This is John with the Christian Outreach Office and I'm excited tonight because everyone likes to share things that they love. If you love something, you want other people to know about it and that's what tonight's about because I'm going to share with you somebody I love, my friend Sean Forrest. Sean, welcome to the webinar. Thank you for being a part of this tonight. Have you been here, John?  Does that sound like the intro post almost? Almost, but it's good. It works, it works. Cheesy poses and all that. Hey, for everyone who's come on board, I want to say thank you for coming outside and being a part of this webinar. It is our desire here in the Christian Outreach Office to be able to serve you and to bring you great content to help you grow in your faith all year round, including things like webinars. We have past webinars up on our website if you want to go check those out, we'll have some blogs, videos and other things that will help you grow in your faith because our mission has always been to go rebuild the church in the spirit of St. Francis who is our patron and our guide and we want to help you become all the guy intended to be when he first created you. Now, let's start with a prayer and then I'll give a few tips. This is chump right into it. All right, let's begin. Father, Son, Holy Spirit, Amen. Good and gracious God, we thank you and praise you for your love, your goodness and your mercy. We thank you for being able to celebrate this extraordinary year of mercy where we focus our attention and our prayer on your kindness, your everlasting, never-ending mercy. And Lord, as we experience that mercy, as we come into contact with your grace and who you are, we desire that a transformance that changes and therefore, as we move forward, we know that the year of mercy has officially come to an end, but the living out of mercy does not come to an end ever. Lord, give us the grace to live in your mercy, to seek your mercy and to show your mercy in real and tangible ways to everyone around us, especially those who are most in need of your mercy. We thank you, Lord. I'm going to pray to have mercy on our country, continue to guide it and lead it, bless our leaders, bless all those that serve, especially as we head into Veterans Day, all those who have served in the military, all those who've laid down their lives that we might enjoy the freedoms we do here in America, bless all those that are currently serving the Lord. And just bless this time, may it be what you want it to be. And we ask this all in your name, Jesus, Amen. Holy Spirit, Amen. All right. Well, the topic tonight is Beyond the Year of Mercy, Loving with a Missionary Heart. And when I think of missionary heart, I definitely think of my good friend, Sean. He's been, well, we've ministered a lot over the last decade or so, different circumstances. But I stand in awe of him when I think of where his heart is in terms of ministry, what he does, because he just, I think he typifies the generous response that God is looking for from each one of us who call ourselves Catholic Christians. So, Sean, why don't you kind of maybe explain a little bit what kind of missionary work you do, how you were drawn into that, and maybe start talking about, you know, what does it mean to have a missionary heart, and how can we love with a missionary heart? Awesome. So, the mission is, well, it's to the poorest of the poor. He's the poorest country in the Western Hemisphere.  Even the slum, it's a lot less than that. So, it's really, it's a country of about nine to 10 million people, and it's estimated that one million of them are orphans. So, it's a pretty tough place. So, we have a orphanage. We have a school. We have homes for the elderly. And then we're building a medical clinic now, though. It's just going to be amazing. It's just so needed, and it's going to save so many people's lives. And so, we help on that end, when we do ministry, we help the people who are sick. We find the orphans, the widows, and we bring them to a place for shelter. But we also find the word of God, because they need to hear it, and they love to hear it, and they don't really have many Bibles. So, is there going to be any other Gospels? Is there going to be us from the missionaries going out to them? Sometimes they get, you know, there's sometimes voodoo, not when you think of voodoo.  Just like, it's more like a wicka, like here, wicking kind of here, wicking late. There's different degrees of it, but that kind of infiltrates into their faith, because they don't hear the gospel enough. They don't have a scripture, so we have to go out and share that with them. The other aspect is, it's not just about them. It's about bringing people over here and giving them a place to be able to share their faith and grow in faith. And the whole, the whole Jesus thing changes when you become a viewer of the word, not just a hearer of the word. Yeah, that's right. I think when we look at what a disciple is, I think the true sign that we've really reached the level where we're living authentically as disciples is when there is missionary impulses, where we feel compelled by what God is doing in us and through us to go forth with the gospel and to do the things that Christ did and really imitate in our lives and take on the idea of being a servant first and putting other people before ourselves. For all of you on board, I want to thank you once again for coming on board. I want to highlight one thing.  And if you look going down, you'll see like different arrows with words next to them. You'll see one that has questions. If you have that, go ahead and click on that arrow. And in that box, you can type in a question for you and myself or Sean. And we'll be happy to answer it. And we're going to start having a conversation. We want to bring you into the conversation by having you ask those questions and we'll respond to those throughout the webinar. Yeah, Sean, I want to see her talk to more people. Let's do this again. That's good. That's just after a while. Yeah. Yeah, much better talk with you than me. So in all seriousness, though, we look at the year of mercy. What do you think, Sean, of yourself, was the most profound impact on your walk with the Lord this past year during the year of mercy? Well, I find that I am a great disclaimer of God's mercy to everybody, but myself. I find that, you know, people are like, it's too difficult. God's this. I'm like, you don't get, God's crazy about you. And then with myself, I hold myself to that. I'm like a Pharisee to myself. And I will, in my head, I'll know that God is merciful towards me. But my heart will be like, no, you know, it's still got to do this, you got to do that. And I can easily become works oriented and stop relying on the mercy of God. And it still keeps thinking like, you know, I got to do this, I got to do that. So it was, I remember I took confession and I was in Norwich, Connecticut. I went to confession and I just laid a lot of stuff out there and the priest was like, okay, so say you're at the contrition.  And it was just all this mercy. I'm like, I just feel like I need to be like, yell that more or something. He just laughs and he's like, yeah, he's like, you got the wrong faith. And we started laughing in the confessional together. And it really felt like, you know, that's Jesus. It's like, dude, yeah, you're not the head. I died through sins. You're sorry for him.  I'm crazy about you. You know, I think, I think for me, and this isn't new, so I heard this a long time ago, I was about 16 years old, I heard this preacher preach this and for me, sometimes I feel like I'm going to get before Jesus, I'm going to be trying to justify myself. I'm like, yeah, I don't know what you're doing. I did this and I did this and he's going to be like, no, no, no, no.  Just go ahead and call me first. When you're like, what? And he's like, yeah, I'm just going to forever put my arms up. Let's talk about this after. So getting the mercy to go from here to here was huge for me. Yeah. And as I listened to him, we shared different parts of our spiritual journey and I think it's always one of those things that Satan goes after each one of us. I'm trying to showcase and believing that maybe our relationship with God father is like other human relationships because we live in a very transactional society. What are you going to do for me in a quick, quick pro quo? And so we always have this kind of maybe kind of quick pro quo mentality with God, God, I'm going to come with you to you and I'm going to ask for mercy, but in exchange, I'm going to have to do this, this and this. It's not going to be free. I know that nothing in life is free. And when you come to mercy, you're embracing the ultimate reality that simply put is too good to be true, but completely true. You know, it's kind of hard to when you're, I have to be careful I say this because I haven't really thought about that much the same thing to me. When you're a speaker, like, I hope this comes out right, it doesn't, it's just your ears are messed up. I find that people put this level of you have to be a certain way, a certain holiness or this or that, and it kind of makes you think like, oh my gosh, I've got to be perfect all the time. And if you're not, you know, like, wow, people will be scandalized if I send them my yarn. After a while, just it can build up and you know, it's like Jesus came to set us free and take our burdens off.  You start building this up on your shoulders and then you crash into sin. So it's like this horrible thing of like, well, I've got to be perfect, which causes anxiety, which causes stress, which leads to sin and fear happen. Now, that's, it's really true, you know, to stand up for Christ and say that you're even trying to do something, you know, I mean, a lot of people have faith to take it outside yourself as a risk, your risk rejection, you reject, you're on the risk of trying to be like Christ and failing. But when we once again, it touches upon the central reality of mercy, right? You know, like it is ours in Christ. And because we're in love so perfectly, you know, we should not be afraid. And fear, the only thing greater than fear and fear is a very, very powerful emotion is the freeing experience of Christ's love. You know, perfect love drives out all fear. And I think, you know, we're, we're afraid of failure, we're afraid of projection, we're afraid of, you know, seeing one thing and, you know, doing another and finding, you know, that yeah, Satan can get in our heads and twist it all around so that, you know, you're right, we can't find peace. So what can you talk about? And what happened, you know, this, this year as you went through this year, how did you find that peace? You know, were there anything in particular that helps you work through that? No, I would say I go like this. I have peace. I don't have peace. I have peace. I don't have peace. And, and this is going to sound weird. I've come to have peace about that. You know what I mean? It's like, no, I'm not perfect. I'm not going to be perfect. And, and I honestly, it wasn't a moment as much as really just to keep going. Right. So just keep trudging on because I'm, I think I'm different than a lot of people as far as, you know, like I go to the student conferences and I'll see people falling in the spirit everywhere and they have this emotional and I rarely have an emotional or an ecstasy with the Lord or something like that. I had one moment encounter with the Holy Spirit that was supernatural. I was 12 years old.  Right. And I truly do encounter Christ. There's a great Stephen Curtis Chatham song. And for those of you who don't know Stephen Curtis Chatham, you've got to get his stuff because he's one of the greatest ever. Because he's not afraid to say the name of Jesus in the song. He's like some people. It's not judging. I guess I could, near a birthday just ruin the whole thing.   Don't look at me.  I don't even know the thought. But in this song, he says, you know, I saw the face of Jesus in a little orphan girl. She was standing in the corner on the other side of the road. I'm the other side of the world.  Now you found me. What now? What will you do with this treasure you found? So through my own family and developing an incredible sense of gratefulness for everything around me, I've really been able to see God's mercy. Just every day like out loud saying, God, thank you for this. Thank you for that. Thank you for this. I tell the kids when I speak to them that when you're not sitting, thank you to God for the little things, you just become rotten. You really become spoiled. And when the troubles come, that's all you've been focusing on your whole life. So they, they, they seem, God doesn't do anything for me. I'm like, you're alive. That's one thing. You're alive, you know. And in America, you know, I remember having one guy say, well, I'm alive, man, but I suffer and I'm like, but you suffered America. It's different. We're not like suffering in him. You can get pain meds. All right, you can lay on a bed. There's a soup kitchen or something. So when you can look and go, I mean, this is, this is a bummer, but boy, there are people worse off than I am. That's, that's really growing and holding us and just gratefulness of God of like, well, this stinks. But you know what, I have cancer, this stinks, but I need a chemo here where I can go to a doctor. There's hope. So it's really, it's really that thankfulness in every little thing. And I, man, I have to practice that. Sometimes I just get working so much that I work, work, work, work, work. And then I start hitting brick walls and I'm like, wait a second, I can't believe I'm even a part of this mission. Thank you God.   Who gets to do that? Thank you God. Ryan, I don't always do that perfectly, John. Sure. Sure. I hear what you're saying, John. And, and Rob, thank you for your comment. He said in this year of mercy, we have committed to weekly adoration. And, you know, and I want to, I want to talk about that because the connection between what he's saying and what you're saying is absolutely true. You know, one of the trees that used to tell her part of their discipline with her sisters in Calta, they used to have to spend two hours a day in adoration. And the reason she had her sisters do that, she said to them, simply put, if you can't recognize Jesus in the Eucharist, you're not going to recognize Jesus in the poor. And if you can't see Jesus in the poor, you're going to lose your heart to do this ministry. You know, having a, having a missionary heart and living the year of mercy is not about making a list of things that you must do to be merciful. I've done this check, this check. It is really entering into this surrender to God.  Give me your eyes so that when I see somebody, I'm not repulsed, but drawn into compassion and if, if called by the spirit to act upon that compassion, that I would see people and I mean truly see people. I was out walking the other morning at, you know, six in the morning and normally when I walk, there's nobody else on the street. And this particular morning, there was another guy walking towards me, he was carrying a couple of grocery bags, imagine he'd get up early, maybe he was bringing home breakfast food for his kids or something. Didn't look like he had a lot of money. He didn't look like, like, he just didn't look like anybody cared about him. And so I got closer to him, you know, as I saw him in the distance, I took my headphones out and said, okay, I'm going to make him in that bag here. You know, I'm not, you know, he was, he was looking at, looking at me as he walked. He didn't want to look up, but when he got about 20 feet away, I said, Hey, so glad to see another person out here this morning. How are you doing?  He said, I'm doing great. How are you doing? I was like, I think he was expecting me to be like everyone else. He was in the world like, okay, this is, I don't want to make awkward contact with somebody I don't know. And I, and what if they want to hurt me?  And that's just one little story. That's not going to make me a saint, but it's a constant, you know, in the little things where you can show mercy, then I think when it comes to the big things, you're going to have work towards those big things. So I might make, you know, living to your mercy is just letting Jesus work in your heart and then moving forward into deeper expressions and deeper reception of mercy. You know?  It's not even, we can go to a third world country, but you can sit with the kid and don't be able to sit with it.  I'm looking down because that's not an inviting person that's going to be people to Christ. You're in a bubble.  You're another human being. All right. That's just so beautiful. And the mercy, like, not just for me to receive God's mercy, but what you're saying earlier, it's like, God, help me really give that mercy to other people. You know, it's, it's, this probably isn't true, but it's not a profound, profound last night, but all these people were freaked out.  And I'm like, I think Catholics, Catholics at Gossip destroyed the country more than those two will. You know, I think, I think somebody goes to the church, but never even says hi to somebody who's new or leaves a welcome or doesn't have a welcoming or merciful heart of like, Lord, I want to know you. I think that's a destructive force in itself. You know, so we're worried about all these things in the world, and it's like, what about our own hearts, our own souls? Are we, because truly Christ is, you know, he's king, whoever's president, Christ is king. We've been seeing that all on the internet, but it's like, do we really believe that? Do we live that? Do we want people to know that? Are we, are we merciful to other people? It's not just like, God, you know, forgive me for my sins. It's like, oh, yeah, I gotta forgive other people who should forgive me. Oh man, that's the hard part. Right. You know, and then we had a great comment and a question from one of our participants named Mary Ann. She said, what are some tips to use when on Facebook that can help us be merciful in our written words, right? So easy to fall into the trap of lashing out and being arrogant. I want to let you, I want to say one short thing. I want to let you speak to this as well, Sean. For me, I think, you know, the key is when you go on, you know, any kind of social media, post, tweet, whatever, do it for one person audience and that's Jesus Christ. You know, write it like Jesus is the only person who's going to write it. The only person who's going to read what you're writing. So you want to make it, if that's your attitude, like I'm not writing, you know, I'm not going to go out there to try to win arguments. I'm going to go out there to be Christ and to reflect Christ. And when we, you know, that's the trap of social media and you talk about it and take your, your sunglasses off saying that to your children. That's great advice.  But this, this, this kind of communication it affects our community. Well, you know, and the trip says that we're supposed to always read things with, with charity and always presuming they mean the best thing by it. Because I have seen so many fights and because you can't put your emotions well and like what you mean when you write things. When you put, when you put a text up or you write something, somebody can take it and look, oh, he meant this. And no, I didn't mean that at all. So we always want to presume when the person writes something that they're writing with the best intention instead of always like going, they meant this. It's like, wait, stop. Could they have meant this? Okay, let's presume on that until we get further evidence of that, you know, it's just this kind of communication is brutal. It wrecks friendships that hurts people just because you can't, you know, the theology embodied person's not there. It's just the writing. And so you're constructing this person through your own wounds while you're reading what they're writing. And they might say something that triggers an old wound from you. They didn't mean it at all, but you jump all over it out of a mirror or wound because the person's not there. So it is, it can be a pretty sketchy way to communicate, right? And I mean, social media and being able to positive for it. And then there, I'm a hero. I'm a hero. I've been through a lot of my interests, I've already done a lot of my will about yours. And it was Catherine who shared that and Catherine, that is a beautiful prayer. You know, for me, receiving mercy and being merciful and overcoming my own, my own self-righteous tendencies, my own resistance to come out of myself. You know, it's never been, I guess, never been easy. I've always had to make a deliberate act of the will. But when I pray for that grace, I always pray that prayer because, you know, never go to the Lord and say, God, I will do this for you. I will be more merciful. Because reality is we don't want to do what we will. We want to do what he wills.  There is a stretching that comes with saying, Lord, not my will or yours. Because if he's going to call us out of ourselves, if he's going to say, look, this year of mercy has ended, but we need apostles of mercy to be walking this planet 24-7, then I guarantee you that the grace to fulfill that impulse, that desire that might be welling up in your heart is there, but we have to be asking for it. Give us this day our daily bread. Give it, give me what I need this day to be able to love and forgive the way you want to. And if you can't find it in yourself and make that year on this prayer, I can't do this, Lord. I'm incapable of forgiving the situation. I'm incapable of loving in this situation, but I know, Lord, that through your grace it will happen through me and as you work in me. And I think sometimes, wow, we can be so, you know, we think we're capable of. We totally misread ourselves and the Holy Spirit can guide us to where we can be. Well, I mean, I speak to so many young men who struggle on the internet, obviously, pornography, all those things, and some of them are like, I will never be able to break this. I will, you know, and they start to go into despair, right, instead of trusting the mercy of the Lord of like, you know, that addiction is not who you are. That's what you're unfortunately caught into, but that doesn't diminish God's love for you in any way, shape, or form. You know what I mean? God's merciful. He loves you and he sees the battle, and that battle is sharpening you in other areas of your life that you're even, that God will even use that to help make you a saint. Yeah, you know, I think that in showing mercy to yourself, I think the thing to remember is our frailty as humans, our frailty in our relationship with Christ is in a real way a grace because it makes us more reliant upon him. I think if we could do this Christianity thing all the time perfectly, we would never learn the true essence of the crowning glory of God, which is in mercy because we wouldn't need it. You know, we would not experience the mercy of God unless we sinned and we celebrate that during the Tribunal always single happy fault that one is such a great Savior, but it needs to be a reality that we not forget because we only pray that prayer once a year, but it's a reality 365, right? We are blessed to know the mercy of God and when God shows mercy, he is showing the completeness of who he is. He is totally justifying us through his divine gift of grace and it's not a contradiction to say God is just and God is merciful because the mercy of God justifies God because it means what he's showing mercy and forgiveness towards us. He's completing the deepest essence of his nature and yet we still bring to that relationship a father, past rejections maybe from our own earthly father that we always had to burn their love that we never had it lavished on us as children and so as adults, we still live in insecurity of truly believing there's a secure place of love for us in the arms of God. We still think because everything else in our life seems to have strings attached to them. When we come to God, we have to find what those strings are and they're not there. We will not find the strings attached with God and we hear words in our youth when we're put down and hurt, rejected and we kind of instead of taking that as an incident that we can move through those wounds become unidentified marker on us and that makes it hard to show mercy because we've not let God touch with his mercy for a while those deep wounds and experience the deep healing so we are free to show it the way he's calling us to. It's so key and as we move out of the year of mercy into the rest of our lives as apostles of mercy, people committed to showing mercy that we first not be afraid to explore the depths of God's personal mercy for us. I can't even expound on that just now. Well, but so let's talk a little bit about the showing of mercy because Jesus was very clear in the Beatitudes blessed are the merciful for they shall be shown mercy. Okay, so mercy is hard because we're prideful, arrogant, self-centered, broke and wounded, you know, and that's when we look into the whole introspective thing. How can a person who's like, I want to overcome my brokenness, my sin and become a merciful, one of some practical tips that we can give to people on this webinar of breaking out of that shell because as long as we're trapped there, the world's not going to change. Only God's mercy level changed this world. You know, it'll make America great again. Man, so what helps me because I feel like honestly, for me, it's easier for me to help the poor, the extreme poor than this to be merciful to like gossips. I truly struggle with gossips. That's that's my thing and really helps you. So when I constantly remind myself that that person is driving me crazy. Is it not holy like me?  I go, wow, okay, couple things. That's incredible for the dignity of that person. And secondly is I better get along with them now because I'm going to be with them forever, man. It's real. But that to me is a huge reminder because we live in this world of like, you know, I don't like that.  I don't like you. I'm going to unfriend you. I don't like this again. Boom, boom. And it's like, wait, it's like, when we die and we're in the presence of God and we're seeing people with the eyes of Christ, that person that you're struggling with here is somebody that you're going to love beyond anything you've ever been in love down here. And you're like, you're going to let them go, man, was I a stumbling block to that person? Because Satan's enemy, not that person. So how do I pray for them in that moment? And even when you pray for them in that moment and you don't feel any love, that's perfect. That's awesome.  I'm just going to will myself to pray for them. Not because I feel love for them, but because Christ loved them first, I'm going to love too. For no other reason than Jesus, you love them.  They're, they're hopefully going to be with us forever in heaven. We're all going to be with you in heaven.  Even if you guys start there, because of my love for you, I'm going to pray for this person. I'm having a hard time loving them at this moment. But because I love you, I'm going to do it. And I think that can like, it, it, it, it shocks your brain out of doing the circular pattern of like, okay, this person harmed me.  I will now attack. I've shot them all. And you keep doing this.  I'm just going to pray for them right now. One Hail Mary. And just kind of break that cycle of that.  And that, and that's part of this identifying in ourselves what, what triggers that defensiveness. You know, you know, the, the, the term mercy comes from the Latin misery, which really means to open your heart to the misery of another. When we look at somebody who's sinning against us, you know, the greatest misery is living in sin.  They are not happy people. And you know, to, to show mercy is a, is a heart thing, because it means that we're willing to open our hearts.  I hold nothing back. I open my heart to the, to the most miserable in the world, to love. And, and if we really want to get into that movement, the first thing that we have to do is to go to the Lord in prayer and first say, Jesus, I want to be somebody who's opened my heart to your, to your mercy. I want you to step into the mess that's me. Because if I don't know, if I don't learn from you how to do that, Jesus, what it feels like to have someone stepping into my own messiness and welcoming and embrace me in my worst moments, through my worst sins, then how am I going to be able to ever go out of myself to another and do the same thing? We've learned from Christ through relationship with Christ, through letting Christ touch us. And if you're feeling stuck in showing mercy, the first thing is pursue the mercy of God with reckless abandon. Be somebody who's hard to embrace the heart of Christ that's open to your own misery and suffering through sin or through woundedness, through the sins of others that have been committed towards you, because that's where a lot of the pain starts. We get hurt and then we don't want to open our hearts and then we can't either, we can't receive or share mercy when we close out our hearts because that's what it brings all of us. It's a heartache, you know, mercy.  You ready to believe that? No? Okay. So I write down when God's delivered me from things and so I don't forget it.   God, thank you for this. Thank you for delivering me from this, man. Thank you. Thank you for that. Or when I was doing this when I was younger and thank you for your mercy and that, it just, for me, it reminds me of where I've been, where I'm going and that God's been there the whole time.  Like, even if you thought of praying for somebody you can't stand, but you didn't do it, that's a potential growth there. When you stop for a second, like, I should pray for that, but I'm not, but at least you thought about it. So even even a little bit. Sure. And it's important to remember that growing in our understanding of mercy and our deepening of shown mercy is part of what we call ongoing conversion. I think oftentimes we live in the society that, you know, you can microwave anything in under a minute and it's instantly ready to go. You can turn on the television, watch a 30 minute episode and it's all wrapped up, or you get things figured out under, you know, 30 minutes, including eight minutes of commercial. So in 22 minutes, all of life's biggest issues can get resolved. And that's just not life. I mean, we are God's handiwork, right? We are a work in progress. So as you, as you start, if you are embracing this call to be more merciful, because there's a number of questions, and I don't want to turn our attention to those shown before we run out of time. Like somebody said, or show mercy to others at our job, and they live up in man, they said that the current culture up there, it's very challenging. What suggestions do you have to keep going in a difficult secular culture? And then the follow up question that she asked, how can we reach our young people such as our 13 year old sons? It's difficult. Yeah, so, you know, and it's also, let me start with that, you know, I'm getting ahead of myself. I go back to the simple idea that if we say a daily yes to the Lord, that's what it takes, a daily yes to being open to His mercy, to take some time every day, affordably, at the end of your day, to look over your day, to see where you fall in short, and just ask for mercy. God, when I had this conversation, I lost my cool. I didn't show mercy. Lord, forgive me, show me your mercy. You know, and ask the Spirit to bring to your mind and your heart, and a few moments of quiet and brain sleep. How did I let God down today? And then right away, ask for mercy, because you will receive it. And it's not, it's like free shine. It's not always that mystical, wonderful, warm, fuzzy feeling, but it's a reality that grows in us. The other thing that Rob suggested, you know, going to adoration. I recommend adoration for people who struggle in prayer, because if you just put yourself in the presence of the Blessed Sacrament, amazing things happen. It's Jesus' body, blood, soul, and identity.  You would never feel yourself getting sicker and sicker and sicker by radiating poison to way down the road. But it would start, it would be happening beneath the surface on a cellular level and you'd be being transformed. And I'm telling you, the cells, our spiritual nature, when we sit before the Blessed Sacrament, even when we don't feel it, slowly but surely, our spiritual nature is being transformed. And it's not maybe we'll be down the road until we bend that discipline, and bend in the presence of the Word. One, though, that all of a sudden the true effect of that starts to manifest itself in our lives. But we have to trust in the true presence and we have to trust that Christ will have His way if we give Him permission. So, you know, I would just say do a daily exam and ask for mercy every day. Know that you need it every day, and don't be afraid to go for the Word. If it's mortal sin that He brings to your heart, then get to confession. And then just the Eucharist. You know, be in the presence of Christ as much as you can. Even if it's one extra holy hour a week, just go to the Lord and just sit there. That will transform you. A prayer life, and that's a prayer life, and it's hard because I know myself, I can tell when I've been praying, when I'm really praying, what I have. You know, it's easy to say, well, I pray like when I walk or I pray. It's like they actually sit and be present. My mom used to say that all the time. I'm like, Mom, you can pray. She's like, I pray all the time. I'm like, no, you worry. You know, you're worried. She's like, oh, yeah, that's true. And I pray in the car and it's like, yeah, that's valid. But that moment you can sit down and reflect your presence. God, yeah, it's the praying man who has the peace in his heart. And it's the praying man who, the praying man and the active man of faith that has that joy in their heart too. When you have a joy, you know, I have disarmed more people on social issues by loving on them greatly than any amount of apologetic work. Rarely does anybody get converted, I think, in the heat. It can happen in the heat of battle of showing your knowledge of this and that. But when you bring them fishing and you're like, you know, I just want to, I just want to love on this person first. And your goal is to love them, not to convert them, not to an argument. That's from the fruit and in a joyful person, it's really hard to not like.  I love him, receive the sacraments. I'm like, there is no death. That's been conquered. Well, like, all right. God loves, I am loved. And then all of a sudden you're just like, in getting used to that, you can't always be like that. You know, you're going to have bad days. But you know who the joyful people are. I get it. There are some people, pious, they walk out of church and I get it the whole time. That's great. There's that time for that. But there's also that time, man, just to really be friendly and joyful. Because who wants to come to a church and it looks like everybody's just moaning and nagging. It's like, you know, it's like, man, God, Christ is risen. I don't know you. It's, it's still the world about it. God loves me. I loved you. I think it was St. Teresa of Avalon who said, Lord save me from the sorrow of the saints. Yeah. And I'm like, whoa, because, you know, it is, you know, the fruit of the spirit working in our life is love, joy, peace, peace, kindness, goodness, gentleness, faithfulness and self-control. Right. So, so if we're in the Lord and in his spirit and we're in communion with the Trinity through our active participation, mass, our perception of the sacraments through our daily prayer and scripture reading, then there should be the fruit of joy in their lives. And this is why somebody said, is, is being merciful just being nice or is it more praying for them or both? Yeah. It's not being nice.   It is having our hearts changed so that we see those who hurt us through the eyes of Christ and are willing to not just, in our minds, say, I forgive you, but really have a movement of the heart where, you know, we're willing not just to, to say words, to disarm or say words, to kind of gloss over that situation, but we're really going to work to restore and love and serve that person and really put ourselves out for, you know, and there were a couple of questions that maybe we could spend just a couple of minutes here, Sean. You know, a couple of people said this, and so I don't want to gloss over it. Obviously, one of the toughest places to show mercy is in our own families. It's easy, I think, sometimes to show a stranger or someone's poor and, you know, our hearts can be moved to compassion for somebody who we just meet, who seems to be down and out. How does our heart continue to move with compassion for somebody who over and over and over again has hurt us, let us down, betrayed us, has not treated us the way that we think we can be treated and we're just, we're dealing with frustration, maybe even its take and move to the point where it's bitterness. You know, how can we move out of that and really love, you know, our families and be merciful with our families the way Christ calls us to? Wow, how much time do we have? But, I mean, what, 10 seconds? I often tell people, explain the truth in three words or less. I often tell people that exact same thing you're basically saying.  Why? Because it's easier. And I think that's why Jesus is pretty clear. He says, love your neighbor.  I mean, I think it's got the courage to go over and do that. It's a third world country, you know, and you got to enter in, but holding a baby or a little kid who really can't wound you in any way, shape or form, or somebody that you're visiting on a mission trip for a week really can't wound you because you haven't entered in that level of intimacy with them. There's a safety there of like going, well, I can do that. But when you have to love your neighbor, you have to see them the next day, the next day, the next day, the next day, the next day.  So that's a tough thing too. So keeping ourselves in check of saying like, are we, you know, these people keep doing this to me. Are we ourselves? Do we keep doing something to them too? Do we keep having the same response, that circular thing? But what helped me was with my father, God just gave me this revelation. My father had this temper and it was really, it was tough when I was young to be around my dad, you know, I was pretty intimidating figure as far as his tempering things like that. And I used to get so mad. And I had this hatred that was really, it was really brutal with my father. And then it was weird, it was just in prayer. And God gave me just this insight to see him as a 12 year old child and realizing what his father was like to him. And seeing that, you know what, he's a kid. We're all just kids. He's just a bigger kid. We're all just wounded. We're all broken. We all have baggage. And I started to feel, instead of anger, sadness. And that was a key moment in my life when it turned to sadness for him, feeling bad.   You really had to have, you were at that point, came out to be a phenomenal father as we addressed things together. God really healed that. But at the time when I started really just trying to look at it with your hand, you're not happy. You're really sad. And I started to feel bad.  It's really sad and broken. So it really helped me to have more mercy when I looked at these people who do things as children and not as God. So when they do break your heart, it's like, well, yeah, we're human beings. It's going to happen. But that's not God. So you can see people as all of us as children of God and broken and wounded and trying to get back. That helps because sometimes we set this level too of like, we have to be perfect for it. Right. And that's not possible. But again, to that person who's, if you have somebody who's hurting you and in physical, you have to tell somebody and get away obviously in that direction.  And so don't be surprised it's going to happen.  And it's actually having an internal dialogue with that person and with God and really like, like getting your brain used to that kind of thinking. I really, I really believe people just are stuck in the same war patterns over and over again. I'm wounded and angry at him for that whole thing. It's like, how can you switch that? So for me, it was visualizing somebody because literally we're all just children before God and some just grown up to be bigger and older on Earth, but they still carry those wounds. So they're just bigger kids with the same wounds. Yeah, I think what you just hear, Sean, actually is a perfect example of kind of what I was trying to get at. And when we are, when we are focusing on ourselves and our woundedness and the way people hurt us, you know, we, it's like putting on glasses that will cause us to see the world a certain way every time. But when we go to prayer and we say, you know, God, help me to see things right.   Like everyone needs mercy, everyone needs compassion. And yet when we get stuck on this internal dialogue and our preconceived notions, we can't move off of it. And that's why prayer is essential to this mercy, to, to allowing God to touch our heart in a way that moves us out of that space where we're, we're enslaved to the past or to, or to fixated on our own woundedness to be able to move forward. You know, and family, you know, you experience the deepest loudly, also experience the deepest hurt because you let these people closest to you. They're the ones that know you're better than anybody. They're the ones that you've shared more with than anybody in that intimacy, in that community, the vulnerability, the community to some deep woundedness, you know, and it happens too often or not. So, you know, the good news in all this is I believe there's always, you know, there's always this, this ability to overcome. We're never without hope. And I think that's, you know, an important part of the takeaways. Keep progressing and don't give up hope. Pray for the grace to forgive and seek forgiveness for yourself.  And I loved her, but I was, you know, just like, okay, you weren't supposed to act that way. You weren't supposed to do that. I have the script in my head that I already wrote that this is how you're supposed to act in all situations. I have these expectations and you've already filled me three different ways and we've been married, you know, for one day. You know, I was like, you know, and not that those things were present as we dated were engaged, but I think, I think I went into this thinking, okay, I'm going to be able to move in with this person finally. And I want to be, you know, roommates with my best friend is all going to be hunky dory. And it's like, when you get that close, you know, even after you're dating, and you find, there's a whole other level of learning to forget and let go. One of the prayers that I think will really help you in showing mercy is to pray the litany of humility. If you struggle with attachment to yourself, your pride, your desires, your woundedness, pray the litany of humility. Pray that you would not be afraid. Pray that you would not be attached to those things. Let them go. And it might take a slow process. You might have, like I said, might have lots of claws in you, trying to keep you, keeping you held down. And as you pray, one by one those claws are removed until you feel you're finally free. There's grass completely. But don't be afraid of the spiritual progress and the spiritual effort it will take to get there. Because if you say yes, God, I want to get there. God will give you the grace. The only thing that can hold you back and find a deeper level of grace and mercy no might is a refusal to go to God and say, God, I'm totally messed up. And I can't get out of this situation right now. You know, I sometimes get frustrated with people when they'll be like, I need help for, you know, my boyfriend. My boyfriend is so lost right now. And I'm like, how bad did you really want his conversion? Are you willing to pray a rosary every day for him? Well, you know, I say Hail Mary, and I'm like going, you've got to want this so much. Like you really love the person point where you're actually going to pray for them.  Or you just want them to work exactly how you want them to work for you? Who are you praying for? Is your prayer actually about you or for them now? Is it so the result will be you're happy because now they're acting the way you want them to? Or is it truly you want them to have a conversion in their praise? Those are two different things. How badly do you want to reach that person? Because there's a spiritual laziness as far as a laziness in our warfare when we're really trying to bring people closer to Christ. Are you willing to fast for them? What are you willing to do for this person? What are you willing to give up? And they'll never know. But do you really care that they're that they're so far from God? When you won't sacrifice for them, you might be further away from God than they are. So it's just kind of a reality check.  There's a just a an incredible thing I have is willing to fast for somebody.  And I will put it in terms of this. When did Jesus have to go through an order to be able to show us mercy? It's across. Scourging at the pillar was the crown of thorns. It was the entire passion was being spat upon having this very blood being punched, being rejected by his closest companions in his deepest hour of being. So anyone had a reason not to, you know, to be out of sorts and not want to show actual mercy in a moment who would have been Jesus. But what do we know? We know that when Peter caught with the gaze of Christ across the courtyard after he just denied him three times as Pope Francis wrote it, it was the gaze of mercy. And that's what moved Peter to tears. He saw in Jesus' face the mercy. And that's what allowed when Peter received restoration and forgiveness from Christ later on the beach, you know, he knew that it was going to happen because he saw the face of Christ. And if Jesus is willing to go through all that in order for me to experience his mercy, what are we willing to go through for our brothers and sisters, our parents, those that we love and order that our relationship with them might be touched by God's mercy, grace, forgiveness and restoration? Because if it's the temple of Christ, it won't come without sacrifice. It won't come without effort, serious effort, and we can't give up. And that's what it means to love and be merciful. It means I will do what it takes to bring restoration. One of the things that really helped me in being more compassionate and less stuck on myself was making sure that I also did do a daily exam saving my wife today in a way that would have been kind of sending rude, would have devaluated her in any way. And if something comes to mind, go to her and say, you know what, I was just thinking about that conversation earlier.  I said this and it must have come across just really rude to you. If it hurt you, I apologize. I don't want to hurt you. I want to show you love and taking, you know, you don't take the moral high ground. You take the humble low road with them and you show them what humility and seeking, you know, seeking back people, what that looks like. So anyway, you know, we're just about out of time. I hit her deadline. I didn't want before we sign off, I asked everyone, give me about five more minutes. Hey, a lot of people have said, well, how can we become involved in missions? Where can I do missionary work with this summer with my family? You know, how many and I are 50, my kids are 17, 20, 22. And that's awesome that you're thinking that way. Other people would leave us, you know, how do we help out in missionary work if we're not able to travel the country, feel the need to help out. I had a couple of comments like that. And, you know, I have been blessed to be able to go down to Haiti with Sean and going back with Sean in March to do a week of mission work. And I can't tell you, you know, I've been on a number of mission trips, but I once lived for a month in the dump of the city of Juarez, Mexico with the poor, so the poor in Juarez. And we would sit at night enjoying a cool breeze because it was like 107 during the day and cool breeze was 78. That was the low temperature. It felt good. And we would sit on the top of this mission building, we'd be able to look across the Rio Grande, there were two million dollar mansions lining the mountainside overlooking the Rio Grande Valley, while these people were living in cardboard shacks and having to go with pallets. But no running water, no electricity.  And I've also been down and seen the work that Sean's doing in Haiti, so I just want to turn it over to Sean and let Sean talk about his mission for a few minutes. And for those who went through and moved from this webinar to maybe take action to do something out of yourself to show mercy and compassion, you know, to be able to do that. So take it away, Sean. Thank you, Sean. So the organization is called Haiti 180, Haiti 180. And it's really just entering in, well, yes, we help the poor, but it's, I call it an intimate encounter with the poor. So it's not like you're just building a house for somebody that you don't need. I mean, that's a beautiful thing to do, but it's, it's, you're going up and cooking for someone who has meat in two days, and you're going to sit down, then you're going to share your faith with them, and then you're going to keep visiting them so that when you leave, you're really going to miss them. They become family, friends, and their faces haunt you in a beautiful way, so that you can't forget them. So it wasn't like a vacation where you meet some people, you forgot about them, but you go, look at this person who inspired me, because they didn't have shoes, they hadn't eaten in two days, and they prayed over me. So, you know, I truly believe people want to do good things, but they just don't know where or how. And the beautiful thing with this is, well, where is, will I say you would need me, and how? Just go to our website, and you'll see a link that says go. And that's right, everybody wants to go on a mission, and explain to you exactly how to do it.  And it's a really cool way to jumpstart, I don't know your faith, it's an instant, or you're on fire, and like, I don't know what to do with this fire, I don't know where to go with it, we'll come over and let these people inspire you, and God's going to bless you too, if you're going over, James 1 verse 27 says pure, undefiled religion is this, to care for the widows and the orphans and their affliction, and keep yourself unstained from this world. So it's like, you got to get rid of sin in our lives, because it's about us getting into heaven, right? You got to get into heaven, and keep growing in holiness.  That's usually what holiness will end up. I'm going to look more and more like Mother Teresa without the holiness unfortunately. So, I should write 12 lips in this year when I was pregnant. And another way, man, if I can do that, if I can plug this, is, you know, we have a, somebody called T-180, it's for people who rarely want to be invested in building a relationship with us, and this is going to sound like an ask, and it is. I'm asking people to be $15 a month, and it's $375 a week for your adults, that's a beer, for those of you who aren't more sophisticated, that's a wine, for your youth, that's a coffee, back to you in June 3rd, but that donation is huge for us, and it's not a lot of money, and it's a good thing to invest in because it really goes to help the people. And, you know, you really see, this sounds so exciting, this part sounds like a commercial, you get my book, I start doing webinars like this, but what I'm trying to do, if you join this, what I'm trying to do is build a relationship with you so that eventually, maybe not this year, next year, next, but you're going to come all around with us, because it is something powerful to go to a third world country, and because you see gratefulness on a whole new level, it's unbelievable, and when you pray with people in a third world country who've had an earthquake kill 250,000 people in 15 seconds, and then hurricanes, and they're hungry, and then you watch them praising, and they have tears in their eyes of authentic love of Jesus Christ, you just, you go, who's helping who here? So, it's like, I'm here for you, and we got food coming for you and everything, but man, I have learned so much, and who you are as a people, it's absolutely incredible. So, if you can support us by being a part of it, come on and mission with us. Join Team 180, it's not a big hit, but man, we can use it, you know, we're a grassroots organization that's very faithful to the church, and so it's not just feeding the hungry, it's also feeding the word of God, and the Bishop there loves us, because since you guys know that man does not live by grandmother, so if you forgive them food, but you're not giving them Jesus, they're still starving, and they get that, so that's what we're about, and it is an adventure, and you've got to take your faith on an adventure.  Faith without works is dead, and remember, youth group isn't works, going to conferences isn't works, that's receive, receive, receive confirmation, receive baptism, receive conferences, and receive songs, and it's like, at what point do you start to give, and give till it hurts, not just out of the change in your pocket, and not just out of like five minutes of your time that you say, I've got to quit my sports here because I haven't done anything to help the poor, that's giving, that's radical living, that's Jesus stuff right there when you're like, you know what, I love these sports, but man, I can go on a mission, I can be helped, I can start a whole program that allows teens to go visit the elderly in nursing homes, and I'll direct this whole thing, that's the greater part, because giving has to hurt in some way when you know, because it's like, that's a lot, but it's an extra gift, and I'm not just talking monetarily, it's like, all right, I'm afraid of flying, I'm afraid of bug, I'm going to go to Haiti, I'm going to go to Jamaica, I'm going to go to these different places and step out of faith, because how can you know how much faith you have unless you step out of faith? You could be one of these people like, I think I have the faith, I'd like them to believe I would do this, I think I could do that, and it's like, last thing, a lot of people are like, I don't feel Christ, I don't feel God, and I would say, if you want to feel the comfort of God, first you must get uncomfortable, we're way too comfortable here in America, and it's very difficult to feel the presence of God when, well, you have the internet, when you need God, you can solve all your problems, you have to get, we have to suffer, if we want to know Christ, we have to suffer for the sake of righteousness and suffer for the sake of God's core, if we truly want to grow in relationship with God, that opens up, your Easter will be incredible, because you'll know you're suffering in a deeper level, and people who suffer, I truly believe have a more intimate relationship with our Lord. Sean, thank you. I know you're a humility and I know how hard it is for you to do the ask. St. Francis is my role model in the sense that he came from a very wealthy background, but ended up giving it all away and then begging in the streets for those who couldn't take care of themselves. And so I will only add this, when Sean and I kicked around this idea of starting the Team 180, you know, I saw the potential to raise up an army of people who would be moved in their heart to say, we believe that what you're doing now, Mary, is saving lives, and he is, to take a baby that would otherwise die of starvation or disease in the slums of quarter prints. When I went down in the first time, it was right after the hurricanes, it wasn't actually a couple of months after the first hurricane that went through, and there was literally, around the slums, is a trench maybe 20, 30 feet deep, and that's their bathroom, but I'm going to use the bathroom. At this particular time, everything that had been wiped out had been pushed into this trench. It was overflowing with garbage. It was overflowing with human waste. As we drove through that neighborhood, we had to get out of town. I can't describe how overwhelmingly disgusting the stench was. And yet, right next to these piles of filth and trash, where people sitting on little pieces of cardboard and trying to sell fruit that they picked off a tree up in the mountains and brought down, because they knew that they didn't sell this and make money, they would die. There were people wandering aimlessly looking for something and not knowing where they would find it, food, care, shelter, and people die by the hundreds of slums of quarter prints every day. And this ministry is not about patting ourselves on the back and saying, we're going to do the great stuff we're doing. It is about taking people literally out of hell and giving them a shot and not just having a decent life here on earth, but eternal life with Christ. And I passionately implore you in Christ, if you have the means and you are moved to go to Haiti 180 and sign up for team 180. Join us in our efforts to save the people of Haiti.  It will change your life in the way that nothing else can. If you shine now that we are so insulated against anything that rubs us the wrong way, we run from pain and yet Christ ran to the cross. He ran into his pain knowing that it would redeem the world. You run to the challenge and the work and the suffering that it is to be a missionary, even if it's just for one week, and you will get closer to Christ because where there's suffering, there's Christ. Where there's the poor, there's Christ. You want to know where Christ is, and especially he makes himself abundantly present to these people out of his great compassion and mercy. And when we go there, and I love to say it, and I think it was St. Vincent Paul that said this, the poor exist to save us. We must take them. The poor exist that we might be saved. We need this for our own salvation, brothers and sisters. So if you moved it all and you want to look for what the next step is, go to Haiti180.com. Find out everything that's going on. Find out how you can get involved. Find out how to support Sean and what's happening down there in Haiti. I love this new man. He has suffered greatly for the gospel in a way that not a lot of people I know have. And out of that, I had just a profound respect and love for everything he does and would love to be able to see as many of you as possible come out as partners with me in supporting this mission through prayer, through finance and coming down there and giving up your time and being blessed. I can't wait to go back. Honestly, I'm like, I know there's, there's that part of these like, I love a high shower and a little bed. I love rolling on my bed and walking 10 feet to my hot shower.  And when I went to look at the first time, car cars were crawling out and I was like, he's fixing up. Like, you're not going to have to go through that, okay? It's, I don't know. I feel like through that one, it's different now. But those are the whole, that was, it's concerning experience I've never had in my life, probably. But man, I mean, like, coming back, I still feel the blessing of best sacrifice in my life and how it's moved me to a deeper willingness to give myself more. Because it's addictive when you experience that rush, that rush of the spirit when you wold in a missionary mode.  Sean, do you have any final thoughts before I close this in practice? Just that last thing you said is perfect. It's different.  In a different way, it's like that when you're on a mission trip with people. Because when you're like, if you get there, and it's a drought, hasn't rained for seven days, when we first went, there's no water to bathe in and everybody stings. All of a sudden there's a thunderstorm and everybody runs underneath the huts and it's all poured down and we're taking showers and our clothes just getting watered in. You know what? You got this one life to have this incredible story.  And there is an adventure out there. Falling Jesus Christ is just, it's a, it's a radical thing. It's not a comfortable thing. And at the end of your life, what a story to tell when you fall in Christ. So yeah, go for it. Amen. So in wrapping up, thank you for being part of this webinar. I hope what I was able to share. I know that there are some particular questions people have about missing trips and what they're like. And, you know, I think we have someone who is, has some medical experience that's interested in what you're doing down there, Sean. Go to his website, find the contact. You know, for those, you know, who aren't positioned to help financially right now, please pray that we get a solid donor base because the goal is after this mission is up and running just to move to the next section of the country where there's nothing built in our life. And when you're talking about too, it's like, you know, I can just tell you something like we're 15 bucks a month. Like I watch people line up and pay six bucks for coffee. And I'm like, remember that whole thing about sacrifice?  Doesn't taste as good, but actually it'll taste a lot better knowing that you didn't go give it to the mermaid and that you gave it to the poor person, you know, you know what I'm saying? I'm not trying to say any product line out there, but it's no coffee taste. Is it right with car trucks? Oops, did I say too much? Alrighty, yeah. So, let's speak of what it is. 15 bucks a month is not a sacrifice for most of us. And I'll end it with that. You know, we're not trying to guilt you. I'd rather have you do this because the spirit of God is moving you to do that. You can look at that face. Come on, let me help aesthetic shop. Help them. Just pray and ask God what He wants you to do and say generously yes to whatever comes out of that prayer. Alrighty. And so, let's close this whole thing with a prayer seat.  Thank you, everyone, for being a part of this. And then, before all our son, please, good and gracious God, we thank you for this day. I thank you for my brother, Sharon, for what he's doing. I thank you for the year of mercy. I thank you for the mercy you've shown me in my life. I thank you for the opportunities you've given me to show mercy. I thank you for the way that that growth has stretched me and at times broken me. I thank you for the way that you've never given up on me.  But I ask God, you expand my capacity both to receive and to show mercy to this world. Lord, let me not think of myself. Let me not think of myself, not let me not think less of myself, but let me think of myself less so that I can be focused on those around me, those who need my love, especially those in the mouth. Bless everyone who's been on this webinar. Bless everyone who's wanted to be on this webinar and make it. We trust in you, Jesus. We trust in you, goodness. We trust in your continued mercy, your continued guidance. And we turn to you, Mary, mother of mercy, our life, our sweetness, and our hope that you would pray for us, that you would draw us close like Jesus's heart of mercy through your immaculate heart as we pray again.  Blessed are I now amongst women and blessed is the free God of Jesus. Holy Mary, mother of God, pray for us sinners, now and at the hour of our death. Amen. Our Lady Mother of Mercy, pray for us. Name our Father, explain the Holy Spirit, amen. This webinar has been recorded. It will be up on our website in a few days. So if you know anyone else you think would be blessed by this message, feel free to direct them to our website. Send them an email when it's good to go. And we'll talk again soon. Thank you, guys. We love you. We'll see you again soon. God bless. Thanks, John. Thanks, John. Bye, everybody.


Good evening, everyone. I am Dr. Nikhil. I am from Vardhaman Mahavir Medical College and Sabdajan Hospital. And the topic for my oral paper presentation is assessment of extra pulmonary clinical radiological sequel in COVID-19 recovered individuals. So, the aim of our study was to assess the various extra pulmonary clinical radiological sequelae that the COVID-19 recovered individuals were presenting with. And also, to compare these complications, the incidence of these complications in mild, moderate and severe cases as categorized by Ministry of Health and Family welfare. Coming on to the introduction, COVID-19 or the 2019 coronavirus disease is caused by a group of RNA viruses known as the SARS-CoV-2. On March 11, 2020, the WHO declared COVID-19 to be a global pandemic. And the first laboratory-verified case in India was reported on Jan 30, 2020, in Kerala. The SARS-CoV-2 virus spreads through direct, indirect or close contact with the infected person through the secretions like saliva, respiratory droplets and also fomites. Also, many case reports imply that airborne transmission is also possible and the virus has been proven to persist in aerosols for up to three hours. Coming on to the pathophysiology, direct viral toxicity, endothelial cell destruction, thrombo-inflammation and immunological dysregulation are the main pathways that play a role in multi-organ damage. And for the entrance of the virus to the target cell, this ACE-2 and this transmembrane protein, TMP-RSS-2 must be expressed on the cell surface. COVID-19 is diagnosed primarily based upon the clinical symptoms, laboratory test results and radiological evaluation. We all know that COVID-19 is most recognized for its ability to cause severe respiratory symptoms and only limited data is available on the radiological patterns of extra pulmonary complications. So, our study was aimed to detect these extra pulmonary issues as early as visible using a multi-modality increasing method in order to assess clinicians in planning appropriate care to prevent further progression and irreversible organ damage. We used multi-modality imaging approach based on the clinical presentation of the patient. So, for example, if a COVID-19 recovered individual present to us with flank pain with raised D-dimer levels, so suspecting renal impact, we did renal CT angiography on semen somatom definition flash 256 lice machine. And we used non-ionic iodinated contrast, which was given with an injector pump. And the dosage was approximately 1.5 ml per kg through a flow rate of 5 ml per second. And during the RTL phase, image acquisition was started with a 6 second delay. And after the threshold of 100 hz unit, as the threshold of 100 hz unit reached at the region of interest within the abdominal laorta. And further we used MPR, MIB and VR methods to acquire images in actual coronal and sagittal veins. To detect deep vein thrombosis, USC Doppler was done on GE healthcare USC machine using linear probe and lower limb venous preset in patients who were presenting with pain and swelling of limbs and raised D-dimer levels. Another extra pulmonary complication that we came through was post-COVID nuclear mycoses. So individuals with comorbidities such as diabetes mellitus or other immunocompromised states such as corticosteroid therapy which was given to the patient during active illness or if the patient was presenting with nasal congestion, nasal discharge, facial or orbital swelling. So MRI, PNS with brain screening was done. This scan was done on 3T MRI GE system with the standard head coil and the acquired sequences in routine protocol were T1, T2 with and without fat saturations per even weighted post-contrast images. Also DWI flare was done. Our study showed that the various extra pulmonary sequelae that we assessed. So we assessed 120 patients, 40 each in mild, moderate and severe categories and the results were that the complications were seen more in the patients which had severe illness. Out of the 40 patients, 10 patients with severe COVID presented with deep vein thrombosis whereas in moderate category only 5 patients had DVD and 3 patients in mild category had deep vein thrombosis. Only one patient out of the 40 in severe category presented with renal infarct and none of the patient in mild and moderate category presented with renal infarct. Similarly, 5 patients in severe category presented with post-COVID mucolysmicosis, one in moderate and none of the patient in mild category developed post-COVID mucolysmicosis in our study. Coming on to the representation of the cases, first is renal infarct. This is an actual post-contrast CT abdomen. Angiophase, here we can see the infra-renal abdominal aorta. This is SMA and this is the left kidney which is showing normal cortical enhancement whereas on the right side we can show that there is no enhancement of the anterior part of the cortex as well as of the posterior part of the cortex in upper pole, the anterior part and some part of the posterior cortex at the interval and at the lower pole there is no enhancement of the anterior cortex whereas some mild enhancement is seen on the posterior cortex. However, if we compare it from the normal side the enhancement is less as compared to the normal side. This area in the superior lateral aspect is supplied by the capsular branch. This is the same patient, again axial section, coronal section. The axial section shows that there is non enhancement of the anterior cortex whereas less enhancement as compared to the normal side is seen in the posterior cortex and these posterior segmental branches are also attenuated whereas no anterior segmental branch is seen here. This is the right main renal artery in the coronal plane. This is the capsular branch that was supplying the superior lateral aspect in the last slide. This part here the black arrow is actually the anterior segmental branch which is non-opacified that's why the anterior cortex is not opacified at upper, inter or lower pole. This is the posterior segmental branch. Here in the neck section we can see that the posterior segmental branch is showing a filling defect here so just give off a thrombus and that's the reason why the posterior enhancement in this slide it is present but it is not normal it is less than that of the normal side. So this is because of the thrombus and the partially obstructing thrombus in the right in the posterior segmental branch of the right renal artery. This is again the capsular branch. The second extra pulmonary complication that we came across was post COVID mycosis a few cases of that this is a MRI PNS with the brain screening of a patient who had uncontrolled diabetes. This is a post contrast T1 scan axial and the coronal plane here in the first image we can see that there is the prominence of the retro bulbour segment of right optic nerve we can compare it with the left side which is normal. There is no enhancement of the optic sheath the nerve is smooth the margins are regular whereas on the right side we can see that there is the thickening of the optic sheath and there is some enhancement of the optic sheath. In the second image we can also see that this there is some enhancing soft tissue thickening seen in the medial aspect of the right orbit which is also extending through the ithmoid air cells. This soft tissue thickening is also involving the medial rectus muscle which is being showed by the green arrow the muscle is also appearing to be bulky and in the third image we can see that the soft tissue enhancement is also seen along the right cavernous sinus this green arrow and it is increasing the cavernous part of the right ICL however we can see that the flow void is maintained. This is another patient with history of uncontrolled diabetes mellitus showing black turbinate sign so this black turbinate sign is basically seen in the angioinvasive fungal infections like mucomycosis or aspergillosis basically these angioinvasive fungal infection what they do is they involve the mucosa of the nasal mucosa or the sinus mucosa and they lead to infarction of the mucosa so what happened the mucosa does not enhance due to the infarction caused by the fungus so in the first image these all are the coronal planes in the first image we can see that there is non-enhancing of the superior turbinate and the superior aspect of the middle turbinate also there is non-enhancing mucosa or non-enhancing soft tissue component seen in the left maxillary sinus this is a post amphotericin B therapy scan which was done after two months here we can see that this black turbinate sign is not seen here and the sinuses and the turbinate show normal enhancement also there is no enhancing soft tissue density seen in the left maxillary sinus so basically this black turbinate sign is not specific for mucomicosis only it can be seen in any angioinvasive infection such as aspergillosis as well coming on to the third extraordinary post COVID complication that came across that was lower limb dvd so in in these images first is the grayscale image of right common femoral vein this is the right common femoral vein this is the common femoral artery the superficial one this is the common femoral vein and we can see some eccentric ecogenic contents with it this green arrow some eccentric ecogenic contents are seen within the right common femoral vein the artery shows the normal human on putting color Doppler the artery shows normal flow here we can see and the vein there is in the vein there is the some patchy flow which is suggestive of recanelization and follow up scan in the same patient after anticoagulant therapy shows normal wall-to-wall color flow in the right common femoral vein also a normal wall-to-wall compressibility and augmentation on distal compression was also seen after the course of anticoagulant therapy so these were the cases these were some of the cases that we came across reviewing the previous literature about the renal complications it was found that ak has been found to be an uncommon complication in patients with COVID-19 and only a few cases of renal abnormalities in COVID-19 individuals have been published earlier and in a previous case report the patient had mild form of disease and renal findings were detected incidentally on CT representing acute renal infarct however in our study only we came across with only one patient that too in the severe category who had renal infarct about mucomycosis it is a fungal illness as we all know caused by a group of molds known as mucomycetes it is an uncommon but severe fungal infection it is a potentially fatal illness that mostly affects immunocompromised patients such as those with diabetes hematological malignancies or with the history of hematopoietic stem cell transplantation and the issue of solid organ transplantation again these patients are also on corticosteroid therapy which make them my immunocompromised and in an Indian study which was conducted by Joshi Ayer et al which comprise comprising of 25 patients 22 patients had diabetes and two had HIV infection injectable corticosteroids were given to all the patients and in their study a T2 hyper intense sinus content with increased mucosal thickness enhancing soft tissue these are all the signs that were seen also the black turbinate sign was also demonstrated in their study COVID-19 necessitated coagulopathy as in our case was seen in form of lower dvd it is linked with the hyper inflammatory and hyper coagulable state endothelial injury complement activation platelet activation platelet leukocyte interactions neutrophil extracellular traps these are all the mechanisms which lead to release of pro inflammatory cytokines and the disruption of normal coagulant pathways and are all the mechanisms of thrombo inflammation a single center study of 163 patients have has been done with without post discharge thrombo profile exists and they found that 2.5 percent incidence of thrombosis after 30 days of discharge so our study was a prospective observation study which was performed in a sample size of 120 patients including 40 patients in each mild moderate and severe categories which underwent various imaging investigation according to the presenting complaints renal angiography was performed in patients who had flank pain and elevated edema levels individual with the comorbidities such as diabetes or other immunocompromised states like corticosteroid medication they underwent MRI BNS with brain screening and individuals experiencing pain and swelling in their limbs as well as the elevated edema levels underwent UC Doppler various extra pulmonary clinical radiological sequel as we discussed they were assessed and the incidence of the sequel in patients recovered with mild moderate and severe disease was evaluated and as we found out that the incidence of these extra pulmonary complications was highest in the severe category patients thank you


From Seattle, Washington, it's theCUBE. Covering DockerCon 2016, brought to you by Docker. Here's your host, John Furrier. Hey, welcome back, everyone. We are here live in Seattle, Washington for DockerCon 2016. This is the premier developer show for containers. This is SiliconANGLE Media's theCUBE. Our flagship program, we go out to the events and extract the signal from the noise. I'm John Furrier. It's my co-host, Brian Graceley, our cloud analyst at theCUBE and Wikibon. Our next guest is Jason McGee, who's the IBM Fellow VP, CTO of the IBM Cloud Platform. Was on last year. Welcome back. Thanks. Good to see you. So you're doing a lot of drone demos. But I got to ask you the first question. Last year we were in the little hallway of the hotel. Fire Marshall's picking us in. Now again, continues to expand here. What's the update on IBM with containers? Give us a quick highlight on your update from last year to this year. What progress have you guys made? What cool things are you guys announcing? Yeah, so it's been a big year for us on containers. You know, we've been part of the ecosystem from the beginning and doing some really amazing things on Bluemix with containers. Last year at the DockerCon, we were just launching our IBM container service on Bluemix. So, you know, high performance, production, container hosting on our cloud platform. Last year, we've got just amazing adoption from clients. And you know, as you see here at the show, it's just an incredible increase in just interest around the container space. So I got to ask you someone who's on the inside of IBM Cloud. Bluemix, we've watched really, we were actually, I think IBM Pulse was the one of the best. We announced, you guys announced Bluemix. And the growth of Bluemix has been phenomenal just in features, but also the market's been rapidly exploding. Yes, absolutely. You guys manage that, and what's the key things, what keeps you at pace with that? Yeah, I mean, you're absolutely right. I mean, the adoption in cloud is just incredible and Bluemix continues to grow. I mean, we're at 20,000 new users a week signing up for the platform. I think one of the big things you've seen is kind of just the, this kind of expansion of cloud into a full-fledged platform. You know, two, three years ago when we were starting Bluemix we had platform as a service and we had infrastructure and they're very separate. And you know, you've seen kind of Bluemix blossom into this full platform of containers and cloud foundry and event-oriented programming and just an incredible diversity of kind of runtime capabilities. And then just amazing services. Like we were talking a little earlier about Watson and Cognitive and all these amazing APIs that are out there. So just seeing just the adoption of all those rich capabilities really grow over the last couple years.  You know, you just mentioned it. You've got OpenWhisk, which is, you know, serverless functional. You've got BlueBox, which lets you do VMs. You've got, you know, containers. You can do native containers, cloud. I mean, you guys have a much broader view of what you need from a cloud perspective. You've got a tie-in services.  And then where's the, you know, how does the bigger picture pan out? Yeah, I think all those labels are really kind of meaningless on some levels. I mean, if you look at a modern cloud platform, it has to span the spectrum. You know, if you look at customer workloads, some people are doing microservices and cloud-native and building new applications and they also have a whole bunch of legacy that they want to bring to the cloud. So our perspective is you kind of need a spectrum from bare metal to VMs, to containers, to, you know, opinionated containers of Cloud Foundry to Ben-oriented. And I think that container space in the middle kind of maybe is in the middle for a reason because I think that's where maybe the bulk of the momentum is really moving is a lot of new application developments going to happen around containers. This great blend of kind of flexibility and speed and agility that you get with containers. I think that's why so many people are here because they see, you know, that benefit on both sides. Well, you need the other tool. You need urban code. You need, you know, develop tools. You need Watson to help you do analytics. And I mean, you need all those things, I think, to sort of make it out. You need all the CI CD tools and you need like all the services. Maybe that's one of the lessons the broader container ecosystem hasn't quite latched onto yet is that as great as Docker is and containers are, not everything's going to be a container. And there's a lot of capability that'll be exposed as APIs and services. And you got to bring those into the platform in a first class way too. What's a developer market look like from a customer perspective? Obviously you guys have a lot of experience in the enterprise. And the enterprise application market is really exploding. A lot of energy, positive energy. They have legacy. So hybrid is going to be the winning strategy. So as I look at the Docker opportunity, how do you guys segment out and communicate to customers around where Docker fits and where the rest of IBM stuff exists and how does the next bridge that? Yeah, so I think, you know, we've been telling the hybrid story for a long time. And I think over the last year or two, we've seen more people come to our perspective that hybrid is just the end state that everyone's going to be in. You know, we're going to have this mixed environment. And I've always felt that container technology like Docker plays this really important role in providing the portability that you need to move across those environments. Because where you want to run is going to change over time. And so, you know, we're positioning and enabling Docker to be used in that way, to be used as the kind of heart of a portable hybrid application. And I think if you look at the rest of the IBM portfolio, they're adapting in that way too. So we're taking a lot of our existing middleware like WebSphere and converting it into those formats. So talk about your relationship with Docker, Inc. and Docker ecosystem. Two different things. Two different things, but you know, tied together. IBM, you've been acting to share some insight into what you guys have done, what you guys are doing with both Docker, Inc. and Docker ecosystem. So we absolutely are active participants in both on the community side. We're helping contribute to the Docker project. We have contributors and core maintainers on the Docker project that work at IBM and kind of helping shepherd that forward and also been working a lot on things like the open container initiative and cloud native computing foundation to put the right governance model around containers. On the commercial side, you know, we're Docker's first commercial go-to-market partner, first partner in the enterprise, first to provide enterprise support for Docker. And so we integrate with their offerings. We go to market together. We sell together, you know, great stories like ADP, who was up on stage today, big IBM customer, running Docker on the mainframe, on ZLinux. You know, they're a joint customer of ours where we're kind of working together to bring this thing to pass. Yeah, IBM does a lot of things. I mean, I was coming out of here on the plane, was watching the US Open, I'm clicking on it, you know, 100, everybody's keeping up with stuff. You guys learning a lot about real-time things.  Like how does that then, you know, kind of apply to people who go like, hey, I want to do real-time for IoT, which I might be, you know, how do those learnings from one domain apply to another? Do you find customers or are looking for that expertise for you guys? Yeah, absolutely. I mean, both just us providing kind of that expertise as, you know, consulting to those people. But more importantly, you know, we gain a lot of learning from running those events and running those high-scale, you know, mission critical. I mean, nothing is more kind of mission critical on a sporting event. You get it wrong, it's over. Like there's no going back, you can't try again, you have to get it right when it matters. And we take all that learning and we apply it to the solutions we're building, we apply it to how we architect our cloud platform. And you know, we've been doing that with the Olympics and with the Masters and all kinds of things over the years. And that's really, you know, part of the heritage of IBM. I think one of our great strengths is we've built a lot of these applications for many years. We really understand at a deep level how to build cloud and how to build highly available performance systems. Jason, what's the coolest thing that people gravitate to when you guys put out the, you know, the IBM portfolio of stuff that you're working on. You got a whisk out there, which we mentioned briefly. You're showing some stuff here. With respect to containers and Docker. Sure. Get your booth or in general, just anecdotally, what do you see people gravitate towards through the IBM technology? Yeah, it's probably a couple of things.  And of course, a lot of the Watson services, one of the things we talked about the show this week is Watson itself is built on top of containers and Docker. And we use that technology internally. On our core cloud platform, a lot of draw to our container service on Bluemix and really this, you know, we're doing something very unique. We're running containers in cloud on bare metal with a native Docker interface. Like you don't have to deploy Docker engines. You don't deploy VMs. You just come to the cloud and run containers. And I think for the developers here that really resonates because they can get to what they want to do. I just want to get my applications running on cloud and not have to worry about setting up infrastructure. How about orchestration and microservices, the future of those critical factors? So clearly microservices are a common use case around the container space. Lots of interesting opinions in the market about how to do microservices. One of the things we announced this week is we launched a new open source project called Amalgamate, amalgamate.io, which is our perspective on a microservices fabric and how do you actually build microservice applications out of a collection of images. I think it's important because, you know, microservices represent frankly a trade off, right? Like with microservices, everyone wants development velocity, right? That's what they're supposed to give you. But in exchange for that velocity, you get a much more complex operational environment. You get, instead of 12 monoliths running, you have 450 microservices each with three instances. You have 1500 things you're running, right? And so you need a framework and tools to help you kind of manage the complexity of that application. So microservice fabrics like amalgamate are an important part of making microservices real and usable. And the Bluemix update, where's that going? With all this energy with the application developers, what's next for Bluemix? What's the big work areas? Yeah, so Bluemix continues to evolve and bringing the kind of whole platform together, giving us that spectrum of capabilities, exposing APIs like Watson, you know, new things like WISC are coming along. So we have a serverless event-oriented programming also built on Docker, you know, one of the only serverless infrastructures that lets you use Docker packaging as the way you actually deliver your code into that environment. So it's really just kind of expanding the usability and the capabilities of Bluemix to handle this kind of amazing diversity of applications we're seeing.  It's now called World of Watson, I believe. Yep. Put a little plug in for that. It's coming up in the fall. So any other updates? You know, we're just excited to be here and to have this amazing community behind us. We've been working hard to make containers kind of a core part of how people build apps. And I think Bluemix is a great platform for people to try it out. Final question for you. For the customers watching out there, and they ask you, help me understand the Docker madness. I can feel it, a lot of energy. Yeah. How do I figure this out? What does stuff fit? My head's mind blowing kind of experiences here. I'm hearing all this great stuff, all these use cases. Yeah, sure. What do I do? Right. Well, one I think Docker is like so popular because it's great for devs and great for ops people, right? It's, there's very few technologies that have been good for both. My recommendation on getting started is always the same. Pick one specific concrete problem or project and go use the technology on that project.  And it will eventually. But to get started, you just pick one thing, right? Pick one app and go build an app on Docker and you'll learn very quickly how to use it in your environment. Great. And the vibe of the show this year? Vive of the show is amazing. I mean, it's like double the size maybe of six months ago. So just incredible energy. A lot more ops this year, which is really interesting to see, like more of a blend of dev and ops people. So that's added in. What's the top conversation you've been involved in? If you had to do a little de-dupe your conversations and stack rank the top one, what's the top one? The top one is orchestration and microservices. Like there's such diversity of opinion. We saw lots of announcements from Docker this week, but lots of other ideas out there. Just immense conversation around like, what's the right approach for dealing with orchestration and dealing with microservices on top of containers? Jason McGee, fellow VP, IBM fellow, and also CTO of IBM cloud. Thanks for sharing your insights here on theCUBE. Good to see you again. I got the closing keynote starting in a few minutes. Thanks for swinging by theCUBE. This is theCUBE. Extracting the signal from the noise. I'm John Furrier, Brian Grace Lee. You're watching theCUBE.