and the formulation of public policy. Structural functionalism focuses on the different levels of a system and their reciprocal influences and also the possibility of making generalisations about them. It is premised on what structures perform what functions in any given system and under what conditions. Key proponent Almond (1960) critically examined Easton’s model and proceeded to look for the functions that could be included among the inputs and outputs of a political system and identified six functions. Chief among these functions is interest articulation, interest aggregation, rule application and adjudication and communication. Political systems consist of units or structures that perform certain or particular functions. The detailed variables with which the model is concerned are structural that is pressure groups, political parties, the legislature among many. Political systems are compared on the basis of the functions that are performed by their units. However, according to Jackson &Jackson (ibid), the structural functional approach does not accommodate itself well to the state as a dynamic entity. The mechanical role of performing functions is assigned to the state. It ignores the human element that those who perform functions of the state may have their own interests. Some critics even argue that structural functional approach places too much emphasis on technology and rational procedures and obscures the relationship between structures and functions. Almond seems to contend that all systems must evolve in the same manner and direction as did the Anglo American Democracies if they wish to develop to higher political stages. David Easton’s model of a political system is the basis of most contemporary political systems. But however, it is only ideal as there are constant changes that occur in the society we live in, therefore an equilibrium can never be achieved. It forms a basis of analysis upon which scientific generalisations can be made. REFERENCE Anderson, J. E. Public policy making; An introduction (3rd edition). Houghton Mifflin Company: Boston Heywood, A. (2007). Politics (3rd edition). Palgrave Macmillan: New York Jackson, R. J. & Jackson, D. (2003). An introduction to political science. Prentice Hall: Toronto Roskin, M, Cord, R. L, Medeiros, J. A, & Jones, W. S. (1997). Political science; an introduction (6th edition). Prentice Hall International (UK) Limited: London

Onsiderations in Choosing Between an Online and...

Considerations in Choosing Between an Online and Traditional Education Leslie De La Rosa COM/155 University Composition and Communication 1 Frances Lord September 1, 2012 Considerations in Choosing Between an Online and Traditional Education In today’s technological age, there are many choices for Americans of all ages to attend college. A student may choose to attend a traditional college or to continue their education through one of the many online programs available. Both online and traditional educations offer a quality education to students, but differ in financial needs, scheduling flexibility, learning styles and career choice. Any person looking to further their education needs to do extensive research to determine†¦show more content†¦Careers in business, accounting or other â€Å"paper based† jobs are ideally suited to an online program. Some careers may require you to attend both an online university and a campus. One such career would be nursing. A student studying nursing can learn the book part online, but at some point he or she will have to get some hands on experience. Social interactions also differ between the two types of education. On a campus, students attend a class, with in structors and classmates. This fosters more collaboration on projects. Many times students are not required to actively participate in class room discussions. In the online setting students are required to participate in the discussions, even though he or she does not see classmates face to face. Students can learn from your fellow class mates as well as the instructor and materials. Generally the students that perform best doing online classes are those who are able to work and learn independently. Instructors are there to help students in both types of education. In a traditional setting the instructor lectures on the topic, assigns reading and may facilitate a discussion during the class. However to speak to a professor outside of the class you usually have to make an appointment. An instructor in an online educational format also assigns the reading materials, but they always facilitate a discussion and generally participate to move the

Essay on My Philosophy of Education - 700 Words

My Philosophy of Education Why do I want to be a teacher? I have thought long and hard over that question, and my answer is â€Å"I don’t know.† My initial thought about going into teaching stemmed from my own experiences. When my son was in school, a teacher gave up on him and said, â€Å"he’ll be a dropout.† They will weed him out when he gets to high school. My son is now a junior at West Virginia University. I never want to see another kid be dropped through the cracks or weeded out, when he gets to high school. Children are our greatest assets. Teachers have an obligation to try every avenue with each student until they find one that works. I know that every time I walk into a classroom of students, I get a chill up my†¦show more content†¦I do not agree with a heavy emphasis being put on achievement test scores. More should be emphasized on what the student learned, not what he didn’t learn. Some people do not do well on tests, but are very capable i n like aspects in the same field. A teacher must be a guide to her students. A teacher’s creativity is an asset and is only bound by her imagination. Teachers guide students through all aspects of life and learning. A positive impact with a teacher leaves a lasting positive impression on a child’s mind. A child will carry a negative impact with him the rest of his life. Teachers are the key to children’s future, be it positive or negative. This is a great responsibility, that teachers should not accept light heartedly. Children will experience successes and failures throughout their life. A teacher can help them learn how to handle victory or defeat in a positive way. I plan on continuing my education, upon graduation. I don’t feel that a person can ever get enough education and with the continuing drive for new programs and better methods, a teacher could fall behind and become obsolete. 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The Effects Of Media Violence On An Individuals Perception...

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As a child, I grew up in a technology age with two brothers, both of whom were heavily involved with violent video games, while I was more consumed with watching movies, which included violence at points. My younger brother and I lived a relatively normal life, where as my older brother, the one whom was most consumed with video games had been mentally and physically victimized through out his childhood due to a hearing disorder. My parents had been very involved in our lives though, continuously concerned about my brothers aggressive behaviors. Children had persistently made fun of his disability, which IShow MoreRelatedMental Illness And Its Effects On The Media Essay1324 Words   |  6 PagesStates’ media creating stigmatization and misrepresentation. Mental illness â€Å"refers to a wide range of mental disorders that affect your mood, thinking and behavior† (Mayo Clinic Staff, 2015). 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Through entertainment and news programming, mass media suchRead MoreThe Home Is More Dangerous Than The Street1692 Words   |  7 PagesIntroduction †¢ It will be argued that the home is more dangerous than the street. †¢ key elements discussed= target population of women, perception vs reality (including fear paradox) and current statistics of street and home crime. †¢ The reason why i have chosen these elements to be explored are because I believe it will be the best topics to be discussed to persuade readers to agree with the contentiion. Body Paragraph 1 †¢ Target population of women = Women face greater risk of death in the

Values and Modern Era Free Essays

Modern mass society presents a sharp contrast, as the young grow up. They are faced with confusions, delays and discontinuities. Adolescents in particular are uncertain about themselves. We will write a custom essay sample on Values and Modern Era or any similar topic only for you Order Now Some are in conflict with themselves, bewildered an insecure. Values are usually influenced by the changing philosophical ideologies, cultural and religious perspectives, social, political and geographical conditions. In modern emerging society, there has been a revolutionary change in the field of values due to many factors in addition to the influence of modern culture, industrialization, modernization, urbanization, globalisation and multinationals.Values are the guiding principles, decisive in day to day behaviors as also is critical life situations. Values are a set bring of principles or standards of behavior. Values are regarded desirable,important and held in high esteem by a particular society in which a person lives. Value education means inculcating in the children a sense humanism, a deep concern for the well being of others and the nation. This can be accomplished only when we instill in the children a deep feeling of commitment to values that would build this country and bring back to the people pride in work that brings order, security and assured progress.Value education refers to a programme of planned educational action aimed at the development of value and character. Every action and thought of ours leaves an impression in our mind. These impressions determine in our behavior at a given moment and our responses to a given situation. The sum total of all our impressions is what determines our character. The past has determined the present and even so the present our present thoughts and actions will shape our future. This is a key principle governing personality development. The human values are resolved having lasting impact necessary for bringing about change in thought and conduct, in the 21st century. â€Å"If there is righteousness in the heart there will be beauty in character If there is beauty in character There will be harmony in the home When there is harmony in the home There will be order in the nation When there is order in the nation There will be peace in the world† At the boyhood state, individual physical development is concerned, during manhood and old age intellectual and spiritual values start dominating the corporal values.Therefore while imparting moral education educators must keep in mind that the young must be educated. Prizes may be given to the deserving persons for showing honesty, bravery, truth etc. The award should be given during school gathering. Contests may be organized on values of life. According to Father of Indian Nation M. K. Gandhi â€Å"If wealth is lost nothing is lost† â€Å"If health is lost something is lost† â€Å"If character is lost everything is lost† Best of all things is character. How to cite Values and Modern Era, Papers

Conqueror free essay sample

October 2, 2005. 7 a.m. the alarm clock rang. I popped out of bed, excited and nervous. The first thought on my mind, â€Å"Today is the day, my first official football game.† I’ve played before but not like this. Not in pads, not with a helmet on my head. My heart started racing, beating faster with every beat. I had only been up for five minutes. I got up and looked out the window. The day was calm. The sun was shining. I thought to myself, â€Å" a perfect day for football.† I took a shower and as the hot water ran down my body, I began to daydream about what I had to do in the day’s game. I made breakfast. The usual sausage, egg, and cheese, with a cup of Tropicana orange juice. After eating, I looked at the clock. In big red numbers, it read 8:10. It was time for me to go. We will write a custom essay sample on Conqueror or any similar topic specifically for you Do Not WasteYour Time HIRE WRITER Only 13.90 / page I had to be at the field by nine. I grabbed my things and headed for the door yelling out â€Å"bye† so my parents knew I was leaving. The whole time on the bus, I felt sick, nervous and I was sweating. I wasn’t even hot. The ride was long. The bus was packed. I got off the Q6 at Sutphin and Archer, and then transferred to the Q65. This was my route to school every day. Finally, I reached the field. It looked beautiful, with the red, blue and white J on the 50-yard line. Too bad we weren’t playing a home game. It was an away game versus Campus Magnet. Most of the team was already there getting dressed so I joined. Putting on that white number 7 jersey for the first time felt great. I felt like football was my destiny, my calling. This is what I was made to do. The bus came. The cheese bus, we called it, because it was the same color as cheddar cheese. We all got on with our shoulder pads and helmets in our hands. By the look on our faces, you could see who played before and who didn’t. To me, it felt like war. I was a fresh soldier going into battle. The ride was quiet. Coach James told us not to talk. He said we should think and visualize what we were going to do. I visualized a lot. I had this feeling. At that time, I did not know what it was. Now thinking back on it, it was fear. I was scared. I didn’t know if I could take a real hit or even give one. We practiced, but it was nothing like the real game. In practice, we took a form and thought about what we were doing, plus we all knew each other. In the game, you don’t know your opponent or his strength and you’re definitely not thinking. Everything just happens before you know it was happening. Finally making it to Campus Magnet High School, we all got off the bus and in two straight lines we walked into the field house. Passing the football field, I remember thinking to myself, â€Å" there’s the battle field.† My coach called it the place where you separate the men from the boys. After everyone entered the field house, we padded up, waiting anxiously for coach to tell use to come out and warm up. That time came, and it came fast. I wasn’t sure if I was ready, but I wasn’t going to back down. We jogged out to the field and did our game time warm ups. Some of us couldn’t wait to play, jumping around and yelling. Others stood still on the sideline waiting for direction. The referees came out. We knew what this meant, GAME TIME! I was one of the captains so I went out for the coin toss to see which team would get the ball first. Campus Magnet won the coin toss. They chose to receive. â€Å"Starting D†, coach called. That was me. I was on the starting defense playing the safety position. We wen t out onto the field and got into a huddle. â€Å"Eagle stack, break on three, 1, 2, 3†. We all clapped and yelled break falling back into our positions on the field. The other team lined up. â€Å"Here it is, my moment of truth†. â€Å"Red 90†¦.† â€Å" This is really happening!† â€Å"Red 90 set†¦Ã¢â‚¬  â€Å"Gotta make the tackle† â€Å" Set hike.† And the game was on. I tracked down the ball carrier and ran full speed. I lowered my shoulders and with all my strength and rammed myself into his side, knocking him down and at the same time knocking the fear out of me. I stood to my feet and realized what I had done. I’ve made my first tackle. I was living my dream. I was playing football. I felt renewed. That tackle changed me. It gave me strength. It gave me heart. It gave me confidence. It gave me the desire to go on. We won that game 48 to 6. That year we went undefeated. Beating every team on our schedule. I was rat ed the best wide receiver in our division. P.S.: Do not be conquered by fear, but conquer fear with strength, heart, confidence and desire.