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judy smith May 2015
Tired of being called names and listening to complaints from your partner because you snore at night?

But more than that, it is important to keep a check on your snoring as an excess of it can be an indicator of many diseases, one of them being sleep apnea, says Dr Kaushal Sheth, ENT surgeon, "People develop sleep apnea when their airway collapses partially or completely during sleep due to various medical conditions. This causes the oxygen levels in the blood to decrease and can be potentially life threatening when it becomes obstructive sleep apnea."

Elaborating on it further, Dr Jayashree Todkar, bariatric surgeon and obesity consultant says "Snoring is an indication of obstacles in a person's breathing. When excessive fat accumulates around the stomach, the lungs do not get ample space to expand when we inhale oxygen; this in turn leads to obstacles in the process of inhalation-exhalation."

However, there are many myths surrounding snoring which is a very common problem. To sleep better one must get rid of the myths that surround snoring and only accept the facts, says Dr Viranchi Oza, BDS as he gives us a lowdown of some stories around snoring:

Myth: Everybody snores, therefore it's normal.

Fact: Snoring is not a normal condition. Labelling it as 'normal' diminishes the seriousness of the condition. Snoring is not just about annoying your partner, it is a sign that the body is struggling to breathe properly during the night. Snoring on a frequent or regular basis has been associated with hypertension and can also be an indication of sleep apnea (pauses in breathing). Sleep apnea sufferers have been reported to have diminished gray cells in their brains, most likely due to the oxygen deprivation of untreated sleep apnea. If left untreated, sleep apnea increases the risk of cardiovascular disease over time. In addition, insufficient sleep affects growth hormone secretion that is linked to obesity. As the amount of hormone secretion decreases, the chance of weight gain increases.

Myth: Snoring only affects the health of the snorer.

Fact: Snoring doesn't just negatively affect the health of the person snoring, but also the health of the person lying next to them in bed. A typical snorer usually produces a noise that averages around 60 decibels (about the level of vacuum cleaner), but with some people this can reach 80 or even 90 decibels (about the level of an average factory). Sleeping with a partner who snores during the night has been shown to increase the blood pressure in the other person, which may be dangerous for their health in the long term. Snoring also causes the partner to have fragmented sleep and lose up to one hour of sleep

every night.

Myth: Snoring comes from the nose, so if I unclog my nose, my snoring will stop.

Fact: Having a stuffy nose can definitely aggravate snoring and sleep apnea, but in it's not the cause. A recent study showed that undergoing nasal surgery for breathing problems cured sleep apnea in only 10% of patients. Snoring vibrations typically come from the soft palate, which is aggravated by having a small jaw and the tongue falling back. It's a complicated relationship between the nose, the soft palate and the tongue.

Myth: I know I don't snore, or have apnea. I am fine.

Fact: Don't ignore your wife when she tells you that your snoring doesn't let her sleep. When a partner snores it is very difficult for the spouse to sleep. There are people who snore excessively and suffer from sleep apnea, but feel absolutely normal. However, snoring increases their risk of getting a heart attack and stroke. The only definitive way to prove that you don't have sleep apnea is by taking a sleep test. Screening questionnaires like the GASP or the Epworth have shown high reliability in identifying patient risk for sleep apnea.

Myth: If I lose weight, I'll cure myself of sleep apnea.

Fact: Sometimes. It's definitely worth trying, but in general, it's very difficult to lose weight if you have sleep apnea. This is because poor sleep aggravates weight gain by increasing your appetite. Once you're sleeping better, it'll be easier to lose weight. This is the one ingredient with many dietary and weight loss programs that's missing or not stressed at all. It's not enough just to tell people to sleep more.

Myth: Health problems such as obesity, diabetes, hypertension and depression have no relation to the amount and quality of a person's sleep.

Fact: More and more scientific studies are showing a correlation between poor quality sleep and insufficient sleep with a variety of diseases. Blood pressure is variable during the sleep cycle, however, interrupted sleep negatively affects the normal variability. Recent studies have shown that nearly 80% cases of hypertension, 60% cases of strokes and 50% cases of heart failures are actually cases of undiagnosed sleep apnea. Research indicates that insufficient sleep impairs the body's ability to use insulin, which can lead to the onset of diabetes. Fragmented sleep can cause a lowered metabolism and increased levels of the hormone Cortisol which results in an increased appetite and a decrease in one's ability to burn calories.

Myth: Daytime sleepiness means a person is not getting enough sleep.

Fact: Do you feel very sleepy even during the day despite the fact that you had a long night of proper sleep? Excessive daytime sleepiness can occur even after a person gets enough sleep. Such sleepiness can be a sign of an underlying medical condition or sleep disorder such as narcolepsy or sleep apnea. Please seek professional medical advice to correctly diagnose the cause of this symptom.

Myth: Getting just one hour less sleep per night than needed will not have any effect on your daytime functioning.

Fact: This lack of sleep may not make you noticeably sleepy during the day. But even if you've got slightly less sleep, it can affect your ability to think properly and respond quickly. It can compromise your cardiovascular health and energy balance as well as the ability to fight infections, particularly if the pattern continues. Lack of sleep has also been associated with road accidents (up to 60% of road accidents involve lack of sleep) and air crashes (Air India Mangalore plane crash in 2010 was due to lack of sleep). Sleeping for less than six hours a night is equivalent to legal levels of alcohol intoxication.

Myth: Sleep apnea occurs only in older, overweight men with big necks.

Fact: Although the stereotypical description does fit people in the extreme end of the spectrum, we now know that even young, thin women that don't snore can have significant obstructive sleep apnea. Sleep apnea begins with jaw structure narrowing and later involves obesity. It's estimated that 90% of women with this condition are not diagnosed. Untreated, it can cause or aggravate weight gain, depression, anxiety, diabetes, high blood pressure, heart disease, heart attack and stroke.

Myth: Snoring can't be treated.

Fact: Have you given up on your snoring thinking that it cannot be treated? There are many different options for treating snoring.

Some treatment options are rather drastic, possibly requiring surgery or prescription drugs, but prior to exploring such options it would be wise to first seek out alternative treatments. You must visit a sleep specialist to get the right diagnosis.

Myth: Extra sleep at night can cure you of problems with excessive daytime fatigue.

Fact: Not only is the quantity of sleep important but also the quality of sleep. Some people sleep eight-nine hours a night but don't feel well rested as the quality of their sleep is poor. A number of sleep disorders and other medical conditions affect the quality of sleep. Sleeping more won't alleviate the daytime sleepiness these disorders or conditions cause. However, many of these disorders or conditions can be treated effectively with changes in behaviour or with medical therapies.

Myth: Insomnia is characterised only by difficulty in falling asleep.

Fact: There are four symptoms usually associated with insomnia:

- Difficulty falling asleep

- Waking up too early and not being able to get back to sleep

- Frequent awakenings

- Waking up feeling tired and not so fresh

Insomnia can also be a symptom of a sleep disorder or other medical, psychological or psychiatric problems. Sometimes, insomnia can really be a case of undiagnosed sleep apnea.Read more here:www.marieaustralia.com/long-formal-dresses | www.marieaustralia.com/bridesmaid-dresses
Suzy Berlinsky Nov 2020
HIGHLIGHTS OF PRESCRIBING INFORMATION
These highlights do not include all the information needed to us e
M-M-R II safely and effectively. See full prescribing information
for M-M-R II.
M-M-R® II (Measles, Mumps, and Rubella Virus Vaccine Live)
Suspension for subcutaneous injection
Initial U.S. Approv al: 1978
-------------------------------INDICATIONS AND USAGE-------------------------------
M-M-R II is a vaccine indicated for active immunization for the
prevention of measles, mumps, and rubella in individuals 12 months of
age and older. (1)
-------------------------- DOSAGE AND ADMINISTRATION--------------------------
Administer a 0.5-mL dose of M-M-R II subcutaneously. (2.1)
• The first dose is administered at 12 to 15 months of age. (2.1)
• The second dose is administered at 4 to 6 years of age. (2.1)
------------------------DOSAGE FORMS AND STRENGTHS -----------------------
Suspension for injection (0.5-mL dose) supplied as a lyophilized
vaccine to be reconstituted using accompanying sterile diluent. (3)
---------------------------------- CONTRAINDICATIONS ----------------------------------
• Hypersensitivity to any componentof the vaccine. (4.1)
• Immunosuppression. (4.2)
• Moderate or severe febrile illness. (4.3)
• Active untreated tuberculosis. (4.4)
• Pregnancy. (4.5, 8.1)
-------------------------- WARNINGS AND PRECAUTIONS --------------------------
• Use caution when administering M-M-R II to individuals with a
history of febrile seizures. (5.1)
• Use caution when administering M-M-R II to individuals with
anaphylaxis or immediate hypersensitivity following egg ingestion.
(5.2)
• Use caution when administering M-M-R II to individuals with a
history of thrombocytopenia. (5.3)
• Immune Globulins (IG) and other blood products should not be
given concurrently with M-M-R II. (5.4, 7.2)
----------------------------------ADVERSE REACTIONS----------------------------------
See full prescribing information for adverse reactions occurring duri ng
clinical trialsor the post-marketing period. (6)
To report SUSPECTED ADVERSE REACTIONS, contact Merck
Sharp & Dohme Corp., a subsidiary of Merck & Co., Inc., at 1-8 7 7 -
888-4231 or VAERS at 1-800-822-7967 or www.vaers.hhs.gov.
-----------------------------------DRUG INTERACTIONS----------------------------------
• Administration of immune globulins and other blood products
concurrently with M-M-R II vaccine may interfere with the
expected immune response. (7.2)
• M-M-R II vaccination may result in a temporary depression of
purified protein derivative (PPD) tuberculin skin sensitivity. (7.3)
-------------------------- USE IN SPECIFIC POPULATIONS--------------------------
• Pregnancy: Do not administer M-M-R II to females who are
pregnant. Pregnancy should be avoided for 1 month following
vaccination with M-M-R II. (4.5, 8.1, 17)
See 17 for PATIENT COUNSELING INFORMATION and FDA
approv ed patient labeling.
Rev ised: 06/2020
FULL PRESCRIBING INFORMATION: CONTENTS
1 INDICATIONS AND USAGE
2 DOSAGE AND ADMINISTRATION
2.1 Dose and Schedule
2.2 Preparation andAdministration
3 DOSAGE FORMS AND STRENGTHS
4 CONTRAINDICATIONS
4.1 Hypersensitivity
4.2 Immunosuppression
4.3 Moderate or Severe Febrile Illness
4.4 Active Untreated Tuberculosis
4.5 Pregnancy
5 WARNINGS AND PRECAUTIONS
5.1 Febrile Seizure
5.2 Hypersensitivity to Eggs
5.3 Thrombocytopenia
5.4 Immune Globulins and Transfusions
6 ADVERSE REACTIONS
7 DRUG INTERACTIONS
7.1 Corticosteroids and Immunosuppressive Drugs
7.2 Immune Globulinsand Transfusions
7.3 Tuberculin Skin Testing
7.4 Use with Other Live Viral Vaccines
8 USE IN SPECIFIC POPULATIONS
8.1 Pregnancy
8.2 Lactation
8.4 Pediatric Use
8.5 Geriatric Use
11 DESCRIPTION
12 CLINICAL PHARMACOLOGY
12.1 Mechanism of Action
12.6 Persistence of Antibody Responses After Vaccination
13 NONCLINICAL TOXICOLOGY
13.1 Carcinogenesis, Mutagenesis, Impairment of Fertility
14 CLINICAL STUDIES
14.1 Clinical Efficacy
14.2 Immunogenicity
15 REFERENCES
16 HOW SUPPLIED/STORAGE AND HANDLING
17 PATIENT COUNSELING INFORMATION
Sections or subsections omitted from the full prescribing info rma tion
are not listed.
2
FULL PRESCRIBING INFORMATION
1 INDICATIONS AND USAGE
M-M-R® II is a vaccine indicated for active immunization for the prevention of measles, mumps, and
rubella in individuals 12 months of age and older.
2 DOSAGE AND ADMINISTRATION
For subcutaneous use only.
2.1 Dose and Schedule
Each 0.5 mL dose is administered subcutaneously.
The first dose is administered at 12 to 15 months of age. A second dose is administered at 4 to 6
years of age.
The second dose may be administered prior to 4 years of age, provided that there is a minimum
interval of one month between the doses of measles, mumps and rubella virus vaccine, live {1-2}.
Children who received an initial dose of measles, mumps and rubella vaccine prior to their first
birthday should receive additional doses of vaccine at 12-15 months of age and at 4-6 years of age to
complete the vaccination series [see Clinical Studies (14.2)].
For post-exposure prophylaxis for measles, administer a dose of M-M-R II vaccine within 72 hours
after exposure.
2.2 Preparation and Administration
Use a sterile syringe free of preservatives, antiseptics, and detergents for each injection and/or
reconstitution of the vaccine because these substances may inactivate the live virus vaccine. To
reconstitute, use only the diluent supplied with the vaccine since it is free of preservatives or other
antiviral substances which might inactivate the vaccine.
Withdraw the entire volume of the supplied diluent from its vial and inject into lyophilized vaccine vial.
Agitate to dissolve completely. Discard if the lyophilized vaccine cannot be dissolved.
Withdraw the entire volume of the reconstituted vaccine and inject subcutaneously into the outer
aspect of the upper arm (deltoid region) or into the higher anterolateral area of the thigh.
Parenteral drug products should be inspected visually for particulate matter and discoloration prior to
administration, whenever solution and container permit. Visually inspect the vaccine before and after
reconstitution prior to administration. Before reconstitution, the lyophilized vaccine is a light yellow
compact crystalline plug, when reconstituted, is a clear yellow liquid. Discard if particulate matter or
discoloration are observed in the reconstituted vaccine.
To minimize loss of potency, administer M-M-R II as soon as possible after reconstitution. If not used
immediately, the reconstituted vaccine may be stored between 36°F to 46°F (2°C to 8°C), protected from
light, for up to 8 hours. Discard reconstituted vaccine if it is not used within 8 hours.
3 DOSAGE FORMS AND STRENGTHS
M-M-R II vaccine is a suspension for injection supplied as a single dose vial of lyophilized vaccine to
be reconstituted using the accompanying sterile diluent [see Dosage and Administration (2.2) and How
Supplied/Storage and Handling (16)]. A single dose after reconstitution is 0.5 mL.
4 CONTRAINDICATIONS
4.1 Hypersensitivity
Do not administer M-M-R II vaccine to individuals with a history of hypersensitivity to any component
of the vaccine (including gelatin) {3} or who have experienced a hypersensitivity reaction following
administration of a previous dose of M-M-R II vaccine or any other measles, mumps and rubellacontaining vaccine. Do not administer M-M-R II vaccine to individuals with a history of anaphylaxis to
neomycin [see Description (11)].
4.2 Immunosuppression
Do not administer M-M-R II vaccine to individuals who are immunodeficient or immunosuppressed due
to disease or medical therapy. Measles inclusion body encephalitis {4} (MIBE), pneumonitis {5} and death
as a direct consequence of disseminated measles vaccine virus infection have been reported in
3
immunocompromised individuals inadvertently vaccinated with measles-containing vaccine. In this
population, disseminated mumps and rubella vaccine virus infection have also been reported.
Do not administer M-M-R II to individuals with a family history of congenital or hereditary
immunodeficiency, until the immune competence of the potential vaccine recipient is demonstrated.
4.3 Moderate or Severe Febrile Illness
Do not administer M-M-R II vaccine to individuals with an active febrile illness with fever >101.3F
(>38.5C).
4.4 Active Untreated Tuberculosis
Do not administer M-M-R II vaccine to individuals with active untreated tuberculosis (TB).
4.5 Pregnancy
Do not administer M-M-R II to individuals who are pregnant or who are planning on becoming
pregnant within the next month [see Use in Specific Populations (8.1) and Patient Counseling Information
(17)].
5 WARNINGS AND PRECAUTIONS
5.1 Febrile Seizure
There is a risk of fever and associated febrile seizure in the first 2 weeks following immunization with
M-M-R II vaccine. For children who have experienced a previous febrile seizure (from any cause) and
those with a family history of febrile seizures there is a small increase in risk of febrile seizure following
receipt of M-M-R II vaccine [see Adverse Reactions (6)].
5.2 Hypersensitivity to Eggs
Individuals with a history of anaphylactic, anaphylactoid, or other immediate reactions (e.g., hives,
swelling of the mouth and throat, difficulty breathing, hypotension, or shock) subsequent to egg ingestion
may be at an enhanced risk of immediate-type hypersensitivity reactions after receiving M-M-R II vaccine
.The potential risks and known benefits should be evaluated before considering vaccination in these
individuals.
5.3 Thrombocytopenia
Transient thrombocytopenia has been reported within 4-6 weeks following vaccination with measles,
mumps and rubella vaccine. Carefully evaluate the potential risk and benefit of vaccination in children
with thrombocytopenia or in those who experienced thrombocytopenia after vaccination with a previous
dose of measles, mumps, and rubella vaccine {6-8} [see Adverse Reactions (6)].
5.4 Immune Globulins and Transfusions
Immune Globulins (IG) and other blood products should not be given concurrently with M-M-R II [see
Drug Interactions (7.2)]. These products may contain antibodies that interfere with vaccine virus
replication and decrease the expected immune response.
The ACIP has specific recommendations for intervals between administration of antibody containing
products and live virus vaccines.
6 ADVERSE REACTIONS
The following adverse reactions include those identified during clinical trials or reported during postapproval use of M-M-R II vaccine or its individual components.
Body as a Whole
Panniculitis; atypical measles; fever; syncope; headache; dizziness; malaise; irritability.
Cardiovascular System
Vasculitis.
Digestive System
Pancreatitis; diarrhea; vomiting; parotitis; nausea.
Hematologic and Lymphatic Systems
Thrombocytopenia; purpura; regional lymphadenopathy; leukocytosis.
Immune System
Anaphylaxis, anaphylactoid reactions, angioedema (including peripheral or ****** edema) and
bronchial spasm.
Musculoskeletal System
Arthritis; arthralgia; myalgia.
4
Nervous System
Encephalitis; encephalopathy; measles inclusion body encephalitis (MIBE) subacute sclerosing
panencephalitis (SSPE); Guillain-Barré Syndrome (GBS); acute disseminated encephalomyelitis (ADEM);
transverse myelitis; febrile convulsions; afebrile convulsions or seizures; ataxia; polyneuritis;
polyneuropathy; ocular palsies; paresthesia.
Respiratory System
Pneumonia; pneumonitis; sore throat; cough; rhinitis.
Skin
Stevens-Johnson syndrome; acute hemorrhagic edema of infancy; Henoch-Schönlein purpura;
erythema multiforme; urticaria; rash; measles-like rash; pruritus; injection site reactions (pain, erythema,
swelling and vesiculation).
Special Senses — Ear
Nerve deafness; otitis media.
Special Senses — Eye
Retinitis; optic neuritis; papillitis; conjunctivitis.
Urogenital System
Epididymitis; orchitis.
7 DRUG INTERACTIONS
7.1 Corticosteroids and Immunosuppressive Drugs
M-M-R II vaccine should not be administered to individuals receiving immunosuppressive therapy,
including high dose corticosteroids. Vaccination with M-M-R II vaccine can result in disseminated disease
due to measles vaccine in individuals on immunosuppressive drugs [see Contraindications (4.2)].
7.2 Immune Globulinsand Transfusions
Administration of immune globulins and other blood products concurrently with M-M-R II vaccine may
interfere with the expected immune response {9-11} [see Warnings and Precautions (5.4)]. The ACIP has
specific recommendations for intervals between administration of antibody containing products and live
virus vaccines.
7.3 Tuberculin Skin Testing
It has been reported that live attenuated measles, mumps and rubella virus vaccines given individually
may result in a temporary depression of tuberculin skin sensitivity. Therefore, if a tuberculin skin test with
tuberculin purified protein derivative (PPD) is to be done, it should be administered before, simultaneously
with, or at least 4 to 6 weeks after vaccination with M-M-R II vaccine.
7.4 Use with Other Live Viral Vaccines
M-M-R II vaccine can be administered concurrently with other live viral vaccines. If not given
concurrently, M-M-R II vaccine should be given one month before or one month after administration of
other live viral vaccines to avoid potential for immune interference.
8 USE IN SPECIFIC POPULATIONS
8.1 Pregnancy
Risk Summary
M-M-R II vaccine is contraindicated for use in pregnant women because infection during pregnancy
with the wild-type viruses has been associated with maternal and fetal adverse outcomes.
Increased rates of spontaneous abortion, stillbirth, premature delivery and congenital defects have
been observed following infection with wild-type measles during pregnancy. {12,13} Wild-type mumps
infection during the first trimester of pregnancy may increase the rate of spontaneous abortion.
Infection with wild-type rubella during pregnancy can lead to miscarriage or stillbirth. If rubella infection
occurs during the first trimester of pregnancy, it can result in severe congenital defects, Congenital
Rubella Syndrome (CRS). Congenital rubella syndrome in the infant includes but is not limited to eye
manifestations (cataracts, glaucoma, retinitis), congenital heart defects, hearing loss, microcephaly, and
intellectual disabilities. M-M-R II vaccine contains live attenuated measles, mumps and rubella viruses. It
is not known whether M-M-R II vaccine can cause fetal harm when administered to pregnant woman.
There are no adequate and well-controlled studies of M-M-R II vaccine administration to pregnant
women.
5
All pregnancies have a risk of birth defect, loss or other adverse outcomes. In the US general
population, the estimated background risk of major birth defects and miscarriage in clinically recognized
pregnancies is 2% to 4% and 15% to 20%, respectively.
Available data suggest the rates of major birth defects and miscarriage in women who received
M-M-R II vaccine within 30 days prior to pregnancy or during pregnancy are consistent with estimated
background rates (see Data).
Data
Human Data
A cumulative assessment of post-marketing reports for M-M-R II vaccine from licensure 01 April 1978
through 31 December 2018, identified 796 reports of inadvertent administration of M-M-R II vaccine
occurring 30 days before or at any time during pregnancy with known pregnancy outcomes. Of the
prospectively followed pregnancies for whom the timing of M-M-R II vaccination was known, 425 women
received M-M-R II vaccine during the 30 days prior to conception through the second trimester. The
outcomes for these 425 prospectively followed pregnancies included 16 infants with major birth defects, 4
cases of fetal death and 50 cases of miscarriage. No abnormalities compatible with congenital rubella
syndrome have been identified in patients who received M-M-R II vaccine. Rubella vaccine viruses can
cross the placenta, leading to asymptomatic infection of the fetus. Mumps vaccine virus has also been
shown to infect the placenta {14}, but there is no evidence that it causes congenital malformations or
disease in the fetus or infant .
The CDC established the Vaccine in Pregnancy registry (1971-1989) of women who had received
rubella vaccines within 3 months before or after conception. Data on 1221 inadvertently vaccinated
pregnant women demonstrated no evidence of an increase in fetal abnormalities or cases of Congenital
Rubella Syndrome (CRS) in the enrolled women {15}.
8.2 Lactation
Risk Summary
It is not known whether measles or mumps vaccine virus is secreted in human milk. Studies have
shown that lactatingpostpartum women vaccinated with live attenuated rubella vaccine may secrete the
virus in breast milk and transmit it to breast-fed infants.{16,17} In the breast-fed infants with serological
evidence of rubella virus vaccine strain antibodies, none exhibited severe disease; however, one
exhibited mild clinical illness typical of acquired rubella.{18,19}
The developmental and health benefits of breastfeeding should be considered along with the mother’s
clinical need for M-M-R II, and any potential adverse effects on the breastfed child from M-M-R II or from
the underlying maternal condition. For preventive vaccines, the underlying maternal condition is
susceptibility to disease prevented by the vaccine.
8.4 Pediatric Use
M-M-R II vaccine is not approved for individuals less than 12 months of age. Safety and effectiveness
of measles vaccine in infants below the age of 6 months have not been established [see Clinical Studies
(14)]. Safety and effectiveness of mumps and rubella vaccine in infants less than 12 months of age have
not been established.
8.5 Geriatric Use
Clinical studies of M-M-R II did not include sufficient numbers of seronegative subjects aged 65 and
over to determine whether they respond differently from younger subjects.
11 Description
M-M-R II vaccine is a sterile lyophilized preparation of (1) Measles Virus Vaccine Live, an attenuated
line of measles virus, derived from Enders' attenuated Edmonston strain and propagated in chick embryo
cell culture; (2) Mumps Virus Vaccine Live, the Jeryl Lynn™ (B level) strain of mumps virus propagated in
chick embryo cell culture; and (3) Rubella Virus Vaccine Live, the Wistar RA 27/3 strain of live attenuated
rubella virus propagated in WI-38 human diploid lung fibroblasts. {20,21} The cells, virus pools,
recombinant human serum albumin and fetal bovine serum used in manufacturing are tested and
determined to be free of adventitious agents.
After reconstitution, each 0.5 mL dose contains not less than 3.0 log10 TCID50 (tissue culture infectious
doses) of measles virus; 4.1 log10 TCID50 of mumps virus; and 3.0 log10 TCID50 of rubella virus.
Each dose is calculated to contain sorbitol (14.5 mg), sucrose(1.9 mg), hydrolyzed gelatin (14.5 mg),
recombinant human albumin (≤0.3 mg), fetal bovine serum (<1 ppm), approximately 25 mcg of neomycin
and other buffer and media ingredients. The product contains no preservative.
6
12 CLINICAL PHARMACOLOGY
12.1 Mechanism of Action
M-M-R II vaccination induces antibodies to measles, mumps, and rubella associated with protection
which can be measured by neutralization assays, hemagglutination-inhibition (HI) assays, or enzyme
linked immunosorbent assay (ELISA) tests. Results from efficacy studies or effectivenes s studies that
were previously conducted for the component vaccines of M-M-R II were used to define levels of serum
antibodies that correlated with protection against measles, mumps, and rubella [see Clinical Studies (14)].
12.6 Persistence of Antibody Responses After Vaccination
Neutralizing and ELISA antibodies to measles, mumps, and rubella viruses are still detectable in 95-
100%, 74-91%, and 90-100% of individuals respectively, 11 to 13 years after primary vaccination. {22-28}
13 NONCLINICAL TOXICOLOGY
13.1 Carcinogenesis, Mutagenesis, Impairment of Fertility
M-M-R II vaccine has not been evaluated for carcinogenic or mutagenic potential or impairment of
fertility.
14 CLINICAL STUDIES
14.1 Clinical Efficacy
Efficacy of measles, mumps, and rubella vaccines was established in a series of double-blind
controlled trials. {29-34} These studies also established that seroconversion in response to vaccination
against measles, mumps and rubella paralleled protection. {35-38}
14.2 Immunogenicity
Clinical studies enrolling 284 triple seronegative children, 11 months to 7 years of age, demonstrated
that M-M-R II vaccine is immunogenic. In these studies, a single injection of the vaccine induced measles
HI antibodies in 95%, mumps neutralizing antibodies in 96%, and rubella HI antibodies in 99% of
susceptible individuals.
A study of 6-month-old and 15-month-old infants born to mothers vaccinated with a measles vaccine in
childhood, demonstrated that, following infant and toddler vaccination with Measles Virus Vaccine, Live
(previously US-licensed, manufactured by Merck), 74% of the 6-month-old infants developed detectable
neutralizing antibody titers while 100% of the 15-month-old infants vaccinated with Measles Virus
Vaccine, Live or M-M-R II vaccine developed neutralizing antibodies {39}. When the 6-month-old infants
of immunized mothers were revaccinated at 15 months with M-M-R II vaccine, they developed antibody
titers similar to those of toddlers who were vaccinated previously at 15-months of age.
15 REFERENCES
1. General Recommendations on Immunization, Recommendations of the Advisory Committee on Immunization Practices, MMWR
43(RR-1): 1-38, January 28, 1994.
2. Measles, Mumps, and Rubella — Vaccine Use and Strategies for Elimination of Measles, Rubella, a n d Co n g e nita l Ru b e lla
Syndrome and Control of Mumps: Recommendations of the Advisory Committee on Immunization Practice s (ACIP), M M WR
47(RR-8): May 22, 1998.
3. Kelso, J.M.; Jones, R.T.; Yunginger, J.W.: Anaphylaxis to measles, mumps, and rubella vaccine mediated by IgE to gel atin , J.
Allergy Clin. Immunol. 91: 867-872, 1993.
4. Bitnum, A.; et al: Measles Inclusion Body Encephalitis Caused by the Vaccine Strain of Measles Virus. Cl i n . In fect. Di s. 2 9 :
855-861, 1999.
5. Angel, J.B.; et al: Vaccine Associated Measles Pneumonitis in an Adult with AIDS. Annals of Internal Medicine, 129: 1 0 4 -1 06 ,
1998.
6. Cecinati V, et al. Vaccine administration and the development of immune thrombocyto pe ni c p urp u ra i n ch i ld re n. Hu m an
Vaccines & Immunotherapeutics 9:5, 2013.
7. Mantadakis E, Farmaki E, Buchanan GR. Thrombocytopenic Purpura after Measles-Mumps-Rubella Vaccination: A Systematic
Review of the Literature and Guidance for Management. J Ped 156(4): 2010.
8. Andrews N, Stowe J, Miller E, Svanstrom H, Johansen K, Bonhoeffer J, et al. A collaborative approach to investigating th e ri sk
of thrombocytopenic purpura after measles-mumps-rubella vaccination in England and Denmark. Vaccine. 2012;30:3042‐6.
9. Rubella Prevention: Recommendation of the Immunization Practices Advisory Committee (ACIP), MM WR 3 9 (RR-1 5 ): 1 -1 8 ,
November 23, 1990.
7
10. Peter, G.; et al (eds): Report of the Committee on Infectious Diseases, Twenty-fourth Edition, American Academy of Pediatri cs,
344-357, 1997.
11. Measles Prevention: Recommendations of the Immunization Practices Advisory Committee (ACIP), MMWR 38(S-9): 5-22,
December 29, 1989.
12. Eberhart-Phillips, J.E.; et al: Measles in pregnancy: a descriptive study of 58 cases. Obstetrics and Gynecology, 82(5): 797-801,
November 1993.
13. Jespersen, C.S.; et al: Measles as a cause of fetal defects: A retrospective study of ten measles epidemics in Greenland. Acta
Paediatr Scand. 66: 367-372, May 1977.
14. Yamauchi T, Wilson C, Geme JW Jr. Transmission of live, attenuated mumps virus to the hu m a n p l ace n ta . N En g l J M e d .
1974;290(13):710‐712.
15. Rubella Vaccination during Pregnancy —United States, 1971-1988. JAMA. 1989;261(23):3374–3383.
16. Losonsky, G.A.; Fishaut, J.M.; Strussenber, J.; Ogra, P.L.: Effect of immunization against rubella on lactation products. II.
Maternal-neonatal interactions, J. Infect. Dis. 145: 661-666,1982.
17. Losonsky, G.A.; Fishaut, J.M.; Strussenber, J.; Ogra, P.L.: Effect of immunization against rubella on lactation products. I.
Development and characterization of specific immunologic reactivity in breast milk, J. Infect. Dis. 145: 654-660, 1982.
18. Landes, R.D.; Bass, J.W.; Millunchick, E.W.; Oetgen, W.J.: Neonatal rubella following postpartum maternal i mm un izatio n , J.
Pediatr. 97: 465-467, 1980.
19. Lerman, S.J.: Neonatal rubella following postpartum maternal immunization, J. Pediatr. 98: 668, 1981. (Letter)
20. Plotkin, S.A.; Cornfeld, D.; Ingalls, T.H.: Studiesof immunization with living rubella virus: Trialsin children with a strain culture d
from an aborted fetus, Am. J. Dis. Child. 110: 381-389, 1965.
21. Plotkin, S.A.; Farquhar, J.; Katz, M.; Ingalls, T.H.: A new attenuated rubella virus grown in human fi bro b la sts: Evi d e n ce fo r
reduced nasopharyngeal excretion, Am. J. Epidemiol. 86: 468-477, 1967.
22. Weibel, R.E.; Carlson, A.J.; Villarejos, V.M.; Buynak, E.B.; McLean, A.A.; Hilleman, M.R.: Clinical and Labo ra tory Stu d ie s o f
Combined Live Measles, Mumps, and Rubella Vaccines Using the RA 27/3 Rubella Virus, Proc. So c. Exp . Bi ol. M e d. 1 6 5 :
323-326, 1980.
23. Watson, J.C.; Pearson, J.S.; Erdman, D.D.; et al: An Evaluation of Measles RevaccinationAmong School-Entry Age Ch i ld re n,
31st Interscience Conference on Antimicrobial Agents and Chemotherapy, Abstract #268, 143, 1991.
24. Unpublished data from the files of Merck Research Laboratories.
25. Davidkin, I.; Jokinen, S.; Broman, M. et al.: Persistence of Measles, Mumps, and Rubella Antibodies in a n M M R -Va ccina ted
Cohort: A 20-Year Follow-up, JID 197:950–6, April 2008.
26. LeBaron, W.; Beeler J.; Sullivan, B.; et al.: Persistence of Measles Antibodies After 2 Doses of Measles Vaccine in a
Postelimination Environment, Arch Pediatr Adolesc Med. 161:294-301, March 2007.
27. LeBaron, C.; Forghani, B.; Beck, C. et al.: Persistence of Mumps Antibodies after 2 Doses of Measles-Mumps-Rubella Vaccine,
JID 199:552– 60 , February 2009.
28. LeBaron, W.; Forghani, B.; Matter, L. et al.: Persistence of Rubella Antibodies after 2 Doses of Measles-Mumps-Rubella
Vaccine, JID 200:888–99, September 2009.
29. Hilleman, M.R.; Buynak, E.B.; Weibel, R.E.; et al: Development and Evaluation of the Moraten MeaslesVirusVa cci n e , JAM A
206(3): 587-590, 1968.
30. Weibel, R.E.; Stokes, J.; Buynak, E.B.; et al: Live, Attenuated Mumps Virus Vaccine 3. Clinical and Serologic Aspects in a Fiel d
Evaluation,N. Engl. J. Med. 276: 245-251, 1967.
31. Hilleman, M.R.; Weibel, R.E.; Buynak, E.B.; et al:Live, Attenuated Mumps VirusVaccine 4. ProtectiveEfficacy as Measure d i n
a Field Evaluation, N. Engl. J. Med. 276: 252-258, 1967.
32. Cutts, F.T.; Henderson, R.H.; Clements, C.J.; et al: Principles of measles control, Bull WHO 69(1): 1-7, 1991.
33. Weibel, R.E.; Buynak, E.B.; Stokes, J.; et al: Evaluation Of Live Attenuated Mumps Virus Vaccine, Strain Jeryl Lynn, First
International Conference on VaccinesAgainst Viral and Rickettsial Diseases of Man, World Health Organization, No. 147, M a y
1967.
34. Leibhaber, H.; Ingalls, T.H.; LeBouvier, G.L.; et al: Vaccination With RA 27/3 Rubella Vaccine, Am. J. Dis. Child. 123: 133-1 3 6,
February 1972.
35. Rosen, L.: Hemagglutination and Hemagglutination-Inhibition with Measles Virus, Virology 13: 139-141, January 1961.
36. Brown, G.C.; et al: Fluorescent-Antibody Marker for Vaccine-Induced Rubella Antibodies, Infection and Immunity 2(4): 360-363,
1970.
8
37. Buynak, E.B.; et al: Live Attenuated Mumps Virus Vaccine 1. Vaccine Development, Proceedings of the Society for
Experimental Biology and Medicine, 123: 768-775, 1966.
38. Hilleman M.R., Studies of Live Attenuated Measles Virus Vaccine in Man: II. Appraisal of Efficacy. Amer. J. o f Pu b l ic He a lth ,
52(2):44-56, 1962.
39. Johnson, C.E.; et al: Measles Vaccine Immunogenicity in 6- Versus 15-Month-Old Infants Born to Mothers in the Measles
Vaccine Era, Pediatrics, 93(6): 939-943, 1994.
16 HOW SUPPLIED/STORAGE AND HANDLING
No. 4681 ⎯ M-M-R II vaccine is supplied as follows:
(1) a box of 10 single-dose vials of lyophilized vaccine (package A), NDC 0006-4681-00
(2) a box of 10 vials of diluent (package B)
Exposure to light may inactivate the vaccine viruses.
Before reconstitution, refrigerate the lyophilized vaccine at 36°F to 46°F, (2°C to 8°C).
Store accompanying diluent in the refrigerator with the lyophilized vaccine or separately at room
temperature (68° to 77°F, 20° to 25°C). Do not freeze the diluent.
Administer M-M-R II vaccine as soon as possible after reconstitution. If not administered immediately,
reconstituted vaccine may be stored between 36°F to 46°F (2°C to 8°C), protected from light, for up to 8
hours. Discard reconstituted vaccine if it is not used within 8 hours.
For information regarding the product or questions regarding storage conditions, call 1-800-
MERCK-90 (1-800-637-2590).
17 PATIENT COUNSELING INFORMATION
Advise the patient to read the FDA-approved patient labeling (Patient Package Insert).
Discuss the following with the patient:
• Provide the required vaccine information to the patient, parent, or guardian.
• Inform the patient, parent, or guardian of the benefits and risks associated with vaccination.
• Question the patient, parent, or guardian about reactions to a previous dose of M-M-R II vaccine
or other measles-, mumps-, or rubella-containing vaccines.
• Question females of reproductive potential regarding the possibility of pregnancy. Inform female
patients to avoid pregnancy for 1 month following vaccination [see Contraindications (4.5) and
Use in Specific Populations (8.1)].
• Inform the patient, parent, or guardian that vaccination with M-M-R II may not offer 100%
protection from measles, mumps, and rubella infection.
• Instruct patients, parents, or guardians to report any adverse reactions to their health-care
provider. The U.S. Department of Health and Human Services has established a Vaccine
Adverse Event Reporting System (VAERS) to accept all reports of suspected adverse events
after the administration of any vaccine, including but not limited to the reporting of events required
by the National Childhood Vaccine Injury Act of 1986. For information or a copy of the vaccine
reporting form, call the VAERS toll-free number at 1-800-822-7967, or report online at
https://www.vaers.hhs.gov.
For patent information: www.merck.com/product/patent/home.html
Copyright © 1978-2020 Merck Sharp & Dohme Corp., a subsidiary of Merck & Co., Inc.
All rights reserved.
uspi-v205c-i-2006r009
Craig Harrison Jul 2014
What is love?
I think it's a virus
infecting so many people
and yet so many are immune.
Left untreated it can lead to a broken heart.
What is love?

We act like it no longer means anything
but we feel it
for friends, family, pets or that special someone,
arguments cause us pain
it can hurt more than we thought, a broken heart

WHAT IS LOVE?
I THINK IT'S A VIRUS
Josiah W Menzies Mar 2013
You grip my throat sporadically, erratically – not often.
And trickle in through passages and pores I can’t defend.
Treacle through fingers.
But you avoid me too, and I hate it just as much.

I wait for your hand to loosen,
I breathe cool air,
Then I feel your absence.

Your gloopy venom is addictive.
I tasted you once, and now my tongue yearns,
And eats itself –
It flickers and twists and spits its serpentine-self out. In vain.
A vague, dull shadowy lustre remains,
Undulating under baited breath,
For another foul injection.

In reality I fear you. I despise you. I hate you.
If you’d only never return,
I could spit you out forever,
And tongue sweeter, healthier, more benign stuff.
No more swilling,
No more idiosyncratic sways upon social norms,
High Society and empty smiles that stifle natural intentions.

You are a disease, and far from untreated.
You are the last drag, the last hit,
The very last dose that no one actually wants.

I rebuke myself wholeheartedly
At even entertaining the idea of having you in my company. Yet there you are –

In every message, in every ransacked draw,
In every turned out rucksack, every old coat pocket,
Every ***** shirt, every unstitched button,
In every visitor’s news, every car back-seat,
Every dusty notebook, every empty fruit-bowl,
Every old, long-unseen smile, every dowsed fire,
Every man woman and child I sit across the table from.

There you are. Somehow. In some form.
Turning my sweat cold like cheap wine,
In what is otherwise an already disturbingly depressing
Struggle to maintain some kind of equilibrium or serenity,
Let alone with your smug mug cropping up scornfully uninvited.

You ****** me before I recognise you.
Helping yourself to the food on my plate with a wink,
While I do nothing as if handcuffed, and chained at the soul.
Then I move to eat.
Hand to fork.
Fork to mouth.
And it tastes of you.
It reeks of you.
And if I were anything but human,
I’d spit you out onto the kitchen floor,
Stamp on the bile you’ve stolen from me,
Burn you with kerosene,
And wage a third world war on the very concept of you ever existing.

But I am a human.
And moments later you have me
‘******* and thinking of death’
As coy and Marvellian as you like.

I indulge in full-knowing paralysis,
Lapping up your unvanquished honeyed venom,
With a voraciousness that redefines Lovesick –
Giving it a whole new meaning
Going beyond the epitome of disgust.

Enslaved, you have me smash myself against the ceiling.
And eat myself over again from within.
Consuming me like the fire I found you in.

You have me rage and conspire against those I don’t know.
But I will conspire against you one-day.
You have me hate others, but I will forever hate you.
You have me search my soul and grate it upon street corners
And the pavement of city-centres,
While you gleefully, whimsically **** my past
Or polish vain, rose-tinted hopes that without you
I’d know were futile and unjust –
Until I ruin them myself, knowing all the while
That you are the author of my unnecessary devastations.

But I will smash your green demonic skull into obsolescence
In some back-alley where none will find your
Bubbling frothing corpse.
You will be utterly repudiated even by the rats.
And the flies will drop you,
Iota
By
Iota,
Onto the tracks at Dalston to be rendered into absolute oblivion.
And I will go, a man unshackled, about my business –
Whether it be of importance or not,
It will be with a conscience cleansed.

But for now, vile sham of an emotion that you are,
I do your inglorious bidding.
Zombified and putrid, my actions smell of you.
They reek of you.

You intoxicate what should be left alone
And endured with silence and rapidity.
Yet you elongate these private, personal trails torturously,
In some sensational Cold War.

It goes without saying,
The world would be well rid of you.
Yet godlike, you endure the ages
Just as we endure you.

Perhaps Keats was too afraid to admit it –
You are the original
La Belle Dame Sans Merci.
Pluto’s daughter in persistent disguise.
To be seen presently
‘******* and thinking of death’.
Nigel Morgan Dec 2012
There was this time before the going home. The supers bowled off with cheery parents or elder brothers a good fortnight before the big day. There were lessons, but despite the best efforts of the staff who remained nobody could take this between time seriously. Mr Gayford for maths was hardly a substitute for Alfie's lively lessons. But Alfie we knew was climbing in the Alps this Christmas and would return with photos and tales that kept us enthralled despite the sums he invented - calculate the air pressure at 4107 metres on the Jungfrau. We all loved him with his self-raising Citroen Safari that smelt enticingly of Gitanes and that scent Claudia his girlfriend favoured. Oh Claudia, so wonderfully and exotically dressed, who seemed a world away from any boy's mother or sister.
 
Mornings were quite different. A later breakfast and then a two-hour practice with Dr. B . Hard work, with new music to learn. But the carols! Oh those sounds, and so different from what we sang all year. Boris Ord's Adam lay y bonden, Praetorius A Great and Mighty Wonder, Torches, In Dulce Jubilo. and as Advent progressed that magical verse anthem by Orlando Gibbons This is  the Record of John.
 
I was just eleven when Dr. B said, as we opened the music folder for the morning rehearsal, 'St Clair, Can you do this for us please?' Not so much a question as a command; you didn't say no to Dr. B. The introduction was well underway before I grasped it was to be me. How I stumbled through it that first time I don't know. I could never hear this piece without tears welling or indeed falling. ' Look Mog is getting tearful' said Richards the head chorister, and the little boys would snigger. And I would blush:  through my freckles to the roots of my auburn gold hair. Did nobody understand what this music did to me, what it said and expressed? At eleven I think I had began to know, and later when I heard it in Kings Chapel, and then conducted it variously to those bemused American students, listened to my gramophone recording, its affect always, always the same. I was experiencing truly what Vikram Seth has called an equal music, something so entirely right, a true conjunction of words and music, a coming together beyond anything as a composer I could ever imagine, a yardstick life-long; it became an acid test of sensitivity to my love of music and has been passed only four times by serious friends and lovers. To know me you must know and feel this music . . .
 
And so on the second Sunday of Advent at Evensong I sang this jewel, this precious flower of music's art. The candles flickered in Her Majesty's chapel and we stood for the anthem. The chamber ***** began its short introduction already weaving together the four-part texture - and then the first solo statement. This is the record of John when the Jews sent priest and Levites from Jerusalem . . . and then the tears fell and the music swam in front of me as though glazed in the candlelight.
 
Who art thou then? And he confessed and denied not, and said plainly, 'I am not the Christ'.
 
Oh that melisma on the 'I', that written out ornament, so emphatic, and expressing this truth with innocent authority. I sang it then as I hear it now. Nobody had to demonstrate and say 'Don't let it flow, let each note be separate, exact, purposeful'. So it was and ever shall be, Amen.
 
And they asked him, What art thou then? (Art thou Elias? x 2). And he said I am not. ( Art thou the prophet? x 2) And he said I am not.
 
The verse anthem is such a peculiar phenomenon of the English Reformation. Devised it is said to allow the hard-pressed choirmaster to train the main body of his singers in a short response, the soloist singing the hardest and most expressive music on his own: the verse. It is also so well suited to the English choral tradition with its Cantores and Decani ordering of voices. I was always a ‘Can’, even later when I joined the back row as a tenor.
 
Then they said unto him, What art thou? That we may give an answer unto them that sent us. What sayest thou of thyself? And he said I am the voice of him that cryeth in the wilderness. Make straight the way if the Lord.
 
And so I wonder still about the place of this text in the liturgy of Advent and why, cloaked in Gibbons’ music, it has remained affecting and necessary. And who is John? a prophet of the desert, the son of Elizabeth to whom Mary went to share the news of her pregnancy and whose own son quickened in her womb as she heard of her cousin Elizabeth's own miracle - a childless woman beyond childbearing age unexpectedly blessed and whose partner struck dumb for the duration of her confinement. Is it just another piece in the jigsaw of the Christmas story in which prophecy takes its part?
 
When I was eleven I thought to 'cry in the wilderness' meant exactly that - tears in a desert place. I learnt later that this was a man who stood apart, was different, a hippie dressed in the untreated skins of wild beasts, who lived amongst those who sought the wild places to mourn, to place themselves in a kind of quarantine after illness or bereavement, who then became wise, and who cried.
 
Such meditations seem appropriate to the season when there is so often the necessity of travel, much waiting about, the bearing down of the bleakness of winter time, though strung about with moments of delicious warmth when coming in from the cold as with the chair by the library fire I craved as a chorister to escape blissfully into fictioned lives and exotic places.
 
How these things touch us vividly throughout our lives; as we watch and wait and listen.
Cody Haag Feb 2017
His eyes penetrate the mirror,
And the glass penetrates him back.
Tears rain down his cheeks,
And his semblance undergoes a crack.

His head hits the pillow,
His eyelashes flutter along to dreams.
Mother watches with weepy eyes,
Then sunlight through the window beams.

His heart flutters like a leaf in a breeze,
Excited by the man before his eyes.
For years he has struggled
With this affection he was taught to despise.

Even as his heart tells him what to do,
The boy continues to hide his truth.
It seems there is much to lose,
It seems a way to ruin his youth.

But the secret ails him—
A condition untreated.
Without exploration,
His heart remains defeated.

Destruction clasps onto him, an iron grip,
And his demons come alive.
He begins to hate himself,
Struggling to survive.

Hatred finds him during his adolescence—
Like a deadly blade wishing him dead.
To survive, he learns a simple truth—
His beliefs must be shed.

Now a cloak of happiness hangs from his shoulders—
His boyfriend is in his arms.
He has parted with society’s silly notions,
Of which only dealt him harm.
Rapunzoll May 2015
Love me so deeply it hurts
I want raw love,
Love that festers like an open wound
if left untreated

Crave me like a smoker
who can't quit their bad habits
I'll be your nicotine
If you keep coming back for more

Touch me like I'm the masterpiece
of the art museum
They tell you not to touch
but you can't resist

Experience me like a joy ride
a rare kind of high
Let our love kindle like a flame
don't let it blow out
© copyright
Xander King Jul 2015
When I was a Girl who's only super power was sleeping and crawling
My mother passed away
Left my father to raise two young children all on his own
He gave up everything for us
Sold the restaurant he had spent years saving to build
The motorcycle he swore would always be his
The one that set off car alarms and ******* neighbors.

When I was a girl who's greatest superpower was my ability to make imaginary friends
I thought my dad was superman
He fixed scraped knees
Fended off scary bugs
And beat impossible levels on video games.
I never realized it but he did more noble feats than kiss booboos and squish spiders.
Money never came easy to us, most of the time my father stayed unemployed so he could raise two children with love
Raised us on the retirement from fighting like captain America for our country

When I was a girl who's super power consisted of seeing the good in the world I always wondered why my dad didn't eat with us most days
Or why the lights sometimes went off
And water was cold
I know now that my superhero chose to pay for food for us over bills
And spread Mac and cheese boxes to last a lifetime
He gave up the comfort of food so we could have full tummies
And for that I'll always be grateful

When I was a girl who's super power was selfishness
I hoped for a mother
Wished on every birthday cake and shooting star
Praying to one day have a mom.
I paid the price for my selfishness
My wish came true the day my dad brought his new fiancé home

When I was a girl who's superpower was invisibility
My stepmother told me my mom never wanted me
Called her a useless **** head
And called me stupid.
I saw my father less and less
And At first he swooped in to save me from the wounds of her words.
But she stole his cape.

I am a girl with the power to masquerade as a woman now
And I speak only a few words to my father a week
My stepmothers words still wound me
But she is my fathers kryptonite
Stripping him of his powers leaving behind a tired man.
she has pulled our family from poverty and for that I'm grateful
But I'll never forgive her being the reason my fathers cape lay folded in the closet.
And every time I hear my father say he misses me it sounds like an apology for the last six years!
And when I say it back
I hope he can hear the begging to see him more.
My dad used to tell me he loved me every night before I went to sleep
Now we go days without saying it.
Without seeing each other
And now every time I hear it whispered under his breath as he gives a quick hug so the hulk doesn't see
It still sounds like the booming voice of the hero who carried me all the way home at three after getting stung by a wasp on the webbing of my finger and sobbing like I was going to die
And I feel the lump in my throat swell every time I echo it back like sonar
And can still see whisps of a cape behind him as he diffuses dr.dooms time bomb by saying the dish in the sink is his and sneaking me a wink.
I refuse to lose my dad to distance before I lose him to disease.

I am a girl learning how to control the power of the world around me
My father is dying.
Liver giving out from years of untreated disease after years of putting his health aside.
And he pulls oh his cape every time he smiles like a rain after a 100 year drought and tells me
'I'll be okay. You know I'm invincible.'
And I always say that I do forcing insincerity out of my voice.
I can see the weight of the cape he has worn for so long take its toll
His back is arching from the weight of having to be strong
A bulletproof savior of this family.
So I will take it from him.
Bear the burden of being strong and putting others needs before me.
I will shelter him under it whenever deadshot's bullets of insults come flying.
Because even though at times I thought I lost him.
With or without a cape
My farther is still my hero.

And I am a girl learning to be his.
late fathers day thing.. He'll never read this.
MissMalice Feb 2015
Quite admirable , awe-inspiring , a divine piece of manufacture
It’s capriciousness is an equivalent of swooning of rapture

This carpet conveys itself as flawless , the fragrance is pleasant

The glossy finish generates a yearning to have it present

The blissful texture is mesmerizing , subject to perfect knitting

Not to mention it’s size is perfectly fitting

~

Though the alternative side seems worn and tattered

And the fabric surrounding is scattered

There are pockets and splits

There are strewed fiber bits

Along the edges are multicolored spots

And the yarn had formed knots

~

At that point the onlooker would become flustered helplessly

Were they to take it into their tenancy ?

Sure it was depleted

And maybe it was slightly untreated

Though it was equally handsome

Despite it’s opposing filthy expansion


~


Then the beholder would ponder a tad

And realize the flaws weren't so bad

They were to be contemplated abnormally

Though as well stood out morbidly

The allotment seemed now suitable

And each side was mutable
Designed to stand metaphoric for point of view among society
Two Blue Beams
rise in the twilight
from dark recesses
of a wounded city

astral projections
paint night clouds
in looming hues
of temporal intent

declarative beams
affirm a bold portent
of an insistent will
and timeless aspirations

one thrusting light
projects wanton determination
bequeathed from unhealed wounds
of a lacerated city

the other casts fervent hope
onto the vast celestial sea
boldly etching upon the heavens
an earnest nations highest ideals

the pillars of light
reveal the dual nature
fixing our place
in a turbulent universe

the brighter light
affirms the beneficence
of liberty's eternal grace
so divinely conferred

received by a higher self
accepted with gratitude
the gracious anointing
of freedoms rich abundance

ride this beam with angry cries
conjure ghosts from a dead past
channel a full measure of resent
its power of restoration is quelled

stirred from nagging agonies
nursed with righteous indignation
untreated wounds fester
the weak blue spire cannot heal

a bleak azure apparition
screams for selfish retribution
heed this dire admonition
a promised fury of
full demonic dimension

the rankled city
yearns to come together
united in communion
around these lights

drawn to the blue flames
like swirling moths
unconscious of what
compels shock and awe

earnest yearnings
flutter to exhaustion
struggle toward the light
aspiring to heal in the inviting glow

transcending the fissures
of our fractured nation
the waning resolve
of a national will

a restless Zeitgeist
cannot be repressed
nor will it relinquish
its will to manifest

a city's fondest hopes
entombed in collective memory
is foretold again
around these bold lights

entranced by the light
a solemn urban campfire
transfixed and sealed
we speak our hearts

holding hands
gnashing teeth
we bite into
our bent knees
tucked up
to sullen chests
heavy hearts
bear pains of loss
dreary tears wash
ash stained cloths
crumpled photos
dear bereavements
of faded memories
and expired hope

resolve is renewed
in bursts of pride
incendiary nationalism
suppress dissent
pummel thoughts
of perceived sedition
pump iron fists as
zealous sledgehammers
forged with conviction
in kilns of
righteous indignation
seething with infected
emotional hangovers
from prurient
tribal diatribes

these sweet sentiments
swing between the polls
of the vast pendulum's arc
along a narrow celestial scale

too and fro
angst and expectation
ebbs and flows
in this astral assignation

the heavenly helix
a set of blue axles
a modern vision
of Ezekiel's Wheel

the rung-less vertices
of our Jacob's Ladder
invites all citizens
to climb again

ascend this pathway
in the company of angels
arrive transfigured
renewed again

build new cities
transcendent destinations
new Edens await
pioneers to explore

fearless pilgrims
sojourn onward
moving to secure
liberty for all

conscious stewards
of the blessed good earth
celebrate rich diversity
of all the beloved

descending back
to an expired past
is a ridged stasis
anchored in Hell

witness flitting
nostalgic phantoms
pathetic pantomimes
of histrionic fictions

the downward path
of the lesser light
tethers us to the place
we cannot leave

The upward light
abhors a hells decent
resolved to vacate
acrimony and hate

the dancing helix opens
a blue portal to heaven
don saintly garb
wing upward in light

transcendence calls us
to traverse with angels
touch the luminescent hem
of God's divine robe

Selah

Music Selection:
Aaron Copland: Appalachian Spring , Simple Gifts

NYC
9/11/10
jbm
void Jan 2019
writhing in pain
i remembered vividly
what the doctor had said to me
"you have manic depression
but you are too young"
and then she walked out

i was thirteen
i didn't know
what that meant

so i tossed in bed
and ate my blanket
but not the food they served me
because if i ate food
then i wouldn't be
pretty
like her

"you can't touch each other
not even fingertips"
i needed love
from someone who knew
my struggle
they took that opportunity away
(for another few months)

"your family is here to visit"
i said i didn't want to

"you are in control of
your stay here"
you didn't even
try to stop me
from lying
my way out
you helped me
lie

"you can't listen
to what kept you alive"
why not?
but you can play songs
that describe
****
with the curse words
bleeped out

"we'll give you the others
information if they leave it
for you"
they did
so why don't i have it

"you can't have any
unsupervised utensils"
then tell me
why
did you leave us
a group of
unstable and
freshly medicated
teenagers
alone in a room
with scissors and glue
scared and confused

"you can talk about
anything in group therapy"
then why couldn't i speak
when i was ready?
was it that
i wanted to tell them
how ******* thankful
i was
to be somewhere that
finally
wanted to help
with people like me

"we want to help you get better"
the biggest lie you told
"if the pill doesn't help, just tell us"
you called me an addict
"you can tell us anything"
you made me feel nauseous
"you're safe here"
you made me undress
after visible discomfort
and tears
so you could look
and poke
and ****

"you have manic depression"
but we wont treat you for it

instead, we will treat you for depression
with a touch of
anxiety
because we don't want you better
we just want you away

I have manic depression
Untreated for at least
Four years.
At this rate
And my mental state(s)
It could very well be
Borderline Personality.

I have(had) manic depression
And they took four years
Away from me.
i was in the mental hospital for 6(?) or 8(?) days. it wasn't all bad, it just wasn't good. if any of you have bipolar or bpd and would be open to talking to me please message me. it's scary to realize this.
Kash Dec 2016
Today was pretend
My own display of good health
Treatment taught me stealth
I picked up some bad habits, They were put to use on this food heavy holiday like nobody's business. I'm not proud. So I wrote a Haiku about it.
Lil K-1 Nov 2016
How can you tell me something
That I'm already doing
Why would you yell at me
When you don't have anyway to prove it
I feel untreated
NitaAnn Sep 2013
Just pray harder, Nita....

I have been on edge and triggered all day long…actually all week now…there are a variety of reasons…and the mere fact that it is almost the  weekend tends to steer me toward the ’bad place’ – and I am falling quickly into the darkness tonight.

There’s no comfort tonight, other than in a bottle of wine and a pill box full of ativan...the therapist would tell me, “Nita, there is no reason to be scared. Find your safe place. Listen to your grandmother’s soothing voice.” Nothing to fear? Are you serious? And the safe place comment always cracks me up! Do you really think there was any place ‘safe’ to go then? Where the hell would I find safety in a 2 bedroom, 1 bathroom, filthy trailer? There was NOsafe place. There was no place to hide! Except inside my head.

I should pray about it. That’s what my very religious grandmother would tell me. ”Just ‘pray harder’ Nita.” God answers prayers. Just pray harder, Nita…pray harder. My grandmother was very religious and very private. Don’t ever air your ***** laundry to anyone, well, with the exception of God. Pray harder Nita…pray harder…

Why didn’t God every answer MY prayers?

Why is that?

Because I wasn't "good enough"?

Because I didn't pray LOUD enough?

Because I didn’t pray HARD enough?

Because no one cared!!!!!!

That's why!

No one really cares now either…throw it all in a container, spray some holy water on it, drop to your knees and PRAY.

DON'T you dare tell me that my fear isn't 'real'. Don't you dare tell me that you ‘care’! No one does! And it doesn't matter anyway - no one can accept the 'unacceptable' - apparently not even GOD!

My grandmother was loving...yes, she rocked me, she sang to me when I was sick - she spent every night with me when I was in the hospital repeatedly for recurring kidney infections... because kids that get f@#ked tend to develop recurring UTIs which left untreated lead to bladder infections which then lead kidney infections. She was THERE! But she NEVER asked me! EVER! No one did!
But I guarantee you she fell to her knees every single night and PRAYED for her f@#ked up alcoholic son and her ******* up grandkids.

Just pray harder, Nita. Just pray harder!

Yeah - I should get down on my knees RIGHT NOW! And PRAY For f@#king  RELIEF!

If I'm still breathing tomorrow you'll know HE heard me!
Edna Sweetlove Sep 2015
Barry Hodges goes all autobiographical in this one

O well-renowned upper-class *banlieue
#, gorgeous Gosforth,
(blest suburb of the mighty Novocastrian metropolis
majestically situated on the Northern side
of the glorious industrial River Tyne
which wends its stately way towards the sea
only pausing to absorb greedily the teeming outflow
of the sewage farm at charming South Shields),
Thrice hail to thee##, O uncrowned queen of Northumbria!


And selbstverständlich### Gosforth's greatest claim to fame
In the annals of literature and cultural glory
Is to be the proud birthplace of yours truly,
Barry Hodges, the immortal Bard of Gosforth;
O sweet Mary mother of God (Ave Maria, cha cha cha),
How could I ever forget my dearest memory there,
Of my first immense accidental ****** incurred
Whilst washing myself manfully in the bathtub one day,
Thus causing a really **** teenage soapy squirt?

Let my ardent fans gawp in terror and wonder
At my countless amorous encounters
And their tragic yet inevitable consequences;
How sad must you be reading how mistress after mistress
Comes to a sticky end (to coin an unfortunate phrase)?
And, verily, other blood relatives are not spared:
Aunts, uncles, cousins, siblings, (parents even),
All are prone to going under a runaway bus or charabanc
Or even tumbling into a frothily noisome manhole,
Gargling sadly in eldritch agony as they drown
In lumpy brown-ale-flavoured untreated Geordie sewage.

And yet, one day, un bel di di maggio#### perhap,
I too may encounter a fate too utterly horrid,
Too utterly horrid to contemplate, oy vay#####;
Maybe involving a blunt machete wielded gaily
By some poor demented cuckolded old *******
Whose pathetic bedroom skills have been derided
By his gloating lady wife after a taste of love's Nirvana
At the hands of the magnificent Master ******* (me).

O dear Lord and Father of Mankind######,
Look down kindly on el gran Casanova,
El Señor Hodges, and thus let me complete
My mighty oeuvre of awe-inspiring poems,
Before the Grim Reaper takes me in his arms
Dragging me screaming o'er that sad bourne of no return,
To the shivering shores of the benighted Underworld.
But, take pause for a moment, dear reader:
If that other poetic genius (by which I mean
sweet, sweet William, the Bard of Avon)
Could manage 154 bleeding sonnets no less
(and Christ knows how much else besides)
Before kicking the *******' bucket
(and he poked that Ann Hathaway too,
a right totally tasty piece I have heard
with a gorgeously provocative keester),
Surely I may be permitted to churn out a thousand odes
(thus ensuring a few dozen golden trophies from my peers)?


If I am to be denied my just literary deserts,
Even allowing for the occasional day off
To respectfully attend the odd funeral or two
of exhausted bed partners and bystanders,
(followed by the happier reading of the will
in which I get the benefits so richly due to me
as a just reward for sleeping with some ugly cow
and thereby giving her the treat of her pathetic life),
I think it's totally out of ******* order
And a right liberty to boot, squire.
Some notes to assist my fans:
# A pretentious bit of French.
## A Macbeth reference.
### A pretentious bit of German.
#### A Puccinian reference for those in the know.
##### A Yiddish joke.
###### A reference to a hymn I used to sing at school (in between groping my fellow pupils behind the bikeshed)
Joseph Childress Sep 2014
I need balance
I’m too extreme like my beliefs
Far too sorry to apologize
Forgiveness would be a lie I couldn’t live with

Balancing under pressure became a crushing defeat
Misfires and misdirection can land the highest man beneath
Untreated wounds breed infection
The lessons learned are easy to remember
Dismembered and off-kilter

Unbalanced drunkards lay wasted like death
Effigies of what used to be
¨**** it¨ attitudes
Added to the frustration
Of falling and failing, my fault
I brought shook hands
Like an addict

Moderation is balance
My mode is moody
******* and impatient
I meditated to medicate anger
¨Endangered species fighting for survival!¨
Was the greatest lie I ever told
I fought a war for peace
More violent than buddha’s
And I won
I won a deadly victory

Balance was not built for chaos
I’m a riot, raunchy
What I want no longer haunts me
I’m not a victim of crime
Im the victor
Missteps led me away from destruction
My mistakes were made
To save me
First poem I wrote in 2 years, I've been adding old poems for a while. Excited to be back in the spirit. Hope you Enjoy!
jeffrey robin Sep 2010
what is needed.......?

AND WHO SHALL EVER KNOW?

hidden feelings

in the alley-images the
returning soldiers face the true
nature of the abomination called amerikka

homeless and untreated!



hidden peoples

we

are the mothers and fathers
sisters and brothers

of every human in the world

AS IF WE DONT KNOW!

let us a tell the truest story

revealing

the naked horror

of the beast
Glottonous Jun 2015
An irrational animal gets high
From the ravenous pump of its own tongue,
Nursing wounds of a disease untreated.

His fat meat skulks through marbled corridors
Around eyes that assign value to worth,
Fixated on transactions to be paid.

The ring and flash of victory courses
Through his silken veins and opens his mouth
To swallow the pride of the defeated

Reflection in a puddle of his own
Drool, clinging shakily from toothless dogs,
Addicted to the peak and crash of trade.
American
Whiteness
the greatest mental illness of all time
even before they were diagnosed
the world has become safer
because the world finally
has funded a wall around America
a padded room institution
where the dissociative disorder
can destroy itself
and not everyone else in the process
the casual crisis
is an emergency
whiteness the coup d’état
is wreaking havoc
on the human soul
domesticated whiteness
riskiest to do business with
spilling blood all around the world
quarantine the biohazard
whiteness on its journey of impunity
when my family was most vulnerable
to the morbid lust
of the mental illness of whiteness
we gently genocidally refer to as social construction
which is really the deconstruction
of the black human
and the origins of humanity
American
American built by the pieces of my family
glued and mortared by the blood and sweat
spilled from them
the most dangerous deconstruction site
in the world
biological warfare
spewing
leaking
uncontrollably
contaminating humanity
polluting its evolution
at war with symbiosis
for the purity of fascism sake
a coup d’état called American whiteness
which is also been a long
untreated dissociative disorder
Out walking in the sub-zero cold
Nose hairs sticking together
**** frost visible on fences
Cheeks, feeling like untreated leather
Snow, crunching, underfoot
Eyes, watering as the wind whips
Ripping my tears from my eyes
And stealing feeling from my fingertips

Twenty minutes and I am numb
My thighs are tight and burning
Wind is howling like a banshee
Hitting full force, so I am learning
My ears are on fire beneath my toque
No snow though, too cold to form
Can't wait to get back home
And let the burning finish before I warm

Through it all, without a care
My dog is leading me around
I'm fully covered, and still I hurt
He's leaving gifts upon the ground
His pads must be frozen
His muzzle is a frozen mask
Finding the perfect spot for one last ***
Seems to be his only task

....all I can say is "I'm freezing, and this ****** owes me!!!"
Sheila J Sadr Feb 2015
It leaves on a midnight search and seizure
to rehab in Arapahoe, Wyoming.
It leaves with grimy charcoal high top Converse
and a distasteful orange hunter-green flannel.
              Bloodshot eyed and strung out on residual
******* hidden in the inner brims of his precious nose,
It leaves fingers torn from the doorframe and without
saying a word to her for years.

It arrives a forgotten promise
clean-sobered with a rough pair of brimstone arms
and scarlett-feathered lips.
It arrives gently holding a wooden ring
dark carved in detox and an “I’m sorry, sweetheart.”
              Apologizing thumbs nip tightly down the hem of her hips,
It arrives delicious and inviting like the scent of
fresh pasta on a hot alabaster plate.

It leaves, again,
high and full-bellied satisfied with the final use
of an old habit.
It leaves without a word of those whispered childhood
embraces on young October nights.
              Leather jacket in hand and Oxford shoes out the door,
It leaves — between the scent of
                                         laundried cotton and lavender sage candles —
It leaves
carrying in its dark pockets all her untreated, distasteful addictions too.


September 22, 2014 // 7:04 AM
Inspired by the poem “Where Does Joy Come In?” by Charles H. Webb
SøułSurvivør May 2017
The Dragon's Egg

To understand my addiction
You have to know the
Back-story.

I was born in the dead of
Winter. Wednesday's child...
Full of woe. I was a preemie.
Mom fell on her stomach while
On a chair trying to change a
Lightbulb. As unpreposessing
A child as ever was born...

I won't go into my childhood
Difficulties too much, as they
Might prompt your judgment
Upon my parents. They were
Not really at fault. They did
The best they could based
Upon *their
childhoods and
Limitations....

Mom was sick.
A great deal. The victim of
Horrific migraine headaches
And an undiagnosed (therefore
Untreated) bi-polar condition.
She had aspirations of being an
Actor. She really should never
Have had three children. She
Simply couldn't handle it. I was
Born only 16 months after her
Firstborn, my sister Chris. This
Definitely didn't help matters.
Then, because my little brother
Mark was born just as her
Acting career took off, she had
Much less time for my sister
And I. She had a newborn, a
Career, a husband and
Postpartum depression. Chris
And I (and eventually Mark)
Were neglected. Not really
Mom's fault. It was what
It was...

Dad was a complex man.
A hot-tempered stoic. A hard
Worker who hated manual
Labor. A war hero who also
Became a runner (he would
Become a severe
Alcoholic - an addiction he
eventually overcame).
A generous miser.
A cultured plebian.
A spiritually minded atheist.

I don't blame him. But the
Last dichotomy was our
Downfall. We were
disallowed from church. Went
To an atheist Sunday School.
We learned about all the world
Religions save Christianity.
Or maybe I missed THAT lesson.
But as a result I had no real
Moral compass to live by. My
Parents tried to teach us
Ethical behavior, but because
Jesus and the Holy Spirit weren't
A part of the equation it was
Doomed to failure. One can't
Simply be "moral" or "ethical".
Without Jesus, we are all
Rank sinners. Sorry if this
Offends some of you. But it's
TRUE. Jesus paid the price.
Only faith in Him can make
A person right with the Father.
All else is vanity. My father
Spent his lifetime trying to be
A "good" man. He tried to
Be a "good" husband. A "good"
Father. But his efforts
Always stymied by lack
Of the essential puzzle piece....

JESUS**.
I wanted to read this afternoon,
But this work kept gnawing at
My concentration. Now I can
Go back to reading. Thanks!
oh
the seasons have changed again
ten shades darker and climbing
they forgot who I was
who I am
gaining momentum
the whiteness that used to insist
that I am white
is confused
now they are leaning towards
not letting me be white anymore
till next season all over again
but this is the season of darkness
I can see it in their eyes
hear it in their voices
mostly being black in America
has been the epitome
of non violent resistance
in the season of darkness
non violent coping mechanisms
to a violent abuser
an abuser
called law
called psychology
called whiteness
called economy
untreated domestic abuse
whiteness calls honors history
dissociating from the repair work
that the American family must face
ever since I was a little
itsy-bitsy - innocent boy
the thought
the imagination
of being able to take out
a militia of whiteness
with my body alone
if and when they get as worse as they are
always prepared for the worst of whiteness
no matter what you say
cannot fool me
can I be more violent?
better at it
so I can sleep for a little while
dreams like some of the white kids
except lucid
In the season of darkness
I can prove it all wrong
the whiteness
its story
the companies it keeps
I can breathe a whole new world out
and breathe in clarity
in the season of darkness
my afros
my mohawks
mean something different
suddenly
my worth
is being threatened with an officer’s gun
peacefully letting handcuffs on
violently beaten afterward
hand over mouth
face in the cement
should out of socket
sciatic nerve damage forever
put in a cell
for the trauma
to reverberate
and echo
back into itself
in the season of darkness
whiteness was overwhelmed
without fear
domino affected
occupied whiteness
brought it down to its knees
that one percent of whiteness
is enough to get us all killed
America
in the season of darkness
www.barnesandnoble.com/w/escape-from-liberty-elan-gregory/1125516297?ean=9780997491623
Graff1980 Feb 2015
We are human
Walking traumas
Left untreated
Open wounds
Being leeched
To treat
The wrong fever
It is incongruous
Being inoculated
Against the wrong disease
Vaccinated with apathy
So we don’t feel
The sores that bleed

But you have to laugh

We are mortal
Not merely men
Nor women
More like
All the things
Around and in-between
Searching
Sub-consciously
For peace
Trying to sustain ourselves
While losing
Everyone else
Crying

But you have to laugh

We are little boxes of flesh
Lego people made to fit together
Chipped
Scratched
Lost and found
Each stress tearing at our flesh
Rending our skin
Like a thresher
Building internal and external pressure
Till we need release
****** and or emotional

But you have to laugh

Ready to cry
Sometimes
We are ready to die
Till the brain twitches
Till the broken switches
Leave you in stiches
And you see something strange
Irony or absurdity
Life twisted in its purity
On the verge of exploding
Not really knowing
But something hits
Something fits
Presses the right button
Slapstick
Stupidity
Intellectual curiosity
Sanity flipped on its heels

But you have to laugh

A chortle a choking gasp
The tension breaks
The air whooshes past
You have no control
You have to laugh
The world doesn’t change
Much
The feelings are still there
But with each laugh
It gets easier to bare
It’s a chemical reaction
With endorphins and stuff
But I don’t think you care
It’s just what you needed
To fight off the despair

So I say it again you have to laugh
Yazad Tafti Jan 2019
you cut me off...

like a ****** does their blood supply...just give me a hit
like a rock climber does to an unnecessary weight
like a cell phone signal going through a tunnel...this provider *****...can you hear me now?
like a chef does to the unwanted edge of an onion...no one eats this **** lol
like an ADHD child hyped on sugar does to their surrounding others
like the zoo does to animals from their native habitat
like a **** would a family from their loved ones
like a barber would to a hippie asking for a fresh fade...hold on let me just take some acid, forget to shower and protest against human rights...right on man
like a serial killer from their emotions
like a surgeon would to an untreated tumor harnessing a body part
like a TV station does to a failed pilot no one laughs at....HAHAHA not funnnyy...hilariouuuss

you cut me off....but i don't know if i can let go.
****.... I like her a lot but not because what she has but because what she is
The old man is in the wilderness,
His children never borne.
His parents torn.
He lives alone.
And he likes it so.
No one to tell him what to do.
No government to bore him too.
No lost or love...
Little effort, and much fun.
Yet still for this man,
There feels a hole,
Something inescapable,
Yet not quite describable,
Somewhere within him,
Something is missing.
Lacking a vocabulary,
He finds himself lacking.
So he carries on his day
Chopping wood for winter,
Eating fish for dinner,
Beating his dog for pleasure,
And sleeping for leisure,
He lives a simple life,
One away from danger.
A hatchet for protection,
And a musket for intervention.
But slowly the hole grew.
Until it weighted more than he did.
Bigger and stronger than he,
Eating him from inside.
Yet he was a stubborn man,
And he would rather die,
Then ask for help.
Or a neighborly "Hi,"
So his illness went untreated,
And his loneliness grew.
He beat his dog more,
and ate a little less.
Cried at night,
And knew naught why.
Like a black hole it consumed,
Everything it could see,
That hole slowly grew,
From out his heart it bleeds.
One Day,
Their was nothing left.
Just the hole,
In the guise of man.
It did not move,
And it did not breathe.
The dog had already went away...
- From Birds Flying Into The Eclipse Of Mars
Josh Whitton Mar 2013
I do not stand alone,
Thinking that in this world,
There is something unknown.

Unknown is the reason for greed,
For wealth and harboring, A ******,
A sickness untreated to allow innocence to bleed.

Unknown is the reason for racism,
Spoken slanders and propaganda's,
Media's misguided music to masses for totalitarianism.

Unknown is the need to be accepted,
A collection of emotions to be displayed,
Not being ourselves - The worst, portrayed.

I need not know a lot for I know this,
That love overcomes all and ties us together,
In an intercontinental consciousness.

I know this because walls have been brought down,
Children play where none were once found,
People still rejoice in helping, healing and sound.

I need not know a lot because this, I have found.
silentwoods Aug 2018
It's way too hot
Call 911
Write out a ticket
To the sun

I may have died
Can someone check?
I need a beverage
Past my neck

I'm breathing in
Somebody's sweat
I'd pat your back
But it looks wet

My last brain cell
Has over-heated
I might combust
If left untreated

I needed that vent
No pun intended
Let's hope this summer’s
Not extended
Amy Perry Oct 2018
Scraggly,
In face and heart
Staggering
By the harbor,
A celebratory place
For families to flock
And sight-see the city
By the ships and the docks.
While the sea gulls fight
Over scrimpy scraps,
A lone man traverses,
Seized by mind traps.
Disoriented by the shadows
Of his past,
Taunting and tampering
With his freedom, at last,
He's broken his vow of silence
He promised he could pass.
Reality so far removed
From his ruminations.
Passerby's passively wonder
What attracted him to the concrete.
Overactive imagination
Is an answer I'd repeat.
Occasionally another may marvel,
Where is his family?
Waiting in vain,
In the background,
In the rain,
Devoid of way to entertain
The possibility to take the reigns
Away from his deceptive beast
That guides his woeful way,
Fighting for fistfuls of his feast -
A price he has to pay
For having an untreated illness.
Now I have no say
In pillows or cement.
He chose the latter.
Now all I can do is feel lament.
If you see my father,
You may see kindness in his eyes,
A mind that's rapidly firing,
Comforting words to himself he's ironing.
If you see my father -
You may see him time and again,
You may see him in the sea gull,
Harmlessly scavenging,
Heartily conversing,
Heartbreakingly existing -
If you see my father,
Let him exist
However he chooses.
I have no choice
But to do the same.
abp 10/02/18
Dave Bas Nov 2010
Denials fears receipts
Lies betrayals deceits

Expectations loss resentments
Perception destruction commitments

Adoration longing craving
Yielding accepting braving

Politics labor expense
Logic confusion dispense

Care concern keenness
New life new world seamless

Divinity concealment hate
Regret trust late

Forgiving losing retake
Patience understanding heartbreak

Dealing retracing abiding
Life God residing

Emotions thoughts dissent
Judgments wisdom repent

Memories traces slaughter
Heart soul fodder

Empathy retraction deafness
Body mind breathless

Oxygen air amiss
Blood veins remiss

Promises sensations overlook
Death sadness overtook

Redemption reprisal regret
Untreated unlearned unmet
Cee Jun 2016
I look back on my life
I reflect on my past.
I saw how I just stood still
Never quite followed any clear path.
How could people respect me
If I didn't make any positive moves?
I live in self-hate
With a bad attitude.
I lost my woman, my children
My home, my family.
My life is a dark cloud I live in misery.
I even tried to **** myself
Just the other day.
But God wouldn't let it happen
He kept me anyway.
I called my pastor
He was busy at the time.
I was having a mental meltdown
I was losing my mind.
I took a handful of pills
That only made me sick.
I can't even end my own life
Ain't that a b*tch.
If I ever succeed with suicide
Don't give Leesah the blame.
I'm just tired of this life
I'm not mentally sane.
The only thing that matters
Is my children that I love so.
They are gone from me
My life has no meaning, I think it's my time to go.
My family has turned their backs on me
I ran them all away.
I have mental issues I'm ignoring
Getting more ill everyday.
I hear voices in my head
They talk to me all the time
They torment me
These voices mess with my mind.
My inner voices are my only friends
I know that sounds quite odd.
The only thing I have to hold onto
Are these voices & God.
Nothing else is there for me
No one else is there.
I live a life of pure loneliness
I think no one else cares.
My-Ex says I'm unstable
She says I'm mentally unwell.
She tried to help me, I refused
Now I live in my own personal Hell.
I saw the pain in her eyes
She looks at me with pure disgust.
I allowed my mental illness
To betray her trust.
I can't believe how my life
Has turned for the worst.
I feel like my life is a joke
I feel like I'm cursed.
The mistakes I made in life
Were caused by my own hands.
I went through living my life
Without any clear cut plans.
I've tried talking to God
To him I constantly pray.
It seems as he's forsaken me
Because he doesn't hear me anyway.
I know that's my illness talking
Those voices wanting my faith to waiver.
I'll never let that happen
Because one day I know
I'll receive God's favor.
My mind is everywhere
Mental illness has a hold on my life.
My-Ex tried to warn me.
Why didn't I listen to my wife?
I thought losing my family
Caused my downward spiral.
But truth be told
It was happening for a while.
My mental illness has ruined me
It's left me mentally & physically depleted.
I messed up my life
Because my illness went untreated.
Is it too late to get help?
Why? My family's gone.
I lost my wife, my children
Do I want to go on?
If I never write again
If this poem is my last write.
I know I was the blame
I finally saw the light.
My pride didn't allow me to admit
I'm mentally unstable, mentally unwell.
Because I didn't listen to Leesah
I live in my own lonely private hell.
Vampyre Kato Sep 2015
Dark Space,
Inside,
A Far Place,
Easily Mistaking As Tar Made,
Sailed The 7 Seas In 3 Days,
I'm On Earth To Learn,
Soul Burns When They Teach Things,
Ripping My Joints ,
Trying To Reach Change,
Even Though ,
I'm Fed Up,
I've Invested To Much,
To Let What Led Up Slip Away,
Sober Mind ,
Multiply's My Vivid Dreams,
Searching The Details,
To See Exactly What It Means,
Perceptions Everything,
What Could It Be,
What I Seek,
Altered My Though Form,
The Way I Speak,
Slowed Down My Impatient Speech,
I Love , Patient Things,
Grateful For My Grandmother,
Who Gave Birth To My Mom,
She Gave Birth To My Brothers,
Unlike Them & My Sister,
A Sibling Different From All Others,
Born With Special Gifts,
Psychic Midst,
Came With A Curse,
Tourette's Syndrome,
I'm Like A Fish,
Outside It's Nitch
I Cant Control My Neck, Wrist , Back,
All I Do Is Twitch,
I Scream So Giant ,
It Sounds So Silent ,
The Burning Pulses, Makes Me Violent,
Indigo Third Eye Violet,
I'm So High On Fear,
Please Replace The Pilot,
All I Feel Is Pain,
See People Smiling ,
I Can See What People Hiding,
Insecurities,
Inside Their Dying ,
They Feel Alone,
Up All Night Crying,
An Em-path,
Emotional Pirate,
With A Sacred Demon,
I Formed An Alliance,
Make No Mistake Thinking I Am Fake For What I Say,
Blood Oath, Darkest Day,
Exchanged A Thing ,
By The Train,
Black Rose,
72 Thorns,
Coldest Rain,
I Notice Synchronicity In Everything,
Don't Miss A Things,
Can't Run From This,
More Of My Gifts,
Visions That Evil Brings,
In My Dreams ,
Demons Scream At Me,
The Ones I Didn't Pick,
To Exchange With,  
Want To Possess,
I Was A Lonely Child,
Not Influenced Like The Rest,
Astral Projected By The Water Fountain ,
Escaped The Place I Hate , Earth,
With Every Breath,
I Had A Therapist, Who I Scared So Quick,
I Had No Friends ,
Just A Magik Wand From My Art Teacher In 3rd Grade,
She Said Was For Energy , Just For Me,
Paper & A Pen,
Don't Ever Loose Please,
Then I Gave It To The First Person Who Gave Me Time To Greet,
We Never Spoke Again , Their Face I Didn't See,
Gave My Gifts From My Mother Away For Friends,
Who Wanted Things , Not Me
I Have Been Cursed , This Misery,
Has My World Cold, Never Felt Home,
19 Years Shivering,
Getting Used To The Sting,
Like A Untreated Sliver Be,
So Alone, I Wish I Could Talk Ghost,
I Only See Em, Come To Visit To Finish Missions,
Then They Go,
Orbs Of Energy, Hover Me,
Rain On My Window Seal,
You Know How You Look Through A Window,
Like The Glass Not There,
My Whole Life Is How It's Been,
I Know How A Window Feel,
19 Years This Window Peels.
Blood Shed,
I Could Write Till , The Night Of My Grave,
Enough For Today,
I Crave Valerie My Melody ,
To Help Make Me Feel A Better Me,
Until Then,
I'm Writing Rituals ,
With A ****** Pen
Me
shaffenstein Oct 2014
What stands after nothing,
what grows in the night?
What answers the calling,
what soothes untreated sight?
Tonight, without knowing,
know we sustained the right,
here now, without crumbling,
fight the dust in the mite.
We'll delight in the other,
never smother the fight...
but when hopeless
feels dopeless,
always answer the cry.
A l o n e

Nothing other than utter bliss
As my eyelids begin to passionately kiss
My count of sheep depletes as my imagination grows
My mind starts to open as my eyes begin to close
Slowly welcoming the air to it’s royal chambers in my lungs
With a handful of dreams within grasp even without opposable thumbs
I become N U M B
Thoughts ricochet around in my head
Until they land upon old wounds left untreated & now infected
Visions of the past present a possible future
Unparallel to those predicted by life's various tutors
Contemplating
Waiting
Waiting
Then I find myself-
soaring high with complete balance
Steering this craft with faith beside acting as my ballast
Leaping from safety and falling towards uncertainty
Diving into a sea full of clarity
~~~~~~~~~~~~~~~~~~~~~~v~~~~~~~~~~~~~~~~~~~~~
And so goes the plunge
I submerge
Pondering deep beyond previously set limits
      Never once resurfacing
Drowning in yet to be deciphered waves

Thus ending the reign of the once realist schemer
Replaced by the newly appointed lucid dreamer

— The End —