医療法人　修命会　土佐丹羽クリニック｜癌｜膠原病｜アトピー｜高知県土佐清水市

 Please be aware that our treatment is not covered by health insurance, and most of our medicine are original.

 Fee for the initial consultation is  \3,500.

Approximate amount of prescription fee would be \10,000-\15,000

which includes several ointments.

Most of Dr. Niwa's ointments are original, and some contains steroid.

 

Differences Between the Branch Clinics and the Tosa (Kochi) Clinic

At our branch clinics, patients can receive medical consultations and prescriptions for ointments and medications.

Only at the Tosa Niwa Clinic in Kochi Prefecture, in addition to consultations, patients may also receive sand-bath therapy and ointment application, if you wish.

 

Payment Methods

At our branch clinics, payments can be made by cash only.
At Tosa Niwa Clinic in Kochi, both cash and credit card payments are accepted.

Consultation Schedule

The consultation dates for each clinic are usually finalized by around 10th of privious month.

Please contact us by email to inquire about available appointment dates.

Please let us know which month and which clinic you would like to visit.

We will provide you with the possible dates and times. Please scroll down and complete the medical questionnaire (Word file)

email : tshp-iren@aroma.ocn.ne.jp

 

Medications Prescribed on the Day of Consultation

On the day of your visit, ointments are generally prescribed in 50 g containers, with prices ranging from 3,300 yen to 6,600 yen, depending on your symptoms.
These are the main ointments we typically use; however, additional topical medications may also be prescribed according to your condition.
In some cases, oral medications may also be prescribed, depending on the doctor’s assessment of your symptoms.

 

※Please come to the consultation with someone who can speak Japanese. If necessary, we can introduce you an interpreter for you. Interpreter fees should be paid directly to the interpeter. The fee varies depending on whether it is your first visit or a follow-up visit, and on the area but it is generally between 6000yen to 10000yen. (For intensive treatment at our main clinic, an interpreter is not required.）

 

Consultation Fees

The initial consultation fee is 3,500 yen, and the follow-up consultation fee is 3,100 yen.
At the Tosa Niwa Clinic, the follow-up consultation fee is 2,000 yen.
If more than five years have passed since your last visit, it will be considered an initial consultation.

 

Payments

Please note that payment at the clinics is accepted in cash only. We kindly ask you to prepare cash before you visit. At the main clinic, Tosa Niwa Clinic, both cash and credit card payments are accepted.

 

We can provide appointment availability up to three months ahead for Tosa Niwa Clinic.

 

The total cost depends on the amount of ointment used, but for one week, the approximate cost is 150,000 to 200,000 yen.
In general, two weeks of intensive treatment is recommended.
However, the final treatment period should be decided based on your consultation with the doctor and your personal schedule.

 

Accommodation Information

There are no inns located near the clinic.
However, there are two family-run inns MINSHUKU民宿 providing meals recommended for treatment.

These family-run inns offer:

• Two meals included

• Cost: 7,500 yen per night (per adult)

• Payment: Cash only

• Meals suitable for the recommended dietary program

• Ointment application is allowed inside the facility

 

 

 We do not have inpatient facilities which is temporarily unavailabel at this stage.

We only have ambulatory care.

 

Adults ( junior high school student or older)  \7,500 (including tax)

Primary school student  \6,500 (including tax)

Children ( 3 years old or older)  \4,000 (including tax)

 

 

Adults ( junior high school student or older)  \7,500 (including tax)

Primary school student  \6,000 (including tax)

Children ( 3 years old or older)  \4,000 (including tax)

 

 

 Dermatology

Average fee is around \300,000‐\400,000 for 2 weeks.

 

Medical diseases

Average fee is from \600,000- per month. Depends on the number and 

 types of tests, staying period, and the type of medication prescribed.

 

If you are considering our treatment, please contact us via contact form or by email : tshp-iren@aroma.ocn.ne.jp. 

 

Payment : We only accept cash and credit card.

 

We recognize the broad range of modern science and we strive forward with frontline methods utilizing science itself.

 

Modern medicine (science) has advanced humanity by disproving some long held religious and spell bound superstitions which have unfortunately resulted in many faults and sacrifices in human history. Modern medicine itself, too, has also been producing them to some extent. However, the only road to overcoming such limitations of modern science is not to reverse back into the medieval era but to fully exploit the scientific way. Tosashimizu Hospital advocates up-to-date modern medicine as the basis of patient treatment.

We never exclude any possibilities prematurely.

 

Overturning the established theories and long held dogma is the core of science. Only facts are the truths of science. Despite what authorities say, what various people say, what is the "conventional" way, etc. all of this may mean nothing if we do not challenge such ideas through investigation. Human beings, including us, do not currently have all the answers about diseases and nature. New theories and new treatments are always concealed by our bias. We should be flexible and open-minded to discover them.

 

We know that we should be always considerate.

 

We never can resolve all the problems we confront even with full knowledge and all of science. We are aware of the limitations of science and of ourselves. Being considerate is essential in our practice. Tosashimizu Hospital pursues the practice following the hearts and desires of the patients, which is rooted at the core of its principles.

Human beings have been gaining more and more knowledge about cancers in recent times. The core of such knowledge is that cancers have far more complicated origins and developmental ways than previously imagined.

 

One gene disorder types of cancer may occur rarely, but most clinical cancers probably have a great many more genetic disorders causing defects in vital cell and mechanical functions.

 

This means that less mature conventional anticancer strategies may fail to produce the desired effect. Tosashimizu Hospital has a deep question,

 

"Are the current conventional anti-cancer methods enough to treat such complicated and numerous disorders?"

 

 

Modern medicine has acquired certain progress in cancer treatment. However it does not mean that the same success is on the same road.

 

One example of the immaturity of current ideas is the slogan;

 

"Detect and treat; the earlier, the better."

 

Such an idea indicates that when we detect cancers earlier (i.e. smaller) we can cure them more often. Is it certain under the limits of current diagnostic and therapeutic technology? Newly found mechanisms of tumor formation, its progression and spread give us doubts about this current method.

 

We consider that modern Western medicine practices excessive treatments against cancer(s). We may treat some or many cancers unnecessarily, especially if they do not kill patients. Such treatment causes no decrease of death from cancer but with the unhelpful damage of normal tissues by examinations and treatments. Prostate cancer is currently in controversy, which is one of the typical examples.

 

Even though a detected cancer seems to be early enough, distant spread may have already occurred, which could not be detected in view of its tiny size. Is the manipulation of such lesions actually beneficial?

 

I will discuss only advanced cancers in this document, as there are so many pros and cons related to the investigation and treatment of early cancers.

 

We have already developed great advances in blood cancer treatment. Blood cancers (leukemia is the typical one) have become considerably treatable and curable with current anticancer drugs. They were entirely incurable and fatal only several decades ago.

 

For blood cancers, the latest improved diagnostic technology does not contribute so much to earlier detection. Therefore, the results are still comparable with those of past days. Therapy for blood cancers has truly progressed.

 

I consider that you should take the radical approach, even if it is the hardest approach, against blood cancers and some limited other specific cancers such as seminoma (a type of testicular cancer).

 

Despite the above, we have not have gained much headway in the treatment against the large part of the vast number of remaining cancers, which are so-called "solid cancers".

 

For example, let us think about stomach, breast and colon cancers. Certain parts of the patients may be expected to be cured completely when the lesion or lesions are radically removed. Therefore, we should carry out complete removal, when possible, if it can be performed without many hazards. Unfortunately, it can never mean that the patient is totally cured. The outcome is not completely predictable.

 

Some patients, even with seemingly advanced cancer, are cured and survive, whereas others do not, even when the lesion is small enough to expect a cure. Some people are cured, whereas others are not. The ratio has been essentially unchanged for over several decades.

 

We should take account of the progress in medicine, with especial focus on diagnostic technology, when evaluating such results. The progress makes cancer detection remarkably earlier than before, which may skew the observed survival period for longer. Percentages of five- year survival rates by themselves do not prove the effects of recent cancer therapy. Essentially, in some cases, we are observing an earlier point on the curve of the natural progression of a cancer because it is detected earlier, but where intervention may still not change the eventual outcome.

 On the theory written above, I would like to propose the most appropriate way to treat cancers.

 

First of all, I would like to emphasize that the following measures should not be used automatically, as they are only a guide of fundamentals. Disease differs from time to time and patients differ from person to person. Therefore we should always be flexible.

 

We at Tosashimizu Hospital, never just put you on a current guidelines of investigation and treatment without thorough consideration. We do not just put you forcibly on a medicalized conveyor belt. We will find the best possible way for you on the basis of your own outlook on life, desires, circumstances, the state of your symptoms, and so on.

 

We will certainly recommend that you take curable surgery, chemotherapy, or curable radiation therapy, if it is suitable for your cancer and your overall condition.

 

However, in reality, most patients who come to us have inoperable cancers, or have cancer that has recurred after operation and/or radiotherapy. For such patients, I will prescribe below our way of treatment at Tosashimizu Hospital.

Molecular target agents for cancers have been emerging recently. They are the group of drugs such as tyrosine kinase inhibitors and anti-VEGF antibodies, which reduce activities of growth factors of cells or tissues directly or indirectly. The inhibition of growth factors can result in the lessening of cancer growth.

 

However, you should know the fact that enormous amounts of growth factors are also produced during and after operations. Naturally such growth factors are generated to cure wounds, but the larger the operation you take, the more growth factors will be released, which, in some circumstances, may give addition growth opportunity to the cancer..

 

Experienced surgeons note that some operated cancers show abrupt growth and / or spread becoming detectable much earlier.

 

Hence, I consider that you should avoid further operations except when you are assured the operation can produce a complete cure. I would recommend that you not take an operation(s) for only for the sake of a medical trial, or only for partial reduction of the cancer size.

 

I would advise you to take a non-curative operation that can reduce your pain and when it can prolong a good quality of life for you. Bowel bypass surgery, which is when a bad area of gut is bypassed and two remaining good areas are joined together instead, is one example of palliative treatment which we offer at Tosashimizu Hospital when required.

 

You will lose your way and feel overwhelmed especially when you may have no idea which will be the better option. Cancer probably does not determine your fate in the short period as noted above. Therefore, you have the choice that you do not have to make a decision right away and you can wait for a while to make your own decision, which is best for you. Taking Niwa Naturopathic Treatment will give you reliable support while you are waiting and pondering.

Some radiotherapy can provide you with a possible cure with less functional damage than surgical operations.

 

I recommend such therapy prior to surgery.I recommend radiotherapy also when prolongation of your life can be expected.

 

We would also consider palliative radiotherapy, on occasions, for temporary improvement of symptoms e.g. airway narrowing, even though it not curative. Radiation is most frequently used for symptomatic therapy to relieve pain from cancer that has spread to bone.

 

Most patients taking radiotherapy under Niwa Naturopathic Treatment give us the paradoxical view that radiotherapy is sufficiently effective but it causes fewer side effects such as fatigue, etc.

Chemotherapy is the most controversial. I will explain this in i) and ii) below.

 

i) Blood cancers, etc.

We do recommend radical anti-cancer drug therapy for blood cancers (and some others), as mentioned previously, and it is utilized on occasion at Tosashimizu Hospital. However, we do not recommend it to elderly patients or those who have cancer that has recurred after earlier failed treatments.

 

On the other hand, we often use anti-cancer drugs for the elderly or when cancer recurs after various treatments. We use such drugs under Niwa Naturopathic Treatment and use them not in a radical way but minimally to prolong a good quality of life and by controlling the unwanted side effects keeping them to a minor degree as possible.

 

In addition to that, we often perform whole and fresh blood transfusions for not only treating anemia but also for an anti-cancer effect.

 

As a consequence, we occasionally observe unbelievable clinical courses when an "incurable" leukemia remits completely for a long period and is sometimes even cured (disappearance of the disease for more than five years and the medication stopped).

 

ii) Solid cancers, etc.

Treatments of cancers that have been operated, that have spread to distant sites or are inoperable solid types, and which are the main part of cancer treatment at Tosashimizu Hospital, are currently part of a heated discussion.

 

Generally speaking, we cannot obtain the most expected effect of life prolongation with current chemotherapy despite of its temporary cancer shrinking effect.

 

Meanwhile, numerous and diverse side effects emerge consistently. These side effects are so apparent to the patients and/or the researchers that clinical blind tests cannot be truly carried out properly. In the first instance, there have been no strict placebo-controlled (no active drug) or no-treatment-controlled studies compared to life-prolonging effects for most anti-cancer drugs. It is disappointing that in the end, we mostly acquire only a few months' extra life even beyond the unpleasant various side effects.

 

One current article on the treatment of pancreatic cancer reports the prolongation of life statistically significant with a new agent, which was only for 10 days! Some researchers propose that we should not count these agents as anti-cancer drugs that have life prolonging effects unless they can give more than three months of extra life.

 

All these facts result in various attitudes in patients. We at Tosashimizu Hospital favor to keep the quality of life better than to cause suffering by the effects of anti-cancer drugs.

 

As a conclusion, I do not recommend anti-cancer drugs for solid cancers generally.

 

Nevertheless I have a few exceptions.

 

iii) Advances in Niwa Naturopathic Treatment

Please remember that Niwa Naturopathic Treatment is advancing every day.

 

The above mentioned concepts and strategies keep changing by observation of facts and events in daily practice.

 

We have the Niwa Research Institute of Immunity which was established over 40years ago and which is attached to Tosashimizu Hospital, where basic research with application to clinical use is being carried out continuously. This produces many useful results for Niwa Naturopathic Treatment. Sand bath treatment, which will be explained later, and specially processed Cordyceps Sinensis which shows remarkable effects on hepatocellular carcinoma are several typical examples.

 

A great advantage of our formula is that we observe patients carefully every day and can feed back various changes of patients to further our research. Recently I found some combined possible effect written below.

 

For blood cancers, along with sufficient Niwa Naturopathic Therapy, I usually administer anti-cancer drugs enough to overcome the critical condition, following which I prescribe the minimal dosage of anti-cancer drug(s) to maintain remission avoiding serious side effects. Some of such patients occasionally obtain amazing results, including complete cure, as mentioned previously.

 

In recent years, I have sometimes come across similar examples related to solid cancers especially breast or ovarian cancers and some others.

 

I have previously treated many solid cancer patients who are close to death, and in the past I usually recommended them to utilize hospice care. However, among some patients I found several who, despite their condition, could survive with mild and minimal anti-cancer drug(s), and have longer lives for several years, without much suffering.

 

The regimen is that firstly Niwa Naturopathic Treatment is put sufficiently into practice and then mild and minimal anti-cancer drug(s) is/are administered to lessen the critical condition. With careful control, the patients occasionally improve and extend their lives for years without pain and suffering.

 

Under sufficient Niwa Naturopathic Treatment, even terminal care patients, who have already undergone the full-line of surgery, radiotherapy and chemotherapy, are restored with the minimal doses of mild anti-cancer drugs that are generally thought to be ineffective. The effectiveness is signified by the apparent improvement in symptoms, a halt in the progression of the cancer, significant extension of life of the patient, etc. The patient's quality of life does not deteriorate significantly either.

 

I object to ill-considered administrations of anti-cancer drugs. Nevertheless, I administer such drug therapies when they may considerably prolong the life of the patient without causing pain and suffering.

 

In all cases, I always put Niwa Naturopathic Treatment at the core aiming for the patients to live longer and energetically.

iv) Summary of strategy

As mentioned above, I recommend the therapies, when possible, that can bring you a cure or considerable extension of a good quality of life.

 

Otherwise, I apply the Niwa Naturopathic Treatment to you avoiding harsh chemotherapy or meaningless surgery, and aim for a better extension of life. Hepatocellular carcinoma treatment is one example of our recent research article as titled:

 

"Evidence That Naturopathic Therapy Including Cordyceps Sinensis Prolongs Survival of Patients with Hepatocellular Carcinoma"

 

that has been accepted and published by an international medical journal through strict peer review.

 

Free full text is available: See Web site 

http://ict.sagepub.com/content/early/2012/08/07/1534735412441704.full.pdf+html

 

We have contributed other articles showing that Niwa Naturopathic Treatment prolongs survival for some other cancers as well, with at least equivalent survival to standard anticancer drug therapy and with negligible side effects. (The prints are available upon request.)

 

I do recommend Niwa Naturopathic Treatment prior to other treatments, even if the prolongation of life is expected to be equivalent to that of standard but with "harder" anticancer drugs or risky surgery.

 

For all cases, we always make efforts to offer you comfortable, meaningful days and to improve your quality of life, in whatever agonizing or serious situation you may be experiencing.

 

I do not estimate your clinical course only by observing the short-term fluctuations of laboratory test results and/or size of tumors, as I mainly observe for your better general quality of life.

 

With regards to what has been written above, I would like to add several things.

 

Tosashimizu Hospital does not have a usual attending doctor system like other hospitals in Japan. All doctors not on duty for the day leave Tosashimizu City and do not come to the hospital out of days. Moreover, since most patients come to Tosashimizu Hospital to consult me, in reality, I manage all patients.

 

Therefore, it is regrettable but you will need to wait for me (Dr. Niwa) before being informed of examination results, laboratory values, estimation of your condition, and so forth. Only one exception is when there is an emergency.

 

Other doctors will not show or explain your own data. However, they will tell you general information of diseases relevant to your state.

 

This system is in operation to avoid harmful misunderstandings and troubles caused by minimal difference of explanations by different doctors. Even the same values shown by different doctors often give different impressions to patients, which could lead to mistrust.

 

I have different views from other hospitals regarding tumor growth, elevation of tumor markers, and other results of examinations or body condition estimation, since we aim to improve your general quality of life. My comprehensive of evaluation stands at the opposite end of others in the field, who often say to the "half dying" to undergo a hard operation and/or anticancer drugs

 

"The tumor markers have decreased and the tumor size has decreased. All is going excellently."

 

To my regret, real progress is disconnected from wishes and prospects of patients and families, as a matter of course from the hardness of malignant disease. I evaluate and estimate your state holistically compared to other similar patients. Please do not be unsettled, but please dedicate yourself to the treatment. Please read this document carefully and aim to understand what we have to offer at this hospital.

 

Based on what has been mentioned above, after a certain period (at least several weeks) of hospitalization I will then make a decision whether the therapy is beneficial or not.

 

Unfortunately if not, we recommend that you be discharged. We will coordinate about you and your disease along with you and your family's desires and the underlying situation.

 

We occasionally do not have time to make such coordination as a result of the sometimes rapid and unpredictable deterioration of a disease (and rarely the sudden death of a patient).

 

We persuade you to continue the hospitalized treatment for three months or more when we see the therapy is beneficial. We will let you know the best way for further treatment upon discharge from the hospital.

 

We have a wish that all the patients who come to Tosashimizu Hospital will undertake a full term of Niwa Naturopathic Therapy in order to realize its benefits.

Chemotherapy is the most controversial. I will explain this in i) and ii) below.

 

i) Blood cancers, etc.

We do recommend radical anti-cancer drug therapy for blood cancers (and some others), as mentioned previously, and it is utilized on occasion at Tosashimizu Hospital. However, we do not recommend it to elderly patients or those who have cancer that has recurred after earlier failed treatments.

 

On the other hand, we often use anti-cancer drugs for the elderly or when cancer recurs after various treatments. We use such drugs under Niwa Naturopathic Treatment and use them not in a radical way but minimally to prolong a good quality of life and by controlling the unwanted side effects keeping them to a minor degree as possible.

 

In addition to that, we often perform whole and fresh blood transfusions for not only treating anemia but also for an anti-cancer effect.

 

As a consequence, we occasionally observe unbelievable clinical courses when an "incurable" leukemia remits completely for a long period and is sometimes even cured (disappearance of the disease for more than five years and the medication stopped).

 

ii) Solid cancers, etc.

Treatments of cancers that have been operated, that have spread to distant sites or are inoperable solid types, and which are the main part of cancer treatment at Tosashimizu Hospital, are currently part of a heated discussion.

 

Generally speaking, we cannot obtain the most expected effect of life prolongation with current chemotherapy despite of its temporary cancer shrinking effect.

 

Meanwhile, numerous and diverse side effects emerge consistently. These side effects are so apparent to the patients and/or the researchers that clinical blind tests cannot be truly carried out properly. In the first instance, there have been no strict placebo-controlled (no active drug) or no-treatment-controlled studies compared to life-prolonging effects for most anti-cancer drugs. It is disappointing that in the end, we mostly acquire only a few months' extra life even beyond the unpleasant various side effects.

 

One current article on the treatment of pancreatic cancer reports the prolongation of life statistically significant with a new agent, which was only for 10 days! Some researchers propose that we should not count these agents as anti-cancer drugs that have life prolonging effects unless they can give more than three months of extra life.

 

All these facts result in various attitudes in patients. We at Tosashimizu Hospital favor to keep the quality of life better than to cause suffering by the effects of anti-cancer drugs.

 

As a conclusion, I do not recommend anti-cancer drugs for solid cancers generally.

 

Nevertheless I have a few exceptions.

 

iii) Advances in Niwa Naturopathic Treatment

Please remember that Niwa Naturopathic Treatment is advancing every day.

 

The above mentioned concepts and strategies keep changing by observation of facts and events in daily practice.

 

We have the Niwa Research Institute of Immunity which was established over 40years ago and which is attached to Tosashimizu Hospital, where basic research with application to clinical use is being carried out continuously. This produces many useful results for Niwa Naturopathic Treatment. Sand bath treatment, which will be explained later, and specially processed Cordyceps Sinensis which shows remarkable effects on hepatocellular carcinoma are several typical examples.

 

A great advantage of our formula is that we observe patients carefully every day and can feed back various changes of patients to further our research. Recently I found some combined possible effect written below.

 

For blood cancers, along with sufficient Niwa Naturopathic Therapy, I usually administer anti-cancer drugs enough to overcome the critical condition, following which I prescribe the minimal dosage of anti-cancer drug(s) to maintain remission avoiding serious side effects. Some of such patients occasionally obtain amazing results, including complete cure, as mentioned previously.

 

In recent years, I have sometimes come across similar examples related to solid cancers especially breast or ovarian cancers and some others.

 

I have previously treated many solid cancer patients who are close to death, and in the past I usually recommended them to utilize hospice care. However, among some patients I found several who, despite their condition, could survive with mild and minimal anti-cancer drug(s), and have longer lives for several years, without much suffering.

 

The regimen is that firstly Niwa Naturopathic Treatment is put sufficiently into practice and then mild and minimal anti-cancer drug(s) is/are administered to lessen the critical condition. With careful control, the patients occasionally improve and extend their lives for years without pain and suffering.

 

Under sufficient Niwa Naturopathic Treatment, even terminal care patients, who have already undergone the full-line of surgery, radiotherapy and chemotherapy, are restored with the minimal doses of mild anti-cancer drugs that are generally thought to be ineffective. The effectiveness is signified by the apparent improvement in symptoms, a halt in the progression of the cancer, significant extension of life of the patient, etc. The patient's quality of life does not deteriorate significantly either.

 

I object to ill-considered administrations of anti-cancer drugs. Nevertheless, I administer such drug therapies when they may considerably prolong the life of the patient without causing pain and suffering.

 

In all cases, I always put Niwa Naturopathic Treatment at the core aiming for the patients to live longer and energetically.

 

We fight against cancers which have cosmic complexity (as explained earlier) with all our strength and weapons, which also have microcosmic potential. The weapons include Niwa processed natural medicines, the Niwa infrared sand bath, psychological support, physiotherapy, specific diets and the surroundings of Tosashimizu Hospital, such as the natural environment, the local town shops and the kindness of the area's inhabitants, etc.

 

I will describe the above contents briefly.

 This is one of the main features of Niwa Naturopathic Treatment. The ingredients are Kanpo (Chinese herbal medicine), mushrooms and herbs, which are all specially processed under the Niwa Theory. Since the action in the body differs greatly because of the processing, you should not imagine it as the same to something with an identical name. They likely have much more difference between eating tofu and eating raw soybeans.

 

See website for individual drugs is as follow:.

 

http://www.tosashimizu-hospital.com/liver_cancer_thesis/

translation_of_selected_passages/translation_of_selected_passages_004.html

Documents are available at this website, while some commentary is also available in the above mentioned articles.

 

Ingredients include vegetative wasp, agaricus, harpagophytum, loquat seeds, etc.

 The sand bath is produced from specially-molded stone balls (a few millimeters in diameter) which emit far-infrared rays when heated. These far-infrared rays warm you deep inside, not simply your surface, and make you far more activated than that compared to common hot springs (onsen).

 As a basis, we supply a Japanese diet of vegetables and fish with low fat and low-calorie. Some of them are obtained or produced in Tosashimizu itself. You can have brown rice at your request.

 We encourage you to take walks (in the natural surroundings, if you can), to sleep well, avoid overwork and manage stresses. Inpatients spend their days in various ways. One day some of them go hiking or fishing. On other days they enjoy singing together and study Korean or yoga in groups.

 I hope you spend each day profoundly and meaningfully by forcing out the worries in your mind, under the full recognition of my indications above.