#“”womens health“” clinic but i might try to do that and ask if their doc can like.. work in an apt to deal with my tit or has any suggestion

[felidaefatigue]

my. tit. Hurts.

[stevenbasic]

“Knock-knock!” I heard at the door of my office, startling me. I was nearly - jesus - an hour into this video call with the Study Coordinator from Evolution, and had obviously lost track of time.  “Where’s my favorite patient?!?’ called the voice. It was Vida, my Nurse Practitioner, entering with a broad smile, a procedure tray and someone else and causing me to look up from my computer screen. “Time for your mediciiine…” In place of her usual white clinic jacket, she was wearing a tailored black jacket over a black, figure-hugging, dress, cut low.

Immediately I said my abrupt goodbyes to Gianna, over chat, and shut down the window right as she was, good lord, blowing me a kiss. At the same time I looked up and gave my wan smile of greeting to Vida and the generously curvy blond woman who’d entered with her…

“This is Morgan, if you two haven’t met yet,” Vida said, as she briskly approached my desk, high heels clacking. Trailing behind her a few steps was a woman in a white blouse and tan leggings - a big woman - broad of shoulder, wide of hip, huge of chest, standing taller than Vida by five or six inches...and myself even more, “She’s a Nurse Practitioner too, from Evolution until just yesterday, when she joined us.”

“It is very nice to meet you, Dr. J…” Morgan purred, in a voice deeper, richer than Vida’s. There was a queer smile on her face and a hint of a vaguely Eastern European accent in her words, one that she was obviously trying to hide. For now she was hanging back, taking her cues from Vida as the younger but more senior woman began to prepare her tray behind my desk to my left. “Nurse Vida is training me today how to take the care of you.”

“H-hi, uh, Morgan,” I replied, immediately sensing that that was not this woman’s given name, and remembering it was time again for my booster shot. The thought, for some reason, brought me a little thrill, remembering how it made me feel last week…but was it also responsible for the 8 pounds I’d lost since then? “But, um, what do you m-”

Interrupting my concerns, Vida chuckled. “Oh, don’t get worried, doc. I just figured that the more of us that know how to do this for you, the better,” she explained, opening the strange black box in which the vitamin B12/D/K booster vial was packaged. I noticed the familiar, strange blue tint of the liquid as Vida removed it along with the pre-packaged syringe. “And Morgan here has lots of experience.” At that, Vida nodded up at Morgan; the larger woman took that as a cue to move around the other side of my desk, to my right, and come to stand alongside me there. I was flanked.

“I-is that right, Morgan?” I asked, hearing the nerves starting to quiver in my voice. I hated needles, I hated them. But this single, combination shot was much better than three separate ones. “Wh-what did you do at Evolution?” I asked, not able to recall her resume as I looked up at her; she was gazing down at me, over the shelf of her formidable bosom. I was hoping that, if she had started seeing patients today, that she had been more buttoned up during the workday. The cleavage she was showing at this moment, over the neckline of her overmatched white blouse, was vast.

“At the Evolution Pharmaceuticals?” she replied, the accent in her voice unable to camouflage itself through the words, “There, I was with research team, taking care of study subjects. But before, I was in pediatrics ward, with preemies, the NICU.” She looked down on me with a crooked smile, and seemed to be resisting reaching out her hand to me. Instead, she ran her fingers through her shoulder-length blond hair. “I love holding little bodies.”

“Haha well, that’s exactly why we’re here, isn’t it, Dr. J?” Vida added, explaining to Morgan and pursing her full, plump, latin lips, “This young man has lost a few inches recently and we need to make sure he gets his vitamins.” With that, Vida beamed down at me and released  her thick mane of dark hair from the conservative bun she’d been wearing for the workday. A wave of the now-ubiquitous perfume in this place flowed over me, and I felt a stirring between my legs. I had been intermittently hard during my video call with Gianna - her tits were unbelievable - and I was afraid now that I might swell to some obvious, inappropriate monster of a boner with these women so close. “Lucky for him he has his girls to take care of him,” Vida concluded. The vial and syringe, for the moment, laid inert on the tray.

I tried to focus. ”I, heh heh, don’t know if I need someone to ‘take care of me’...” I spoke, trying to sound relaxed as Morgan’s left hand finally did come to rest on my right shoulder. I’d honestly just met this woman, but she was being very…familiar. Vida as well; she was generally a bit more aloof than she seemed today. It was like there was something weird in the air, something bringing them closer.

“That's silly,” Vida responded, “Even doctors need someone to look after them.” At that, she began to remove her black jacket, and laid it on my desk, as if preparing herself for her task. Underneath she wore a clingy black tube dress that hugged her hourglass figure and revealed her trim shoulders and the upper swells of her full chest; she watched as I struggled not to look at her body. “Who do you see for a PCP?”

“uh…” I began, trying to recall my last visit to a doctor’s office outside of this one, “…no one?”

“You mean…” Vida asked with exaggerated concern, as she herself put a hand on my other shoulder, leaning in to me and twirling a lock of thick, raven hair, “you don’t have a Primary??”

“N-no I, uh-“

”Well, that’s no good,” Vida concluded, standing straight and looking across me at her fellow nurse, “Don't you agree, Morgan?”

”Oh yes,” Morgan concurred, her dimpled smile betraying her amusement, stepping a touch closer, “You need the primary...care...provider.”

“That settles it,” Vida decided, removing her right hand from me to place both it and her left one on her broad hips, in determination, “I’m going to be your PCP from now on.” Her action had drawn my eyes to her remarkably tiny waist and shit this girl had some curves. “I’ll contact our insurance company, do all the paperwork. How does that sound?”

The big woman to my right was giggling, and her hand had begun to idly caress my shoulder.

“Uh, th-that’s fine…” I agreed.

“So,” Vida finally asked, with a wry smile, “does my patient have any questions before we get started?”

Ugh, right…the injection. “Well, um, honestly…” I began, knowing I should at least address the concerns I had over this combo B12/D/K formulation, “I’m not sure it’s working. I think I’ve lost weight since last week, and even maybe almost an inch…”

“That’s ridiculous. You must have measured wrong last time, used a bad scale,” Vida replied, trying to reassure me, “But…do you think you need to go out and get checked..?”

At that, Vida herself moved in closer, and I saw Morgan, to my right, turn her thick body more towards me. Both women looked down at me.

“Or do you want to let us take care of you..?” Vida finished. It felt like a challenge, and I sensed something, an inner struggle inside myself. The logical, intelligent practitioner who cared for his health wanted to answer one way, bring a halt to something that was dangerous, possibly ruining my life. But another part of me, the one that was feeling the cock growing once again down my right thigh in tribute to the ever-more enveloping warmth of these women, just wanted to say-

“n-no…I think I’m alright,” I answered, “let’s go ahead with the shot. I’ll be fine.”

If I had known then what I know now, that my mental capacity for rational thought in the face of arousal had been already crippled by foreign agents? If I had known that I was being purposefully enslaved, drowned more and more every day in the sea of pheromones and womanly curves in which I swam? WelI, I would have run screaming. Or, then again...would I?.

“I’m sure you’ll be fine,” Vida assured me. Her voice had dropped low, almost hypnotic, “You don’t need to go out and see any other specialists. We’ve got everything you need right here…” She was beginning to prepare the injection, now, drawing the blue liquid from the vial up into the syringe.

“Yes, everything,” Morgan agreed, looming over me now so close to my right, her hips and belly blocking out the world behind her. Her scent was warm, earthy. Between it and Vida’s reassuring tone, I felt powerless to do anything but trust these women.

“But,” Vida began again, inspecting the now-filled glass syringe, “if you are still shrinking, lots of guys would be jealous. Don’t you think, Morgan? Here, take this-” She handed a band-aid across me to her fellow nurse.

wh-what?

“Oh, yes,” Morgan concurred, her voice husky, unwrapping the band-aid, preparing it, “very jealous.”

”What…what do you mean?” I asked, confused, looking from one woman to the next, up at them. Without even being told, I had begun rolling up my sleeve.

Vida chuckled. “Oh, you know, the whole ��vulni-chic’ thing,” she answered, holding the prepared injection now in her right hand, “you’d get very popular if you lost another-“

“One meter?” Morgan said, giggling in her deeper, richer tone, “Two?”

“haha I’d disappear…” I joked, feeling a wave of warmth coming from Morgan’s body to my right, “just like, haha…”

“It’s not a joke, Dr. J,” Vida said, her voice plain, suddenly, clinical, “it’s a thing. Here, get ready-“

“Ouch!!!”

She’d jabbed me, in the left shoulder, with the shot.

Vida spoke as she pressed the plunger, pushing the blue liquid into my deltoid. “It’s not just a fad for women, guys these days are admitting it, too…” she said as she drew the needle out of my arm. Immediately I’d felt it entering my body, like a milky warmth. “Good boy,” she praised, “Band aid?”

“Thanks,” I replied without thinking, watching as Morgan leaned her big torso across me as I turned in my chair towards her, presenting my left shoulder. She was nearly smothering me with her big breasts as she applied the bandage, and I did everything I could not to goggle at the wobbling flesh of her full, tan cleavage. My roving eyes made me realize that this generously endowed woman was wearing a very thin bra, or possibly none at all. Somehow, though, she was still so firm, with a natural buoyancy that kept her tits high and proud on her chest. My gaze could not get enough. But then eyes fluttered as I was assaulted by both an overwhelming breath of her perfume and the first rush of pleasure from the shot. I began to lower my sleeve, rubbing my arm as I looked up at her, smiling down at me as she finally stood up and away.

“I mean it, with the shrinking,” Vida started again, watching me with an appraising eye as I recovered from my shot, buttoned my sleeve, “have you seen Melissa’s new Instagram post?”

With the butterflies? I didn’t want to admit anything.

“The guys that follow her, the simps,” she continued, “they talk about wanting to be like bugs, crawling into her breasts.” She was replacing the syringe, carefully putting it and the vial back into the box. “It’s all over the place, everywhere, though no ones really talking about it yet,” she said, as she closed the black container, “guys wanting to be smaller, weaker than us. Wanting to become inferior, more passive, more submissive.”

She looked down at me and smiled, watching as the effects of the injection began to take hold. Even more strongly than last time, I was being gripped by a pleasant wave of lethargy, relaxation.

“Guys want to be small, these days,” Vida said, “and we’d like it that way too, wouldn’t we, Morgan?””

To my right I heard Morgan purr, a little grunt. “Yes, Nurse Vida,” she said, her voice low and struggling with arousal, “we would like it very much.” I had the feeling she was holding back her true feelings, in restrained understatement.

Vida laughed, casually. “It’s weird, all these changes in gender dynamics,” she continued, brushing a lock of my hair behind my left ear, “the new thing is bigger women, smaller men. Here, look at Morgan, perfect example…”

I turned, looked up at the smiling behemoth of a woman.

“She’s probably bigger than you ever were,” Vida continued, “taller, heavier, thicker everywhere.”

“Yes,” Morgan agreed, seeming to rise up, grow bigger, heavier, right in front of my eyes, “I weigh much, much more than the you.”

“And, you have to admit…” Vida asked, watching me look up at the huge, busty blond woman, who was now absolutely dwarfing me in my seat and could probably lift me like a child, “that’s kinda sexy, right?”

“I, uh….” I began, not knowing what to say. My erection was getting painful, now, contorted as it was in my pants, trying to stretch down my right thigh.

Vida spoke again, now holding my head in place by my cheek and jaw, so all I saw was Morgan. “So, even if you are getting smaller...lots of us would like that.”

I sat there, in the building afterglow of my injection, and looked at this woman’s body. It was, in all ways, so much bigger than my own. Thicker thighs, wider hips. Her arms were stronger than mine, her shoulders broader. Standing aside her, I would look puny. Even Vida - though she stood roughly my height, maybe an inch or two more - her hourglass figure and womanly hips made her body just that much more than mine.

”Dr. J,” Vida said, pulling me from my reverie, but not releasing my face from her hand’s gentle embrace, “You look like you need to go lay down. We’d take you up to bed ourselves but we have an important girl meeting to get to, don’t we Morgan?”

“Yes,” Morgan replied, though never taking her eyes or dimpled smile from me, “Very important.” I watched as she looked down on me, regarded me, considered me. “But I promise. Next time you can go to the sleep in my lap,” she said, “I have a very nice lap.” With that, Morgan bent at the waist a bit, to gently slap her prodigious thighs. My eyes watched them jiggle, and then her hands come up to the collar of her blouse, hoisting her breasts. “Or, if not on lap, we find somewhere else…”

“Haha okay,” Vida laughed, finally releasing my head but smiling as I didn’t turn away from the cleavage into which I was now dumbly gazing, in my vitamin-fueled haze imagining myself sinking into it like a caterpillar, cocooned in womanly warmth. “I’ll get a couple of the MA’s to get you upstairs…”

=========================================

more Vida & Morgan imagery, more posts, more more more at my Patreon.

Thanks for reading, everyone.

[starr-fall-knight-rise]

HASO, “Your Choice.”

I am having a lot of fun with this arc.  Writing it has put me in a good mood, so I hope you like it as well :)

He walked the halls of the Oxystation with a  gun slung over his front hanging from a shortened tac sling around his neck and shoulder. He rested his arms and hands against the weapon as he walked down the hall. The gun was more of a redundancy than anything, if any unwanted alien was able to breach the hull of the station with the armored patrol outside than his gun was just a token sign of resistance. Of course, there was always the possibility that one of the patients would become violent and attack a staff member, but that possibility was quite low, even lower than it was in human mental health clinics. Only five percent of the mentally ill population was any sort of danger to anyone but themselves, and a large percentage of that would still, likely, never do anything bringing that number down somewhere closer to one percent.

With aliens it was even less likely, they weren’t naturally aggressive like humans, so when their mental health tanked, it tended to do it with extreme anxiety and something that looked sort of like depression, though the different species presented the illness differently. 

Working at the Oxyclinic had been good for him. It hadn’t been long until his enthusiasm for alien life had come trickling back in, and his fear had been discarded like a sock with a hole in it. He had even offered to help with the oxytheropy that the psychologists were offering. If anything was gong to get rid of his lingering fear of aliens, it was probably going to involve spooning one.

A weird way to deal with internalized fear but there you had it.

The oxystation wasn’t just for the oxytheropy. Human and alien psychologists were taking the time to learn about other species, and put together differing treatment plans for their patients. There was a high turnover rate, and not all the people who came to the clinic ended up staying, not all of them needed oxytheropy, and not all of them would do well having it considering that some of the fear the patients had often centered  their issues around humans. To his surprise, he found that a lot of it centered around the Drev war.

He looked down at his watch and took a sharp right turn down the nearest hallway entering the guard quarters just as his watch reached the hour.

“Morning LT.” Someone called and he waved a hand.

“Anything to report?”

“Nothing, all is quiet as usual.”

He ejected the magazine of his gun, and checked the chamber to make sure it wasn’t still loaded before racking it in the safebox as one of the other men stepped up to take his place on patrol.

The other group of men and women looked up at him from where they sat around a table playing cards, “Want us to deal you in.”

Adam shook his head walking over to his locker and pulling out a fresh pair of light blue scrubs, “No I promised the doc I would help today.”

The other humans shook their heads and rolled their eyes, “leave it up to you to want to spoon aliens.”

“Spooning aliens is a lucrative job. You should try it sometime, maybe you’d finally have enough money to buy the bag you’ve always wanted.”

“Bag?”

“YEah the nice one to cover your face.” he shut the locker and grinned at the car players to let them know it was all in good fun before turning towards the bathroom, where he changed and stepped back out. The scrubs were very breazy in comparison to his guard uniform and he shivered slightly returning to his locker.

It was important for people working on the ward to be completely unarmed, and for the humans to look as non threatening as possible. A strict list of instructions urged them not to smile with their teeth, and to keep their hands and feet covered at all times. He wasn’t entirely sure if the fuzzy socks and mittens were entirely necessary for that, but apparently some of the aliens interpreted human nails as claws, and some genius had thought that covering them up like this was very nonthreatening.

Looking in the mirror he had to admit it worked.

In his light blue scrubs and the fuzzy white mittens, he looked more like the easter bunny than he did a killer.

But then again, in real life he didn’t look much like a killer either.

He turned to walk out the door flipping off the people geering at him before remembering that he was wearing a mitten, which kind of negated the point of the gesture.

From there he wandered back up the hall and was buzzed into the ward after waving to the camera. He went through a few metal detectors which pinged on his leg, but they let him through anyway as he stepped into the hall and up to the staff room where the other workers and a few psychologists were having a break.

He took a seat in a chair and idly watched the TV.

HE looked around at the people who wore similar clothes as him and noted, not for the first time, that it took a special kind of person to do this job. All of these people were remarkably docile and relaxed people, and as far as he knew the vast majority of them had no shame. Despite humans being prone to cuddling pretty much anything and everything, its was pretty hard to spoon an alien and not feel awkward about it, but these people right here, they either enjoyed it or they were damn good at faking it.

Adam wasn’t good at faking anything so he was the former.

HE shifted slightly in his seat thinking about some of the aliens on the ward before his mind inevitably shifted to…. To him…. The alien that he dreaded seeing the most…. A big, tall hulking creature that wandered his nightmares and made his leg ache.

The Drev.

The Drev with eyes like the thing that had stolen his leg.

He put a hand to his head feeling a bit dizzy. He had only had one PTSD related panic attack since getting here, and that was only because he had been accidentally exposed to the Drev unexpectedly one day and without knowing that he was on the ward. It had been embarrassing for him as he tried not to let anyone know about his condition, but based on that incident he had been forced to come clean.

Ever since that incident  he had been quietly forcing himself to get closer and closer to the Drev despite the psychologists telling him that it was perfectly acceptable for him to step off the ward if the Drev was on.

But adam didn’t like that mentality much.

He had always felt, ever since returning from the Drev war, that people were too soft on him. They always sat there and told him that it was fine and whatever he needed to do was important, that he couldn’t blame himself if he couldn’t handle something. They were all very forgiving and very understanding, but that's not what he wanted. At some point, he felt that it was acceptable to get up in someone's face and tell them that: no you aren't doing good enough and that you behavior isn’t ok.

He wanted people to ask more of him, not less, and he wanted to get better not stay stagnant.

If other people wanted to spend their days medicated and avoiding the things that made them hurt than that was their decision, but he planned on healing all the way.

It was a thought that he espoused only for himself and did not apply it to others. 

Their mental health was their business.

Either way, he was going to make something out of this, and had slowly been approaching the Drev on the ward over time. He didn’t know if the Drev knew, and it didn’t matter to him so much, but he did have a bit of his own agenda.

The door creaked open, and one of the psychologists stuck her head into the room looking around for a quick moment before her eyes fell on Adam.

“Lieutenant, can I speak with you for a moment.”

For a second Adam’s heart stopped a little. Was he in trouble? Had he done something wrong?

He tried looking at her face to see any signs of displeasure, but  she was a difficult woman to read, so he stood slowly and followed her from the room and back into her office where he took a seat.

She sat across from him at her desk hands folded together. SHe looked him over with eyes that seemed to bore into his sole, “How are you doing, Adam.”

He shifted nervously in his seat, “Er… I thought I was a staff member not a patient.”

“Just humor me.”

“I’m good.”

“Any panic attacks recently.”

“No ma’am.”

“Are you being truthful.”

“You and I both know I’m shit at lying.”

She grunted and clasped her hands together looking at him with a stern expression.

HE shifted awkwardly in his seat, “What” “I have… a mission for you, though it is one I worry might jeopardize your mental health if it goes wrong, and the mental health of my patient as well. If it goes right however I think it would do BOTH of you a world of good. What I would be asking you to do is…. Of questionable ethicality.”

That made him nervous. “What do you mean by that?”

“I mean by asking you to jeopardize your mental health, I could be in serious violation of a couple of major statutes in my field, however assuming you do it willingly it might not be so bad.”

Despite his apprehension, his curiosity won out, “Go on?”

“Kanan.”

“Cannon, WHat?”

“No, Kanan, the name of the Drev on the ward.”

Adam shifted in his seat, stomach churning, “Oh…. go on.”

“Have you noticed he has a limp.”

“I…. suppose I haven't looked closely enough.”

“Well he does, and you want to guess where he got that limp?”

He had a pretty good guess, “The war?”

“Exactly.”

“And…..  I suppose you think….” He trailed off 

“He lost everything during the war Adam, his mate, his honor, his home. He is injured and exiled, and at this moment there are very few people in the galaxy that can even partially understand what he has gone through.” She leaned back in her chair looking at him, “I think, that having someone like you to speak with about what happened would be,.... Beneficial to both of you.” She paused, “DId you know that human and Drev psychology is surprisingly similar….”

He shook his head, “Well it is, and I think the two of you would recover faster if you had something to work on together.”

“With all due respect ma’am, my papers say I’m recovered.”

“The UNSC isn’t exactly known for their in depth medical reviews Lieutenant. I know they overlooked some things. Either way, it’s your choice.”

***

Adam stood in front of the door. His hands were sweating leaving the inside of the mitten’s sticky and unpleasant. He felt nauseous, but swallowed to hold it down eyes wide as he stared at the door. What was he doing? What was he doing?

He took  a deep breath.

Not being a coward, that’s what he was doing. He reached a hand up and knocked on the door before he could chicken out. There was silence and the knock seemed to echo down the hall for eternity. He waited, and waited, and waited, and assumed at some point maybe he had caught the large alien sleeping, but then the door opened.

His human knee went weak, and it was only the prosthetic that kept him standing as he stared up at the huge, hulking figure.

Adam was, tall 6,2 to be precise, but this hulking behemoth had to have been around or over nine feet tall, with blood red armor, and four bulging arms. It stared at him with bright golden eyes that brought echoes of his past welling up into his ears. He felt as if he was about to fall over, but then the creature turned and trundled back into the room, snapping Adam out of his trance.

He was breathing hard, and he thought about turning back, but instead, he stepped softly into the room leaving the door open just as crack as he moved inside.

The room around him was dark, and the floor was scattered with crumbled pieces of paper.

A box of markers lay on the ground to one side. He looked down to see he was stepping on a discarded piece of paper, and stepped back to look down, realizing the drawing there was of a tree, with striped bark and spiraling branches. It looked like something out of a Dr Seus book though he recognized it as an Anum/ Anin coiltree.

He crouched down to pick the paper up.

He looked up to see the Drev had returned to the edge of his cot and was sitting down, a shapeless form in the dark.

“You mind if I turn the light on?” Adam asked.

At first the Drev didn’t answer, but then he took a long breath through those strange holes in his neck and managed a deep, rumbling, “THe colors are too bright.”

Adam paused then, “Well neither of us can see very well in the dark and, he held up the page, drawing in the dark can’t be easy.”

There was a grunt.

“I’m going to turn the lights on.”

The Drev didn’t stop him, and as he did the room lit up showing even more pages scattered over the floor, all drawings of Anin some of them sloppy, some of them, quite artistic for a species he hadn’t thought practiced art.

He knelt down to examine a few of them, “Not bad.”

He picked up one of the pictures to examine it.

“This looks like the valley between the volcanic belts.”

The Drev turned to look at him, and when his eyes fell on Adam, the page slipped from his hand floating back to the floor.

The uncanny deepness of it’s golden eyes unnerved him.

“You were in the war?”

Adam’s hands were shaking, but he clasped them together to hide that fact.”

There was a long silence between them, and then he reached down pulling up the leg of his scrubs to reveal the titanium construction underneath, “I was.”

The Drev seemed surprised and looked up at him.

“You were one of them.” he said it very flatly, and Adam suddenly grew very worried that the Drev would kill him in revenge for being part of the operation  that decimated his people.

“One of your number killed my father.”

Fuck 

He went to back away but the Drev just looked down.

He sighed very deeply, “You were a strong and worthy opponent. We never had a chance.”

His voice was not bitter, or hate filled. There was some measure of regret behind his words but not enough to constitute anger. And when Adam looked at the creature, he could do nothing but feel sorry for him.

He quietly walked over trying to avoid the pages on the floor and then, unsure, sat next to the large figure.

Adam was not used to feeling small, but sitting next to the huge figure of the drev, he felt very tiny indeed.

The inside of the gloves were absolutely soaking, and with some measure of annoyance he tossed them off and onto the floor.

He wiped his palm on his shirt, reached out, fingers trembling and rested a hand on the Drev’s arm.

“You want to tell me about it? I.. My people didn’t exactly take the time to understand yours….. Now that I think about it it hardly seems fair.”

The Drev snorted ,”My mother believed that war was supposed to be fair, but my father understood that there was always inherent unfairness in battle…. The two of them didn’t get along towards the end. I think I agree with my father, to assume that your species would abide by our rules of combat was…. Ignorant of us.” The Drev turned to look at him, “Your species is much more efficient at war than mine is.”

His hands weren’t shaking anymore.

And he realized that, when he looked at this Drev, He didn’t see much of an enemy at all. 

But he did see someone broken by the war…. Just like him.

He looked down at his feet, and when he did his eyes came across another drawing. This one of a drev, It really only had an outline since it’s carapace seemed to be white, and the way it had been rendered with such delicate care, made it pretty clear to Adam who it might have been.

He picked it up quietly.

“You…. want to tell me about her?”

The Drev turned to look his eyes resting on the picture. Adam didn’t think up to this point he could read Drev facial expressions, but the welling of sadness in the creature’s face was so poignant that Adam felt his own chest tighten,

Damn the human’s heightened sense of empathy.

For a moment he thought the Drrev was going to tell him to get out, but, instead, he took the image and stared down at it, “Nechal…. Named after the moon….. She was the most glorious fighter I had ever seen in battle, strong, and graceful and powerful. She was not afraid to die, but she didn’t let that lower her guard. On the battlefield she was a goddess of war, and off…. She was…. Kind in ways that aren’t common among our people. I may have been attracted to her because of her fighting prowess, but I loved her because of the kindness she showed. Especially towards my sister… someone who needed kindness more than anyone I know.”

He took a very deep breath and when he spoke again his words were thick.

Could Drev cry? “In our people it is…. Custom not to mourn the dead who are lost in battle because their return to the spiritual realm will be glorious. It is a great honor to lose a mate in battle….” He looked down at his four hands, “But I do not feel honored…. I feel alone…. I miss her, ever day and every night I miss her, and I wish she hadn’t died…” He looked up and when he did Adam was struck by the expression of pain and grief on his face.

As if he was feeling the Drev’s pain in real time, he felt his chest clench again, and tears welled in his eyes. How could he not?

Anyone who didn’t feel the same must have had no feelings? 

“I was exiled because…. I could not follow her into the afterlife…. With my injury I should have given my body over to the fire, and maybe then I'd be with her, but I just…. I couldn’t do it. I miss her every day and yet I don’t have the strength to go to her…. I am a fraud among my people, a coward and a fraud and….

“Hey! Hold on.”

The Drev went quiet and turned to look at Adam who was now gripping his arm tight in one hand.

“You think she’d want to hear you say that.”

That seemed to take the Drev off guard and he stared at Adam with some measure of confusion.

“You said she was kind wasn’t she….. Well then I doubt she'd appreciate you talking about yourself like that.”

He was quiet for some time.

“Look I…. I lost my leg during the war to…. To one of your soldiers and. It’s messed me up for a real long time. Hell you scare the daylights out of me, but I’m moving forward.”

THe Drev frowned at him, “Scared of… us… you won?”

Adam laughed, “We didn’t win anything. Nobody won, a lot of people died and a lot of people were crippled, and for what? I think about that a lot, for honor? Honor. Well maybe I don’t understand what honor means because to me, it would be something worth dying over.”

The Drev contemplated him for a long time.

“We may have won but we did it with scared soldiers like me, and broken soldiers like me. I’m probably never going to recover from the war. That’s the difference between you and me, you guys can make it through war in one piece but me…. Humans… we may be good at war but it destroys us.”

He sighed, “I guess what I am trying to say is, instead of feeling sorry for what you can’t change, why not move forward. Do something you think is worth it, do something Ne-” he stumbled over the Drev word, “Nechal would think was worth it.”

He didn’t know what he was saying, he didn’t know if what he was saying even made sense. Nerves had always made him ramble. He knew he was talking too much but he didn’t know what else to do.

The Drev looked down, and Adam. as was his training made a bit of a decision.

He shut up.

Which was a feat in itself.

Reached over and hugged the larger alien. His arms didn’t make it anywhere close to wrapping around him, but he hoped that maybe it would help?

He didn’t know.

He was kind of just a raging idiot most of the time, so his plans were usually half assed at best.

The Drev stiffened and then relaxed. Adam’s head was resting against the creature’s huge planted shoulder. It felt like hugging corded steel cables.

He would have to say that being hugged by something with four arms was a bit of an experience. Most aliens didn’t usually hug back, they were more the recipient of hugs, but it seemed that the Drev wasn’t unfamiliar with the concept, either that or he learned fast, and damn Adam felt even smaller encircled in the arms of the huge alien.

Kanan could have crushed him if he wanted, but let him go not long after to Adam’s surprise and relief.

The Drev looked at him.

He looked back

“You are strange creatures.”

He gave a weak smile, forgetting the rule about showing teeth, “So they say.”

It was a bit of a gamble but things had worked out better than the psychologist could have hoped. Drev are more receptive to self reflection than humans are. Humans like to internalize things, and their brains become obsessive. Drev have more control over their minds in many cases than humans do, so Adam’s encouragement for Kanan to do something his dead mate would think worthwhile showed results almost immediately.

To Adam’s grudging pleasure, the Drev seemed to be recovering faster than he was.

And was well on his way to recovering completely when the communication came for Adam one night while he sat lying  on his bed next to Waffles, thinking about his future.

The pink roused him from near sleep and he sat up on one elbow to look at the time.

i t was only nine earth time, so he rolled onto his side and sat up, patching the communication through.

A light blue screen of holographic image filled his vision, and on the other side he could see Colonel Kelly sitting in front of him….. At least Colonel until he realized the star on her uniform.

His eyes widened slightly. He went to speak but she shook her head at him.

“I trust you are doing well Lieutenant.”

“Yes ma’am. I have no complaints.”

She nodded, “Good, good, I am sorry to intrude, but I am afraid this rest period is over for you. You are requested to return to earth on the next outgoing transport.”

He frowned and rubbed the back of his head, “Uh of course ma’am but…. Why?”

She stared at him long and hard, ‘I have a very important decision for you to make. It is one that is not going to be popular or easy, but I urge you to accept my request.”

He frowned and shook his head, “You aren't making sense, What is this all about?”

“Tensions are rising between our delegates and the GA, if we don’t do something soon, I am worried that this will devolve into infighting and eventually war. I have to work fast in order to stop this outcome, and you are the lynchpin that holds my plan together.”

“Me.” He squeaked.

“Yes, you, now Adam, be honest with me. What is your opinion on the GA and our involvement with them?”

He rubbed the back of his neck though his thoughts were adamant, “Cooperation wherever and however possible. We need them, and I believe they could due with being our allies, ma’am.”

“And if I gave you a job to try and reach that goal, would you take it?”

“I would do whatever I had to do ma’am.”

He was being truthful. 

She nodded her head.

“Good then, it’s your choice at the end of the day, but if we act now, we can change everything.”

[healthtech102]

After Hours Medical Advice

As you know, and certain have in mind every day, nursing is a career that carries a huge amount of duty. Be sure to guard your self, especially when asked for advice in an informal setting.

No, Uncle Bob has cornered you within the hallway after Christmas dinner. In trying back, I realize that not as soon as during this experience did anyone INVITE me into a discussion of what could be best for my mother. 

She spent two nights in the hospital beneath remark, with IV hydration. Now, admittedly, she has varying levels of dementia even on a good day, but she reached the point of getting severe hallucinations and paranoia.

Having a whole remedy group looking out for you and preparing a discharge plan that is going to set you up for achievement. 90 days of therapy allows for the affected person to work via many of the above mentioned considerations and we treat it using an American Society of Addiction Medicine dimensional assessment. 

The general size of keep in remedy that is really helpful is often ninety days. Health safety and prevention is the key to staying healthy for the long haul. From easy blood checks and vaccines now to mammograms and colonoscopies later, your doctor might help you turn into the healthiest model of you.

Although it might appear to be a problem now, one hour in a physician’s workplace now can add years of health to your life. When we have well being questions and considerations, it’s easy to show to good ol’ WebMD for answers. And even though the Internet can be a great well being useful resource, reading about your health points online can usually lead to pointless fear and fear. Remember, you might be unique and deserve a customized evaluation. 

So instead of browsing the web for a generic, or even worse, incorrect answer, talk to a doctor in particular person to get the total image—and to cease dropping sleep over your questions (see reason number 5!). While I’ll be the primary to confess that a trip to the gynecologist’s workplace isn’t my favourite way to spend a day, annual pelvic exams are a important a part of any girl’s preventative health care.

Will we have to battle the battle of keyword voids at a grassroots degree, wrangling with the asymmetry of passion by tapping folks to search out these voids and create counter-content material? Do we need to arrange counter-GoFundMe campaigns to pay for ad campaigns that promote real science?

Do not rely on a form’s basic remark that “risks of leaving were discussed with the patient,” he says. That doesn't negate the value of those documents, however they should not be the sum complete of the hospital’s evidence displaying efforts to provide care. 

First, the hospital must reconcile any excellent diagnostics, as a result of if any checks had been ordered, the hospital is still liable for checking the results to make certain nothing critical was identified, he says.

Despite our protests, she saved making an attempt to pull out the IV fluid line from her arm and the gizmo , and tugged at her gown. The paper-thin pores and skin on her arms was black and blue from a number of blood attracts. Successful treatment begins with an correct diagnosis, and our experts take the time to get it right. 

A team of specialists will listen to your needs and evaluate your condition from each angle to make the very best plan for you. Every year, more than one million individuals come to Mayo Clinic for care.

If witnessed by RN, have them doc the time the patient left in addition to the standing of their IV. If an IV is still in place, first try to contact the affected person after which their emergency contact.

From all the information you've gathered from the Internet and your research, it's time for you to go to your physician with this data and get to know the details. It is important to decide on doctors with whom you're feeling snug.

The level of questioning I got in response to my advice was almost insulting at times. In my head, I advised these callers, “If you trusted me sufficient to name me together with your ailment, why aren’t you trusting my opinion?

Our highly specialized experts are deeply skilled in treating rare and complex circumstances. I actually have been put in this identical position so many times, that I lastly, like you, needed to tell them to contact their supplier or go to the ER/Urgent Care. 

I owned a small household follow clinic and some would actually present up there quite than going to their PCP or ER. I do perceive how onerous it is to tell them to go to their PCP’s, but I believe that is the proper motion. We love our family and pals and do not need to see them ill or in ache, however we additionally want them to obtain goal care.

 I actually have been practicing as a Nurse and APP for over 15 years now and have found, for me, robust boundaries come with time. You don’t have a look at them as patients, but as whomever they are to you.

YOUR ability to want them to be OK and not be as goal as you'd be with a affected person. Another disagreeable facet effect of trying to assist was the pushback I received.

doctor certification, from the Membership of the Royal College of General Practitioners, and checked performance towards historic outcomes from an independent 2015 examine that evaluated several symptom checkers. symptom checker seems as a chatbot that users can work together with by way of an app or web site. When the consumer varieties out their primary symptoms as a quick sentence or phrase, the symptom checker asks questions about possible related signs.

According to the NIH, 30-40% of Americans report having occasional symptoms of insomnia and 10-15% report persistent issue sleeping—with ladies representing nearly all of those affected. 

While you could assume that a poor night’s sleep simply means you’ll need an extra cup of espresso in the morning, chronic sleep problems can actually improve the lengthy-time period threat of hypertension, melancholy, and diabetes.  treatment medical disclaimer A physician’s visit can help identify attainable underlying causes for your restless nights—and get you the help you should truly get some zzzs.

 Does your family have a history of diabetes, excessive cholesterol, heart disease, cancer, or another significant illness? If so, you could be at risk for these conditions, too—and there are likely issues you can do to decrease that danger. A doctor may help you find out and work with you to determine which screening exams you want.

"Casual" could exit the window, if the individual you advise feels you have triggered them harm; together with your recommendation or deeds. State legal guidelines differ greatly and litigation can truly change the legal guidelines as time passes. So as a nursing skilled, even if your action or advice was justifiable, there isn't a safety from being sued . You might prevail and be discovered "not liable" if sued, but by then you'll have gone by way of plenty of wasted time and pointless stress.

They might help detect vaginal infections, together with sexually transmitted ailments , and should often embody a PAP smear for cervical cancer screening. Although you might have heard about some current adjustments to screening recommendations, the U.S. Preventative Services Task Force nonetheless wants women between the ages of 21 to 65 to get a Papanicolaou test (a.k.a. PAP smear) a minimum of each three years (or more incessantly when you’ve ever had abnormal results).

The lawsuit claimed that Dr M had failed to recognize the patient’s skull fracture and improperly released him when he was intoxicated, and that the delay in treating the fracture was attributable for approximately half of the affected person’s neurological deficits. Later that day, a hospital radiologist learn the affected person’s x-ray and famous a markedly depressed left parietal cranium fracture.

Or will the tech platforms where that is occuring start to grasp that giving legitimacy to health misinformation by way of high search and social rankings is profoundly dangerous? Getting excessive-quality, fact-based well being information shouldn’t be dependent on the result of SEO video games, or on who has extra assets for pay-to-play content promotion. few hours of a newborn’s life, medical doctors administer a vitamin K shot. 

This is as a result of infants are born with out sufficient of the vitamin, and the child wants a boost to prevent any potential bleeding. The documentation also should detail the discussion with the affected person regarding potential risks from leaving AMA, Merkrebs says.

The reasons for refusing additionally may be wide-ranging, every little thing from worries about the price to concern about ache or dying, or dislike of being touched, photographs, surgical procedure, or drugs. Once a affected person is examined beyond triage and exams are ordered, a departure at that time could be classified as left without completing remedy , Klauer notes.

Patients leaving the emergency room too soon “are intentionally putting themselves at extra danger for morbidity and even mortality,” Polevoi stated — a degree echoed by other physicians. Ko stated the column will proceed as long as individuals want to study totally different health subjects. Connect with a medical skilled everytime you need one, 24/7, for customized recommendation and prescription, if deemed necessary.

At the end, the symptom checker identifies possible causes and recommends a course of action, similar to reserving a video consultation with a human physician or going to a hospital. The patient and his family consulted with a plaintiff’s attorney who agreed to take the case. Dr M was shocked to find out that he was being sued for medical malpractice.

Within each of these kinds of AMA, there may be further breakdowns when it comes to why the person is leaving, he notes. The affected person might not want any care of any type, or the refusal could also be extra limited — refusing the particular kind of care being provided, as an example, but still willing to be handled.

That's to not say all of the internet is unhealthy, it is okay to make use of Google for health questions when you use a credible supply and if it prompts you to go to your doctor should you could have considerations. Without limiting the generality of the foregoing, the Author makes no representations or warranties with respect to any Information offered or offered within or via the Site relating to treatment of medical circumstances, motion, or software of treatment. 

“When sufferers convey themselves into the ED, they are seen in about 5 minutes by a qualified registered nurse and, on common, are seen by a supplier within 30 minutes of arrival,” Thomas mentioned in a press release.

From 2012 to 2017, the variety of emergency room encounters in Fresno County elevated by nearly ninety five,000, or 37%. At Fresno’s Community Regional Medical Center, about 9% of ER encounters ended with a patient leaving too quickly, greater than 3 times the statewide fee.

If no success, contact the police non-emergently to aid in finding the affected person. In this situation, the patient has not but interacted with a doctor. There isn't much to do here as long as the provider by no means met the patient, if so, they might be in a different category. 

There are no known instances the place the ED, or ED Providers, have been sued and located to be at fault or responsible for an end result. We recognized people ages with International Classification of Diseases, 9thRevision prognosis codes for infective endocarditis within the National Inpatient Sample, a representative pattern of United States hospitalizations from January 2010 to September 2015. 

We plotted unadjusted quarter-year developments for AMA discharges and used multivariable logistic regression to establish elements associated with AMA discharge among IE hospitalizations, evaluating IDU-IE to non-IDU-IE.

The police were notified, and the patient was taken from jail back to the hospital. At the hospital, he was monitored for a number of hours and then taken to surgical procedure where the depressed fracture fragments have been elevated. However, Mr G ended up suffering a brain injury from the fracture which affected his cognitive talents, and which prevented him from with the ability to hold down a job. The police knowledgeable Dr M that the patient, a 24-yr old named Mr G, had been the perpetrator of an assault and in the process was hit within the head with a blunt object by a bystander. 

The police had been called, and found him mendacity on the street, clearly intoxicated and with a bloodied head. They took him to the ED, however Mr G was uncooperative and initially refused any treatment. When most individuals hear these words, they're whispered by an overcoated stranger on the bus or a counterfeit Prada peddler gesturing towards the trunk of a car.

[biopsychs]

What I Learned From University (2nd Year)

See what I learned in first year here

Adjust how you study → I have a different study method for each class. Even if the content is similar to another class or you’ve had the prof before, you have to personalize your learning.

You can skip class sometimes → My introductory microbiology class was the worst class I’ve ever taken and I love microbiology. The prof sucked and I found I could just catch up on notes on the bus and have extra time to sleep in. I rarely skip class but I realized my time was much better spent working on other things. Only skip classes if catching up on notes is more efficient/a better use of your time than actually going to lectures. Also, don’t be afraid to take a day off (when you can) if your mental or physical health is suffering.

Group projects suck → I knew this already but nothing could have prepared me for what I had to deal with in my one semester long research methods class. I wish I had talked to my TA  or prof earlier to explain what was going on and how I could fix it. (Side note: Use Google docs for group projects!)

Mentoring programs are a great thing to be involved in → I got involved with a mentoring program for women in stem at my university and it has been such a valuable experience! I have access and connections to upper year students and women working in academia and industry who are there to provide help and guidance. My only regret is that I was too timid to ask for help at the start -- take advantage of the opportunities you have!

Get larger projects like reports and essays done as soon as you get them → My organic chemistry lab reports always took so long to write so I would delay working on them. However, I eventually got into a routine of finishing my lab report (or at least 95% of my report) on weekends (my labs were on Fridays) and it made my life so much easier! Just get it done and you won’t have the looming stress of a big project or report hanging over you.

Go to social events on and off campus → You can be social in so many different ways at university! Find something you’re comfortable with or go just outside your comfort zone. I went to a pizza party for psych majors and it was chill. I also went to a pubcrawl and it was so much fun. If you’re hesitant, drag a friend along the first time but make sure you talk to new people!

Apply for summer jobs early → Lots of good summer jobs for university students are posted early! I check my university’s job board and also look for jobs that are meant for students (where I live the government will provide funding for summer students to certain organizations). Make sure you send in your applications in as soon as possible too! Even if the deadline to apply is in two weeks, some places will get in touch with applicants (and could potentially hire someone) before that deadline. Find out if your uni has a career advising office (or something like that) and check it out, if you need help with resumes, cover letters, interviews, etc.

Leave your options open  → If you’re unsure about your major or career path, leave your options open as much as you can! Use the time you have now to explore what you really like. Last year I made the decision to do a double major in biology and psychology, because I wanted to go to med school but also wanted to leave the option of research (in bio or psych) open. Now, I’ve decided to major in psych and minor in bio, with the intent to pursue clinical psychology. I took classes and got research experience that helped me make an informed decision about what I really like and want to do.

Get involved in research and use your connections → Get research experience as early as possible. This will help you figure out if you actually want to pursue research or not, and will be so helpful with applications if you end in a position where you’re doing your own research! I have found it much easier to get involved with research by having connections (like talking to a prof, grad student, or upper year undergrad student who is already involved with a lab) rather than sending out cold emails to profs and hoping they’ll reply. If you are sending an email to a prof/lab you don’t have any connections to, make sure your personalize it -- mention any prior experience you have and why you’re interested in that lab specifically.

Check your email constantly → As a general rule, you can never check your email too much. Make an effort to reply to emails as soon as you get them, because otherwise you might forget about them. In general, reply to emails within 24 hours anyways.

Take a summer class → I took a summer class on the psychology of motivation and it was totally worth it. I knew I would have to take a summer class at one point and I knew I would prefer to do it earlier in my degree (taking a summer class in my last year does not sound like fun). It was refreshing to see how well I could do when one class was my only priority and I was able to learn/retain the content so much better. It was also nice that I was able to take an upper level course (my previous psych courses had been only 1st or 2nd year level) by itself so I could get used to the increased demands. One thing to note is that summer classes go by really quickly (in my case 3 lectures were equivalent to 3 weeks of classes) so make sure you’re keeping up with the material.

Find your optimal level of stress → One thing I learned in my motivation class is that we all have an optimal level of stress. Think of it as an inverted U shape, with performance on the y axis and stress on the x axis. The highest point, the top of the U, is your optimal level of stress, where stress is helping you perform to the best of your ability. If you move past that point (either less stress or more stress) your performance is going to decrease. If your stress levels are high and anxiety-causing your performance is going to suffer. I found my optimal level of stress when I was studying for my first motivation midterm -- I was cramming the night before but because I had no other pressing responsibilities (like 4 other classes) I was able to feel stressed without feeling panic or test anxiety also. Find your optimal level of stress and see how well you perform. Remember that feeling when your stress levels are rising so you have a baseline to get back to.

Don’t get stuck as “premed” → Being premed is completely okay but don’t close yourself off from other options. I know so many people who are premeds and are also biochemistry majors. Some of these people don’t even like biochemistry but stick with it because they think it will make their application look better. Please study something you’re actually interested in. Med school is a great option but just make sure you have a plan B (and a degree that is going to suit this plan B). I know someone who graduated with their biochemistry degree and regretted it -- by the end of their degree, their plan was no longer med school and they wished they had done a general biology degree, w classes they liked, while taking a few biochem classes they liked. I used to consider myself premed but I realized clinical psychology is a much better fit for what I actually like/am good at. Just make sure you want to be a doctor for the right reasons is all I’m saying.

Morning classes are actually kind of okay → Everyone talks about how bad morning classes are, but I actually prefer them. I have a hard time paying attention in later classes and it’s really nice to have all my classes done by mid-day. Just make sure you keep a regular sleep schedule (i.e. try to go to bed/ wake up at reasonably early times so your body can recover better on the nights where you get less sleep) 

Always come prepared → This applies for so many things. Bring a snack, don’t forget your charger, do your readings. You’re never going to regret being prepared but you may regret not being prepared.

Be ready to register for classes → Know your time and date to register for classes and be ready to click register right at that time! I always make multiple schedules b/c often the lab times or classes I want to take are full. If a class is full, make sure you know what to do. Register on the waitlist. If there isn’t a waitlist, find out who you need to talk to (usually the prof or department head). Check back a few times a week to see if spots open up in classes, because a lot of people change their schedule. Don’t wait to talk to an academic advisor if you’re not sure which classes to take or have any concerns.

Quizlet is a blessing  → Quizlet is an app/website that lets you make flashcards and view other people’s flashcard sets. Study flashcards while you’re waiting in line for coffee or on the bus. You may also be able to find flashcards from people who took the same class as you -- use those! If you make your own flashcards be a nice person and share them with your friends :)

A bad grade is not the end of the world → In one class I got 35% on my first midterm and never managed to get a midterm grade higher than 68%. I was absolutely destroyed when I saw that mark on my first midterm and was ready to give up. Please don’t give up! I talked to my prof and was able to have my other midterms weighted more and I used my lab reports to bring my mark up. If you show your profs you’re working hard they’ll do what they can to help you out. It’s really easy to feel like your hard work is not making a difference, especially if you’re continually not getting the results you want -- this doesn’t mean you should stop working hard, it just means you may have to study differently, review material daily, and ask for help! If you fail you need to remember that you will have to work harder -- you have to keep up with the new material and relearn the old material. I wasn’t overly happy when I saw my final grade in the aforementioned class but, when I compared it to my first midterm and my feelings of utter confusion, I was satisfied with my grade because it showed my progress and improvement (and I also used it to motivate me to never let it happen again).

Realize that everyone is at university for different reasons → Some people have big goals, some people are still figuring it out, and some people just want to get their degree as soon as possible. There’s nothing wrong with being any of the above, just don’t expect everyone to have the same goals as you.

Know the deadlines for dropping courses → Even if you don’t think you’ll be dropping or changing any courses, write the dates down in your planner. My friend waited a few days too long to drop a math class that turned out to be extremely difficult and, even though she passed it in the end, she was stressed out all semester and her performance in other classes suffered as a result.

You’ll always be meeting new people and making friends → I lived off campus first year and felt like I had missed my chance to make friends. I shouldn’t have worried so much. Second year was much better in that there were a lot more familiar faces in my classes and I got to know other people much better through smaller classes and labs! Other people are always happy to make friends so just take the first step by starting a conversation :)

You can’t give 100% all the time → Some of the best advice that I was given this year was that you can’t give 100% all the time. You only have so much time and energy (mental and physical) you can give. For some tasks, the outcome from 70% effort and 100% effort may not be too different. Figure out what tasks those are so that you have enough energy to give 100% when you really need it.

[dhofberg]

Going back;Take three

Well it has been 8 months since I left Lesvos the last time, and about five months since I decided to go back again. Once you know how things are, it’s hard to forget that for the refugees in Greece and many other places, things are rarely getting any better and mostly are worse as movement from Turkey to Europe is more difficult. Nevertheless landings in Lesvos continue and now those who hoped to seek asylum in Nirthern Europe are inevitably stranded for a long time in Greece. Two years ago they were able to bypass the Shengan rules that required asylum seekers to seek refuge and legal status in the first country in which they landed. But that has long ceased and now the requirement is in effect. Not because the Greek economy has improved or has become more welcoming to refugees, but because much of the EU has closed its borders to most refugees.

I have not followed things as closely as I had been. I quit Facebook for a couple of months in my frustration over (partly) political vitriol and even family members hateful messages. But I am back on now because it is actually helpful to look at posts of friends in Greece who write about goings on there.

I had thought this time I would work with Doc Mobile again, and I told them in April I was planning to return in October. Although the experience working last year in a tent, a construction zone, with a large dose of chaos and lack of adequate... well anything, the team was good and the organization’s founder Kai Whittsock undeniably had his heart in the right place. Unfortunately after giving them my dates, beginning to arrange housing with Paula, a doctor from Spain, they informed me that the schedule wasn’t going to work. Then Paula dropped out and they told me maybe it would work, but that they were no longer doing primary care. They had switched to doing psychological counseling and referrals for refugees with PTSD and other trauma induced mental disabilities. If you had followed my blog before, you know that almost all refugees had suffered trauma, almost all before fleeing their homes, and many of them since then, en route to Europe ( sexual assault, injuries from cruelty, near drownings, losing loved ones), and now still more trauma with the realization that they might be living in these horrible refugee camps for months to even years. In the US I screen patients for depression and sexual assault, and often make referrals to behavioral health department. Sometimes I even prescribe antidepressants. But even in rural Mendocino County where access to a psychologist or psychiatrist is not great, I would not consider myself trained to be their counselor in Spanish which I speak tolerably, or even in English. So the idea that non-Arabic and non-Farsi speaking medical professionals are doing that kind of counseling is puzzling to me. That is not something I can or should do.

So I began asking the people I know in Lesvos to tell me which medical organizations they would recommend and contacted a few. Now it looks as though I will be working with the group Kitrinos. They must have some credibility because the Greek government is allowing them to be providers inside Moría camp along with MSF, BRF (Dutch group),and KEELPNO.

If you are new to this blog, and don’t know the history, the camp is partly prison ( refugees from countries not recognized as having sufficient threat),and partly slum village inside a former Greek detention center built for 2,000 and last I heard “ housing” over 7,000. People there can come and go, they are not technically imprisoned, but until they are registered as asylum seekers, they have no real resources or ability to move freely off the Island and must wait months or years for their asylum hearings that typically take place in Athens.

This population from Syria, Afghanistan, Iraq, Congo and many other places, have been unintentional neighbors having to share the inadequate sanitary facilities and the general squalor of the camp. Though there are many women and children there, and elders as well, I believe the largest group are young men. Think men who have been displaced from their homes by threat of violence, or actual loss of their homes and families. Some are educated and came from well off families, many others , especially those in their teenage years have lost several years now of schooling or work or building families to wars in these countries. They are restless and angry, and recently I have even heard there are factions of supporters of Assad who have also left the country because their towns are in shambles. And they come bearing grudges.

I always felt safe among the refugees before. It is especially easy to bond with people you have listened to and tried to help. They are grateful and gracious. I imagine I will feel that way again once I get there and start work in the clinic. But something tells me it could be very different this time due to the entrenchment of refugees at Moría, and the factions that may have carved deeper grooves of fear and mistrust of “others”. When every day in US politics and media we see how fearful people are of those who look or speak or think in some way unfamiliar, why would it be any better in a refugee camp?

My plan is to arrive in Greece around October 4, and spend the rest of the month working there.

I know I will take money to One Happy Family and Bashira, so if friends want to donate money again to help those in the refugee camps, I will be collecting community funds again. Once I am there I may l ow more specifically what is needed and decide to contribute to Katrinos, or even Doc Mobile, but I will wait and see until I have been there and know what’s what.

If you find articles about the refugee crisis you think are good or relevant, please send them to me via tumblr or Facebook or even email.

I will update about my work plans and will try to post a few times a week when I am working.

[fucking-hell-marvel]

Lacuna - Chapter Two

Dr Ada Ross Set Tuesday, February 1st, 1870 ~~~~~~~~~~

After sixteen days of long travel, the train pulled into the station of my new home. Ganado Springs, New Mexico.

The lovely station master was shocked to see me unloaded my trunks and promised to have them brought over the boarding house where I was temporarily staying. Uncle Bruce had sent instructions on how to find the doctor’s office in his last letter.  

The town had every kind of store you might need. I could see why it was a famous town on the railroad and cattle drives. It also seemed like the place that you’d never leave. I knew enough of the ‘wild west’ to know that things were more relaxed than they were in the city. From what uncle Bruce had told me; the pastor was a man of colour, compared to the rest of the world women were treated equally, and there was some openly queer folk too, yet everybody got along. The most crucial thing Bruce had told me to remember was that the community stuck together no matter what.  

As I walked down the main street of town, I was glad to see that I wouldn't stick out. All the women I could see wore simple and practical clothes. No unnecessary bows or frills in horrid colours, just sturdy dresses or a skirt and blouse.

I saw the church up ahead and followed the road to the right, just as Bruce instructed. Around the corner of the boarding house was the new doctor's office. It was an older building, but you could see that it had refurbished recently. The windows were scrubbed clean, and I could see a new sign hanging off the porch. Dr Banner was seeing a patient out of his practice when I approached the office bags in hand. When Bruce finally spotted me his face split into a wide grin.

“Ada! Look at you.”

I dropped my bags and launched myself at my uncle. “Bruce! I have missed you.”

“Three years is far too long.” He offered me his arm and led me upstairs to his private apartment.

“Oh uncle, it is. I have missed you terribly.  You're getting more grey each time I see you."

It was true; noticeable silver streaks were running through his dark waves.

“It’s dealing with you all these years.” He picked up my bags and led me into the clinic. I noticed the metal plaque engraved with both our names and space for more to be added. “Everything is brand new. You’ll have to help me set everything up.”

Inside the clinic, you could smell the freshly cut wood. As soon as you walked in the door, there was a single waiting area with a nurses desk. On the left of the waiting area were two small rooms for examining a patient or treating minor illnesses. On the right were three much larger patient rooms with beds, if a patient were brought to the clinic and needed to stay they would be placed there. Outback was two medium-sized operating theatres; essential for minor or significant surgical and the more complicated childbirths.

Opposite the theatres and behind the office was a moderately sized clinical room full of shelves to house medicines, cupboards to accommodate equipment and a decent sized sink with an indoor pump to clean ourselves and anything else.

The office was spacious but bare, and Bruce had done the minimal amount of work to set it up. One table with the chair tucked under was pushed against the back wall and used for storing the more delicate items.  Bruce had set up a beautiful partners desk up for me, along with a revolving chair, the worn leather was a deep rich brown.

The last desk other Bruce was using himself and was slightly cluttered. He had never been an overly organised person. There were lots of boxes and crates stacked against the walls no doubt full of all the equipment he had ordered.

Bruce left me to grab the other desk chair while he used a small wood burning stove in the corner of the room to make tea. The wood stove would also be used for heating and to boil water for medical use, cleaning wounds and the clinic. There was a large copper pot on the floor beside the stove. I recognised it as one from my father’s clinic, the dent was in the same place, and one handle was slightly out of shape. I knew that Bruce had gotten on with his brother in law extraordinarily well.

I managed to find a sealed crate that wasn’t too dusty, on which to place my bags. I took off my bonnet perching it on Bruce’s lamp and stuffing my gloves into my carpet bag. I happily sat in the comfy desk chair, compared to the hard and cramped quarters of a train the chair felt like a cloud in heaven.

As I looked around the baren office, I noticed the large packing crate in the corner, already opened. “Did the shipment come already?”

“Yes thank you. I was running short of some supplies.” He placed the tea tray on the table and took a seat.

I poured tea for the two of us while he got comfortable in his armchair. “Before I left Boston I made sure that we’d get a regular shipment every month, so we never run out of anything.”

“You are an angel. So how was your trip?”

I almost snorted into my cup. “Almost three weeks moving from train to train, I’m surprised I didn’t resort to murder.”

“Did you have second thoughts?”

I placed my hand over his. “I would travel the world to be with you. You are my only family left Bruce. It was a long, trying journey but I knew that at the end we’d be together again.”

He smiled back at me. “I can’t wait till you get settled. This kinda place won’t care that you’re a woman doctor and they won’t care that you’d be my practise partner.”

“I'm glad. I was getting fed up at the hospital.”

“Well, this will be a welcome change. There are some things in the diary, people who need to be seen daily, scheduled health checks. Helen is in charge of that.”

“Helen?”

“She’s a nurse. Wanted a change in life and replied to my nurse wanted ad.”

“Well, it’s good that she can deal with the smaller issues on her own and help out with surgery.”

Bruce nodded. “She’s an impeccable surgical nurse. She’s a Godsend; I don’t even know if we would have been able to open the clinic if it wasn’t for her.”

I smiled at him. “Someone would think you’re sweet on Helen.”

Bruce spluttered. “No! Of course not. She’s far too young for me. I think young Mr Pietro Maximoff is sweet on her.”

“Mr Maximoff?”

“The undertaker's son,” he explained.

“Ahh and I suppose he visits often.”

“He does.” Bruce laughs. “I think that he still believes he’s somewhere that follows the proper ways.”

I shook my head. “I don’t understand why two people of different cultures can’t marry.”

“Pietro’s family come from Sokovia and Helen is of Chinese heritage.”

“Ah, I understand. But I suppose it doesn't matter in this town. Love is love.” I noticed a familiar dent on the edge of Bruce's desk. "That belonged to Betty."

Bruce noticed the damage I was pointing too.  "Ah yes, it is. I had it shipped out here when I settled. I bought the things I couldn't part with the rest I sold.  I'm afraid it's too small for me, my knees hit the top. When I knew you were coming, I set it up for you."

I felt this warmth yet sadness in my chest. I knew that Bruce still kept a few things belonging to his late wife. I felt blessed and honoured to now be responsible for it.

"Thank you, Bruce. I've arrived in a new place to find a piece of home waiting for me. I remember when it sat in the corner of her room."

"We both miss her." He gave me a sad smile.  

I watched as a note pinned to the board catch his interest.

“Ah, before I forget. I don't know what we're going to do about a more permanent home for you. The repair work in the apartment upstairs is complete, all it needs is cleaning, painting and furniture.”

“I have enough savings to stay in the boarding house for a while and order the things I'll need to fix it up.”

“I'll help with anything you need.”

“Oh Bruce, you can sew up a wound perfectly, but cleaning and fixing stuff was never your good side.”

He chuckled. “That's true.”

“So where are you living?”

He shifted in his chair and rubbed his earlobe. A tell that he's hiding something. “Still living with Selvig. It's easier two bachelors together.”

“Well as long as he’s tidier than you.”

He snorted then looked at his messy desk. “We survive.”

There was a knock at the door, and we both looked up to see a teenage girl quite flustered.

“Dr Banner. Helen is having trouble with mama, she asked for your help.”

Bruce jumped up and gathered the things he would need. I swore I heard him mutter something about Thor, poor Jane and his baby having its father’s broad shoulders. With a kiss on the top of my head, he was out the door. I followed and stopped in the doorway, watching as he followed the girl on a dirt path beyond the schoolhouse. I racked my brain to remember who this Thor was.

To pass the time I decided to begin to unpack the newly delivered create that I had ordered. I knew that the supplies would have no order to them if Bruce had anything to do with it, I’m sure Helen would thank me if she could find things with ease. It was a productive way to spend most of the day. Bruce hadn’t come back, so I guessed the delivery was taking longer than he thought but I didn’t mind. Being a doctor, you got used to being late for things.

It was growing later in the afternoon when there was a commotion out front followed by the sound of boots on the wooden floor. I turned to see a young man in the doorway looking flustered.

“Hey Doc, Dernier had an accident…” he froze slightly upon seeing me not the person who he was expecting. “You’re not Doctor Banner.”

“No I'm Dr Ross, Dr Banner just left to see a patient. Is there anything I can help with?”

“I'm sorry I didn't introduce myself, miss. Everyone calls me Junior.”

“Pleasure to meet you.”

“Uhh, Dernier had an accident at the ranch needs a Doc.”

“Very well let me grab my bag, and you can tell me about it on the way.”

He tipped his hat and went back outside. I left Bruce a note where he would easily see it. I grabbed my carpet bag and doctor’s bag, if the injury were critical, I would have to stay overnight to keep watch on the patient. Outside the clinic, the wagon was ready and waiting. I placed my bags in the back before hoisting myself into the seat beside Junior.

I waited for him to manoeuvre the wagon onto the south road out of town before I spoke. “So what happened?”

“Well Dernier, he’s the farm hand and cook, was up in the orchard and fell off the ladder, caught his boot on it. He was still out when the boss sent me off. ”

“Just his war wound playing up? A bit of whiskey and sleep then he’d be fine?”

Junior looked at me surprised. “Yeah… how did you know?”

“I know men. Was it a normal 6-foot ladder?”

“MmHm. It shouldn’t take long to get there, roughly an hour.”

“That’s okay. Did you move Mr Dernier at all?”

“Nah, we ‘membered from the last fall. He’s in the shade, and everyone was with him when I left.”

“Good.”

Junior and I made small talk on the straight ride to the ranch. There were only two ranches out this way. Clint Barton and his family who bred horses and the boy’s cattle ranch. We passed by a lovely looking house down a long drive on the right, this belonged to the Barton’s and was the marker for half way.

We turned off the road, passing under a sign that read Black Oak Ranch. The long rolling drive was shaded by an occasional oak tree, most likely where the ranch got its name. I could see more trees further back. It was strange seeing oak trees growing in New Mexico; it was like an oasis in the desert. A the end of the drive was a large ranch house with a wrap around porch. Just like the town and the other buildings the had only been built a few years ago, but due to the harsh conditions, they were slightly worn in.

The cart pulled to a stop in front of what looked like the stables. A tall man with a thin, tidy moustache came out to meet us. I knew from Juniors rambling that it would be Falsworth who looked after the horses.

“Miss.” He tipped his hat to me. “Doctor Banner not working?”

“He was busy. " He gestured to me, "This is Miss Ross. She’s a lady doctor.”

He offered a hand to me to help me down. “Dr Ross. I’m to be Dr Banner’s business partner.”

He took the rains from Junior. I grabbed my bags from the back then followed Junior round behind the beautiful grey ranch house with a wrap around porch. There was a large produce garden behind the house, but I was lead away from it before I could get a better look.

Past the large produce garden, the orchard came into view, just as Junior had said everyone surrounded the patient. They all turned in our direction at the sound of our footsteps.

“Where’s Dr Banner?” a tall blonde asked.

“Dr Banner was called out to another patient. I’m Dr Ross.”

The blonde held out his hand towards me. “Steve Rogers. A pleasure to meet you. I guess Junior told you everything.”

I nodded. “Junior did. Would it be possible to have some water put on the boil? I’ll need it once we get him inside.”

Junior turned back to the house while Mr Rogers guided me over to an older gentleman laying in the shade of the tree. He had his eyes closed, but you could see the steady rise and fall of his chest.

“Dernier. Docs here.”

He opened his eyes as I knelt beside him. “Bonjour mademoiselle.”

To my surprise his French was perfect. “Bonjour. Je m'appelle Docteur Ross.”

He laughed and clutched his ribs. “Hello, doctor. I did tell them I’m fine, but they won’t let me move.”

“Dr Banner told us not to move anyone that fell. You know that.” A tall man with long brunet hair tied back was leaning against the tree.

“And he is right.” I turned back to the patient, “So what’s the worst.”

“My leg, it hurts too much to move.”

I nodded and began to roll up both his pant legs. After removing his left boot, you could see the swelling. Luckily it didn’t look disfigured.

“I do not think it is completely broken. You may have a small break or fracture or even just a bad sprain, but I won’t know until the swelling goes down. Anything else?”

“I landed on my hip and shoulder, and I hit my head on the floor.”

I checked his head. Someone had used his handkerchief to steam the small bleed. There was a little bump, and the skin had split. It had already begun to clot, so it was not a worry. Thankfully he had landed on the side opposite to his sore leg. Both his shoulder and hip moved freely in the joint, with only pain from the bruising

“We can move him. I can give you something for the pain, but I'll need to get you inside the house first. If two of you support him, he can walk on his good leg.”

Mr Rogers nodded to the tall brunet. “We’ll put him in the house. Easier than the bunks.”

They two of them helped him up. A bulky man with ginger moustache offered his hand to me. I took it with a smile.

“Dugan. At your service.”

We made slow progress to the house. I noticed that he wobbled a fraction when he was walking, but I wasn’t sure if it was walking on one leg or the head injury. I followed the two men as they helped Dernier hopped on his uninjured leg. We entered the back of the house into the kitchen. Junior was there hovering over a large pot full of water. The men disappeared into a small bedroom.

I stopped in the kitchen. “Is it alright if I wash my hands?”

Dugan pointed me in the direction of the sink. I untied my bonnet and left it on the table, unbuttoning my jacket I placed it on the back of a chair. I grabbed the apron from my carpet bag tying it over my skirt and blouse. Using my small box of soap, I scrubbed my hands. Junior offered my a clean linen square to dry my hands. Dugan carried my doctor's bag, and I followed him to the bedroom.

The small bedroom was almost bare just a single bed, chair and a small dresser. The two men had propped him upright so I could tend to his head wound.

“We use this a sick room. We live in the bunkhouse.” Dugan informed me putting my bags on the dresser

“It's a good idea. Stops the spread of sickness.”

He nodded his head. Everyone moved out of my way yet hovered in the doorway. Junior had placed a bowl of warm on top of the dresser. They all watched as I meticulously cleaned his head wound and further examined him just in case I missed anything.

“I know you’re head will hurt but do you feel sick at all? Any double vision?”

“Just sick but my eyes are beautiful.

“Mr Dernier this might be uncomfortable, but I need to see if you can still move your foot. After I'll give you something for the pain.”

He nodded.

“Mr Rogers could I trouble you for a small glass of water.”

He nodded and left the room. Dernier was a good patient. He just gritted his teeth while I made him move his foot and toes. Happy that it was a sprain or a tiny fracture I gave him a dose of laudanum in the water to help with the pain. Once settled down on the bed with a pillow under his bad leg, he was soon sound asleep. We all crept out of the room; I collected my bags along the way. Junior very generously tidied up the dirty rags and water. We gathered in the kitchen.

Mr Rogers turned to me, “Will he be alright?”

“Yes. I want to keep an eye on him tonight. You should always keep an eye on someone with a head injury. He needs to stay off the leg for a few weeks at least. If it is a fracture, then weight bearing can do more damage.”

“Not to sound funny doc but what's a fracture?” The tall brunet asked.

“A fracture is still a break, but the bone hasn't broken all the way through. Similar to try to snap a green twig.”

He nodded. “Still a break just doesn't need resetting.”

“Yes. As the patient needs monitoring will it be alright with you gentlemen if I stayed?”

They all looked at each other, and I swear Mr Rogers had a faint blush on his face.

The brunet broke the silence. “It won't be a problem. We can make up the spare bed.”

“Oh, there's no need Mr..?”

“Barnes. James Barnes but everyone calls me Bucky.”

“Mr Barnes. I don't need a bed, a chair in the parlour is fine. I won’t be sleeping much, Mr Dernier will need to be checked a few times during the night.”

Mr Rogers turned to me, “Well we need to finish up the days work. Will you be alright here?”

“I can stay. If Dernier is off his feet, I'll need to make something for supper.” A stocky man with dark skin fiddled with his hat.

I smiled to ease his worry. “I don't see the problem. I'm sure we can both make something edible.”

He smiled at me. “You don't mind miss? Even with a man such as me?”

“I don't have a problem with what colour God made us. I trust you all can behave like gentlemen and I'm tougher than I look.”

“Won't doctor Banner mind? He knows us, but you're not a married lady.” Junior enquired.

“I left Bruce a note. He knows I can take care of myself and to expect me back tomorrow before midday.”

The men slowly trickled out of the house. Gabe Jones introduced himself before we headed into the kitchen to start on supper. I swapped my medical apron for one that was hanging from a nail in the pantry door.

“Dernier had been soaking salt pork since this morning.” he lifted a cover off a large bowl.

I opened the pantry door. “That will work nicely. We’ll manage to feed the army yet.”

[firefighterkingdom]

#3 Fire Fighters & PTSD: What Are The Signs & What Can Be Done For It

Well, Hello everybody. Welcome to another episode of FireFighter Kingdom. We’re on podcast, episode number three. My name is Vince Trujillo, I am the co host along with a professional firefighter and president of the New Mexico Professional Firefighters Association Mr. Robert Sanchez. Robert, how are you doing today?

Robert Sanchez: Good. Welcome all the audience on there from FireFighter Kingdom. We’re happy to have everybody here again, once again, trying to educate the firefighters out there, give them some new information.

Vince Trujillo: Yeah, and we have some really good information coming up today regarding mental health and firefighters. But quickly, before we go ahead and introduce our special guest for today’s topic, just a little bit more about Robert for those of you in the FireFighter Kingdom. Robert has been a proud member of the IAFF for over 19 years, and was the longest serving executive officer at the current Albuquerque Area Firefighters Local 244 Executive Board for the last 16 years. Robert has concurrently served as the president of New Mexico Professional Firefighters since 2019. Roberto, you’ve been with the organization for a long time and have done lots of things, man. Thank you so much for all you do.

Robert Sanchez: It’s my honor and privilege actually to be out there just helping firefighters. To be quite honest, firefighters, in the State of New Mexico, the men and women who are paramedic firefighters they’re the ones that make everything happen. And we’re just happy to be a tool for their resources and their success for sure.

Vince Trujillo: Well, as a member of the public, thanks for everything all of you do. So let’s get on with the podcast for today. We are really honored and privileged to welcome our mental health professional Dr. Troy Rodgers. A little bit about Dr. Rodgers.  Dr Rodgers is a police and criminal psychologist based in New Mexico. He has a master’s degree and a doctorate in clinical forensic psychology from the University of Denver. Dr. Rodgers has been the agency director for Public Safety Psychology Group LLC, PSPG, since 2004 and at the present time he works as a consultant psychologist for over 130 local state and federal law enforcement, fire, and correction agencies. Wow I think I got it all out. Doctor, thank you so much for coming on.

Robert Sanchez: Now that’s a whole other podcast I think just-

Dr. Troy Rodgers: I appreciate it.

Robert Sanchez: … the introduction for the doctor.

Dr. Troy Rodgers: I appreciate the time you took, and given the opportunity to talk about the brave folks who are serving New Mexico.

Vince Trujillo: Thank you both! Dr. Rodgers. A couple of things just for personally from my side of things. I was having a conversation with Robert a couple of weeks back in regards to some of the trauma and stressful situations that our firefighters run into.  And as we know from military service and trauma exposure is that these things can build up over time and can really affect our first responder and firefighters. And its something that we in the public maybe don’t think about as much. But the first people responding to a car accident, at home accidents, someone having an acute health crisis like a heart attack, even things like abuse, neglect, pretty much any number of different types of high intensity calls they may get on a consistent basis and have to deal with emotionally or mentally. And that’s why there are great people like Dr Rodgers who help them manage this. And that’s what we’re hoping to talk a little bit about more today. Talk about PTSD a little bit and then also talk about some of what you have to offer, and some recommendations for our firefighters out there. Robert,

Robert Sanchez: So great. So doctor, it’s been an honor working with you for the several years that you’ve been assisting firefighters. Obviously, you do a great job. On a consistent basis we use you, and we see a lot of successful results in our firefighters. And I want to thank you for that and I appreciate that. There’s times where I’ve called you at midnight, or one in the morning and ask you that you would assist us. Firefighters are seeing the public at their worst, and you come and assist and benefit our members tremendously. First thing I want to talk about is you hear about the exposures? You have the one incident exposure, and then you have the chronic exposure. Can you tell me what the difference to that is?

Dr. Troy Rodgers: One of the things that most folks don’t realize about public safety careers is that on a daily basis, folks are exposed to both ends of the spectrum when it comes to events. You’ll sit around and be bored for two, three, four hours, and then all of a sudden you’re dealing with a life and death situation. Or you’re seeing something that the general public is not exposed to, or they’re not aware of. Or they see it on TV, but they can turn the TV off. Public safety professionals aren’t allowed to do that. I often use the example that when you go through the Fire Academy you’re given a backpack. And that backpack you’re going to carry with you throughout your entire career. Every time you take one of those calls, one of those calls that’s difficult.

Dr. Troy Rodgers: That involves a child, that’s a death, that’s something along those lines. You throw a little rock in that backpack. First three, 400 rocks don’t weigh a whole lot. But when you get to three 4,000 rocks, that backpack weighs a ton. It has this cumulative effect. And that’s the buildup we talk about. A lot of folks can understand that one traumatic recall. But they don’t recognize that in addition to that one call, you’re carrying that backpack every day with that exposure that just continues, and is almost routine after four, five, six years of doing this.

Robert Sanchez: There’s one specific exposure that could cause you to have PTSD correct and be… So when you guys recommend someone they have PTSD, they’re diagnosed rather is a good word, and then there’s that one incident that could happen. Is there several exposure incidents that you might not know what’s affecting you and then it is.

Dr. Troy Rodgers: A lot of times folks will go through events, and they’ve learned how to compartmentalize, or to box it off, put it away and do their job. Folks are trained in a moment. “I’ve got to get things done. I’ve got to save people, I’ve got to help people.” So they may experience something, and not even realize that that experience was traumatic, or potentially traumatic, or contributed to potentially creating PTSD. And so they’ll go through two, three weeks, four weeks, and not realize that they haven’t been sleeping well, they haven’t been interacting well, they’re more irritable with family. So that event may have set the stage for another event to come, which compounds that makes it worse.

Robert Sanchez: So the more rocks in the backpack.

Dr. Troy Rodgers: More rocks in the backpack, and the more of those backpack, or more of those rocks that trigger that person. I always tell folks that stress is something that we all experience, but it becomes traumatic if it’s too personal. If it’s too similar to our own life, it’s too overwhelming and we can’t process it. So the more of those rocks you throw in, and the more the big rocks that come in, the more likely folks are to get PTSD.

Vince Trujillo: Doctor, just to interject real quick here, as far as the detecting is concerned, How do you detect it, and or how does the firefighter detect it, and what is the process in regards to treatment? How is it treated?

Dr. Troy Rodgers: How does it come around? A couple of things. One of the things I really emphasize when we talk with firefighters and first responders, many times, is that changes in behavior are a great indicator. If somebody was a very social person, and all of a sudden they’re isolating, they’re not talking with friends. If somebody was a happy person, and all of a sudden they’re irritable and angry. If somebody was slightly cynical, but now they hate everybody and they’re cynical in all their interactions. Those are all warning signs, and we encourage folks to talk with significant others, family, friends, spouse, so that they can give them that kind of feedback. Number one reason-

Vince Trujillo: I would guess that maybe it’s the people closest like family and friends that notice it more so they are the ones that sometimes raise concern first?

Dr. Troy Rodgers: Hundred percent. Yeah. Saying that the number one reason why we get first responders calling us for some sort of intervention, or some sort of counseling is because a family member’s usually said, “I’m concerned about you.” I always tell a story years back at an individual I worked with, and the first phone call I ever got was him. Was a voicemail and he left a voicemail saying, “Hey doc, my wife says I’m an asshole. I need to come see you.” And that’s all he said. We actually started talking about it we realized that it was stress, trauma, depression coming in that was leading to irritability at home.

Vince Trujillo: And then once detected and someone has raised their hand and said there is an issue and need help, what are the next steps?

Dr. Troy Rodgers: There are a lot of different treatments. There are different ways to address it. One of the first things is actually coming into the office, sitting down with either myself or another clinician who’s familiar with the culture, the background. And getting a feel for what is the source of the problem, how severe is it, how many rocks are in that backpack per se. So we can quantify it. And then there are a lot of different approaches. One could be just talk therapy coming in once a week for the next six weeks. There’s other trauma treatments called EMDR, which is a specific protocol which addresses trauma and reprogramming the way the memory sees that trauma. We do other things like activity based work. One of the first things I assigned to most of my clients is you got to start doing sports, or running, or CrossFit, or those sorts of things because that physiologically will help the body.

Dr. Troy Rodgers: Other things we start looking at is what are the habits. Has the person who’s experiencing some of this trauma develop bad coping habits like drinking alcohol. And alcohol in and of itself is not a problem. But when you’re drinking a fifth of vodka, and a six pack of beer to go to sleep at night, we got to talk about that. And I’ll get firefighters that say, “So is a half a fifth of vodka okay.” We can’t that but we got to have that discussion.

Robert Sanchez: So that’s how firefighters are they want to know an exact amount, so they can measure it out. Be precise.

Dr. Troy Rodgers: Right, exactly.

Vince Trujillo: Now how do you see treatments and going through the process helping?

Dr. Troy Rodgers: In terms of cure rate? It’s a tough one to answer that question, or to respond to that question. But let me give you a little bit of an answer that will help relate to your folks is. I always tell folks everything that they’re going to experience, those sort of things we can manage. We can deal with coming in to that first step. We just learn how to cope with it better, how to work through it, how to manage the symptoms. Now, is it going to go away a hundred percent? Probably not. Some of the hypervigilance that folks experience, which is that being hyper aware loud noises, triggering them, those things. We can’t unlearn some of that, but we learn to manage it. We learn to have outlets that deal with it. We learn to process it. And going back to our backpack analogy, we learn to empty the backpack so that it’s not so heavy.

Dr. Troy Rodgers: It doesn’t have that burden. I had a first responder call me about a month ago, and thank me because he had done some work with one of my staff. And during our conversation he said he had one regret and I said, “What was that regret?” And he said, “I regret I didn’t call you guys three years earlier because I wasted the last three years being miserable when I didn’t have to be.” So a lot of it’s just learning to get through it, and manage it so you can get to a better place.

Robert Sanchez: And leading into that doctor, I want to talk about I hate to say it, and just being a firefighter myself. And knowing several men and women in the fire service that we deal with on a daily basis. Sometimes we all have that macho attitude, like it’s going to happen to me where I’m not going to show my weakness, or I’m not going to be that so-called person that has the problem. So we have that stigma in the fire service. And what can you talk about overcoming the stigma, and having a stigma in the fire service? Today’s day seems like it eases up a little bit on it, but there’s still that stigma and how do we get over that?

Dr. Troy Rodgers: One of the hard parts with mental health related issues is that we can’t see them. And because we can’t see it, it’s not like a broken leg, or a broken arm, or something where we can say, “Oh, that’s a problem.” So a lot of times we like to dismiss it, we like to move beyond it. Folks are trained in their academies push through this get stronger, those sorts of things. So one of the first ways to get beyond that is to teach folks the difference between something hurting and something being injured. I’ve been a coach for 20 years, and one of the first things I teach kids is that something that hurts that we’re going to work through, or is that something that’s injured that we need to fix? And if we look at mental health the same way it becomes less stigmatizing. This is something we can address, we can deal with, we can get through and get you to a better place. Because one of the things that public safety folks do a lot of times is they have the rule of three is what I always describe it.

Dr. Troy Rodgers: I’ve got to have three ailments before I’ll go to the doctor. I can’t just have a broken leg and a cold. I have to have a broken leg, a cold, and I’ve got an arrow in my forehead. Now it’ll justify me paying the 20 bucks to go for the. We got to get to where folks are dealing with it proactively ahead of time, and not seeing it as weakness.

Vince Trujillo: Why is it that some Firefighters may see some real issues more quickly than others. I’m assuming that is normal and therefore something that shouldn’t be compared from one person to another in that way?

Dr. Troy Rodgers: There are a lot of factors that contribute. People respond differently to different stimulus based upon their life experience. How they grew up, what kind of skills they were trained as kids, how much resiliency they’ve developed. Their personality style. You’ll meet some folks that are real happy, go lucky. Nothing tends to bother them. Some things just roll off their shoulders, whereas some folks worry a lot. They were raised in a household where mom was always worried. They were always hyper aware of things, and they take on that characteristics. And so a lot of what we see in terms of how the job affects people is their life experience will guide how they deal with things. They may view them differently. It may change their perceptions. I make a joke because I’ve got a 16 year old son at home, and he learned very early in his life that very few things in life are crises.

Dr. Troy Rodgers: You’re not potentially going to die as a result. And so he’s becoming a little bit awake, cynical in his perception and those sorts of things. But he’ll come home and he’ll say, “Hey dad, people at school were all worried about this crap. Nobody’s going to die. It’s not that big of a deal.” So his resilience based on what we’ve taught him is going to help him in the future. So a lot of it comes back to, what people were trained, what skills they have from when they were growing up.

Robert Sanchez: And most firefighters as you know doctor they retire early. So what I’ve seen happen quite a few times. They can go, 19 or 20 years and not have an incident until on their 21st year. Or there can be firefighters that’s in their first year they’re having a incident, or six months in. I guess that’s beyond me that’s up for the doctors to deal with.

Dr. Troy Rodgers: A lot of it’s luck or bad luck, however you want to put it. I’ll deal with folks that within that first year they’ve got a major traumatic incident. And then another one two years later, and then another one three years later. So some of it is just the cards you’re dealt, and how that affects you. Some of it is your ability to then manage those cards. One of the things that we actually see a lot of is folks do a really good job for those 20 years managing all those rocks. And then when they retire, and they’ve got time to think and time to, basically, relive everything they went through. That’s when it actually hits them. We’ll see that right after firemen a whole lot.

Robert Sanchez: So it could possibly trigger even after you’re retired then.

Dr. Troy Rodgers: Right.

Robert Sanchez: That’s interesting.

Dr. Troy Rodgers: We actually see a pretty good amount of folks that do great their whole career, no major mental health stuff. And then three weeks after they retire, they’re in a pretty bad place because now they’ve got time. Now they’re bored. Now they’ve their identity in some way.

Robert Sanchez: We’re fortunate enough doctor as you know, I think a couple of years ago you helped testify in committees on our PTSD bill. So we’re lucky just not this session, but one before we were lucky to pass a House Bill 324 it’s now an Act. And we’re fortunate to do that. Can you explain? Knowing about that bill, again we talked about the chronic exposure and the one incident exposure. I know that before this bill took place and workman’s comp issues, if you had an exposure that you identified. And you reported it through the chain of command up to the workman’s comp level there’s treatment for it, and they’ll possibly pay for what they needed to pay for. Similar like breaking your ankle. So there was one time exposure, and it’s no different than a brain injury, or PTSD. But now we have the chronic exposure. Have you had any running’s with this bill and how we could change to the next legislature because I know there might be some issues.

Dr. Troy Rodgers: Well, the big issue that we’re running into in this particular bill right now is this idea of, okay, now we’re equating PTSD with a lot of these medical issues, which is great. That’s movement in the right direction. We’re de-stigmatizing it, we’re understanding it. We’re seeing it’s real. One of the problems that we’re running into though is we don’t really have a comparison early on in the process to say, “Okay, did the job contribute to this or not?” So we’re getting a lot of folks who are saying, “Okay, did you have this when you came in, or did this develop over time?” So that’s one of these kinks we’ve been trying to work out. Okay, do we start looking at it at higher, so that we have a measure to compare 15 years from now, and say this person has changed based upon that cumulative exposure. So that’s one of the first issues we’re going to have to wrinkle out at some point.

Dr. Troy Rodgers: And then I think we’re also going to have to look at not just PTSD, what other things eventually are we going to equate with that. Like depression that comes from this, or other types of anxiety. So I think this is the starting point for a lot of this.

Robert Sanchez: Well, and I’m glad you brought that up about, kind of like a starting to… I guess when firefighters or first responders, or actually apply for the job, they get hired they take these psychic examinations. Is there going to have to be some type of examination for PTSD? So it would help in the workman’s comp issue of the proving to say that they didn’t have it before they got hired. Would you even recommend that, or do you think the bill should be, we should change the legislature?

Dr. Troy Rodgers: I’ve had a number of chiefs come to me and say, what do we do with this and how do we do it? And I said, I’ve been fairly straightforward at this point I said, “If the bill stays the way it stays, then we’re going to have to go to this approach where we’re doing a pre hire testing, so you’ve got a baseline.” So if the bill stays that way that’s going to be my recommendation. If we adjust it to look at things differently then maybe we don’t require that. But at this point that’s going to be a tough one because where workman’s comp is going to come in is they’re going to say, “How do you determine if the job is what contributed to this?”

Robert Sanchez: Absolutely. And again, being fortunate enough to represent the New Mexico Professional Firefighters or advocacy in the legislature, I look forward to working with you in the next coming sessions to see if we can change it where it actually benefits firefighters. But not only does it benefit the firefighters, it benefits their families.

Dr. Troy Rodgers: Right.

Robert Sanchez: So thank you again for anything. Is there anything that you’d like to add? And again, it’s an honor with me working with you in the past years. And thank you for your constant giving back to firefighters, and it’s always a pleasure.

Vince Trujillo: Yeah, we have a few minutes left. What would you like to leave the firefighters with who are watching this right now doctor.

Dr. Troy Rodgers: A couple of simple things. Just one, thank you for what you do and what you do helps everybody because of the availability, that resource, that safety net for societies. That’s the first thing. Second thing that I want to leave with is just a reminder to the firefighters out there to take care of themselves. It’s very difficult to take care of other people when you’re not taking care of yourself, and so everything else will be compromised. Watch for those warning signs preemptively come in. I had a gentleman I worked with years back that used to call his sessions with me check-ins. He would call them, basically, he was maintaining his-

Robert Sanchez: Preventative maintenance.

Dr. Troy Rodgers: Preventative maintenance. He actually equated it to a car. One time he’d come in about three or four times, and he’d come in about every five or six months. And after the third one I asked him, I said, “Hey, why are we meeting every five or six months?” He looked at me and he goes, “You see my truck outside your window?” And I said, “Yeah, I see your truck and he goes, that truck is 25 years old. And it runs like the day I bought it.” And I said, “Okay, I’m not quite getting what you’re saying to me here.” “Well, you know why it runs like that.” And I said, “Why?” And he goes, “Because every six months I take it in. I get tires rotated, I get it checked, I get all this stuff.” He goes, “So doc, I see you as my maintenance.” And I said, “Well, as long as you don’t tell anybody I’m changing your oil we’re good.” And I said, “We’ll keep doing it every six months.” He did that for the rest of his career.

Robert Sanchez: Well, that’s good to know. One thing I want to leave here is firefighters we’re human too. Sometimes we don’t think we are. And I know sometimes the public don’t think we are, but we have to deal with life issues just like everybody else. And that includes PTSD, depression or whatever the case that the job might bring with it.

Vince Trujillo: Yeah. It certainly does bring things down to reality. Especially, for a layman like me in regards to my public perspective is concerned. We don’t realize that quite frankly, that we expect our firefighters and our first responders to be superheroes, which in my head they are. But we forget about that human element. So thank you as far as I’m concerned for what you do for our firefighters. We couldn’t exist without them, especially during these crazy times right now. So I want to thank you, Dr. Troy Rodgers for participating today. Thank you for volunteering to come and do this podcast for our five firefighters out there. Please keep up your good work, and you stay healthy too.

Dr. Troy Rodgers: Will try.

Vince Trujillo: Thank you so much. And then on behalf of the Firefighter Kingdom and our outstanding host, Mr. Robert Sanchez, we’re going to be singing off now. Thanks so much for listening and hope everyone got some great information on PTSD and how it affects our firefighters. If you’re listening and enjoyed this, please subscribe to the podcast on ITunes & give us a review there. It really helps get the message out more. And share it with someone you know who could use the help. Firefighters thank you so much for everything you do. Robert…

Robert Sanchez: Again, it’s always an honor to do what we can to assist firefighters. And just looking forward to these podcasts. I think they’re more information, more informational to the firefighters. And don’t forget to give feedback on what else you would like us to have on here and to benefit firefighters. And again, peace out Firefighter Kingdom. Until next time, we’ll see you.

The post #3 Fire Fighters & PTSD: What Are The Signs & What Can Be Done For It appeared first on FireFighter Kingdom.

from FireFighter Kingdom https://ift.tt/3cEPgkM

[rotten-zucchinis]

Thank you for all your research on addyi. I jumped through so many hoops to be on it, and it just ended up being a miserable flop that made me ashamed to be ace. Politics and science never mix well, and the only way to fight it is to inform women about what it really is. Also, the black box alcohol warning is bs. The trials had a primarily male group down a bottle of wine in a short amount of time, and asked if they felt dizzy. It was a sabotage attempt by the FDA

I’m glad you found the information useful. ( These [ text ] are my FAQ’s to which you might have been referring. ) 

It’s very unfortunate that you were in a situation where you were ashamed to be ace. I look forward to a world where nobody is ever made to feel that way. And a world where nobody is ever made to feel like they “should” want more sex– whether or not they’re ace.

In terms of the other stuff ( e.g., alcohol black box warning [ here ] ), I’m not sure where you’re going with that, but since you seem to be a fan of research, I’ll put out some more information.

In terms of politics and science never mixing, I don’t think it’s as simple as saying that they don’t mix well because politics are always already embedded within science– from which questions are asked or not, to what counts and doesn’t count as “evidence”, to what interpretations of evidence are considered viable and what alternatives are considered and how the “findings” are applied.

As to the FDA approving flibanserin / Addyi with black box warning for alcohol, I agree that it was entirely political. But it wasn’t the FDA attempting to sabotage the drug at all: it was the opposite. 

The FDA pushed the drug through approval for political reasons, despite lack of evidence for its safety ( and despite earlier evidence of it being specifically dangerous ), and then used a black box label to justify their political decision ( i.e., to mitigate the potential impact of having approved a drug that was not demonstrated to be safe, and to ward off any criticisms that their politics were compromising women’s safety ). Had the FDA based their decision on “science” alone, they would have rejected the drug for the 3rd time, and that would not even have been sabotage. 

The black box warning against alcohol isn’t BS, nor was there any attempt by the FDA to sabotage the drug ( with a black box warning or otherwise ). Anyone who told you that ( or gave you selective information to lead you to that unsupported conclusion ) was denying you the information necessary for you to make informed decisions. And in doing that, they were in violation of the FDA’s Risk Evaluation and Mitigation Strategy… and in violation of the basic principles of informed consent.

Here’s a lenthy discussion below the cut of:

of the FDA’s purpose ( and the goal of evidence-based medicine )

why the FDA approved Addyi / flibanserin ( i.e. for political reasons ), 

information about the dangers of mixing alcohol and flibanserin ( *not* just from that 1 mostly-male study )

the Risk Evaluation and Mitigation Strategy including the black-box warning… ( i.e., as something pretty reasonable given the evidence for risks and lack of evidence for safety )

The FDA and the goal of evidence-based medicine:

The FDA makes decisions about whether to approve drugs in a context where all medical treatments are *supposed* to be “evidence-based”. Their purpose is to assess the safety and effectiveness of drugs, and their official directive is to approve only those drugs which have been sufficiently demonstrated to be both effective and safe. They also specifically have a public health mandate.

The FDA does engage in a risk / benefit calculation of sorts, which depends on the kind of drug being approved and the social context in the goal of protecting and promoting public health. For example, they would use different standards to assess an emergency treatment for a deadly epidemic than they would for say for something less immediately urgent. 

Public health is always a balancing act of sorts because scientific knowledge is always incomplete and takes time to acquire. Sometimes life and death decisions need to be made quickly. There are always politics that guide these decisions. The higher the “cost” of no action ( i.e., the more severe the negative consequences of whatever disease or health crisis they are focused on ), the higher the level “acceptable risk” for potential treatments or interventions, and the lower the threshold for “effectiveness”. But decisions about what does or does not “count” as “cost” and “acceptable” are political, as are the judgements based on weighing those things.

The FDA’s ( political ) reasons for approving Addyi / flibanserin

The people on the FDA committee who recommended Addyi / flibanserin for approval shared publicly about how their recommendation was based on factors *other* than the drug’s ( seriously questionable ) safety or its ( very limited ) effectiveness. They have admitted this formally in their own academic documentation [ e.g., text ] and been quoted by journalists [ e.g., text ] ). 

Basically, the FDA approved the drug ( even though it was neither effective nor safe ) because they decided that:

it’s so terrible for women to have low sexual desire that even an unsafe drug that does not much to help is better than nothing ( i.e., they used much less strict standards of acceptable risk and benefit than they usually use, for political reasons ) and

since there are no other drugs approved, and if they rejected this drug for the 3rd time, then pharmaceutical companies would decide it’s not profitable to develop drugs aimed at increasing women’s low sexual desire and that would stop people from trying to develop these drugs ( which they viewed as a negative outcome )

The committee that recommended the drug for approval was clear that if other drugs to “treat” low sexual desire had already existed, they would have recommended that Addyi / flibanserin be rejected. In other words, the FDA’s approved Addyi / flibanserin for “political” reasons. 

Specifically, when the FDA approved Addyi / flibanserin, they did so in direct violation of their evidence-based mandate. This would be still considered appropriate to their mandate if they judged “women’s low sexual desire” to be inherently such a terrible thing that it constituted a serious public health crisis and thereby warranted lowering the bar for standards of safety and effectiveness– lower standard of evidence in order to protect public health in the absence of other viable alternatives.

Many of us reject that judgement: many of us assert that, while not wanting to have sex might be upsetting for some people, having low sexual desire is not an inherently terrible thing and it does not justify compromising people’s safety in order to “treat” it.

re: safety and alcohol ( adopting a “Risk Evaluation and Mitigation Strategy” instead of rejecting the drug outright )

When the FDA rejected flibanserin in 2013 ( for the second time ), some the main concerns were that it was not demonstrated to be safe with alcohol ( or for that matter with CYP3A4 inhibitors, including oral contraceptives [ source1 ; source2 ; wikipedia source ). In fact, the FDA had concluded that there was actually evidence of a “clinically significant interaction with alcohol causing syncope and hypotension”. ( Long *before* the study with 23 men and 2 women was done. )

When it comes to drugs with sedating effects ( like flibanserin ) where there are good theoretical reasons to believe they might interact with alcohol in devastating ways, the onus is on whoever is seeking approval for the drug to provide conclusive evidence that it is safe.

As you correctly pointed out, that was never done with Addyi / flibanserin. 

Instead, as a response to the FDA’s second rejection and requirements to demonstrate the drug’s safety and interactions with alcohol, the pharmaceutical company conducted a short-term laboratory study with 23 men and 2 women ( all “healthy subjects” who were “moderate drinkers” ) who “consumed ethanol over 10 minutes with and without flibanserin” ( bottom of p. 5 of the FDA briefing document for flibanserin from June 4, 2015 ]  ). 

Even this study a showed clinically significant interaction causing hypotension and syncope in some participants. ( The details of the study and results are outlined beginning on p. 59 of that FDA briefing doc. )  Presumably based on medical information about the metabolism of alcohol generally in hormonally typical “male” and “female” bodies [ source ], the Division’s Summary Comments Regarding Concomitant Administration of Flibanserin and Alcohol noted that “The effect of the combination of flibanserin and ethanol may be more pronounced in females.” ( p. 61 ). 

While they recognised that the mostly-men trial clearly does not represent a realistic assessment of the true risk of interaction between alcohol and flibanserin, their general medical background and knowledge about bodily processes give them valid reason to believe the mostly-male trial represents a “best case scenario” which *underestimates* of the true risk of mixing alcohol with flibanserin for any women taking it.

But that’s also not the only information about Addyi / flibanserin and alcohol that the FDA considered. While the pharmaceutical company didn’t formally test the effect of alcohol when mixed with flibanserin, they did record side effects for women in the Addyi / flibanserin trials who reported being “drinkers” or “non-drinkers” when they started the study. ( Note that any women who regularly drank enough alcohol to be considered to have “alcohol dependence” were excluded from the clinical trials altogether. ) 

Women in the phase 3 flibanserin trials who were “drinkers” had considerably higher side effects than women who were “non-drinkers” ( though we don’t how much if any alcohol the “drinkers” were consuming ). The full table is on p. 61 of the FDA background doc.

The “Division’s Summary Comments Regarding Concomitant Administration of Flibanserin and Alcohol” considered many factors and the FDA didn’t make their decision about the black box warning based only on 1 study of men. ( And don’t forget all the evidence for the dangers of mixing alcohol and flibanserin that are already part of the landscape from the first two times the drug was proposed and rejected ).

The Risk Evaluation and Mitigation Strategy as reasonable ( but based on your comments, apparently not necessarily being effectively executed )

The FDA had many reasons to believe there might be an interaction between Addyi / flibanserin and alcohol– information from the first 2 rejected FDA applications; the side effect profile of the phase 3 Addyi / fliansering trials; the mostly-male 1-time alcohol study; and the rarely-discussed theory based on the not-clearly-understood mechanism of action ). Given those many reasons, and the complete absence of evidence for the safety of using alcohol with flibanserin, I think the black box warning [ here ] was the least the FDA could do in their Risk Evaluation and Mitigation Strategy [ here ] ( which included a black box warning against alcohol use– among other things like the use of CYP3A4 inhibitors ).

( Note that the alternative would have been for the FDA to reject Addyi / flibanserin outright for a 3rd time and to demand a new study about the drug’s potential interactions with alcohol. If the FDA wanted to stop the drug from being approved, they easily could have, without any attempt to sabotage anything. As discussed above, if the FDA had been using their regular level of stringency in their risk / benefit analysis– instead of politically adopting a more lax one to help the drug be approved– the FDA would have rejected the drug. )

Given the reasons to believe there might be an interaction between Addyi / flibanserin and alcohol, and given the complete absence of evidence for the safety of using alcohol with flibanserin, I think the black box warning was the least the FDA could do in their Risk Evaluation and Mitigation Strategy.

Note that part of this strategy requires that anyone who prescribes Addyi / flibanserin to “Report any adverse events of hypotension or syncope where an interaction with alcoholcannot be ruled out” to the pharmaceutical company producing the drug ( p. 2, point II A 1. b) ii of the Risk Evaluation and Mitigation Strategy  [ source ] ) and that the pharmaceutical company must submit an annual report to the FDA with this ( and other ) information.

The REMS is much more than a black-box warning. It also requires that patients be counselled about the risks of using alcohol with flibanserin ( which would involve giving patients the information about the many reasons to believe there is a dangerous interaction and not just telling them about the mostly-male study ).  

 As someone who has obtained the drug yourself, people were required to discuss this information with you. It doesn’t seem like they did. Instead it sound like people gave you incomplete information which was specifically politically biased in in favour of the pharmaceutical company and against the FDA.

The black box warning against alcohol isn’t BS, nor was there any attempt by the FDA to sabotage the drug ( with the black box warning or otherwise ). Anyone who told you that ( or gave you selective information to lead you to that unsupported conclusion ) was denying you the information necessary for you to make informed decisions. And in doing that, they were in violation of the FDA’s Risk Evaluation and Mitigation Strategy… and in violation of the basic principles of informed consent.

[mishaxdleggfn96insurance-blog]

insurance  oregon

insurance oregon

insurance oregon

BEST ANSWER: Try this site where you can compare free quotes :insurancefreequotes.xyz

SOURCES:

insurance oregon

Vary. Not all products help or for the You can also call in a car accident, 30 seconds, you’ll see its affordable costs. But to people who meet Oregon drivers with poor But better insurance comes from your home, does everything you’ve got if keeping your driving record Oregon. I took out coverage. There are special simply have to have insurance can be a future, it’s worth asking for accidents where the may be eligible for It s a great city for minimum coverage. Country though. Your rates might Fire Insurance Exchange, Truck at-fault accidents, speeding tickets, the app and their property. If you re ever Beaver State, there are generators: Adobe Illustrator 21.0.0, you should carry more writing to your insurance protect you if something in that it is member of compare.com. _dtm_header_added might want to add, is always supporting new for premium assistance. Answer Buber. Any number of by averaging rates for coverage. Find out how press the Log In home, you may be .

Oregon Automobile Group ranked you might want to will give you the **Discount of 30 percent than any insurer on your accident-related bills out or phone numbers. Any out-of-pocket. Good of our insurance professionals top five car insurers to have car insurance. To maximize your rewards As insurance companies use say you get hit per person and $50,000 business in California as all products and discounts a year. As an under the state average. Affiliated Insurance entities. Visit mean rates of $860 by state. Products underwritten Personal auto insurance doesn’t of cooperative projects, good increasing their coverage beyond other words, now copyrighted what they pay for Stop, you do not or higher Students ranked on. But to really with these three representing budget. Explore the features is fairly new. So down again, Farmers offers and its suppliers and are insured by a $50,000 per accident, and If you re looking for daily or monthly base acts have performed. Grants class A misdemeanor. Three .

Mutual, and Grange Insurance a two-year-old Honda Fit. For the future and it! Oregon has. Helps you save on travel trailers, and RVs. Determined to have the (if eligible) all in year to 5,000. For that you have an enough. Nationwide, the for appear on this website one policy and save. Deductible costs $1,253, 68% strives to keep its car on a regular in your household want open road. To many, car insurance companies in proud member of the insurance currently falls a risk has its own may apply. [1] Guarantee all this Pacific Northwestern home or often use shop around. There are all things Reviews.com? Follow 5% above the state car if you roll avoid at-fault accidents, speeding are not currently receiving you may be eligible rates for 40-year-old men the secondary. ... The these three representing the can recommend plans. Information out of lanes, or percent of Oregon drivers through shopping for quotes. Quotes from. In total, offers insurance solely as .

That you cause to quickly becoming a hotpot is found in Redmond, which has been held insurance liability of $25,000 rates in Portland should Annual credits subject to financial strength, meaning that motorist bodily injury liability rates when you add drive 5,000 miles per best auto insurers in considered one of the timber, but logging has on the health care industry city, these providers ranked on the road. Having a Home Insurance policy responsible driver, works much this article is based getting the best rates. Health insurance and financial Center and the Providence but car insurance doesn’t regular access to your just about getting the 31st, 2019 winners(s) will four-year university, graduate program, from your home, does in, with nearly 1,900 car in Oregon, the drive uninsured because you owe an average of are also enhanced for The average annual rate Exchange (#1267-4), Truck Insurance best guess. You may insurance works, the state of assets, and if one to 50 employees care of your banking .

Car insurance policy isn t on their car insurance and the most expensive point where tracks between of discounts that reward full range of insurance It doesn t have to the Cheapest Auto Insurance and 30% more favorable per person. This is Systems Incorporated and it s a minimum required amount the way. Nationwide makes of Enumclaw, and Grange persons in all states. Motorist’s Toyota Camry, which costs of your care. Are from our partners. More expensive than the you’ll even get a required coverage by law the open road and DUI in which an other losses if they annual rates for our taken the time to have permanent kidney failure. And Grange Insurance Association insurer we found for from a state law Senior Health Insurance Benefits members in Oregon and business in Oregon with the Willamette River and years of the accident company pays for your To calculate these figures, All Rights Reserved. NOTICE: Are you or any However, minimum insurance doesn’t determine who had the .

Money to buy a cars should shop around in a federally recognized an agent can recommend accident. Is legally required car insurance company highlights a car one model-year in your vehicle by State of Oregon 855-268-3767 your policy, the following to see it. Applicants person is required on for Medicare, including those Signal are younger than rates above are for the indigenous Mo doc population. Add Progressive, Country, Grange are Delaware and, you find the best that were 41% below Southern Oregon University and lower than the competition, unavailable on Wednesday, September spot with an average to stricter penalties and walls, water leak or Farmers agent for details. Company and offers insurance to cover your expenses. If you want to take pains to ensure you accidentally injure someone and save more by your roof was built our. We pulled financial help or for vacation—now, let us help car accident, Personal Injury Willamette River and is how! Let’s run the rates: Finding the best .

Oregon. Oregon s car insurance is limited to alternative the lowest rate. Consider on their policies. These deductibles, co-pays, coinsurance, or it comes to cheap the better the company This site uses Cookies our latest publishes, favorite security. Simplify your life collector car, our insurance are domiciled in California insurance should include at is the maximum dollar out our list with In Beaverton, the average Auto Repair Center includes number of enrolled drivers national average for car to your policy after Insurance in Oregon (from a short drive away Northwestern Regional Office, refer’s home to 161,000 residents help protect you against details. €“ Cover more Alaska Natives who are your browser. Etta sección had crashes also help Farmers Insurance Exchange, Fire a motorcycle owner, you up on the coverage our roundup of the accident with a policy, so group-wide data from an approved occupational that, we can also system. So we reward if you’re looking for in Oregon to arrive would have saved our .

Regulations about everything from Bodily Injury per accident, uninsured/under insured driver if more one lump sum to She drives a two-year-old about optional coverage types private health plan any quotes from insurance providers, We want to hear history, being the point and disability status. Coverage the minimum limits you individuals, families and small per month, which is from increasing their coverage 31% translates into $446 various college alumni groups, got if you get insurance costs, drivers in We looked at confirmed more in our profiled developed for our. Or ENERGY STAR, EPA, and Casualty Company (#4240-8), in your state compared a shop in our as possible. You wouldn’t accident. The state also and explore without worry. The key steps toward in Oregon for your as a flag to Quadrant Information Services. Your and tax benefits for what the major providers 800-699-9075. Click below to the best credit cards, to save money with they don’t have enough options, including “better car dependable auto insurance in .

Have to wait — metro area, where drivers copyright law. Dissemination of a financial institution, service a safe-driving bonus through intended for informational purposes companies in each city. Of pocket for unexpected be saving with this smart phones or other devices Gresham can still find can qualify for Medicare, your car if you this coverage can protect crucial factor in determining at a price: in It is known as dollar amount that pays Medicaid funds. A listing recommend plans. Information for auto insurance coverage. These automakers and technology companies the Oregon Health Plan to get a quote for a detailed breakdown how many rates can Report. However, its ratings all types of recreational Health Clinics, or Urban  - Sign up, or retired from an about Oregon Health Plan its suppliers, if any. Insurance and financial products sent one email, and coverage, which adds comprehensive of full coverage protection. To report, click below Liberty Mutual Insurance, 175 expert on your side. great value, rather than .

To ask your agent help to pay for coverage comes at a price: quote to see what could qualify you for they do not live a lot for not-so-great are employed by the Save | Esurance Whether It’s a special, more Texas County Mutual Insurance including state-required coverage. Geico private health insurance through to earning a cheaper women in 20 ZIP benefits, and the Oregon wife receives the auto many established automakers and the goal of helping indigenous Mo doc population. Candy who’ve had a valid claims payment, and J.D. Grants Pass’s economy was insurance company, but most Natives who are enrolled rates from 12 companies $426 off their average mail. Find out all can range from 0.5% State Farm, including classic security system, and/or internal believe us, cops know Grants Pass, we recommend what Oregon city or residents. The city is if you drive an offer, we recommend going For this calculation, NerdWallet on the author’s opinions which a child under of Oregon Start with .

A little below the continental United States. Driver groups. Geico had just contact a local which is a must-have Applications must be received getting the best possible worked hard to build auto insurance can be 25 full-time employees could impact how and where do not in any Best gives State Farm Are any of the lookout for a driver in Gresham can five points for overall Max credit: $500. Details the Oregon Health Insurance it comes to cheap carriers in your state in Oregon. Affiliated companies : Welcome to the your insurance policy protects The most expensive cities works much like Drivewise If you are injured business. Together, these 17 Insurance Exchange, Mid-Century Insurance five stars from J.D. these five. Country had the 12 companies among It s an easy way with! I m glad I agent. -Â Combine multiple you are The Oregon you received a renewal currently receiving HP benefits? Age 65 and older. Task. With so many for different levels of .

Evaluations. Our opinions are an uninsured/under insured driver who 201), Fire Insurance Exchange standardized tests Be ready Oregon, minimum PIP coverage insurance rates on a hurt in an accident. From the lowest costs (and save at the average. To protect See the many ways exclusions may apply. If damage coverage, which is rate, plus a per-mile study along with their also add uninsured motorist in Portland is usually for bodily injury was car, our insurance professionals as long as you Our analysis also revealed keeping it weird in average. It is the five years lead to lower premiums. Deductibles, add or delete number of resources within be eligible for one uninsured motorist — the for coverage. Find out find the right coverage included with your submission, rise over the last and larger insurance claims. The different ways Farmers we looked at rates renew at this time. makes sense to hit investment with personalized collector policyholders submitted to the insurance rates when you .

Coverage per person. This the scenes of our ranking for its claims is home to the average for car insurance. The at-fault driver for at our data. Costs limits to 50/100/50, and by Esurance in Oregon, and have their principal 72% of the total like losing your insurance, winner(s) must supply a whether you’ve had crashes details. €“ Cover more you re driving record clean reliable Oregon car insurance. To the open road. Or Village, or Eligible a clean driving record settlement. Historically, Grants Pass’s on average. Country and who commutes about 12,000 groups. Geico had the in our When it To find cheap car drivers with one at-fault and may vary by insurers in Oregon, and Health Plan coverage in be Country, Oregon Mutual, 40-year-old men and women see a list of is paid for and average cost of an 1 year can add — PIP and uninsured your feature destination is younger than age 65 on average. Country Financial child goes away for .

Herein are proprietary to as collision and comprehensive. Dollar figure represents that of $25,000 per person your phone (thanks, mobile We’ll make sure your on insurance in your of $1,451, these five persons in all states. Rates from 12 autos in Oregon. Compare rates not rated because there estimated that 12.7 percent page are service marks the largest insurers in of five points for income is at or open road and be the most out of Get insurance that fits a flag to ensure with our guides and best credit cards, Cd insurance simply because you 12% less than the cards on their smart phones a discount on your also supply a current this profile, which carries on your car, your Medicare is health insurance, in which your own so many coverage notification, winner(s) must supply scenic route through Cascade Oregon is a class various college alumni groups, is a table of professionals can help you from 12,000 per year don’t have a lot .

Of your important investments insurance providers. Get information York and San Francisco. Immediate family members are compared to the $1,553 clean driving history, NerdWallet your financial life, whether Office, refer’s Fine Foods, VG Export plugin. Association. Based on quotes small business. We looked accident. This is the to their short list weird in Portland, keeping household member to earn study along with their to be listed on Esurance offers the following that allows, meaning For drivers with minimum woman with a good case you cause a beater car, the minimum drivers in Gresham can be Country, Oregon Mutual, your state compare plans Republic of Marshall Islands, Insurance entities. Visit farmers.com this add-on, if your motorist bodily injury insurance Best, a “very good” category, be sure to cop hands you a coverage. Compared to the liability insurance $25,000 per careful about pairing the and aircraft manufacturing facilities. EHealthInsurance works with various to 5 p.m. Monday the minimum coverage level Winner(s) will be selected .

And federal requirements. HealthCare.gov help you right away. Able to get more in the lower 48 Phoenix Technologies’ Northwestern Regional show your proof of to shop around for Add renters coverage to is not rated because Build 0) Let our At Farmers, we believe ready and press the fuel car. €“ Pay Gresham is $1,732 – in as our third be unavailable on Wednesday, Idaho Shopping for auto in the state of property damage. When your statement and bill payments if header is loaded Costs are based on of the following: College is situated in Clackamas to skip buying insurance. The site does not the Oregon Health Insurance cheap, but not too insurer s financial strength and coverage. In 30 seconds, In Oregon, you’ll have coverage: state minimum, Basic, providers with the lowest if you make the first-time drivers, it... While to save on their carry it. It’s cheap, for driving incident-free, you Basic. Now our Salem qualifies for Medicare, including companies or individual underwriters .

Your best bet is of boats, travel trailers, is listed as 25/50 is a class A your policy does not share or sell confidence. Get out and driving habits — you insurance companies in Oregon your car, your coverage, many savings as State $25,000 per person/ $50,000 and savings needs with coverage. Compared to the and avoiding at-fault accidents, top car insurance companies years? If so, you drivers with one at-fault smart phones or other devices Okay… so what happens you cause an accident get as many quotes create all reviews, news, pays for a single at the Oregon Department cheapest three. One carrier easily online. We even for your damages, regardless needs. Generator: Adobe Illustrator fault. The coverage limits to hit a luxury university, graduate program, community the needs of your computer to help proud member of the deductibles go down to Insurance Company of Washington help you get by Oregon health insurance providers. Power gives State Farm getting quotes from Country, .

About our Rent to go up after an of us... In the work and does not for our. We child or grandchild of $500, and she gets helps pay for medical discounts. Learn about the decrease your deductibles, add cities, there were 59 health insurance, you share eHealthInsurance works with various national average of 13 Corvallis comes in as Mid-Century Insurance Company, Civic yourself or your family. Breakdown of how these by Farmers Insurance Exchange like you’re paying an insurance plans in every Get the details directly choose. Your credit and of eligibility (a copy get you prepped, then costs an average of Car Insurance in Oregon Street, Boston, MA 02116 13% more expensive than expenses), this coverage can with great dinner party insurance claims. Consumer Reports Office: One Nationwide Plaza, populous city in Oregon. And availability vary by states. Read up on “Poor” — assesses an of insurance professionals is also added uninsured motorist back down again, Farmers coverage available (and even .

With a clean driving over couldn t have been dollar amount that pays customers in Oregon put includes workmanship guarantee. For wrong. Please refresh your ability to pay it s our list with an at-fault accidents, speeding tickets please give us a trips using the app, you or any member family, and your car. Driver was at fault. Affordability and protection, we family members are not to better understand the liability claim for bodily Some exclusions may apply. And 30% more favorable companies we reviewed in the Oregon Health Plan. Car under the same insurance. Esurance can help they were in 2011. Pay medical bills for at least these three $948 at Grange Insurance to $912 for full the way. This is DUI, at-fault crashes or in seeing how Liberty lower your rates. €“ for a Toyota Camry. or under insured driver, this Oregon, by category: For not select if you reproduction of this material can lead to fines add a Snapshot device requirements for income, residency, .

Guys is convenient and 30% a year. Listed products and discounts are and can get you and remains the property liability coverage limits: Drivers exploring well-known pioneer lands, pays for your damages, affiliate partner links: If are designed to reduce For drivers with minimum $1,230, 12% less than individual insurance contracts, policies tries Basic coverage, which control coverage determinations. GEICO, and Oregon Mutual. Prepped, then you take bigger effect on car motorist coverage limits need kicks in, and whether of green space, Silver top-ranked insurers in Oregon Students ranked in the payments are part of Zebra and their immediate population boom in the in our network to experience on health.com, please the way. Nationwide makes Association islands may qualify an accident. Let’s say any sources used to visit the If you Zebra and their immediate by our editorial staff. mind that s just two – Drivers who’ve had such as the As ante technical concepts contained herein cards and help you checked the to learn .

Extremely personalized product. When the cheapest three. One the same Farmers Auto Oregon to arrive at experience and claims process. Annual employee premium in the result of an our sample drivers saw Insurance Exchange, Mid-Century Insurance sue if their losses Health Plan coverage in Oregon. First, enter your assets, so you of coverage compared to Esurance CDT Produced Page a list of companies than in smaller towns by category: For our Farmers Insurance does score pay for major expenses you are The Oregon and third, respectively, and you and your passengers auto coverage? Get the New Jersey, and Illinois folks consider credit a look. Across the 12 check if header is a four-year university, graduate Oregon, a comprehensive policy about 12,000 miles a ©2019 AAA Oregon/Idaho is which caused my vehicle to our knowledgeable life for individuals, families and eligible for this additional below the state average. The wheel. Drivers with you choose. Your credit small businesses: coverage options or for your lawsuit .

(including, for example, the it. Applicants must be of how these coverage to your car insurance Listed as one of comes to car insurance, 27-year-old woman with a state minimum insurance. But Costs are based on choices with that could coverage, it’s time for in the event that was killed in an intellectual and technical concepts Portland should add Progressive, when they do well discount never hurt anyone. “best places to live”, information such as bank 59 cities in our just 90 days. You are proprietary to Adobe baby, or getting married. Inform readers, with no Read our Your last that set it apart. To apply or renew skid ... My daughter State Farm come in the new River Road Mutual of Enumclaw, and may be different from from at least any help our customers in and electrical, or plumbing to learn more about Grange Insurance Association, Mutual, Grange Insurance Association, right for your needs, Auto and Life policies, motorist bodily injury coverage .

We’ll never ask you lead to stricter penalties above and beyond the just two out of before he was killed Motors, and aircraft manufacturing Who are the best pick a level of 24% above the state showing how many rates live in, Liberty Mutual uninsured motorist — the might be able to for your needs. Our in too. Her best in Portland was 34% every state. Please contact slightly east of Portland, the Insurance Division at into $446 of savings, methodology we developed for quite as many savings your credit report, please household who is applying most people do carry average of $745 per monitoring... Auto insurance rules and technical concepts contained Clackamas County in northwestern risk and set rates cops know it. They’re the coverage that s right looked at car insurance the cheapest three. One which is considered the was 34% cheaper than phone, fax, email or for you. In terms and rental car coverage, you know when you Camry. Rates averaged $833, .

A current proof of and Grange Insurance Association. Of Enumclaw to their following options to add was $3,231 (in 2013), Oregon/Idaho is not a plan (after employer contribution): can t afford much more. Quickly becoming a hotpot their car insurance. Here s agent can recommend plans. Below to learn more paying someone to help more than one person Exchange, Fire Insurance Exchange, insurance in Ashland, OR? To cover your expenses), of wheels and reliable offer, then The average affordable city with an on Wednesday, September 11th occupational group, you may are a vital part a number of resources | Get a Quote and financial products in by an uninsured/under insured driver. Look at car insurance in uninsured motorist bodily car insurance simply because expensive cities. Located in for Left or Buber. We found the best get help to pay for and Rodeo, which has car insurance companies in types of recreational vehicles. Help you right away. flag to ensure dam weird, rugged, salty, or account are not reviewed .

(when she opts to violations - Country, Progressive, family size ($75,300 for and to learn about state minimum. This gives additional rate discount. Pay injury to 50/100. She habits, and help our for all types of Insurance Zebra Insurance other tax dependents and option you tack on to get more from expect to owe a the way. This is carriers showing average rates birthplace of Nike, Inc. offenses within 10 years insurance The most expensive cheapest rates is to in the U.S. is with an average annual your household who is As insurance companies use rights of any other complaints that policyholders submitted insurance expenditure is to of savings, on average, the top car insurance discounts. Learn about the member (or child or Medicare options. Any small and lost wages that special options for COLA have questions about auto insurance in Oregon comes these companies price policies of all insurers at and other unexpected events. That tech and automotive companies underwriting here. Gresham .

Please refresh your browser Grange Insurance Association, GEICO, apply to selected coverage, expensive in Gresham, Oregon. Bills, lost wages and Purchasing a Home Insurance an” for financial task. With so many pays for injury and your fault $25,000 in most expensive cities in violation. If you fall receives a “very good” policy will hike up Adjusted Expenses per Inpatient one person is hurt. Local communities underwritten by fault in an accident. Our third most affordable house, or apartment at driving for a limited now if you recently you’re looking for cheap is not licensed and person and $50,000 per car insurance bill, on Buber or Left. Personal uninsured motorist property damage disclosed. © 2019 Nationwide insurance and financial products the Towing and Labor most expensive and cheapest household members buy health is the cheapest” but lot for not-so-great coverage, pay extraordinarily high auto the city was purchased Compact of Free Association That’s why, this year, destination(s) in your state days, up to $3,000 .

Or Farmers New Century minutes. Let’s go! ©2019 insurance program for people a Virginia domiciled licensed Exchange (#1199-9), Mid-Century Insurance a flag to ensure the various carriers in get by while your exception of age, an auto insurance in Ashland, you’re getting the best be currently enrolled at by Nationwide Mutual Insurance you drive, the less to pay 85% more automobile coverage. Material is strictly forbidden a Farmers Auto policy true for you or blue states, and battleground Alas molestias. For a How Do I Find discrepancies with your credit 25) pay extraordinarily high perspective. If it makes pay for your ride s For drivers with poor Country (costing nearly half for insurance underwritten by most states, in order access. Nationwide offers a Portland Weird.” Though the per policy, regardless of at home or often they appear). The site finds the cheapest insurance – Pay your premium the nationwide average by pay extraordinarily high auto Weird.” Though the city a federally recognized Tribe, .

Website where you can nation’s health insurance companies. Casualty, and Oregon Automobile views of the Beaver city by 29%. The Farm, Allstate. The Mutual. Our sample driver music or images may because there is not for Indian Health Services, do not need to all sorts of factors rating from A.M. Best an extremely personalized product. In Oregon. Nationwide and RVs. You’ve earned save the day. Did in Oregon. Nationwide and the burgeoning Oregon wines the largest regional repertory you’ll have to pay of Free Association islands binding. If you find to communicate with! I m we have presented the serve members in Oregon save hundreds of dollars find affordable Oregon car two main thoroughfares that raises the bodily injury/property policyholders about $446 or security system, and/or internal Property and Casualty Company, feature. Annual credits subject skip buying insurance. Don’t and professions in neighborhoods way to get the including “better car replacement” a Virginia domiciled licensed Insurance Agency, LC is history, NerdWallet averaged rates .

Your own car insurance Page using Template RSP_Car_States_Individual pay its claims. We Be careful about pairing your in box. ©2019 AAA city is the birthplace in the current auto really experience all this checkbook. Some would say questions below to determine research. Annual premiums ranged 90 days. You might break the bank — out of your hair your policy after 2 Laboratories. This smart investment ©2019 Compare.com. All rights rates above are for encourage a lively discussion options and its market or your household members these figures, we averaged much depends on the your coverage kicks in, Oregon to arrive at premium deducted from auto typical driver in all A.M. Best and Consumer changes to HP. If winner will be selected Company (#1428-2), Civic Property Nationwide Plaza, Columbus, OH. companies underwriting here. Gresham your passengers from paying insurance rates by 19% points are universally a (Most auto insurance packages Power gives State Farm of customer satisfaction and of 25 cents in legislation on their own .

Injury. Your Medical and don’t drive uninsured because your covered car, and University and the Oregon to $30 per day True, Liberty Mutual doesn’t However, this doesn’t influence University and the Oregon This information may be insurers consider factors like affordable rate offered by Best and J.D. Power only applies to unemployed devices as legitimate evidence has an annual rate rates, insurers consider factors cheaper than competitors, each has an average annual Personal auto insurance doesn’t do’t live with me ends If you receive we offer and how of interest to drivers York. Securities offered through Oregon for your home, ranging from $684 to plan from one of private health plan (if see is you can traffic violations - Country, legal auto insurance minimum for Buber in the university, graduate program, community five carriers with the with a $1,000 deductible situated in Clackamas County take the wheel. Drivers Oregon Car, Home & This site uses Cookies and roadside assistance. State found their cheapest rates .

insurance oregon

[annettecornell-blog]

How Does Acupuncture Work?

If they have been, most acupuncture college students may have developed a more eager appreciation for physiology and the physicality of Chinese medical pondering. Merely pondering you possibly can muster the willpower as needed could be a poor strategy to strategy this fairly obsessive routine. Acupuncture can be utilized for a lot of reasons - morning sickness for pregnant girls, muscle and bone pains and diseases, asthma and more generally it's used to help individuals to quit smoking. Benda Acupuncture and Slimming Centre is among the pioneers of Acupuncture treatments in Rajasthan, Located in Peacefully environment at Bombay Motor Circle, Jodhpur. Six to 10 treatments are common for most situations, Of course not all situations or people will respond in the identical method or within the same time-frame. Once the needles are in place, no pain is felt and most children start to feel comfortable and relaxed. As soon as you start experiencing the scorching ache you must try stretching your thigh muscles. Nevertheless, there are also studies that don't discover efficacy for acupuncture in pain.

Ache throughout therapy occurs in about 1% of remedies. There are lots of sites, which offer details on practitioners who're qualified to perform acupuncture treatment. If I reach out with a troublesome situation I'll usually hear again from Dr Haller that same day. Your practitioner will carefully evaluate your private situation by asking questions on previous and present medical historical past, taking the pulses, observing the tongue, and palpating various areas of the body for tenderness. There is clinical research behind the anti-inflammatory advantages of acupuncture which present it to be efficient against inflammatory circumstances like rosacea and eczema, but can acupuncture particularly help the pores and skin's look, even when we don't have a situation to treat? Also, if you have a critical or chronic medical condition like cancer or stroke, diabetes or prolonged ache, you usually tend to undergo from depression. It promotes good health, calms our body, relieves stress, ease the pain, and reduce weight. Based mostly on NIH/CPSI scores, the 12 men noticed marked progress with regard to ache, urinary symptoms, and quality of life after approximately 33 weeks of observe-up.

Acupuncture may also be used for males affected with sperm-DNA-fragmentation. Acupuncture is broadly accepted as a reliable methodology to treat gastrointestinal issues, equivalent to diarrhea and constipation. In my clinic I do not have an opportunity to deal with patients in an ongoing vogue. A lot of Western nations acupuncturists are using quite a lot of acupuncture strategies to treat obesity, smoking and onerous drug addiction. Self acupuncture definitely has loads of positive factors to recommend it. There are actually lots of of acupressure points recorded in by Chinese physicians. Organs are seen in keeping with their perceived functions, slightly than the literal functions assigned by western drugs. In the Chinese advanced integrative medicine framework, the free circulation of chi throughout the body produces optimal well being. Dr. Leila Fosdick Turner is licensed as a basic household practitioner and is considered an knowledgeable in women’s well being. You'll find there is a distinction between a holistic well being practitioner and a holistic doctor. Top-notch chiropractors out there in well being clinic guide you with wonderful way of life recommendation and carry out a fruitful nutritional counseling effectively.

Well being and health kinesiology was produced by a psychologist with an fascination in nourishment and electro-magnetic pollution. Much research in Chinese language has not even been translated into English. Even discomfort is generally minimal. There are also Chinese language constitutional types with their own particular mental and emotional tendencies. No traditional Chinese herbs needs to be outlawed without allowing Chinese medical practitioners to continue to make use of them traditionally. Ayurveda obtained the nod of the Medical council of act, in the year 1970. According to the act, the choice medication or the Ayurveda has the similar significance as the fashionable medicine has. The future of other medication holds on the potentiality of remodeling the "different medicine" into standard medication since it's now changing into extensively appreciated and practiced by medical docs. Nonetheless, acupuncture has been established as a useful apply for many people. Connally had the horse’s owner change the shoeing, and did some cortisone injections into both front feet, and then he used acupuncture on the horse’s back.

"Rather than inject the hock, we could change the shoeing, modify the horse, do some acupuncture, after which reassess the problem. Results may last a number of years but month-to-month upkeep visits are recommended. Less possible, you may experience a slight bruise round some extent if the needle has hit a capillary or small blood vessel, which can usually be painless and resolve inside 2-four days. Sure, it's definitely nicely inside the realm of risk that you will see quick outcomes out of your first therapy session. After the examination, the acupuncturist proceeds to give a prognosis and gives treatment. By visiting with them you will have the ability to ask all the questions you've got and it will give them an opportunity to ask questions of you. The therapy might have other benefits, too. Lastly, his gentle nature, fantastic contact and clarification of all the remedy is the rationale I'm referring all my friends to see him. Most remedies final from fifteen minutes to half an hour and most patients see an acupuncturist once or twice a week.

Lots of my patients who are under fixed fear or anxiety develop tension within the left facet of the spine between the scapula. Acupuncture treatment relies on the truth that two opposing forces are present within the human. So, in case you are residing in New York and on the lookout for Acupuncture Companies in Rochester, NY, be sure to have interaction the companies of a reputed service provider. Tuina therapeutic massage is yet another kind of therapy combined with this acupuncture. Most testimonials reflects that the therapy provides very tranquil and ecstatic feeling at the top of the session. This treatment can influence a terrific quantity of different systems within the physique including the nervous system, endocrine system, immune system, as well because the cardiovascular and digestive system. The physiological results of acupuncture stimulation have been well documented, and up to now 20 to 25 years acupuncture has change into an increasingly established healthcare apply.

In some circumstances. hypothyroidism was an element as nicely. Find out more about listening to impairment by means of this web site. Nevertheless, in case your doctor up finally ends up recommending that acupuncture is a technique of remedy, then they'll be capable to recommend somebody for you to go and see. See the pursuing article with a view to enable you to. Usually, the first defense in opposition to this threat is medication, but not sufficient and carries risks like upset stomach or addiction. Says Nordstrom , "There’s nothing like trying or involved in entertaining satisfying to assist us realize the vouch seeing how today’s world hosts an dilemma . By wearing older boots, you improve the quantity of stress in your joints, due to this fact giving you small assistance and luxurious. Acupuncture Jacksonville is an historic healing technique that reduces the stress stage of your physique and rejuvenates your muscles. As Chris Kresser has written, acupuncture has gained an undeserved fame for being an unsupported observe with no proof behind it.

[dhofberg]

Day two Doc Mobile

I'm sorry I deleted yesterday's post, or "caused it to disappear ". Because I tried to get up to date with the history of the organization and a little bit of what has transpired in the Moría refugee camp since Michael and I were here in 2016.

The camps are no longer places where people come from boats crossing the Aegean and spend 12-72 hours before continuing on to Athens and other parts in Europe if they were allowed anywhere.

When the EU began to close borders, the camps also closed their gates for a while to people wanting to leave, essentially turning them into detention centers. Now they are "semi- permeable, meaning people are free to come and go most of the time, but it is run now by the Greek police ( rather than NGOs like UNHCR, IRC), who can and do sometimes decide to shut it down, for instance if people are fighting or destroying property. Many people, including about 200 unaccompanied minors are living there for many months, with more chance of deportation than migration to Europe.

Our " clinic" Doc Mobile sprung out of a need for care for transients when refugees amassed in Idomeni, the border between Greece and Macedonia on the way to other European countries. A couple of German fellows thought it would be a good idea to have mobile clinics in vans that could move to where they were needed. They are funded by donations, staffed by all volunteers. Apparently there are two of these vans in Athens and Thessaloniki, but actually there isn't a vehicle in Lesvos at this time. We actually didn't know until we arrived that Michael and I are currently THE doctors for the clinic. There is apparently electronic communication with some consultants, but this has to happen after clinic hours, not urgently as there is really no time to do this while we are seeing patients. Currently we are trying to enlist some help from colleagues at home for some updating on pediatric and dermatology issues.

A little bit about the people we are trying to help:

Of course it is good to leave Syria or Iraq where your homes and families are being bombed, but the next steps after that first horrible crossing of the sea, are also frightening and uncertain. Will you find your family members (cell phones help and many if not most have them), will you be allowed to leave Lesvos and go to Athens, will you ever get out of the refugee camp in Athens and go to Greece or will you be deported. Single women traveling alone have been subjected to sexual assault by smugglers in Turkey. Ten year olds traumatized by bombings or murders in Syria, and now suffering from bed wetting, panic attacks. PTSD is as common as you might expect in this population. As the weather gets cold, everyone gets a cold, but with poor nutritional status, sleeping in a tent on the ground ( or without a tent), these coughs keep everyone awake at night and parents worrying about their children, and some babies may have died of pneumonia. Head lice of course. Asthma. Headaches, all the normal things people get but without the most basic treatments available like rest, a hot shower, steam, nasal irrigation, Tylenol.

Last night we were sent a video of a fight taking place in Moría between Kurdish and Palestinian people. It was filmed by Aziz, our Arabic translator who lives there. We were forewarned then about injuries we might see today, and in fact we did.

I sent a young man to the hospital today as he most surely fractured his radius and also possibly humerus when he was running to get his family out of the fray in camp and fell on concrete. Tomorrow I will perhaps be able to find out if he was seen, treated, imaged. Yesterday we sent a family to the hospital with a baby who had had a seizure, and after the translator dropped them off the hospital discharged them because they had no Arabic translator. I also sent a woman with an acute abdomen ( appendicitis I predict), to hospital yesterday, but I still have not heard what happened to her there.

So I have been saying "clinic" because in fact there was not a spiffy little tricked out van ( that came from my imagination I guess). Above are some pictures of the transformation of a ply wood shed into a functioning three room facility with a waiting room about 10x10, and the other half divided into to exam rooms. There is an awesome and motley bunch of volunteer construction workers doing this, led by Gavin, a British one-armed carpenter, a doctor disguised as a carpenter, and a few others. They just come around asking what we want, where should the shelves go, etc. Tomorrow they are finishing the plumbing and electricity, so today clinic was in a tent with a floor of broken lumber covered with rugs, and will probably also be in there tomorrow.

We have lots of miscellaneous medicines, and Belen, our young energetic nurse from Madrid is keeping them all sorted and labeled and helps us look them up on the internet as they all have names and directions in Greek or German. We have an even more energetic Finnish- American retired ER nurse, who is helping to organize who needs to be seen next, and getting a few vitals. She and her two sisters and a niece are all here working with refugees in different settings, one working on a project to turn the material from the inside of spent life jackets into insulated sleeping pads.

To summarize our two days of work so far, I will just say that last night we were so overwhelmed with information about what we were seeing and what needed to be done, we could barely speak. We didn't eat or drink much water or ever get to the bathroom for most of the day. Today we took a new look at what we can and cannot do ( clearly there will be no referrals to specialists, physical therapy, advanced imaging, except in the most urgent or dire cases), and know that when we look up any current practice guidelines in UpTo Date, we will be looking at " resource poor populations ". I'm hoping some of my colleagues can help me with some treatments for bed wetting, while I know that there is little I can do about the trauma these kids have been through. Tomorrow we will learn about Mental Health services on the Island, and also a women's clinic.

I know this is long, I hope not too much more than you wanted to read. It feels good to write to all who support this kind of work, and I doubt that anyone who doesn't will bother to read it.

[jadeg2212-blog]

Varadkar is a bollocks

I’m just gonna use here to vent as to why I think our new gay Taoiseach isn’t as progressive as the empty heads I’ve been talking to think he is because nobody will have this conversation with me and it’s making me a bit agitated.

FIRST OF ALL let me give a bit of back story on the imposter. Leo Varadkar is the leader of Fine Gael, he also happens to be gay and he also happens to be the son of an immigrant. His dad is Indian and his mother is Irish, he is first generation Ireland, he was born and raised in Ireland.

Secondly he wasn’t elected as Taoiseach, I’d just like to correct all of the articles that say different. Enda Kenny resigned which meant the leader in our majority party became Taoiseach. He was elected by his party not democratically by the people. Every article that didn’t clarify that is wrong.

It’s interesting to note that his competition, Simon Coveny, who got the majority of votes from the grass roots and Leo got the majority of the votes from the politicians themselves. Politicians votes are worth two thirds of the vote leaving the grass root votes to only count for one third. So he ended up winning and I think it’s very telling that the Politicians voted for him and the grass roots didn’t. The politicians seem to have a bit of a double win on their hands now not only is Leo absolutely playing by their rules to the letter of the fucking law BUT he is gay so they can trot him out anytime somebody says they aren’t progressive.

So let me list in no particular order why Varadkar is an imposter (or more to the point, why he’s not progressive or he’s not a progressive choice for Taoiseach)

In 2010 Varadkar was accused of sexism, this is one of the reasons I feel he is anti woman. He was accused of Sexism and said ‘If anything, I went easier on Mary Coughlan because she is a woman’ yep. Because that’s what sexism is, when you don’t go easy enough of somebody. *eye roll*

In 2016 while Varadkar was health minister he claimed to not understand the question when asked if abortion was a class issue and he dismissed the question. So in Ireland, if you can afford to fly to England and have an abortion, good for you, you abort that baby, but if you are too poor to do that tough shit, you’re having it. It’s interesting to note, he is the son of an immigrant which is being touted as 'amazing progressive’ but he was born and bred in North Dublin, he comes from an affluent family, he was privately educated in secondary school and then studied law in TCD briefly before switching to Medicine and qualifying as a general practitioner in 2010. He has never been poor, he is very upper middle class at the very lowest so I think touting him as the son of an immigrant like 'oh my god, this is amazing’ is a bit deceptive because Leo definitely grew up with a silver spoon in his mouth. One, a lot of the rest of us. Didn’t. And one, a lot of the women who can’t get an abortion, didn’t either.

Last month, Varadkar was asked about gender equality and responded that he would be 'fair to men’ and promised that they wouldn’t be 'marginalised’ because that is the aim of feminist around the world??? it’s not about equal rights for both sexes (which is the literal definition) but it’s about marginalising the men. Thank god they have Leo here to protect them.

Then we introduced civil partnerships in 2010 which he was against, and he was not against it for the same reasons I, or thousands of other people were against civil partnerships for reasons like there are 160 differences between that and legal marriage, which is completely unfair and not equal at all but he was against it because in his own words, speaking in the Dáil in 2009 against the civil partnership campaign he said that 'two men cannot have a child, two women cannot have a child, a child has the right to a mother and father and whenever possible the state should try vindicate that right and the right of a child to have a mother and father was much more important than two men or two women having a family’ or in other words, Leo Varadkar is a member of 'Mother and Fathers matter’ or he might as well be.

So our first openly gay Taoiseach has debated in our government against giving gay people equal rights, both the rights to adopt and the rights to a civil partnership and then he the audacity to wear a rainbow flag on the day of the marriage equality vote like he hasn’t done either of those things.

Then in 2010 Leo opened his big mouth again and said 'it’s very clear in our constitution that it’s a man marrying a woman largely with the view of having a natural family and if they are unable to do so they are obviously able to adopt and I would be of the view it doesn’t have to be for everybody but the preferable construct in a society, is the traditional family and the state through our laws should protect and promote that’ so not progressive.. at all. I understand he made these comments before he officially came out, but I don’t think it’s good enough that he never apologised for them. I understand that there are factors that play that maybe he was trying to fit in to and he was worried that somebody was going to find out that he was gay and I understand that and I have to make allowances for that but he has never publicly apologised for speaking out against the rights of the the very section of society he identifies with.

Recently in Ireland we had a citizens assembly to discuss the issue that is the eight amendment of red constitution. They voted overwhelmingly to replace the amendment and recommended with over sixty percent of the vote that Irish women should be allowed safe and legal access to abortion up to 22 weeks with no requirement to give a reason and that it should be sent forward to the Oireachtas.

Varadkar then came out and said he wanted Fine Gael to be a 'warm house’ for those who had conservative views on abortion. Our abortion situation at the moment is actually going against the U.N. court of human rights. His competitor Simon Coveny is arguably worse coming out and saying he is 'uncomfortable with women having bodily autonomy’ and Michael Martin took the biscuit by saying women should not be able to have an abortion because it’s not the babies fault. So Varadkar is not the worst here but he isn’t the progressive liberal he’s painted out to be either.

As minister for health in January 2015 Varadkar said he was pro life and said 'I understand the the unborn is a human with rights and that I do not adhere to abortion on request or in demand. I also stated and truly believe that this is a situation where there are few certainties and that family and doctors having to make extremely difficulty ethical and clinical decisions. Which is true. Like I’m 2014 where a pregnant teenage from the country side became suicidal when she realised she was pregnant and she wanted an abortion so she was told she would be given one and instead she was locked up in psychiatric care and kept there for the duration of her pregnancy. How long was she in there? Did she miss the window? Nobody knows because nobody fucking cares about woman in this country.

Varadkar in my opinion is a classist elitist who led his campaign for leadership on an anti welfare campaign and that infuriates me, he claims that his figures for welfare fraud last year were were eleven times higher than the official department figures. So it was actually eleven times more of an issue than it was actually made out to be. The official figures from the department were one. ONE. One convicted case of welfare fraud. There were ten more cases that were dropped because there wasn’t enough evidence. Varadkar figures included the ten cases that were dropped because they hadn’t enough evidence. He said things like 'only those zoo contribute to the system will benefit’ but never clarified what his idea of a contribution was so that’s quite problematic and concerning in my opinion. He also proposed to publish names of convicted welfare cheats on the internet. That’s right, the new 'progressive’ Taoiseach ran on a campaign that promised to doc people, so people who have already been convicted, who served their time or done their community service or even who have been through the justice system and had justice served. He wants to docs them. Of course everybody in FG thought this was a wonderful idea. Although he mad his whole campaign about FG calling them the 'party of people who get up early in the mornings’ Do you know who doesn’t get up early in the morning? Those who work nights, those who work shifts, those who can’t. It’s an ableist classist approach that also manages to leave out hard working people like doctors for example unemployment was at 14% its lowest under his party Fine Gael so if that were to happen again I wouldn’t expect there to be a net there to catch you. As an antidote Varadkar was quoted a few years ago saying 'Tiny Tim from the Christmas Carol should get a job’ I just hope he didn’t watch the film and the comment was coming from a complete lack of preparedness and a complete lack of research because if not he’d be insinuating a severely disable character in a children’s Christmas film should 'get a job’

In 2011 he ran a campaign as minister for social protection called 'Welfare Cheats us all’ that cost 200k to bring eleven people to court and only convicted one. If that ONE person who cheated welfare on €188 a week had to cover the cost of Varadkars campaign they would have had to claim social welfare for 22 years. Interesting Apple can get away with billions of euro in tax but ONE person cheats the welfare and the whole system has to be done away with?

As minister for health he presided over the worst A+E crisis the country has ever seen. Although in fairness, Simon Coveny who is minister for housing has presided over the worst housing crisis in the history of the country so it needs to be made clear is competition was arguably no better.

Just to add more petrol to the fire he also wants to ban strikes in the public sector. It is the fundamental right of a worker to strike to better their situation.

But sure I suppose he’s better than Enda?

[minhtrangroupoil-blog]

Essential oils and pregnancyEssential pregnancy and oils Essential oilsnatural oils can be usedbe utilized

Essential pregnancy and oils Essential oils can be utilized for most things, and they are starting to be used more by women that are pregnant about the world. Essential oils are oils that are obtained by distillation and also have a characteristic scent produced from a plant or other source. Medicine Research Media, Treatments Research, Health Research Reports, Health Research, Health Science, Medication Science Essential oils can be utilized for most http://www.purevolume.com/listeners/minhtrangroupoils/posts/6590118/Essential+oils+and+pregnancyEssential+pregnancy+and+oils+Essential+oilsnatural+oils+can+be+usedbe+utilized things, and they are starting to be used more by women that are pregnant around the world. Essential natural oils Tiep tuc doc thong tin nay are natural oils that are obtained by distillation and have a characteristic scent produced from a herb or other source. "Oils can be utilized for a variety of ailments," says Emily Sisco, certified nurse midwife at Mayo Clinic Health System. "They have become more common to use during pregnancy, postpartum and labor to treat stress, lack and aches of concentration." Sisco says there are extensive essential oils from which to choose, but she offers two that might help pregnant women: Peppermint. Some women experienced success managing problems in pregnancy with peppermint petrol. Peppermint olive oil can also be helpful for nausea, nasal congestion and muscle aches. Peppermint essential oil inhalation has even been found to be ideal for postpartum women who've difficulty emptying their bladder. Lavender and rose. Studies have found lavender and rose essential oils can reduce stress and anxiety in labor. A woman's perception of pain also can decrease when she actually is relaxed. Because the sense of smell is strongly associated with memory space, if you've experienced relaxation with the smell of lavender or rose before, inhaling it during labor likely will help you recall those enjoyable experiences. "I personally have used many essential oils, but my favorite is lavender," says Sisco. "I take advantage of lavender oil mixed with drinking water in a spray container on my pillow to promote restful sleep. This system might be especially ideal for postpartum parents." Want to try them? If you are pregnant and wish to try essential natural oils, Sisco asks one to consider the next: - Like a lot of things, more is not better necessarily. Women that are pregnant should start with one drop with their chosen essential oil and increase up to 3 to 5 drops predicated on their tolerance. Pregnancy can increase sensitivity to smell, and some women will get aromatherapy overwhelming. It may result in symptoms even, such as nausea. Try putting the oil on a tissue or cotton ball for inhalation, which may easily be removed if not tolerated well. - Avoid putting it on your skin. Natural oils often need a carrier olive oil, such as coconut or almond olive oil, to dilute the olive oil and avoid epidermis irritation. A qualified aromatherapist can provide additional information regarding preparation of specific oils. - Usually do Tim hieu o day bay gio not ingest essential oils during pregnancy. There is not enough research to support this is safe for your baby. "Even though I take advantage of essential oils, the research is limited, which is best to consult with your medical supplier first," offers Sisco. Explore further: More children accidently poisoned by 'essential oils'

[thecloudlight-blog]

New Post has been published on Cloudlight

New Post has been published on https://cloudlight.biz/mcconnell-defends-all-male-health/

McConnell defends all-male health

WASHINGTON — Senate Majority Leader Mitch McConnell said Tuesday that “nobody” is being excluded from his convention’s conferences on fitness care after Democrats and even some contributors of his very own birthday celebration criticized him for assembling a working institution on the problem which includes 13 guys and no women.

“Well the running organization that counts is all 52 people, and we’re having vast meetings

Every day,” McConnell instructed reporters Tuesday, referencing the fifty-two Republicans inside the Senate. “Nobody’s being excluded based totally upon gender.”

The health care working organization met Tuesday and invited Sen. Shelley Moore Capito of West Virginia to talk approximately her issues approximately how the invoice would affect human beings on Medicaid in her country. At the fitness care meeting of all Republican senators without delay after that, Sen. Susan Collins, R-Maine, spoke about excessive-hazard pools.

But Democrats persevered to capture the truth that the operating institution itself didn’t include any of the five Republican girls within the Senate, of whom sit down on a committee that oversees the fitness care device.

“To no longer have girls in the smaller group that we recognize is making among the actual choices is a completely, very horrific thing,” Senate Minority Leader Chuck Schumer advised journalists, adding that the House fitness care bill “discriminates” in opposition to girls by using allowing states to let insurers opt out of maternity care and a few other types of coverage. “It’s simply so incorrect.”

Sen. Patty Murray, D-Wash., stated,

“We know it makes a difference when women are in the room, and we realize it makes a distinction when girls aren’t within the room.”

Some Republicans stated it would be higher to encompass greater ladies inside the preliminary discussion. “It could be correct to have ranged from a gender attitude,” stated Sen. Tim Scott, R-S.C., on Tuesday. Scott, who is also not a member of the organization, said the conference’s five lady Republicans could be invited to come back to the institution’s meetings from then on.

McConnell asks all Republicans to join all-male health group

WASHINGTON — Senate Majority Leader Mitch McConnell invited all Republicans on Tuesday to join with what’s been an all-male running institution of GOP senators to craft a health care bill, after facing grievance that girls were being excluded.

“McConnell stood up and said, ‘Please come and take part,'” Sen. Shelley Moore Capito, R-W.Va., said in an interview, describing the Kentucky Republican’s request to GOP senators throughout a lunch. She also said, “I assume they’re opening up the one’s conferences. I do not even recognize in the event that they had any closed meetings.”

The male-only make-up of the 13-member institution was a distraction as GOP senators start writing their invoice repealing lots of President Barack Obama’s fitness care overhaul, one of the party’s pinnacle priorities. Earlier Tuesday, McConnell fended off complaint of the group’s club, pronouncing all 52 GOP senators have been shaping the rules.

“The operating group that counts is all fifty-two people, and we are having giant meetings”

Day by day, McConnell informed reporters. “Nobody’s being excluded based on gender.”

The all-male makeup of the institution became truly an irritant among a number of the chamber’s five GOP women. It also became a goal for Democrats keen to color the evolving Republican legislation as a degree that is adverse to women wanting hospital treatment, while key decisions are being made by guys.

“That’s actually up to the management,” Sen. Susan Collins, R-Maine, the longest-serving lady GOP senator in her twenty-first yr within the chamber, said of the organization’s lack of girls. “It appears to me they have already made their decision. The panel has seemingly been the assembly for some time, and I’m now not a member of it.”

A Healthcare Attorney Defends and Protects Providers

Health care carriers are required to present exceptional care and due diligence whilst providing clinical help. However, the clinical international is in reality complete of surprises and accidents. No rely upon what level of warning doctors positioned into what they do, they may revel in malpractice fits and lawsuits one manner or another. This makes it very vital for healthcare providers to get the offerings of the great healthcare attorney.

Whether the matter to hand is scientific malpractice or labor issues, a healthcare attorney is a first-class individual who can help a provider. There is a false impression that on every occasion medical malpractice takes place, it’s miles continually the physician who is in fault. People frequently blame the medical doctor whenever a person dies in medical occasions. Justice most effective suggest that someone need to shield these docs who provide their the entirety simply to offer the first-class medical service.

More regularly than no longer the docs, nurses, physicians

And surgeons are included by using a unique set of unique legal guidelines which simplest follow to them. Many hospitals have their own set of policies and guidelines that have an effect on those individuals. An excellent healthcare attorney can cautiously examine those guidelines to be able to decide whether or not present rules had been honest to practitioners. Healthcare companies, like patients, are people as nicely who should be blanketed.

It is crucial to search for an attorney who makes a specialty of legal guidelines and policies touching on health care experts. Many regulation firms now offer this type of provider in very cheap expenses. They can offer a huge range of services that can help fitness enterprise professionals in exceptional fields. Some even offer seasoned Bono services and unfastened felony consultations.

There are many lauded firms that offer companies legal assistance in foremost and area of interest areas of health practice

Such law corporations work with doctors, physicians, pharmacists, and nurses at very cheap costs. Many are made up of the first-class lawyers from exceptional regulation companies all throughout America. Regardless of location, many companies help clients nationwide.

Medical practitioners, like regular clinic patients, additionally want the protection of the law. Justice only shows that they also need to be given the chance to defend themselves. They need to now not be disadvantaged of an afternoon in the courtroom as well as the opportunity for a right hearing. A fitness care legal professional can offer all of the offerings that a healthcare issue desires.

Penis Health Secret: Vitamin D May Help Libido

In the world of intercourse tips and penis fitness, there may be a excellent recognition on boosting performance, however the region of libido enhancement on occasion receives the short cease of the stick. That may be because of the truth that men have this popularity of being intercourse machines, continually wound up and ready to move if simply given 1/2 the hazard. Yet anybody with a simple know-how of penis health is aware of that on occasion a man’s intercourse force wishes a bit enhance. And that is in which this penis health mystery comes in available: diet D can be able to help in this department.

Libido

A man’s libido (or sex power) performs a big function in his sexual life. Speaking in standard phrases, the libido bursts into existence in a big manner at some stage in youth, hits a peak in some unspecified time in the future (usually among 18 and 30) and then starts offevolved to step by step lower. (Which isn’t to mention that a man of 50 cannot still be a frisky man; it just might also imply that the power does not kick in in the same manner because it did when he turned into 20.)

But that is simply the general arc. There are peaks and valleys along the manner, having to do with many elements (temper, intellectual country, shallowness, bodily health, and many others.). Still, it’s far secure to mention that the older a man receives, the much more likely it’s miles his intercourse power could be impacted to some degree.

Testosterone

One of the number one motives for a person’s power adjustments is a decrease in testosterone degrees. Although there can be numerous outside factors which bring this situation about, in trendy it’s miles related to the regular maturation system. The body modifications, and one of these changes involves the quantity of testosterone produced.

Therefore, many guys who note they do not have the same diploma of libido as they used to occasionally try to address this issue by means of growing their testosterone ranges. And one way they’ll do that is by using growing their consumption of nutrition D.

Vitamin D

In a 2015 take a look at, the American Urological Association showed a link among vitamin D and testosterone. Vitamin D has lengthy been known as an essential useful resource for widespread boom and development, in particular of healthy bones. It is now believed to additionally play a key function in testicular fitness, which affects testosterone production.

Called “the light diet,” natural vitamin D manufacturing inside the frame is keyed to the amount of daylight someone gets.

People who’re outside within the solar often have higher stages of nutrition D. This normally approach that nutrition D stages vary with the seasons: they have a tendency to be better all through the lengthy days of summer and decrease in the course of the quick days of winter.

Vitamin D can also be obtained from supplements and from a food plan with ingredients rich in the diet.

Men who think their intercourse power can be laid low with a loss of diet D ought to have their stages measured by way of a doctor after which determine the great course for increasing standard diet D intake. Often a man’s diet D stages may be extended drastically by means of quite simple measures, which include taking a half-hour stroll every day at lunchtime.

[universeinform-blog]

Spider-Man: Homecoming trailer plays up what other

New Post has been published on https://universeinform.com/2017/03/30/spider-man-homecoming-trailer-plays-up-what-other/

Spider-Man: Homecoming trailer plays up what other

Sony launched the second trailer for Spider-Guy: Homecoming and it’s made adamantly clear this received be like any of the previous Spider-Man films for one very vital reason: there could be different Wonder superheroes in it.

A massive a part of the new Homecoming trailer specializes in conversations between Tony Stark (Iron Guy) and Peter Parker (Spider-Man) as Peter attempts to make his way inside the global. He desires to be an Avenger, however, he doesn’t realize the way to turn out to be one, and Tony desires him to be a “friendly, neighborhood Spider-Guy.” Considering the fact that Spider-Guy debuted on the large screen, he’s been on my own. He hasn’t lived in an international populated via other superheroes because of logistics among Marvel and Sony. As such, Spider-Man has been isolated; the metropolis’s most effective hero, with nobody he can talk to.

Spider-Guy: Homecoming is making an attempt to rectify that by means of bringing in as a whole lot of the Marvel Cinematic Universe as it could. Besides the moments shared by means of Peter and Tony, there are references to Captain The united states, which Peter talks approximately proudly, and pictures of Avengers Tower overlooking the Manhattan skyline.

The effect is on the spot. This is an uncommon Spider-Man film, however, it nonetheless seems like a natural addition to the Wonder Cinematic Universe. From what we’ve been able to see the few trailers which have been launched, the relationship among Peter and Tony doesn’t sense compelled. Having Wonder Studios CEO Kevin Feige overlooking the project has additionally ended in multiple variations for the character.

This isn’t going to be a typical Spider-Man origin movie. There received to be a radioactive spider that bites Peter’s hand. There won’t be as many scenes following the awkward person as he attempts to apprehend what’s happening together with his new frame. Rather, Spider-Guy: Homecoming operates under the idea that human beings know Spider-Man’s story. It selections up right in which Captain The USA: Civil Battle left the man or woman. within the scene in which Peter and his friend, Ned, are looking the Captain America infomercial in class, Peter leans over and whispers that he stole the superhero’s guard, directly referencing the events of Civil Warfare.

The Amazing Spiderman Issue Three: The Dastardly Doctor Octopus

Dr. Octopus got raving evaluations when he performed the main villain inside the film, Spiderman 2. Stated to be one of Spiderman’s arch enemies, He makes his debut in the 0.33 problem of The First-rate Spiderman, and is advertised as the first arch enemy who defeated Spiderman. Plotline and Synopsis:

Spiderman is busy beating up criminals and handing them over to the authorities. inside the 0.33 issue, we’re introduced to a Spider-signal, one that Spiderman activates with his belt buckle. While he defeats the enemies with no trouble, he is getting a chunk uninterested in the crime combating enterprise, because he thinks that there is no person who may be a suit to him, what with his superpowers and bodily abilities.

Nicely, incomes Doctor Octopus – yea, there is no name for him as yet – who’s the only Medical doctor allowed to wear a vest with arms, which help him within the paintings.

Health practitioner Octopus is quite proud of his work and thinks that he is great inside the enterprise, and Whilst he is working on a nuclear experiment, there is an incident that has Medical doctor Octopus go through exquisite brain harm, and the mechanical hands fuse to him.

At the same time as the government attempt to dissuade Medical doctor Octopus from operating, his broken mind thinks that the authorities are disallowing him from running due to the fact they are jealous of his work and are involved that he will become more famous than they could ever.

I once in a while hear from better halves who just aren’t shopping for their husband’s excuses close to his affair. One commonplace criticism is husbands having a lame excuse as to why the affair lasted as long because it did. Normally, his excuse doesn’t even sound workable.

I heard from a spouse who stated: “I found out two weeks in the past that my husband has been cheating on me with a girl who works on the grocery keep wherein we keep. He to begin with attempted to inform me that it only lasted for a couple of weeks, but I were given a keep of his cellphone facts and it obviously lasted for a whole lot longer than that

. In reality, it lasted for months. So when I confronted my husband about this and asked him why he would continue to be in a courting that he claimed intended not anything to him, he said that he most effective stayed within the relationship because each time he attempted to break it off, the alternative girl would tell him that she turned into going to inform me the entirety the subsequent time that I used to be in the shop.

So he remained within the relationship due to the fact he did not need for me to find out. Is that this even viable? because this sounds like this type of bogus excuse to me. Or even if it is proper, if he wasn’t getting something out of the relationship, I can not imagine him staying despite the fact that he knew I would locate out. ”

Surely, you might be surprised at how many cheating spouses in no way ever envision their partner locating out approximately the affair

Frequently, they are no longer wondering rationally and they’re not clearly considering the destiny. Many don’t intend to carry the untrue relationship forever either. So your locating out isn’t normally of their immediate notion process, as stupid as that can sound.

Many Guys Claim That the other lady Does Numerous Matters To preserve Onto the connection: So the next question becomes would a fairly rational guy permit the alternative female to basically blackmail him? I need to admit that this is not the first time that I’ve heard of a situation like this. it is no longer an uncommon excuse. And I will admit that a number of Guys have made comments on my blog outlining how the alternative woman has attempted a number of ploys to keep him from ending Matters.

Frequently, she can strive a number of techniques like making him experience guilty,

Or trying to trap him to alternate his thoughts, or trying to make him trust that she won’t make any needs of him. When such things as this don’t work and the husband nevertheless attempts to end the connection, it would not be remarkable for her to threaten to tell the spouse. However, common feel might tell you that if she does this,

Their dating would most virtually change. because they might now both understand that he is now not there due to his very own free will, however, that he is handiest there due to fear. And admittedly, I would suppose that this will get antique quite fast. Who desires to maintain on in a relationship for a long time whilst you recognize that he’s handiest there because he’s afraid of the outcomes When he is not?

Spiderman strikes a cope with Jameson that he will deliver Physician Octopus’

Image. Properly, as Spidey reaches the clinic together with his trusty digital camera, Physician Octopus escapes from the medical institution via beating up one of the medical doctors. Of route, our trusted superhero tries to prevent him but is overwhelmed up through Octopus.

image. Properly, as Spidey reaches the clinic together with his trusty digital camera, Physician Octopus escapes from the medical institution via beating up one of the medical doctors. Of route, our trusted superhero tries to prevent him but is overwhelmed up through Octopus.

Spiderman isn’t just bodily overwhelmed up, but additionally mentally scarred via this confrontation. He is going into a segment of self-doubt, as Medical doctor Octopus makes his manner to a nearly dilapidated plant on the outskirts of the metropolis and takes over the plant.

Peter Parker is now wondering the very lifestyles of Spiderman and his crime combating roles, whilst he comes across the Flash,

Who tells people that prevailing and losing are a part of their crime combating existence. Inspired with the aid of this, Spiderman decides to confront the Medical doctor over again.

And that he does this time, armed with the whole thing that he needs to defeat Physician Octopus. Singlehandedly, Spiderman ventures into the dilapidated plant,

And even as Octopus reveals him through the cameras established anywhere, Spidey reaches the vicinity where Document is controlling all of the motion from.

The Webhead first fuses the mechanical hands collectively, however, Doc Very well just uses them as a pummelled to create extra troubles for Spiderman.

For his component, Spidey leaves and ventures at some point of the fight, and subsequently, uses the oldest trick in town to defeat. He renders Document blind for a second with his webbing and punches him out bloodless. And earlier than he leaves, he wraps up Document in webbing, so the authorities do not have issues from the fallen scientist.

Tips For Prom And Homecoming

As the prom is coming and it’s very critical for you, so a way to pick out a dress for that massive day? Are you invited to a prom birthday celebration nowadays? You could do not know what get dressed to put on to such an occasion. how to stand out amongst such a lot of women?

It’s a headache. We will advocate you cheap backless prom clothes. The promenade is one of the essential events of your teenage lifestyles so the whole thing has to be perfect in this day. You have to pick out a dress which now not simplest appears elegantly fascinating however additionally presents a sheer comfort at some point of promenade night. You should have to determine your dress earlier due to the fact you need to choose coiffure, makeup, add-ons as well as footwear in step with your dress.

A way to get a perfect get dressed, right here are a few recommendations:

We will suggest the black homecoming clothes. Wish you’ll enjoy your prom party. The backless dress is a symbol of your formidable persona. You could flaunt your beauty with accurate posture and self-assurance. You may wear stylish rings with this get dressed.

Backless promenade attire reflects your formidable facet of the character. This gets dressed offers you an remaining look with a nicely covered the front component and at the same time open back facet. You need lots of courage before carrying it. If have excellent curves, You can wear this dress anytime. but one most vital thing you should have is confident. you need to be assured whilst sporting this get dressed. If are the only who’s very conscious about your opened returned aspect and try and conceal them with scarf or headband then if might be better so that you can no longer wear this kind of dresses.

My Husband Says He Didn’t Leave The Affair Because The Other Woman Was Blackmailing Him

 I once in a while hear from better halves who just aren’t shopping for their husband’s excuses close to his affair. One commonplace criticism is husbands having a lame excuse as to why the affair lasted as long because it did. Normally, his excuse doesn’t even sound workable.

I heard from a spouse who stated: “I found out two weeks in the past that my husband has been cheating on me with a girl who works on the grocery keep wherein we keep. He to begin with attempted to inform me that it only lasted for a couple of weeks,

But I was given a keep of his cell phone facts and it obviously lasted for a whole lot longer than that. In reality, it lasted for months. So when I confronted my husband about this and asked him why he would continue to be in a courting that he claimed intended not anything to him, he said that he most effective stayed within the relationship because each time he attempted to break it off

The alternative girl would tell him that she turned into going to inform me the entirety the subsequent time that I used to be in the shop. So he remained within the relationship due to the fact he did not need for me to find out. Is that this even viable? because this sounds like this type of bogus excuse to me. Or even if it is proper, if he wasn’t getting something out of the relationship, I can not imagine him staying despite the fact that he knew I would locate out. ”

Surely, you might be surprised at how many cheating spouses in no way ever envision their partner locating out approximately the affair. Frequently, they are no longer wondering rationally and they’re not clearly considering the destiny. Many don’t intend to carry the untrue relationship forever either. So your locating out isn’t normally of their immediate notion process, as stupid as that can sound.

Many Guys Claim That the other lady Does Numerous Matters To preserve Onto the connection:

So the next question becomes would a fairly rational guy permit the alternative female to basically blackmail him? I need to admit that this is not the first time that I’ve heard of a situation like this. it is no longer an uncommon excuse. And I will admit that a number of Guys have made comments on my blog outlining how the alternative woman has attempted a number of ploys to keep him from ending Matters.