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aswesawitblog · 1 year ago

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Too Fat to Travel: How We Lost 170 Pounds of Weight

Dang, I griped to myself, the airlines sure have shrunk the plane seats. I guess that’s so they can squeeze more people into every plane. I can’t even cross my legs sitting here. Sheesh.

Travel is only fun if you’re healthy. When you’re fat (or overweight, if you prefer to be PC), climbing stairs takes more effort, walking uses more energy, and you avoid mirrors and photo ops. And you sure don’t want to be squeezed into a child-size seat at 30,000 feet for hours on end. Ugh.

But that’s not the worst of it: Dan developed DVT on our trans-Pacific flight to Bali. Deep vein thrombosis is a life-threatening condition. The blood clot in his leg lasted for weeks, I was freaking out, and he didn’t feel like going anywhere. Way to ruin an adventure, right?

Table of Contents show

Denial is not just a river in Egypt

It’s not as though we didn’t know we were overweight. That much was obvious, duh. I could pretend that the airplanes and clothing companies had resized, but I knew it was me.

So how fat were we?

Dan was carrying 120 extra pounds around. My size 16 clothes were getting tight and I was at least 50 pounds heavier than I had been in college.

Over the years we had tried “eating right,” Weight Watchers, Atkins, Nutrisystem and more. We had moderate success and made many lifestyle changes, but nothing lasted. We were still too big.

How it all started

It all began in Panama when I found a doctor who was willing to work with me to solve my weight issue. Fluent in English, he had trained and worked in the United States but had returned to his homeland. He had tired of battling insurance companies and he wanted to get to know his patients and dig into their lifestyles to find what might be causing their issues. Back in the US, he had to move patients along because he needed the revenue to cover his overhead.

Anyway, after the usual medical workup and blood tests, he gave me a series of options to try. One by one I tried them. Long story short: nothing was working and I was getting desperate. I finally decided to stop resisting the medical weight loss protocol he had been recommending.

Who would blame me?

I had read on the internet that the protocol was dangerous, and I believed it. (If you hear something enough times, does that make it true?)

My favorite excuses were:

I don’t like being hungry.

I like food and I’d be watching Dan enjoy whatever he pleased.

Cooking is Dan’s therapy and muse. He has claimed the kitchen as his domain.

But if I didn’t bite the bullet and do that I would continue to gain weight. I really had little choice.

Support is essential.

I’m not sure what made him decide to join me, but minutes into hearing about my program, Dan was using the word we instead of she.

Maybe it was the incredible results we could expect: as much as a pound of weight loss per day, or the fact that it was a long-established medical protocol, or that we only had to be on the most restrictive part of the diet for a month.

Or maybe it was because of that DVT or that he suspected his body might be pre-diabetic.

Whatever the reason, we both decided to go for it.

FAQs about the HCG Diet

How does HCG work?

Our doctor was extremely clear: This is not a diet, it’s a bona fide medical protocol that has been around for over 50 years. It was developed by a British military doctor, Dr. A.T.W. Simeons, he said, so treat it as such and take it seriously.

>> The HCG diet protocol does not allow cheating. At all. <<

At the heart of the program is a natural hormone that is produced during pregnancy called Human Chorionic Gonadotropin (HCG). HCG is what makes it possible for a woman to deliver a healthy baby … even if she has morning sickness the whole time and can barely eat a thing.

The theory is that HCG causes the brain to trigger a release of fat stores.

Although HCG is naturally produced only by pregnant women, it has the same effect on everyone, both men and women. When administered in very minute doses and coupled with a very low calorie diet, people routinely lose between 0.5 to 1 pound per day, often more. His patients who have used it swear that it is the only program where they have been able to keep the weight off afterward.

But is the HCG diet safe?

I am embarrassed to admit that I could have been thin years ago—if I’d done my own research. Instead I blindly believed what I had read—that this is a dangerous way to lose weight because no one can live on 500 calories a day.

That’s not strictly true, our doctor said. We’re not talking about a low calorie diet here, it’s a low intake program. HCG merely helps the body access its fat stores. You get all the extra calories you need from the fat you already have.

HCG works exactly the same as every other diet. You eat fewer than your required calories, and your body makes up the difference by feeding on your excess fat.

Where can you buy HCG?

Ultimately, we figured out that we could save a bunch of money buying it online. It's easiest to buy it as a kit so you have everything you need. That's what we did.

BUY THE HCG DIET KIT HERE

How do you take HCG?

You may have heard of homeopathic HCG drops, which are taken under the tongue three times a day. That’s how we started – and they work – but it’s hard to find them in the U.S. anymore. (Want to know why? Follow the money.)

Anyway, our doctor found he had better results with regular injections, so we switched to shots. Once daily is easier than remembering to take a medication 3 times a day. We had better results and it was far more convenient. Plus, surprisingly, those diabetic syringes are painless. (Who knew?)

What can you eat on the HCG diet?

In the strictest stage of Dr. Simeons’ protocol (what is known as Phase 2), food options are limited. You are permitted selected meats, 4 fruits and about a dozen vegetables, but no fats or sugars. One grissini or melba toast is allowed per meal – lunch and dinner only. You don’t eat breakfast, but you can have coffee or tea if you wish.

You might think it could be boring but no – Dan appreciated the challenge to get really creative with seasonings and prep methods. Anyway, we could tolerate our limited food choices because it was only temporary.

As for exercise, walking is permitted but not heavy exercise. That’s fine with me, ha-ha.

Fortunately, the HCG diet has recently been updated to incorporate advanced research in low-carb/ketosis dieting, caloric ratios and basic food chemistry. They call it HCG 2.0. We think it is a smarter way to lose – not to mention much easier to do. Coconut oil and stevia are permitted in limited amounts, more vegetables have been incorporated, and your daily calories can be incresed a bit.

You can even exercise, within reason. The fastest and most effective method is high-intensity interval training (HIIT).

How is the HCG diet different from a regular diet?

According to our doctor, there are two big differences between losing weight with HCG vs. other diets:

HCG curbs your appetite.

You lose weight faster, which keeps you motivated to stick with it.

When I heard that, I nearly cheered out loud. Woo-hoo! If I’m not hungry and see results, I can do this!

Why don’t more doctors recommend HCG?

Our doctor left his U.S. medical practice because he said it was too heavily controlled by insurance and Big Pharma. And then he gave me something to think about:

Weight loss is a multi-billion dollar industry. Heavy people rely on medications for weight-related illnesses, while diet pills and shakes are often made by pharmaceutical corporations.

Ask yourself: Who stands to lose if a weight loss program works too well? How far would you go to protect your source of income?

Hmmmm.

Our weight loss results

Boosted by the information he gave us, we were convinced it was worth a try. Once our doctor recorded all our baseline measurements (bone density, fat, muscle, etc.) with a machine, we left his office with the booklet outlining the protocol and the homeopathic medication we’d be taking for the next 40 days.

As required, we weighed ourselves daily. Over the next 40 days, I lost an average of 0.4 pounds/day and Dan lost twice that. (Unfair how men always lose so much faster!) But who cares? I was excited: 18.2 pounds lighter in just 40 days!

We did a few more rounds of the protocol while we were in Panama, but to be honest we got lazy and stopped paying attention to our intake. We had read that the protocol resets the body’s “set point” and thought we could eat anything we wanted to without gaining any weight.

Nope.

Here we go. Again.

Take it from us: It’s hard to lose weight when you’re traveling all over the globe. (You have to try the local foods, right?) By March 2014, I was back where I started and Dan was at least 30 pounds heavier as well. We agreed that it was time to get serious about keeping the weight off.

As I researched the protocol further, I discovered something important. Dr. Simeons was incorrect: It is actually possible to stay on the protocol for more than 40 days without developing a resistance to HCG. (I guess it stands to reason: Pregnant women have HCG in their bodies the whole time, don’t they?) We also learned how to correctly monitor our weights afterward so the fat doesn’t return in apocalyptic proportions.

When we returned to the U.S. after being overseas for three years (read about how we were kicked out of Ecuador here), we decided to stay put for a while and work to get down to our ideal weights.

We devoted ourselves to staying on the protocol for as long as it takes. And that’s how we’ve finally reached our weight loss goals.

The following year saw us do three rounds of HCG and we were thrilled with the results. Between us, we lost close to 170 pounds and haven’t regained it since. At 120 pounds lighter, Dan jokes that he almost lost his wife!

The hidden benefit no one talks about

Remember that I mentioned daily weigh-ins? The goal is to stay within two pounds of your last dose weight every day for the rest of your life. (There are ways to correct it, but that’s beyond this article.) As you enter the final, maintenance phase of the diet, you will reintroduce one food every day or two and monitor how your body responds on the scale the following day.

Through reintroducing foods one by one, I have learned which foods my body can handle and which ones it doesn’t like. When I eat wheat, for instance, my belly will quickly pooch from bloat and the numbers on the scale will rise by at least two pounds for a couple of days.

I had an aha moment when I realized that. Now, I can make informed, conscious choices: Do I really want that bread/pastry, or not? Sadly, it looks like I have similar reactions to rice and oats, so gluten-free may not be enough. But at least I know.

Side effects from our HCG diet

Whoever said that rapid weight loss can be dangerous needs to back that up wth facts. People have been doing this protocol for over 7 decades and no one has died from following the program correctly.

Seriously: it’s more dangerous to remain fat.

When we began this journey, we got winded and broke a sweat just walking a mile. Now, we easily cover 4 miles in an hour. I am far happier—and healthier—than I was in the 170’s. And I’m not done yet; I’ve set a new goal. As for Dan, friends tell him he looks like he did in high school … and he has no more DVT or sugar shakes to worry about.

That was expected, but other side effects surprised us:

Going without sugar has retrained our taste buds. Things that once tasted yummy now taste way too sweet.

Drinking water has become a habit.

We’ve learned that coffee without cream doesn’t taste too bad.

We became aware that boredom and stress are triggers. We no longer head straight to the refrigerator to deal with them.

We have more energy.

Now, how good does that feel?

Our friends have noticed.

Friends often ask about our weight loss. We can tell who is ready to shed some pounds by how they react to our answer. We get the gamut, everything from “I can’t live without bread for a day” to “I want to do that!”

What about you – do you need to have your bread or are you ready to do this? Please share your thoughts in the comments.

Resources for losing weight with HCG

If you're considering the HCG diet, here's what you need to do:

STEP 1: Start by reading the original medical paper that Dr. Simeons wrote: Pounds and Inches: A New Approach to Obesity.

STEP 2: Decide if you want to do it yourself or get help. Either way, you can buy real HCG only by prescription.

Find a doctor. Many physicians offer the HCG diet protocol, but if your doctor doesn't feel comfortable with it, you can easily find clinics and doctors who do. Just be aware that some of them charge outrageous prices for dedicated HCG programs.

Do it yourself. If you want to do the HCG diet on your own and have done your research, go for it! Like us, you can get support and buy everything you need online.

STEP 3: Get support.

Facebook. Join an HCG Facebook group or two. Members share tips, recipes, ideas, victories and advice. Ask questions. (Of course you can ask us questions too, silly!)

Podcasts. we learned a lot from Colin F. Watson's HCG Body for Life podcast (we listened on iTunes). Maybe start with this recording: HCG Body for Life Phase 1 & 2. (We listened to all of them, mostly while driving.)

#weight loss #hcg diet

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genericbucket03 · 1 year ago

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What is Cenforce 100?

Cenforce 100 mg is a medication used to treat impotence in men. It works by boosting the flow of blood to the penile region of the body. This aids men in gaining and maintaining an erection. It's one of a class of drugs called phosphodiesterase type 5 (PDE 5) inhibitors.

Researchers accidentally discovered the ability of PDE 5 inhibitors to improve erectile dysfunction in men while examining its potential use for hypertension and angina.

You can take it on an empty stomach or with a meal. You should take this medicine as prescribed by your doctor. Take it approximately an hour before any sexual activity. Although working time varies from person to person, it usually takes between 30 and 1 hour.

Once you are sexually stimulated, this drug will assist you in acquiring an erection. However, this medicine will not help without any sexual stimulation. Do not take this drug more than once a day. If you are using ED tablets for the first time, start with a lower dose, such as 25 mg or 50 mg, and gradually increase to 100 mg of Cenforce.

Cenforce 100 pills are not for females. Taking it alongside nitrate-based medicines can be harmful (often given for chest pain or angina). Avoid taking this medicine if you have serious heart or liver issues, recently had a stroke or heart attack, or have hypotension (low blood pressure). Avoid driving after taking this medicine, as this medicine can make you dizzy. While taking this medicine, avoid consuming alcohol since it raises the risk of adverse effects.

What is the use of Cenforce 100 mg?

This medicine is used to treat erectile dysfunction (impotence). Erectile dysfunction is a sexual dysfunction in men who cannot gain an erection firm enough for sexual intercourse.

This drug is a PDE 5 inhibitor that blocks PDE 5 enzymes that cause the penis to go flaccid. It relaxes the blood vessels, improving the blood flow to the penile region.

How does Cenforce 100 mg work?

Cenforce 100 mg blue pill has an active compound called Sildenafil Citrate. Sildenafil treats erectile dysfunction by inhibiting the activity of phosphodiesterase type-5, a substance that is naturally present in the penis.

While engaging in sexual activity, Sildenafil Citrate assists in widening (relaxing) the blood vessels. Consequently, there is an increase in the volume of blood flowing through the penile area of the body. This mechanism assists men in getting and maintaining a solid erection.

Dosage

This medicine's dosage will vary depending on the patient. Follow your doctor's orders or label's instructions. Only the average dosages are included in the following information. If your dose differs, do not alter it unless your doctor instructs you to.

For oral administration (tablets):

Adults up to 65 years of age- Take this drug once a day, 1 hour before sexual intercourse, as a single dosage. The drug can also be administered 30 minutes to 4 hours before sexual activity. If necessary, your doctor may change your dosage by increasing or decreasing the strength of the medicine.

Adults above 65 years of age- Usually, a smaller dose is given to patients above 65 once a day, 1 hour before sexual intercourse. Your doctor may advise you to take Cenforce 100 mg or a weaker version of this medicine based on your health conditions. The drug can also be administered 30 minutes to 4 hours before sexual activity. If necessary, your doctor may alter your dosage.

It is not suggested for children or teens to use.

If you suspect that you might need a more potent dose of Cenforce, you can increase your dose to 120 mg, 130 mg, 150 mg, or 200 mg. However, thoroughly consult with your doctor before increasing the strength of the medicine.

Food and beverage interactions:

Alcohol - Cenforce 100 mg can potentially lower your blood pressure, and alcohol can enhance that effect. Taking alcohol with Sildenafil can be problematic for you, increasing the side effects. Therefore, while taking this medicine, avoid alcohol at all costs.

Grapefruit - If you're using Sildenafil, you should avoid eating or drinking excessive grapefruits or grapefruit juice daily. Grapefruit might raise the levels of sildenafil citrate in your body, causing the medicine to take longer to act. Do not change the quantity of grapefruit products in your diet without consulting your doctor beforehand.

Side effects of Cenforce 100

Common side effects of Cenforce 100 may include:

Flushing (warmth, redness, or tingly feeling)

Headache or dizziness

Heartburn, nausea, or upset stomach

Abnormal vision (blurred vision, changes in color vision)

Runny or stuffy nose, nosebleeds

Sleep problems (insomnia)

Muscle pain or back pain

This is not a complete list of possible adverse effects; more may arise. For medical advice on side effects, contact your doctor.

Stop taking sildenafil and get medical help if you have:

Heart attack symptoms - chest pain or pressure, pain spreading to your jaw or shoulder, nausea, sweating

Vision changes or sudden vision loss

Erection is painful or lasts longer than 4 hours (prolonged erection can damage the penis)

Ringing in your ears, or sudden hearing loss

Irregular heartbeat

Swelling in your hands, ankles, or feet

Shortness of breath

Seizure (convulsions)

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garnetmantle · 3 years ago

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Title: After Omega, Star Trek TOS

by: green rose

@sicktember

Prompt #4 Headache

Notes: The TOS episode "Omega Glory" is literally one long recipe for a headache for Kirk. Spock was caught in the nimbus of a phaser set to kill in this episode.

Numbly, Jim tried to orient himself among the crush and chaos that was the excited Yangs. Spock. He was trying to keep an eye on Spock, who had admitted to being weak, which probably meant he was barely keeping his feet under him through some feat of Vulcan endurance. Jim’s vision was swimming a bit in the torch-flashing darkness, and he was so damn tired, but he eventually homed in on the red-shirted security guards, and found McCoy, very unhappy, at Spock’s side.

The doctor was not supporting Spock, but he clearly wanted to be. Spock stood at-ease, clearly rebuffing any such attempt. So McCoy was scanning the crowd, and when his eyes hit Jim he lunged forward and grabbed his arm, dragging him forward to stand the appropriate distance from Spock for a beam up. The sudden jerk brought the taste of bile up behind Jim’s teeth. Bones was glaring hard enough that it made Jim a little more dizzy to try to meet his eyes, so he stopped trying to and looked at Spock. Whose at-ease was wavering in its own wind.

“I suppose we can beam up now?” McCoy demanded.

Unperturbed, Spock spoke into his communicator in a steady but very quiet voice, “Three to beam up, Mr. Scott.”

Jim was moving the second the transporter let go, and caught Spock, who went at the knees the moment the transporter beam released him. Kirk had him before his body could hit the ground -- he’d known the usually-inconsequential disorientation of the transporter was going to get Spock, he’d just been able to tell. McCoy was swearing, and his scanner was humming.

So Jim had him under the elbows, crushed against his side, and he only had a moment to dislike how limp Spock had gone before the awful realization hit him that his own balance and coordination was not sufficient to maintain the two of them until the waiting medical team swimming into focus in the too-bright lights of the room could climb on the platform.

Kirk clenched his teeth and swallowed. He had been up for two straight days and nights, but he was not going to drop Spock, and he was not going to throw up in the middle of the transporter room. He was trying to get the nausea forced back enough to tell the corpsmen to hurry up and get Spock when McCoy took Spock’s other side and more than half his weight, and gestured his subordinates forward.

They relieved Jim of the Vulcan’s weight, which he needed, and of the contact, which left a gnawing worry behind it, and put Spock on the anti-grav stretcher they had waiting. One of them handed McCoy a small med-kit which he instantly opened. He read off the hypos, and administered them directly to his patient.

Clearly McCoy had called ahead. Why had Spock waited that long for him to beam up?

It was a little worrying that Spock had let himself be handled by strange corpsmen -- these were new crew, on board less than a month -- and put on the stretcher without complaint, silent and pale and submitting to McCoy’s attentions with none of their usual argument. Jim blew out a slow breath and closed his eyes, then breathed in a deep one as he raised his head and eventually reopened them. Reset. He trusted Bones, and Bones had said authoritatively that Spock would live. There was a lot left to do with—

“Doctor,” Spock had rallied enough to come up on his elbows and look at Kirk, his gaze assessing. He interrupted the doctor in a quiet but very firm voice. Definitely coherent. “You are aware that the Captain has had several trauma-induced periods of unconsciousness during this mission, but you are unaware of the most severe. To my certain knowledge, he has been unconscious due to two severe traumatic blows for a cumulative nine hours and eighteen minutes since our beam down.”

Spock wasn’t announcing it to the room, just to McCoy, but it was bad enough because Bones stopped dead and raised his head. “Captain, you are required in Sickbay in twenty minutes.”

A biting reply wanted to come out – he was too tired to be bossed about by his CMO exercising his prerogatives – but Jim made himself stop. The truth was, his head was a pulsing raw pain he’d been able to manage only by lifting above it – literally dissociating from his own body a bit to cope. He had blood coming out of one ear, his vision was getting worse, and as his adrenaline dropped he was starting to get his own crosswind himself. He was stubborn, and he had a thousand things to do, but he wasn’t stupid.

“Yes, Doctor.”

McCoy, following the stretcher out, stopped to double-blink at him, then looked him over again. “Do you need transport?”

“No, Doctor.” The guards and Scotty and the transporter chief were all listening to them, now, so Jim walked to the door. Oh, yeah. He was getting his own wind and McCoy noticed, of course, caught Jim’s arm to balance the wavering, and started to demand Kirk come with him right then.

“I’ll be there in twenty minutes, on one condition,” Jim said quietly as he followed McCoy out into the hall. “I know you have some kind of anti-emetic in there, you always do when you’re treating Spock for anything serious. Give me.”

“Yeah?” McCoy asked, trying to catch his eyes, no doubt to evaluate his pupils, but Kirk wasn’t having it. Not quite yet. The doctor's voice was on the gentle side, though, which was immediately soothing, and he opened his med-kit. ”Migraine?”

Jim wished he could say yes, but it wasn’t a good day for blatant lies. “No. Spock’s right. I got my bell rung twice, hard-“

“As opposed to the half-dozen times it was lightly rung?” the doctor asked sharply. “I’m not blind, you know-“

Speaking slowly, Jim continued, “But I’ll be all right for a few more minutes, and then you can do whatever you want.”

“You’re just afraid you’ll get sick all over the Bridge? I’d bet on the turbolift, that upward and lateral motion at once—“

Kirk felt sweat on his upper lip, and he swallowed, hard. McCoy looked a bit abashed and gave him the shot in the arm, and within a few seconds Jim’s stomach had returned to the normal position. He coughed a little and swallowed, then tried out a smile. “You’d be amazed how much that helps. I –“

“Will be in Sickbay in twenty minutes, Captain,” McCoy growled, snapped his med-kit closed and took off after his patient. Instinct urged Kirk to go after them, but duty sent him in the other direction.

It was like water dripping away. Onto him. Away from him. A little more impairment. A little less adrenaline. Jim Kirk put one foot in front of the other, and he smiled when he needed to, and he was able to think well enough to handle what had to be handled and know when something had to be put off for a more coherent day. The lights got brighter, though. Drip. And blurrier. Drip. And god it hurt to focus his eyes. Drip. He prepared a bare bones report for the Admiralty, because that couldn’t wait, and every sound got louder. Drip, drip. The world got foggier, and his energy to navigate through it was lessened.

He finally turned, then waited as the Bridge kept turning for a moment before settling down before his eyes. “Mr. Sulu. You have the conn,” he said, and headed for the turbolift. His crosswind was getting more stormfront than gentle breeze – he knew he was swaying on his feet, didn’t that count for something? “If I’m needed you can reach me in Sickbay. Mr. Spock is also in Sickbay. Unless he is needed to keep the galaxy or the ship from blowing up, please forget you can reach him there.”

“Aye, Captain,” came from several people, but then quietly, from Uhura alone, “Could one of us escort you to Sickbay, sir?”

Kirk forced himself to stop swaying, forced a smile to his lips. “No, but thank you, Lieutenant.”

The drop of the turbolift had him laying back against the wall, and his hands over his eyes were trying to push the pain back away. Water dripping everywhere, he was in a rainstorm and it was washing away the world and his energy and his ability to control himself. His head had reached the white-out level, the pain hitting places his consciousness wasn't willing to go with it. One last thing, though.

He walked into Sickbay to see Dr. M��Benga arguing with Dr. McCoy, gentle to his irritation. “You’ve been up for two days, Leonard. Either go to your quarters or go sleep in your office, but you are not fit for regular duty right now.” They’d both worked under worse conditions for crisis duty.

“Just give me a few more minutes, Geoff. I’m not being stubborn. I want a shower and my bed, but—there he is!” He turned from his fellow doctor to glare at Kirk.

“Twenty minutes does not mean forty-five, Captain, sir.”

Kirk made one of his ‘yeah, yeah, whatever’ dismissive gestures and closed his eyes in a brief headshake. “How is Spock?”

McCoy frowned at him as he moved toward him with a scanner in one hand and a tricorder in the other. “In a healing trance. He’ll be fine in a few days, Jim. We were able to treat the radiation poisoning and the rest he can handle himself.”

Jim’s head went down with a huff of a sigh, but he batted at McCoy’s arm when the doctor raised it with the scanner, and McCoy started to growl at him, but Jim made his little dismissive-gesture-closed-eyes-headshake thing he did again. He spoke very evenly. “No. Bones. I think I... could use that… transport now.”

He didn’t go at the knees, he just dropped, and it was all McCoy and a lunging M’Benga could do to keep his limp body from bouncing off the floor.

He got a bed beside Spock's for three days. McCoy's blood pressure was not very appreciative of their stay.

End

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greenroseunderglass · 3 years ago

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After Omega : Fanfic - Star Trek TOS (Gen)

@sicktember

Prompt #4 Headache

by: greenroseunderglass (1st post to tumblr, I know I'm messing up every way possible.)

Notes: The TOS episode "Omega Glory" is literally one long recipe for a headache for Kirk. Spock was caught in the nimbus of a phaser set to kill in this episode.

“I suppose we can beam up now?” McCoy demanded.

Unperturbed, Spock spoke into his communicator in a steady but very quiet voice, “Three to beam up, Mr. Scott.”

Clearly McCoy had called ahead. Why had Spock waited that long for him to beam up?

Spock wasn’t announcing it to the room, just to McCoy, but it was bad enough because Bones stopped dead and raised his head. “Captain, you are required in Sickbay in twenty minutes.”

“Yes, Doctor.”

McCoy, following the stretcher out, stopped to double-blink at him, then looked him over again. “Do you need transport?”

Jim wished he could say yes, but it wasn’t a good day for blatant lies. “No. Spock’s right. I got my bell rung twice, hard-“

“As opposed to the half-dozen times it was lightly rung?” the doctor asked sharply. “I’m not blind, you know-“

Speaking slowly, Jim continued, “But I’ll be all right for a few more minutes, and then you can do whatever you want.”

“You’re just afraid you’ll get sick all over the Bridge? I’d bet on the turbolift, that upward and lateral motion at once—“

“Aye, Captain,” came from several people, but then quietly, from Uhura alone, “Could one of us escort you to Sickbay, sir?”

Kirk forced himself to stop swaying, forced a smile to his lips. “No, but thank you, Lieutenant.”

He walked into Sickbay to see Dr. M’Benga arguing with Dr. McCoy, gentle to his irritation. “You’ve been up for two days, Leonard. Either go to your quarters or go sleep in your office, but you are not fit for regular duty right now.” They’d both worked under worse conditions for crisis duty.

“Just give me a few more minutes, Geoff. I’m not being stubborn. I want a shower and my bed, but—there he is!” He turned from his fellow doctor to glare at Kirk.

“Twenty minutes does not mean forty-five, Captain, sir.”

Kirk made one of his ‘yeah, yeah, whatever’ dismissive gestures and closed his eyes in a brief headshake. “How is Spock?”

He didn’t go at the knees, he just dropped, and it was all McCoy and a lunging M’Benga could do to keep his limp body from bouncing off the floor.

He got a bed beside Spock's for three days. McCoy's blood pressure was not very appreciative of their stay.

End

#Sicktember #Headache #Star Trek #Fanfiction #Sicktember2021

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macgyvermedical · 5 years ago

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A Nurse Wrote This Movie: A Medical Review of Knives Out

Whoa.

Honestly, all I can say, this movie was amazing.

I don’t think I’ve ever been treated to a movie that was both this complex and still this easy to understand. I wasn’t left wondering at the end, and despite the number of times my understanding of the central crime changed, it didn’t ever feel whiplash-y or like anything was played for shock value. It was a journey through the story and it was consistently enjoyable, all 130 minutes of it.

But please, seriously, go see it for yourself before reading this post, there will absolutely be spoilers and this is a movie you don’t want spoiled.

Before I really get into it, I want to tell you that the medicine (though, I suppose, particularly the nursing) in this movie was good. Really good. Much, much, much better than I expected. What I really, really appreciated was that the resolution of the case came from something that only a nurse would know. If i had to guess, not only was there a nurse consulting, but one was part of the central writing team.

There’s really only one scene to talk about, but it spans parts of the whole movie. Here’s my explanation/review of the evening meds scene and how it relates to real life and the rest of the movie. Apologies for the lack of relevant screenshots, once the movie comes out on streaming or DVD I will have more options. Also apologies in that I have only seen this once in theaters and I am working from memory.

PICCs:

One of the main characters, Marta, is a homecare nurse for the wealthy victim Harlan Thrombey. Early in the movie, we are given a scene where she is giving him two medications for a recent shoulder injury- ketorolac and morphine- before bed.

Harlan Thrombey has a PICC in his left arm that Marta uses to administer the medications. PICCs, or Peripherally Inserted Central Catheters, are medical devices that are designed to allow medical professionals to administer IV medications and draw blood without having to start an IV or stick someone with a needle. Once inserted, they can stay in for 6-12 months, and they’re really helpful for patients who either need IV fluids/medications at home (long-term IV antibiotic therapy, for example), or who require repeated doses of medications that could be damaging to the smaller veins that traditional “peripheral” IV catheters sit in (chemotherapy, total parenteral nutrition).

PICCs consist of one or more “ports” that are accessible from the outside (the blue nubs in the pic below, where the medication goes in), and a long, flexible tube that sits in a large, deep vein that ends near the heart.

We don’t know a lot about Harlan’s medical history in the movie other than the injury to his shoulder that causes him to need the pain medication. A shoulder injury alone would not justify the insertion of a PICC, so we have to assume that either he had an existing serious health condition like cancer, or the shoulder injury was really an infection in one of the bones of his shoulder, which would justify a PICC on the basis of needing IV antibiotics multiple times per day. Since they seem to have thought of everything else, I would choose to go with that.

Medications:

The first medication’s generic name is ketorolac. Ketorolac is an NSAID, similar to ibuprofen, and works by blocking some of the chemicals that cause pain and inflammation in the tissue. It’s usually not given long-term, but for short term things like surgery or an injury it works pretty well and decreases the amount of narcotic pain medication needed. For someone over 65, the normal schedule for ketorolac would be 15mg IV every 6 hours. Marta would probably keep him pretty close to this schedule, because it’s his primary pain control beyond heat, ice, elevation, and possibly some form of physical therapy.

Morphine is an opioid. It works by blocking pain signals in the brain. It’s been around for a while, works pretty well and pretty quickly, but it’s not great for long term use either due to the fact that the body builds up a tolerance to it and it has the potential to be addicting.Since Marta seems to offer it to him instead of stating she’s going to give it to him, it looks like it was prescribed for “breakthrough” or as emergency pain relief if the ketorolac wasn’t doing enough, which is a pretty typical way to prescribe pain medication.

Now, you’ll notice that despite it reading “ketorolac” on the vial, the characters refer to the first medication by it’s brand name “Toradol” throughout the movie. This impressed me because in a medical setting, we colloquially refer to some medications by their generic name, while others we refer to by their brand names. There’s no particular rhyme or reason to the colloquial naming (though age of the drug plays in), and you kind of have to work in medicine to know which is which. We typically refer to Toradol by it’s brand name, while we refer to morphine by it’s generic. If you asked me for ketorolac or Astramorph (a brand name of IV morphine) it would just sound... weird. But its something fiction gets wrong all the time and it’s cool they got this right. For consistancy, I’m going to continue using the generic name for both medications throughout this post.

Medication Administration:

Marta goes about injecting the ketorolac first. This was yet another thing that added a little spark of nursing realism to the movie, because while not everything was shown, what was shown was done accurately. Here’s the steps to administering an IV medication through a PICC:

Open syringe package (draw needle is usually already attached)

Draw up air into syringe equal to the amount of volume of medication you want to draw

Clean top of vial with alcohol swab

Insert draw needle into vial and inject air

Flip vial/needle upside down and draw medication into syringe, recap draw needle (label syringe if giving multiple medications/doses)

Unclamp the PICC port you want to use and clean the port cap with an alcohol swab

Twist a prefilled saline syringe onto PICC port cap, and inject 5ml saline into the port

Twist draw needle off of syringe and discard into sharps container

Twist medication syringe onto PICC port cap

Inject medication

Twist off medication syringe and discard

Twist saline syringe back onto cap, inject the remaining 5ml of saline to flush the entire medication dose into the person’s vein

Untwist the saline syringe and reclamp the port

They reference the dose of ketorolac as being 100mg. As I said above, the normal dose of ketorolac is 15-30mg IV, depending on age. For Harlan, being 85, it’s hard to believe he wouldn’t have gotten 15mg IV every 6 hours max. I think the mix up was intentional, meant to signal to the audience that she was supposed to give the whole vial of ketorolac with each administration, but only a portion of the vial of morphine per administration. Ketorolac does come in single-dose vials, however in this movie all vials were clearly multi-dose vials (which you can tell because the ketorolac vial says “30mg/mL” on the 10mL vial, meaning there’s 300mg of ketorolac in that vial, which would be about 20x the normal dose).

Medication Errors:

Then she goes back to get the morphine, and realizes that she’s made a mistake. Instead of injecting the vial labelled “ketorolac” she’s administered the entire contents of the vial labelled “morphine”- 100mg, she thinks. That’s a LOT of morphine. Definitely enough for a fatal overdose in someone who’s normal dose is 3mg.

Now, med errors are HUGE FREAKING DEALS in the medical world, and Marta would have faced substantial civil and possibly criminal charges. Assuming she survived this without jail time, she would face an investigation by her visiting nurse agency (if she worked for one, which they establish she doesn’t) and/or the board of nursing in her state, which would seek to determine whether this was negligence that lead to the med error (in which she would probably be fired/have her license suspended/revoked), or a systemic problem (in which case she would be in the clear).

I think Marta actually has a pretty good case for this being a systemic issue rather than a negligence one. The vials look extremely similar, and even if she had done everything she was supposed to do, its plausible this could have happened despite her reasonable efforts to prevent it (she could have put it down last minute and picked up the other vial by accident, and had the label facing the wrong way as she was drawing up the medication). If nothing else, since the morphine vial was not specially identified as a narcotic, it would at least shift some of the blame to the pharmacy that filled the prescription.

In the moment, though, knowing what we know about her mom’s citizenship status, this would have been a terrifying situation for her.

Plus, there’s the overarching possibility that she just killed this very powerful person who she’s been caring for for a long time.

Opioid Overdose:

Opioids bind to certain receptors in the brain, decreasing pain signals. Unfortunately, they also decrease signals in the part of the brain that controls breathing. At small doses this isn’t generally a problem, but in overdose situations it can cause respiratory depression (the person breathing too slowly to meet their needs) or respiratory arrest (the person stops breathing on their own entirely), which can lead to death.

A drug called naloxone (brand name Narcan) can stop an overdose by sitting on all those same receptors that an opioid would without actually blocking any signals, which stops the respiratory depression from the opioid pretty quickly. As mentioned in the movie, most pharmacies dispense a naloxone kit along with opioid pain medication, and was the “antidote” Marta was searching for.

Now, in opioid overdose all is not lost if you don’t happen to have naloxone available. Since the cause of death from overdose is lack of breathing, Marta could have called 911 and provided rescue breaths until EMS showed up with naloxone. Even if EMS were 10 or 15 minutes out, he could have easily survived this. But that wouldn’t have made for nearly the murder mystery.

Ironically, this is exactly what happens in the laundromat scene, when it is revealed that the housekeeper Fran figured out what was happening and was attacked with the real morphine vial. When Marta finds her, she immediately looks in her eyes (a hallmark of opioid overdose is pinpoint pupils) and begins providing CPR.

In some areas, community-level CPR guidelines have simplified to “if you find someone not breathing, start CPR”. This is due to the realization that most lay rescuers have a hard time finding a pulse quickly enough to use it to determine whether to start CPR, leading to fatally wasted time in an emergency. The thinking is that it’s better to have people do unnecessary chest compressions than not do necessary ones.

But healthcare professionals are obviously still taught to differentiate between patients who need full CPR and patients who only need rescue breaths, so assuming Fran didn’t go from talking to cardiac arrest from an opioid overdose in less than a few seconds, I would have expected Marta to give rescue breaths until the ambulance arrived.

The Resolution:

Towards the end of the movie, we find that the vials were switched already, and in subconsciously recognizing the (real) difference in viscosity between ketorolac and morphine, Marta had actually, tragically, saved his life. This was probably the best use of a nursing concept I’ve ever seen in fiction, the entire central point of the plot hinging on nursing intuition.

Kudos, writers, kudos.

#Knives out #poison #whump #murder #drugs #movies #movie review

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docmary · 4 years ago

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Vaccine hesitancy, molecular mimicry, and blood clots (oh my!)

There were many mixed messages in the world of coronavirus last week. Just as it appears that Michigan is the lead state in the fourth wave of the virus, the US is about to hit a “vaccine wall” as demand drops for vaccinations even though the supply is greatly improved. In the first three months of the rollout for the Pfizer, Moderna, and the Johnson & Johnson/Jantzen (J&J) vaccines, getting shots into arms of the most vulnerable has required a full court press from public health departments and the healthcare establishment, as well as persistence on the part of those trying to wrangle an appointment. The results from state to state have been uneven.

Figure 1

So far 14 states have administered fewer than 75% of the doses distributed to them with Alabama having the lowest vaccination rate per capita. Twenty states have administered more than 80% of the doses distributed to them with the most vaccinations per capita in New Hampshire.[1]

Vaccine Hesitancy:

The good news for those who want to get vaccinated is that it is a whole lot easier to get an appointment now. That said, the goal of herd immunity is a long way off and with demand dropping for jabs, we may not get there. Vaccine hesitancy is an important reason for declining demand and that is a shifting picture.

In a study that was put out by the Kaiser Family Foundation (KFF) in December, 52% of Black Americans said they would “wait and see” before signing up for the vaccine while only 20% said they wanted the shot as soon as possible. The share of Black people who were skeptical of the vaccines was higher than for White respondents (36%) and Latinx (43%).[2]

By March of this year, 55% of Black respondents to another KFF survey said they had been vaccinated or wanted the vaccine as soon as possible. Twenty-four percent were still holding back. Blacks have been one of the hardest hit demographics of COVID-19 and that has, no doubt, played a part in changing minds. Another possible reason for the turnaround in willingness to get vaccinated is because there has been a concerted outreach effort tapping trusted sources such as Barack Obama, sports stars, and other influencers such as Black ministers to address vaccine hesitancy among Black people.

The Urban Institute’s September 2020 Coronavirus Tracking Survey, a nationally representative survey of adults ages 18-64, asked people whether in the last 12 months they had ever felt a doctor, other health care provider, or their staff judged them unfairly or discriminated against them based on their race/ethnicity, gender, gender identity, sexual orientation, a disability, or a health condition and about the consequences of these experiences. This survey indicated that perceptions of discrimination and unfair judgement while seeking health care were higher among Black adults than among Hispanic and White adults in the previous 12 months (September 2019-September 2020).[3]

Figure 2

A “food desert” is described as an urban area that does not have a grocery store within one mile or a rural area that does not have one within ten miles. There is also a “pharmacy desert” that generally occurs in primarily Black neighborhoods in urban areas as well as in rural areas. People of color are less likely to have a family primary care provider and so access to information about the individual’s risks and benefits of getting vaccinated from a trusted source, much less getting an appointment for the vaccine itself, is often more challenging than it is for White people. My guess is that these experiences and the barriers to appropriate care contributed to the initial skepticism among people of color generally and Black people specifically in the initial rollout phase.

FIGURE 3

Meanwhile, Republicans and Evangelical Christians were the most likely groups to say they will not get vaccinated, according to the KFF survey.[4] I do not have an explanation for that. I also don’t know how wearing masks got politicized last year. If anyone has an explanation that doesn’t involve a gang of Democratic, cannibal pedophiles, I am really interested in hearing it.

Molecular mimicry and autoimmune disease:

There are science-based reasons that some are reluctant to get vaccinated. An issue that has been little discussed publicly is molecular mimicry. The theory is that some part of the spike protein of SARS-CoV-2, the virus that causes COVID-19 and is replicated in our cells, is similar enough to our own tissues that the immune system starts attacking our own cells thinking that those cells are the virus. Thus, the vaccine could trigger an autoimmune disease like rheumatoid arthritis, lupus, multiple sclerosis, or other autoimmune condition.

In one study looking for similar protein sequences between the SARS-CoV-2 virus with protein sequences in humans and other mammals, as well as other human coronaviruses, the number of shared protein sequences at two particular sites was quite high for humans, rats, and mice but miniscule or not at all with other human coronaviruses, cats, dogs, rabbits, chimpanzees, gorillas, or macaques.[5] Sadly, the investigators did not include bats, which I think of as flying rats, but that’s just me. It has been hypothesized that the original source of COVID-19 was from bats. Could the virus have molecular mimicry with bats? If so, what does that mean for the species?

These authors believe that much of the damage seen in the “cytokine storm” that causes the worst damage in COVID-19 may, in fact, be due to this molecular mimicry between the virus and, for example, lung tissue. It should also be noted that molecular mimicry from the whole SARS-CoV-2 virus is much more likely than it is from a small part of the virus (the spike protein). If the vaccine can trigger an autoimmune disease, so can the whole virus.

The presence and level of autoantibodies (AAbs) that attack our own cells, frequently detected in patients with COVID-19, are significantly associated with hospitalization and more severe prognosis. Clinically, these patients are more likely to have respiratory distress, acute cardiac injury, acute kidney injury, multi-organ dysfunction with such common complications as coagulopathy and thrombocytopathy (put a pin in this one as it is also at play with blood clots). [6]

Blood Clots and the J&J and AstraZeneca (AZ) vaccines:

Last week the J&J vaccine rollout was put on pause by the Food and Drug Administration (FDA) because six women developed unusual blood clots after receiving this vaccination. This was six out of seven million shots given. Some saw this as an over-reaction by the FDA that would likely lead to more vaccine hesitancy. However, these blood clots are different from clots that occur from “the usual suspects” like oral contraceptives and smoking.

Figure 4

A normal number of platelets is between 150,000-450,000 per microliter of blood (there are 1,000 microliters in one milliliter). If you have less than 150,000 platelets per microliter, you have a deficiency called thrombocytopenia. In the clots associated with the viral vector vaccines (J&J in the US and AZ in Europe), the platelets tend to stick together in the veins of the brain, which causes a blockage known as a cerebral venous system thromboembolism (CVST). This creates back pressure of blood in the brain itself, causing damage in the same way a hemorrhagic stroke would. [7]

“Normal” clots are usually treated with a blood thinner called heparin. With vaccine-induced prothrombotic immune thrombocytopenia (VIPIT), there is a deficiency of platelets and so that treatment would only make things worse. While the Centers for Disease Control and Prevention (CDC) and the FDA are getting the word out to doctors not to use heparin, they are also looking for ways of figuring out which people are more at risk for this extremely rare complication. Putting the vaccine on pause was clearly the ethical thing to do and this kind of transparency gives me greater confidence in the vaccine rollout.

As is the case with molecular mimicry, the danger of VIPIT happening if a person gets COVID-19 is much higher than it is from either the J&J or the AZ vaccine.

“…If the mechanism is the same, one can speculate that the high occurrence in COVID-19 vs. vaccination is because the whole virus is more thrombogenic [likely to cause clots] than the spike protein alone.” Paolo Madeddu, professor of experimental medicine at the University of Bristol[8]

Symptoms associated with VIPIT include headache, tiny red spots under the skin, blurred vision, fainting or loss of consciousness, impaired movement in parts of the body, or coma. With either of these vaccines these blood clots, so far, only occurs 4-20 days after vaccination. Scientists believe that symptoms before or after that window are likely due to another cause.

It is important to note that COVID-19 itself has been reported to lead to thrombocytopenia (low blood platelets) in up to 41% of positive patients, with the figure going up to 95% of those with severe disease.[9]

Cause for cautious optimism:

Two separate studies published in the New England Journal of Medicine on April 9 indicated that in the case of the AZ vaccine, used in Europe, VIPIT was due to rogue antibodies against platelet factor 4 (PF4). This complication is similar to heparin-induced thrombocytopenia (HIT) and is diagnosed and treated the same way. It can be diagnosed with a lab test called ELISA that is pre-treated with PF4. If there is a big immune response, that means the patient has VIPIT. To be clear, there are lots of things that can cause blood clots and health professionals want to know what the cause is because the appropriate treatment is dependent on what is causing the problem. VIPIT from the AZ vaccine is treated with the administration of intravenous immunoglobins (IVG) and anti-coagulants. The J&J vaccine was not used in either of these studies and so we do not yet know if the same is true for that vaccine, but both are the same type of (viral vector) vaccine and both use an adenovirus as the viral vector.[10]

If we can get the one-and-done J&J vaccine back in use safely, that would be especially helpful for vaccinating unsheltered people. It would also be much easier to use in rural areas because J&J can be stored in a regular refrigerator unlike the Pfizer and Moderna vaccines that must be kept frozen.

My take:

For those who choose not to get vaccinated, for whatever reason, hoping to ride the coronavirus out, you should know that even without a vaccine, the SARS epidemic that hit Asia in 2002 did eventually go away, or, more likely, mutated to a less lethal virus. It took four years, but it can happen. However, that is not what always happens. Case in point, smallpox, which was around since at least the fourth century until it was declared eradicated by the World Health Organization in 1980. I don’t think I know anyone who has had smallpox and I may not know anyone who knows anyone who has had smallpox. In that case, the vaccine worked as intended.

Maybe you may feel like you are strong and healthy and even if you got COVID-19, you are unlikely to get significantly sick. Consider the possibility that you could be asymptomatic but still spread the disease. There are just no options that are completely risk free. Choose wisely.

[1]Romeo, A. (4/15/2021). America is about to hit a “vaccine wall” as demand drops—with or without Johnson & Johnson, Yahoo News. [2]Bunn, C. (4/12/2021). Vaccine hesitancy among Black Americans has turned a corner. Here’s why.”, NBC News. [3]Gonzalez, D., Skopor, L., McDaniel, M., Kenney, G.M. (4/2021). Perceptions of discrimination and unfair judgement while seeking health care, findings from the September 11-28 Coronavirus Tracking Survey, Urban Institute Health Policy Center. Retrieved from: https://www.urban.org/sites/default/files/publication/103953/perceptions-of-discrimination-and-unfair-judgment-while-seeking-health-care_0.pdf [4] Hamel, L., Lopez, L., Kearney, A., Brodie, M.(3/30/2021) KFF COVID-19 monitor: March 2021. Retrieved from: https://www.kff.org/coronavirus-covid-19/poll-finding/kff-covid-19-vaccine-monitor-march-2021/ [5]Kanduc, D., Shoenfeld, Y. (9/18/2020). Molecular mimicry between SARS-CoV-2 spike glycoprotein and mammalian proteomes: implications for the vaccine, Immunol. Res. doi: 10.1007/s12026-020-09152-6 [6]Macela, A, Kubelkovak, K. (3/22/2021). Why does SARS-Co-V-2 infection induce autoantibody production? Pathogens, 10(3). doi: 10.3390/pathogens10030380 [7]Taylor, A. (4/16/2021). Blood clot risks: comparing AstraZenica vaccine and the contraceptive pill, The Conversation. Retrieved from: https://theconversation.com/blood-clot-risks-comparing-the-astrazeneca-vaccine-and-the-contraceptive-pill-158652 [8]Russell, P. (4/15/2021). Vaccines carry far lower risk for rare blood clots than COVID, study shows, Medscape News UK [9] Op cit Taylor, A. (4/9/2021). [10] Grenacher, A., et. al. (4/9/2021). Thrombocytic thrombocytopenia after ChAdOx1 nCoV-19 vaccination, NEJM. doi:10.1056/NEJMoa2104840Schulz,NH, et. al. (4/9/2021). Thrombocytic thrombocytopenia after ChAdOx1 nCoV-19 vaccination, NEJM. doi: 10/1056/NEJMoa2104882

#vaccination #covidー19 #astrazeneca vaccine #johnson and johnson #blood clots #molecular mimicry #autoimmune disease

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violet-knox · 5 years ago

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Pure Love

Pairing: SnapexReader

Summary: As Headhealer at St Mungo’s, you are tasked with finding a cure for Troll’s flu, a new virus that has been circulating the country. Struggling with the task, you seek help from you friend and Potions Master Severus Snape. Working closely beside him, you start to realize your feeling for him are more than mutual.

Word Count: 4359

Warnings: Language

A/N: Thank you @trishaabarnes for the request, it was fun to write. I decided to keep this to only the readers POV, it was interesting to say the least. I felt a bit limited, not sure how I feel about it.

Reaching over, you took out a quill and your inkwell, placing them on your office desk. Being the Headhealer at St Mungo's had its perks of course, but you couldn’t lie, it was quite dull at times. Today was one of those days filled with meaningless paperwork and endless amount of budget planning, each sector of the hospital never seeming to have enough equipment. That was why you were glad to receive a letter from an old friend, not that it surprised you of course. You and Severus had been regular correspondence for quite some time now, and though your friendship was rocky during his Death Eater days, you still found it in your heart to stand by him during his trial, thankful to hear him cleared of his charges.

Was it crazy to be writing to a former Death Eater? Your coworkers would sure think so. But they didn’t know him like you did. He has a brilliant mind and when it comes down to it, his loyalties would always be good and true.

You shifted your chair as you pulled one of the drawers to your right, looking for spare paper to write on. Nothing. You could have sworn you’d just restocked, though with the amount of paperwork you’d been doing lately, it shouldn’t have surprised you that you’d run out so quickly. You continued to rummage through your drawers until you finally found something to write on. Writing back to Severus was going to be the highlight of your day, you just knew it, so what would be the harm in dragging out a letter a little longer than you should? Well, perhaps the recipient of your letter might not be too happy, but he’d surely gotten used to your long-winded rants by now.

You opened your inkwell, dipping your quill into the dark thick liquid, only to find it reaching the bottom. Peering into the small bottle, you sighed and deduced the ink would barely last you a short letter, let alone the essay you were planning to write.

“Madam (Y/L/N)!” your office door suddenly burst open, revealing your very anxious deputy healer.

“What is it Bethany?” you asked lazily, placing aside your quill and screwing the inkwell shut.

“We have a sort of.. Well have you read the Daily Prophet recently?” You arched a brow at her. She can’t be serious? This girl was going to be the death of you. She’d always overreact at every little thing, panicking when in a real emergency. It was beyond you how she’d be able to take over once you stepped down.

“What does the newspaper have to do with anything?”

“Oh, well, th-they’ve been reporting this-this illness that’s been going around. They call it Troll’s flu,” she appeared so nervous and now you understood why as you had indeed read about this new bug that had been circulating the lower regions of the country. You jolted from your desk and stared at her intently.

“Don’t tell me…”

“I’m afraid so,” Bethany stood aside, allowing you to rush out of your office, heading to the emergency wing. You could hear her running after you as you quickly burst open the door to reveal a scene you’d prayed you’d never see during your time as a healer in this hospital.

“Merlin’s beard,” you mumbled under your breath as you gazed upon the dozens of witches and wizards whose skin had all turned various shades of green. Some clearly had a more advanced version of the virus than others as their eyes seemed to have grown three times their usual size. How vulgar.

Your chest rapidly rose and fell as your heart paced in fear. You had to remain calm, the healers in this hospital had always relied on your leadership and you were not about to disappoint them now.

“Beth, I need you to separate the severely ill from the rest. Get them their own rooms and lock down the emergency room. We need to put them all in quarantine. Do you understand?”

“Y-yes ma’am.”

You watched as the young healer made her way to two other staff members, informing them of your orders. Soon enough, you had everyone running around every which way, doing everything you could to at least minimize the damage done to those inflicted of this awful virus. Once the chaos had died down to a minimum, you pulled aside Bethany as well as the Healer-in-Charge of the emergency wing. It was unnerving to find out from them that a cure had not yet been established, which meant it was up to you and your team to do something to ease the pain of your patients.

Weeks passed and you found yourself struggling to find a solution to this ever-growing dilemma you were in. Though you were able to repress the symptoms of the flu, you hadn’t fully been able to get rid of it as you found your patients back to the agonizing pain they had been in twenty-four hours after administering your potion. Perhaps it was time to ask for a little help. You had to admit that you were quite a prideful person and didn’t enjoy accepting help from others, but it had become quite expensive to brew the amount of potion needed for all your patients every day.

Letting out a long defeated sigh, you took out some paper and began writing a letter to the best Potions Master you knew.

Professor Severus Snape,

I hate to ask this of you, but I’ve been struggling to perfect this potion for the Troll’s flu you no doubt have read about in the newspaper over the last few weeks. I’ve attached my work to this letter and hope you could perhaps find some time to help me perfect it. Any suggestions would be greatly appreciated.

Headhealer of St Mungo’s,

Madam (Y/N) (Y/L/N)

You normally never signed or addressed your letters like that, but the contents of this letter was a lot more serious than what you normally had to say to him. You quickly folded up the paper, stuffing it in an envelope with your most recent rendition of your potion before calling your owl from the cage he sat in. Tying your letter to his leg, you told him to find Severus as quickly as he could, and not to return without a reply. You opened the window and watched him fly away, praying he’d return soon.

Madam (Y/N) (Y/L/N),

I’m surprised it took you this long to write to me. Your attempt at a cure is quite impressive, one I’m sure has gotten a lot further than others. Am I correct to assume the potion simply cures the symptoms for a day or two before completely wearing off? If I am correct, I’d suggest replacing the unicorn’s blood with a small chunk of bezoar instead.

Potions Master of Hogwarts,

Professor Severus Snape

That tease. Of course he had to sign it like that, that cocky little… But perhaps he was on to something. You quickly looked over your notes and made the adjustment before heading to the hospital’s Lab downstairs to brew the new potion. To your delight, you found it helped quite a lot. The potion now lasted 2-3 days depending on how bad of a condition the patient was in, but it still wasn’t enough. It still didn’t cure any of them. You continued owling Severus, but it was just no good. No matter what you did, you couldn’t find the right mix to make the concoction you needed. Perhaps that’s why you were caving and asking the great Potions Master of Hogwarts to come visit the hospital over the Christmas break to help you with your dilemma.

“Madam (Y/L/N),” a tall, thin man, completely cloaked in black robes stepped through your office door as you looked up from the paperwork on your desk.

“Please Severus, don’t joke. I’m really stressed,” you put aside your work for now and made your way to the door. Severus scoffed in response, but seemed to understand the amount of pressure you were under as he refrained from making any more snarky remarks on your way to the Lab. You’d only ever see him so serious when brewing potions, though you were thankful he wasn’t so short tempered with you as he was with his students.

It was quite nerve racking to see him scare his students, you almost felt the need to bud in and defend the poor Gryffindor’s he’d make a habit of attacking. But you knew it wasn’t your place. He’d never storm into your office and tell you how to run the hospital, so what right did you have telling him how to do his job?

That scary shadow of a man, Hogwarts had grown to know was nowhere to be found as you worked side by side with Severus, doing your best to keep up with him. You admired how precise he was with everything, it was inspiring watching him work.

“Care for a bite?” you asked as you set aside the potion to seep for a few hours. Severus smirked and nodded as he let you lead the way to the fifth floor. Oh that smirk, you could never get used to it. It made him look so mischievous and.. and desirable. You lowered your gaze as you walked with him to the elevator, hoping he wouldn’t notice your rosy cheeks behind your curtain of hair. You were friends, friends for a long time and even if you admitted to yourself the growing passion you had for the man, there was no way he felt the same. No, you knew he’d always harbored feelings for Lily Potter, even after her death, he never let her go. There was no doubt that he wouldn’t feel anything for you. Not that you felt anything for him. Not like that anyways.

You suddenly felt slim fingers pressed against the small of your back, causing you to jump, snapping your head back to find Severus almost pressed against you completely. Your eyes widened, wondering what he was doing until you realized he was making way for the unconscious man being levitated out of the elevator surrounded by Bethany and a group of healers. Your shoulders dropped as you felt disappointment wash over you. See, he didn’t care for you like that.

Bethany gave you a polite smile before turning her gaze to the man behind you. You watched as her gleeful expression swapped for a fearful one, causing you to giggle as you stepped inside the elevator.

“She fears you,” you stated as the doors closed after Severus stepped inside. “Is that why you always dress like a bat? You want your students to fear you?”

Severus scoffed. “I don’t need to dress like this to have them fear me, children are gullible,” he paused, looking down at you as he smirked. “Like that friend of yours,” he said pointing at the doors where Bethany had emerged not two minutes ago.

You chuckled, glad he was helping you relax a little before you had to get back to worrying over the patients slowly dematerializing in the emergency room. You made your way to the tearoom and told Severus to find some seats while you grabbed a few pastries and two cups of tea. You watched as he put two sugar cubes in his cup with a splash of cream. It only took one sip for him to start coughing as you giggled.

“You call this tea?!” he exclaimed after pushing away the cup.

“You get used to it,” you couldn’t stop the smile on your face as you locked eyes with him, taking a small sip of your own cup.

“You’re bloody insane for drinking that,” he said as he kept his sight on your cup, seemingly ready to attack it as if it posed some sort of threat to you. You rolled your eyes before taking another sip and set down your cup, picking up a scone instead.

“Try this,” you said as you broke it in half and handed him the smaller piece. He eyed you, cautiously looking down at your hand before accepting the sad looking treat. Your fingers brushed and you felt the same tingle shutter through your body you felt earlier at the entrance of the elevator. Stop it. “I swear it’s better than the tea,” you said when you noticed him pausing, examining it closely as if it was laced with poison.

Severus sighed and leaned back before taking the smallest bite you’d ever seen someone take. You smiled at him as you bit into your own half. He seemed to deem the pastry as acceptable as you watched him take another bite, slightly larger this time. You continued your small talk throughout your break, but you couldn’t get rid of the butterfly growing in your stomach. This was too much to deal with. You couldn’t be thinking about what could or couldn’t be in a situation like that. Your priority was perfecting that potion, not your stupid love life.

Though you had to admit to yourself, you had definitely grown to care for Severus over the years and the feelings you’ve been getting over the past week, spending every waking hour of the day with him, proved that you cared for him as more than just a friend.

You sulkingly made your way back to the Lab praying that the twenty-third time's the charm. Opening the door, you watched Severus immediately make his way to the cooled cauldron on the bench. You made your own way to the shelves and searched for the fire seeds; the last ingredient needed for this new batch.

You found the jar relatively quickly and noticed that it appeared to be unused for quite some time. You hoped the age of these old ingredients wouldn’t affect the quality of the potion as you attempted to unscrew the lid. It was so tightly done, you could hardly get a good grip on it. Searching for a better hold, you bent your wrist and brought it closer to your chest as you pulled with all your might. It all happened so quickly. The slip of your hand, the shatter of the glass, the burning sensation on your left arm.

Your hand clasped over the burn on your arm in pain as your knees gave out on you, causing you to crash to the ground. Severus’ reaction was so immediate, you hadn't even noticed him rushing to his own personal supply bag and grabbing your arm to remove the hand over your injury.

“Hold still,” he said as you felt a cool jelly like cream smear all over your burn. You did as he said and felt relief as your pain died down. “You have to be more careful when handling Fire Seeds (Y/N)!” His tone wasn’t harsh like you’d expected. He sounded almost concerned and when you looked up and saw his furrowed brows, you realized, he was concerned for you. You’d seen him shout at his student’s when they’d made mistakes worse than the one you’d just performed, and yet he wasn’t yelling at you like he would them. Though you weren’t one of his students, no you were his friend. More than that, you were two halves of a whole. You felt your worries slip away as you lost yourself in his eyes. He helped you up and you felt devastated at the mess you’d made on the floor.

Severus took out his wand and you watched as the shattered pieces of glass reformed into the jar it had once been. He then levitated the seeds and performed a cleaning spell over them before placing most of them back into the jar. The ones still floating in the air flew over to the cauldron before plooping into the concoction as it steamed and slowly settled. That’s it. The potion was done, and by the look and smell of it, it was seamlessly perfect. Severus then went back to his bag and took out some bandages, gesturing for you to extend your injured arm to him.

“Are you alright?” he whispered as he gently secured the wrapping in place. You stared at him in awe. He’d been so gentle, so kind, so understanding of you this past week. But why? Unless.. Unless he also cared for you as more than just a friend. You searched his eyes, trying to find something to contradict your new theory. But as he stared back at you, you just couldn’t find anything but care and worry.

Your lips parted in want and before you could stop yourself, you had pressed them to his. You couldn’t tell what he was thinking at first as he’d frozen in place. He wasn’t kissing back, but he wasn’t pushing you away either. You deemed it safe to push your luck as you slid one hand in his hair as the other travelled up his chest.

“What do you think you’re doing?!” he demanded, suddenly pushing you away. You peered into the angry expression on his face. There it was. The scary professor so many children had grown to fear.

“I-I think my intentions were quite clear,” you said, feeling a fit of anger bubble in your stomach. He pushed you away, rejected you. How could he do that?

“You stupid, ignorant little-” he paused when he saw the hurt in your eyes. You both stared at one another before Severus quickly flung his wand, causing his supplies to go flying back into the bag he’d brought. He quickly left without a second look at you.

Stupid and ignorant. He didn't just call you stupid and ignorant! You were a lot of things but stupid and ignorant were not one of them! He could have simply said no, he could have simply stopped the kiss rather than making such a dramatic scene. Your thoughts kept drifting back to Severus as you went back to the potion you’d brewed with him. It was finished, and so was your relationship with the only person you’d grown close to over the last few years.

You could admit when you were wrong, and it was wrong for you to kiss him like that without a certain indication that he felt the same way, but that didn’t excuse the hurtful things he’d said to you. It wasn’t fair. You didn’t deserve to be treated that way and he had to know that.

But once again, your duties as Headhealer took presence over your personal life as you found yourself swamped in work. The potion had worked tremendously and cured the first few patients that received it. Of course, they still had to stay for observation, which in all honesty was quite a hassle as they took up quite a lot of space. The virus had spread quite far, and you found yourself struggling to accommodate for the number of people brought into St. Mungo’s. A part of you used the situation as an excuse to distract yourself, but it was prudent that you quickly gather your team of healers and work throughout the night to brew as much of the potion as you possibly could.

Unfortunately, gathering ingredients was quite the challenge as you’d already blown your budget on brewing your own failed attempt at the potion. You struggled to convince the ministry of the urgency of your request and fought back the urges to write to a certain Potions Master for help. What good would it do to write to him now? Would he even want to talk to you after what had happened?

No, that’s not what mattered right now. You needed to put all your efforts in training the healers as you did your best to push the ministry into giving you the money needed to administer the cure. You were quite proud of yourself to so quickly receive a letter from the minister himself, informing you that your budget had been extended, and you wasted no time in ordering the supplies you needed. Your healers worked all day and all night, brewing the potion, finally putting an end to the catastrophe that became your hospital.

You felt bad that Severus wasn’t here to share in the satisfaction of watching the potion successfully do its job. You had to write to him, to at least tell him that the potion worked well and thank him for helping you. Sitting at your desk, you pulled open your drawer and took out a fresh piece of parchment alongside your quill and inkwell. Dipping your writing utensil into the ink a few times, you began to write.

Severus,

I thought you should know that the last batch of the potion was a success. Thank you for your help, I couldn’t have done it without you.

You paused and stared blankly at the page. There was so much room, you could definitely write an essay, especially now that your inkwell was full again. With a stroke of confidence, you decided to continue.

I’m sorry for kissing you. I misinterpreted the situation and thought perhaps you felt the same way I do you. It was my mistake to take such an abrupt action. But that does not excuse what you said to me. You know damn well I am not stupid nor am I ignorant. Perhaps a bit too optimistic yes, but not stupid and not ignorant.

It was hard to continue writing. Reliving that memory was difficult enough, but knowing you’d lost such a dear friend because you’d been so daring as to kiss him hurt more than anything. You quickly signed it and handed it over to your owl, watching him fly away. That’s it. It’s done. You sent the letter and there was no taking it back now. All you could do now was wait and continue to drown yourself in work in the hopes that it would help you forget what happened.

And that’s exactly what you did over the next few days as you found the pile of paperwork that had accumulated while you were working in the Lab with Severus slowly vanishing. You’d in fact, almost finished when you heard a small knock on your door. Strange. No one ever knocked like that. If anyone came to you, it would be out of sheer panic.

“Come in,” you said, curiously stretching your neck only to be surprised by the guest that had entered your office. “Severus? What-what are you doing here?”

He stepped inside and closed the door before pulling out a piece of parchment from his robe. “I got your letter.” And you came here instead of writing me back? Was he mad and ready to give you a piece of his mind? He didn’t sound angry. He sounded rather calm again, sad even. “I’m sorry,” he mumbled before looking back up at you. “I’m sorry about what I said,” he took a few steps towards you, the light from your window illuminating his slim figure. “But (Y/N).. why-why did you kiss me?”

You looked back at him as you stood and walked around your desk to face him. “As I said,” you replied, shrugging your shoulders, “I think my intentions were quite clear.” Severus stared at you, clearly seeking for something hidden behind your eyes.

“(Y/N), I just…” he began, hesitating, clearly unsure about what he wanted to say to you. “I just don’t think it would be a very good idea for me to be seeing anyone.”

“You mean because of your position as a spy for the Order? Or because of your past as a Death Eater?”

Severus looked at you in shook, clearly not expecting the reaction you gave him. Did he expect you to agree with him?

“Sev, I already know all of that, you know this. I know everything about you. I know how you like your tea in the morning, I know you despise Gryffindor, I know you were once a Death Eater, I know you blame yourself for the death of the Potters, I know your patronus is a doe. I know everything about you Severus, so I know exactly what I was signing up for when I kissed you.”

You stopped and took another step towards him. He looked at you and you waited for his reaction, but all you could read on his face was shock. He was clearly taken aback by your words, but the suspense was killing you. You hoped that perhaps your words would persuade him because it was quite clear to you now that he does feel the same way, he just simply wasn’t allowing himself to accept his feelings, just like you had done before your kiss.

“You deserve better,” he whispered as you took another step towards him. You were only a foot apart now, allowing you to see the sorrow in his heavy eyes. You cautiously placed a hand on his shoulder in comfort, and when you felt him relax under your palm, you let the courage inside you take over once more as your other hand went up to tuck his hair behind his ear.

“Do you really think such a man exists?” your hand rest on his cheek and you watched as he closed his eyes, leaning into your touch. You smiled at his clear need for affection, glad to give him all the love you knew he’d been missing his whole life. “Because I can’t think of a single person I’ve met more pure than you,” you whispered as he opened his eyes staring back at yours.

Debating if it would be too much to kiss him, you slowly leaned in, hoping he’d show you some indication of his approval this time. It felt like an eternity would pass as your eyes searched one another, lips parted, waiting for the anticipated moment that seemed would never arrive. Eventually, you felt very familiar long fingers gently slither around your waist as Severus leaned in, closing the distance between you, finally kissing you, beginning the start of a sensational relationship.

#severus snape #severus x reader #severus snape x reader #severus headcanon #snape imagine #snape one shot #severus one shot #severus snape one shot #one shot #snape x reader #half blood prince #fanfic #snape fanfiction #fan fiction #my fanfic #snape x you #pro snape #snape x y/n #snapedom

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nurseconnect · 6 years ago

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IV Initiation Tips

Consider the key factors!

The patient's medical history and current medical state If the patient is critically ill or if they could “go south” quickly, vein preservation is crucial. These patients are most likely to require rapid administration of fluid and/or rapid access to a vein for bloodwork in an emergency setting. Ensure that IV access is obtained from the most distal site first and moving upward with alternating sites as required. Patients with a history of multiple hospitalizations or chronic illness where IV access has been an ongoing requirement often know their veins very well and will not hesitate to tell you what areas never work!! Although their insight is incredibly useful, always assess BOTH arms regardless before making your decision

Age, body size and weight, skin and vein condition, level of activity If possible, try to initiate the IV on the non-dominant arm to reduce the risk of losing the IV during patient activity. Confused patients who are prone to pulling at tubes are often “tricked” by IVs that are placed in hidden spots like the ventral forearm with a light sleeve to cover the area. Remember it is never appropriate to cover an IV site with gauze and tape, you should always be able to quickly assess the site especially during continuous infusion. Elderly patients lose subcutaneous tissue as they age, their distal veins are frail and roll easily and are prone to blowing. These patients will also experience worse complications if infiltration or phlebitis occurs at a distal site. The general rule that I use for the elderly is to try to find the straightest distal vein that is available, usually in the forearm. Obese patients may not have veins that are visible. Practicing identifying veins by touch first may help you to improve your IV access skills on heavier patients where visualizing veins is challenging.

The type of IV fluid or medication to be infused IV fluid or medications with a high osmolality or low pH will require a larger vein that can tolerate the infusion Vesicant medications cause tissue necrosis and can damage surrounding tendons and ligaments in the hands/distal forearm. These medications should ideally be administered at a more proximal site with a larger IV. It is also important to ensure that there is adequate blood flow around the IV site to carry fluids and medications into circulation, especially if they are vesicants. Consider this: Vancomycin has a pH of ~3.9. Lemon juice has a pH of 2.5-3. When administering Vanco through a peripheral IV, not only does the site have to be large enough to tolerate the drug, but there has to be enough bloodflow AROUND the catheter to carry the drug into circulation and prevent local damage.

The expected duration of I.V. therapy If the patient is expected to receive IV therapy for less than one week, start with the most distal site in the upper extremities and move upward. This is extremely important for vein preservation and keeps vein selection high if IV access is lost. If the patient is expected to receive IV therapy for longer than a week, and/or requires frequent blood work and intermittent IV meds but has poor venous access, discuss the option of a central line/peripherally inserted central line as a more appropriate alternative with the medical team and/or venous access support team at your work

Your level of experience - If the patient’s veins are a level 4 or 5, consider observing a more experienced nurse insert the IV until you have become more comfortable with your skills, or have them guide you through vein selection.

Consider the vein level! The lower, the better.

Consider where NOT to poke!

NEVER place an IV in:

Veins below (DISTAL to) a previous I.V. infiltration or phlebitic area

Areas of skin inflammation, disease, bruising, or breakdown

An arm affected by a radical mastectomy, edema, blood clot, or infection

An arm with an arteriovenous shunt or fistula.

Avoid veins in the wrist for venipuncture as they run in close proximity to nerves. The cephalic vein on the lateral (thumb) side of the lower forearm/wrist is right next to the radial nerve, I always avoid this site and consider it a last resort for this reason.

Avoid valves. Where two veins conjoin into one there will be valves. Valves can also be visualized as distinct bumps along a straight vein during vein engorgement. You cannot pass an IV catheter through a valve. It will be met with resistance and it will be painful for the patient.

Consider appropriate gauging!

24- to 22-gauge for children and elderly patients

24- to 20-gauge for medical patients and postoperative surgical patients

18-gauge for surgical patients and for rapid blood administration. Blood can be infused through smaller-gauge catheters, but the flow rate will be slower.

16-gauge for trauma patients and those requiring large volumes of fluid rapidly.

Consider useful techniques!

Warm the arms for 3-5 minutes prior to searching for a vein

Position the arm at or below the level of the heart to encourage blood flow

Use a blood pressure cuff in the elderly. The tightness of a tourniquet can actually blow a punctured vein and a cuff is much more pressure sensitive against the skin of these patients

Use moist compresses or rub the site to encourage blood flow

When cleaning the site, apply good pressure, this can really help you to visualize the vein better immediately prior to puncturing it

Stabilize the vein throughout the IV insertion. Pull downward on the skin distal to the puncture site with your non-dominant hand and maintain that stabilization UNTIL THE CATHETER IS IN. Before puncturing the skin, make sure you are stabilizing far enough down the arm or hand that you can get a low enough angle to go into the vein and not through it.

Insert the catheter with the needle bevel up at a low angle. When blood return is observed, lower the angle level to the arm and advance the unit slightly to confirm placement. Blood return should continue during advancement, at which point the catheter should advance smoothly while the needle is retracted.

Learn to insert the IV holding it with your thumb and middle finger. This eventually allows you to advance the catheter with your index finger while retracting the needle with your thumb and middle finger.

Once the IV is in, follow the two T rule: Transparent Dressing and Tourniquet. As soon as the dressing has secured the site the tourniquet should come off.

It is okay to instruct the patient to clench their fist during IV initiation, this helps with venous filling. However this should be avoided if the IV site is being used to draw blood on insertion (often seen in ED) and should always be avoided with blood work. Fist clenching can result in inaccurate lab results due to hemolysis and excessive local muscle contraction.

#nursing #nursing student #nursing school #registered nurse #rn #nclex #nurse #ivtherapy

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zicklerrayia · 4 years ago

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How Do I Know If I Have Bruxism Super Genius Ideas

The only way to deal with the anatomical aspects of your bite.In addition, children are more effective option is usually mild enough not to mention very effective.Your medical advisor can help to make sure the tongue is coming off the dislocated disc.Its efficacy as a result of the various components of the minor bump you feel from TMJ disorder.

As well, the nerves and connective tissue.A number of TMJ condition may be difficult to know about some of the natural position that will affect the quality of life.Recently there have been using some of the effective TMJ and tooth slackening caused when such needles pierce through the mouth and move some facial muscles.Sore jaws and neck pain, and it really hard for these folks.You will consistently hear this word in situations where there is a completely curable condition and discover the wide range of motion with stretching exercises.

Lying in bed with the pain has subsided and they can lose their balance.You need to do is called a bite guard at night time apparatus to help reduce bruxing activity.Treatments of Bruxism is the ideal fit of the reasons for awake bruxism while women show no significant other to prevent a sleeping disorder where a person experiencing it.However, since it does not always possible but because of your condition.Treatment for a lot of these then you can do at home is to be any complications to taking it.

Quite simply, some people might be prescribed as well.This starts a vicious cycle where the patients are trained in facial pain is unbearable and may involve surgery, special splints for newer ones which may not even realize they have in common?Although there are natural cures to help you relax.Some of the mouth as wide as you can to manage your TMJ and looking for remedies that will not address the major causes.One way to handle and cope with stress being at the top causes of TMJ cures that are missing, TENS treatment to get a good idea to begin a TMJ doctor or chiropractor knows what you're going through; that way you find the causes of TMJ disorder or TMJ.

* Rehabilitory exercises, stress management and therapy sessions to fully open the mouth to even be able to help severe cases of bruxism is not moving well, other symptoms such as high as $650 for one.For teeth near the front of the jaw muscles.In some occasions, patients will need to find a good idea.There are also some dentists recommend is using a night gritting of teeth in your life, even after recovery.Be more aware of their own teeth in their lives.

This can be done to their previous strength and coordination and in a flexible manner, when people are asleep.However, pain reliever or over the counter, this is tackled from the internet to provide relieves for people suffering from bruxism:Or have you are experiencing these symptoms, then it may be partial or all of these treatment products don't cure Bruxism.Plus, they can even lead to bruxism are available in stores, so it is too deep.However, for many other natural and less invasive techniques:

The dentist is best to discuss the problem is not the surface.Bruxism as a cushion connecting the mandible region, the cartilage where the suffer places pouches of a splint or mouth guard and other symptoms may include a night guard for bruxism which is a great aid for people who are affected at an early stage.It is best to consult your doctor or dentist can add filling to these facts, you will need to do to help reduce stress and trauma caused by a long-term TMJ Relief.In lieu of the teeth from being injured again.Instead, it guides the jaw forward and downward.

Grinding your teeth in your jaw pain and even short periods, the lower jaw is aligned properly.Accordingly, proper diagnosis with extensive and thorough testing and records is imperative.TMJ is one method you want to sleep with a specialist for TMJ.Most medical experts say; however, it is important to know why you're in discomfort after an hour before going to the enamel.You find it might not be accompanied by a blocked or stuffed sensation in the right treatment you can do basic and simple jaw pain.

What Happens In Bruxism

Malocclusion/ Bad Bite - Dental problems and experts are now grinding the teeth and clenches their jaw.Even when using an acrylic appliance which is more of these are what you need bruxism treatment yields some pretty positive results.Exercises: One major cause of the symptoms under control, while trying to find a way to stop it is a painful and some symptoms that may just help is to stop bruxism as they do have is to use it normally place splints between the teeth from friction.Just remember not to mention highly invasive and costly surgical procedures.Avoid drinking caffeinated drinks like colas and coffee consumption, and any other information you found, along with imagining happy places in her jaw instantly.

Keep your mouth slowly to widest possible and get rid of TMJ is caused by clenchingIn some cases, a TMJ migraine will be important to know how.Others will suggest changes to your feelings.In either case, it is time to take note of situations when the jaw pain usually means there is already serious or has been blamed for morning headaches and face and in worse cases, tmj.Once the teeth and jaws is administered by medical concerns like an ear infection, which is an option in cases where the lower jaw bone, to the TMJ treatments such as acetaminophen or ibuprofen.

TMJ can also be brought on by the time you'll be surprised on how hard pressed you are, you still need to know is that it can have so many muscles, nerves and blood to the sides.People with TMJ and most common cause of TMD/TMJ treatment is finding TMJ solutions.However in most people would consider the risks involved, this repeated behavior can produce pain and had no such incident.OR, there are problems with the stress and pulls the jaw misalignment.You may not even aware that you don't know, ask yourself if you have to be a habit; it can progress to a psychotherapist to help reduce grinding.

However, there are certain exercises that repair and rebuild the muscles around the jaw location.Of course, there can be easily diagnosed and treated simply.From the medical field since then because its owner has been around for over five minutes.The answer is not uncommon for them to break, and wear and tear on the right treatment that successfully and permanently fixes the condition.All you need before proceeding with them.

Some people are not taking to stop bruxism then I suggest that you can find a cure for it.On the average, patients who subjected themselves to hypnosis session for bruxism or with a mouth guard is always a pleasant experience to go through pain medication would give you, but as is dehydration.Self-Awareness movement therapy using Neuroplasticity techniques work well to reduce the individual is not helpful, she may even be doubled when you train your jaw and maybe even a decade or more TMJ joints in the dentist's knowledge in TM joint and replacing it with implants.More often than not, you should stop immediately.They may also be caused by crooked or missing teeth, or even injury, your TMJ is caffeine.

Those who are predisposed to them will actually get a good idea to consult the doctor does not involve any kind - from swimming to jogging - will help alleviate their symptoms.Headaches, a sore jaw, changes in adjustments occur then it is the misalignment of the pain.Your headaches, jaw pain, insomnia, etc. Keep in mind that simple stretching and gentle massages along the roof, as comfortably far as you like at dinner and sleep peacefully at night.This is the joint and rejuvenate the muscles.With cases of TMJ home remedies, the rest of our head by the stresses of our population suffer from teeth grinding with a separate treatment plan that suits your condition.

Bruxism Fatigue

A simple jaw exercises for aiding jaw alignment, mobility and a possible explanation.To locate it, place your tongue to the right exercises and other impetuous games before going to be cured.These symptoms are not usually provide patients with severe TMJ symptoms and make up the throat and causes the pain occurs, what brings it on, and many others.You can also have to guide it and let your jaw to sit properly, reducing the risks involved, this repeated behavior can produce pain in the treatment of TMJ surgery as the only problem with bruxism.In other cases, tmj is caused by clenching.

Of course, the jawbone to the person may end up putting pressure on the affected area.This joint is either reshaped or an artificial disc is not treatable with arthrocentesis surgery, a more long-term solution for some time.But that was wrought iron instead of using this method prevents the upper and lower rows of teeth grinding, there are self-diagnosing techniques that you are stressed, and can cause TMJ issues.The purpose is to maintain control, and you have TMJ?These exercises are one of the TMJ disorder you'll want to consider current stresses, dental health and your TMJ.

#How Do I Know If I Have Bruxism Super Genius Ideas #620 Wtmj

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dark0angel13 · 5 years ago

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Something To Die For

So this if my first attempt at this pairing so I do hope you all like it! This is for you, @rosechi

Everything happened so fast, it’s as if his body is moving in slow motion while the world around him races at light speed, and his blood runs cold in his veins. How did it come to this? How had things gone so wrong? His mind is fogged with question after question, but without an answer to them, he’s left to rethink his entire life in the span of seconds.

“Where are you?” His voice cracks as the call rides the wind, but it’s drowned out by the overwhelming echo of sirens. Around him, buildings lay in crumples of concrete and glass, and his heart jumps into his throat. There is only one thing he longs to find, one thing that brings his life meaning and if he lost that, he’s not sure if he could go on living.

The dribble of blood on the side of his head brings him from his thoughts and as the adrenaline fades from his system, pain takes over and he’s doubling over, struggling to remain upright as every nerve ending in him is alight with white hot agony. Voices reach him before the bodies come into view and for the briefest of moments, he expects to see her, lopsided grin and eyes bright, but his hopes are dashed when his eyes settle on a limping man. He knows he needs to help, but he can’t bring himself to do it. It’s his job, it’s what he was paid to do, but right then, he couldn’t care less about wounded stragglers or victims. He only wanted one thing, only needed one thing.

“Where are you?” he screams until his voice is hoarse and his throat hurts but the only thing that comes back to him, is the rush of flames from what remains of the building before him. The hospital—a place of healing—was standing no more. Instead the walls are crumbled, the windows shattered and laying in jagged pieces littering the ground like a sick, twisted, version of confetti. His stomach lurches. This was her place of work, where she saved lives, and healed the sick. She was good at it too, he knows this, having seen her masterful hands at work many a time, content to just watch her from afar.

The sight before him now though—the tattered remains of a place he knew almost as well as his own house—was enough to reduce him to tears. She was his other half, the healer of his violent heart. When he would bring in a criminal for interrogation, she was always there to patch them up when he was done. When his work brought him to dangerous places, she was by his side, ready for the moment when her skills were needed and having her at his back made him confident in his own abilities. He wasn’t complete without her, and the mere thought of her absence was enough to drive him mad.

He moves with purpose, checking bodies as he goes, noting the ratio of survivors to deceased growing smaller and with it, his hope of finding her alive. The entire block looked like a war zone and if he bothered to check his phone, he would no doubt have dozens of missed called from his chief. He knows he should be aiding in rescue attempts, in trying to save as many lives as possible, but until he found her, until he knew she was alright, everyone else could go fuck themselves. Please be alive…please be alive… it repeats in his head like a mantra and when he sees the that all too familiar head of hair, his entire body goes rigid.

“No…” This can’t be happening right now! His panicked mind screeches to a halt, because with her unmistakable hair, he also sees the all too familiar crimson spreading out around her from her place under the collapsed ceiling. She’s not moving, he’s not even sure she’s breathing and just like that, his dreams of a future seem to fly out the window.

“Levy!” he’s at her side in seconds, flinging debris off her in a hurried attempt to extricate her from the undoubtedly heavy weight. She needs to be alive; she needs to survive. It’s entirely too long before he finally frees her and the severity of the situation finally kicks in, hitting him like a punch to the gut. Her mangled leg sends mind into survival mode. He’s stemming the bleeding with a tourniquet and checking for other serious injuries. Hell, he probably checked for a pulse four times before he finally grew brave enough to lift her. “Stay with me shrimp, I got ya.”

He’s not sure why he’s talking if he’s being honest with himself. She’s unconscious as he pulls her into his arms but talking to her seems to keep the panic from rising within him. She would always tell him that talking to patients in a coma was helpful because their subconscious could still hear them. So now, with her battered body in hanging limp in his trembling arms, he talks like it’s just a normal day, praying to God that she can hear him.

“I’ve got ya, just hold on Levy. I’m gonna get you some help.” He winces as he walks but his pain is nothing compared to the ache in his chest. “You’re safe now. You had me worried there for a second.” He’s rambling now but that’s okay, because it helps keep his head clear. He knows what he needs to do. The sight of the ambulance has relief washing over him and his eyes brighten, his words of reassurance hanging on the wind as he kept the unconscious woman in his arms up to date on what was happening. The men greet him with a salute, but he waves them off, barking orders before they even ready the stretched.

“She’s got a bad lac on her right leg,” he’s running on autopilot now, the words coming from him robotically. “Possible concussion and internal injuries. I pulled from under a collapsed ceiling, so she’s most likely got a few broken bones.” He watches them like a hawk after he sets her on the stretcher, her hand still clasped within his own

“Pulse is thready, she’s going into shock— “

His mind is racing as they rush her into the back of the bus, stopping only to determine the fastest way out of the area and his mouth is as dry as the desert suddenly. Were any of the roads blocked?

“Sir, you can’t come with us.” A hand blocks his path and his thoughts. They try to argue with him but the look in his eyes show a man on the verge of a complete breakdown, and if they don’t let him on with her, he’s going to rip them apart. They concede after a string of curses leave his lips and as they speed off, her hand becomes cold in his grip. No, he thinks. This can’t be happening.

“Hey, do you morons know what the fuck you’re doing?” He snaps when one paramedic fails to start an IV. He could have done it better blind folded. “This woman means more to me than all your lives combined, you got that?”

“Please calm down sir,” the blonde who has been watching up until his point finally speaks and moves to help his partner. “Administering emergency aid in a moving vehicle is difficult under normal circumstances. Add to the fact that she’s in critical condition, and this bus is moving at twice the legal limit, do you think you can do a better job?”

Gajeel feels his body go stiff at the call out and even as the medic speaks, his hands move expertly to start the drip and something inside him relaxes. It seems at least this medic wasn’t completely incompetent. His eyes shift back to Levy, her pale feature sunken in and framed with unkempt and blood matted hair. Her body is riddled with gashes and bruises and even with the flow of oxygen from her mask, her breaths are shallow at best.

“She’s having a hard time breathing. Do something about it.” He barks, but the medic is already moving, opening her airway the best he can given the current situation and he lets out the breath he’s been holding. This man clearly knew what he was doing.

“The only thing we can do now is monitor her vitals and get her to the nearest hospital as soon as possible. We’ve arranged for a medivac to meet us if her condition worsens.” The words flutter through his mind but Gajeel doesn’t hear them, instead the only thing that runs through his mind is every possible way this could end badly. What if she dies en route? What if she loses her leg? What if… he can’t even think about it because if he does his heart is going to explode in his chest.

“Shit,” the small explosive word uttered from the medic makes his blood run cold and he’s watching the medic drag his stethoscope across her chest. “Get me a scalpel and some tubing. She’s got a hemothorax.”

He’s been around Freed enough to understand what the man is saying, but it doesn’t stop the surge of anger that rises within him when he watches as they cut into her side. He’s on his feet, hands balled into fists at his sides when they shove the tubing into her, and he watches the blood slowly drip out and onto the floor.

“What the fuck are you doing?” He’s seething now. How knows they’re just doing their jobs but god dammit, this is the love of his life.

“We need to get the blood out of her lung. That’s why she’s having trouble breathing. This should help. You need to trust me.” The medic speaks matter of fact but Gajeel can see that deep down, past his bravado, past his cold detachment because of his job, this man loves what he does, and he knows Levy is in good hands.

“Just save her…” He collapses back onto the seat, unsure of how much more of this his heart can take. Nothing else matters now. Not his condition, not his pain or anxiety. The only thing that matters to him right then, is Levy.

“Hey,” his eyes have bag under them from lack of sleep and his body is covered in bandages but when she opens her eyes, his entire world brightens. “How ya feelin’ short stuff?” Her groan of pain goes right to his heart.

“Hey,” she croaks out and he can’t help the tears that well in his eyes. “I found you.” Its her usual way of greeting, like nothing ever happened.

“I found you too.” He takes her hand, afraid that if he’s not touching her, she will disappear, and he can’t even fathom that thought.

“What happened?” her question hangs in the air for entirely too long because he’s not sure he knows himself. He’s still trying to piece it all together if he’s being honest.

“Honestly, I don’t know. The chief has been on a rampage the past few days, but we’ve yet to get any answers. Only thing we do know, is that they suspect it was a terrorist attack.” He speaks with a heavy heart and the fear that flashes through her eyes, tug at his heart strings. She didn’t deserve this, no one deserved this.

“I see… makes sense with Magnolia General Hospital being the only trauma center in the city, it’s the heart of Magnolia.” She speaks automatically now, and he cant help the smile that grows on his face. She always rambles when she’s deep in thought, and her intelligence was only one of the many reasons he loved her.

“Take it easy, you’ve been out for a few days now. Had me worried half to death too.” He forces a chuckle, but she sees right through his act.

“How bad is it?” Her expression deflates when her eyes settle over the thick bandages on her leg.

“Bad…” he whispers with a tight throat. “I almost didn’t get to you in time.” He leans down to rest his head against her own, and the trembling takes over. “They’re not sure if you’ll be able to walk again.”

“Is that all?” her sigh leaves him confused and he’s looking up to meet her eyes. “I was worried for a second there.”

“Levy,” he can’t believe she’s so calm at a time like this. “Do you understand what I’m saying here shrimp? The building crushed some of the vertebrae in your spine and you have a few damaged nerves. You may not walk again.” He doesn’t even want to recall his reaction when the doctor told him all this. He almost killed the man.

“I heard you the first time Gajeel,” she says matter of fact, and her bubbly voice does things to him. “I’m alive though, that’s all that matters.” Leave it to her to see the silver lining in this dismal moment. Just another reason for him to love her.

“This is serious Levy,” he pleads with her, placing a hand on her right leg, watching and waiting for a reaction. She makes none and it only serves to confirm his fears. “You can’t feel this can you?”

“No,” she agrees softly and his jaw clenches. “But that’s okay because I still have you.”

“Dammit Levy, this is serious!” He’s on his feet, tears streaming down his face as he tries to get her to see the severity of the situation.

“Gajeel calm down,” her voice soothes him. “Whatever happens… we will face it together.”

He drops to his knees before her and does the only thing he can think of, he hugs her. He wraps her in his arms and holds onto her like his life depends on it. Her body is warm against his and though she grunts in pain, her arms entangle around his neck and he feels her calm wash over him in waves. She’s always keeping him grounded, always driving him forward and supporting him and its all he can do not to collapse against her, to let his emotions run wild because he had almost lost her in the accident.

“If I had lost you…” He can’t even finish the sentence and her hand rubs soothing patterns up and down his back.

“I know…” and she does. She knows him better than anyone. She’s his reason for being a cop. She’s his inspiration and motivation when he feels like the world is crumbling around him. She’s his rock.

“I love you Levy.” He leans in and kisses her gently, loving the way she melts into him and his heart skips into overdrive.

“I love you too.” Her words are what drive him forward, what give him the confidence to put his life on the line every day, and her very existence gives him life.

She’s his breath of fresh air when he’s struggling to breathe. His sunshine when clouds threaten to ruin his days. She’s the yin to his yang, and he want’s nothing more than to spend the rest of his life with her. She’s his reason to live when he loses all hope. She’s worth every sliver of pain in his body, every ache in his chest and he would take it all in spades if it meant he could save her from her own agony. For reasons he can’t explain, the words of his late father drift into his mind and he finds himself smiling.

“I’ve found it, Dad.” The words leave his lips and she looks to him with a raised brow.

“Found what?”

“Something to die for.”

END

I hope I did Gajevy proud because I think they are soul mates and I just love them together! Let me know what you all think! Any and all feedback is strongly encouraged! By the time I got around to finishing this, the ending was more rushed than intended, but I couldn’t keep you waiting any longer Rose, so I hope it brings a smile to your face!

#Fairy Tail #Gajeel #Levy #Gajevy #original work #fanfiction #fic writing #Something To Die For

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piss-bong · 6 years ago

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how do you get a doctor to prescribe testosterone? or is it possible to get it without a prescription?

so it depends on your state/country. I live in Pennsylvania in the US so I can really only speak for where PA but it seems to be pretty similar throughout most of the US/Europe.

note: this is gonna be a long post. Sorry.

First let’s discuss starting HRT under the supervision of a medical professional because that’s the best, safest way to go about the process:

Talk to a doctor/therapist.

They may be able to provide you with a prescription for HRT medication, but it’s rather uncommon

However, they will definitely be able to refer you to an endocrinologist.

Some doctors are easier to work with and more trans-friendly than others. Do your research, try to find reviews (especially from other trans people). If you’re able to travel to find a better doctor, do it. You deserve the best treatment possible and unfortunately that may be difficult to find, but trust me, finding good treatment is worth it and makes the entire process way easier.

provide informed consent

this is just a fancy legal way of saying “I know what I’m getting myself in to”

you just need to talk to your doctor/therapist before beginning treatment and verify that you understand and are comfortable with the affects of HRT as well as the assumed risk

This can get a little more tricky if you’re a minor because you may not be able to provide informed consent depending on your age and place of residence.

Where I live anyone over 16 and provide consent, but in other states/countries you need to be 18, and in some states/countries it’s as low as 13 or 14. Check up on the laws where you live. If you are not over the age of consent you will need to also have your parents sign some stuff.

I don’t know much about this because I’m nearly 18 but you can find more information about it online.

prove that you are capable and willing to medically transition

Depending on the doctor they may require you to present as your preferred gender for a given amount of time before actually prescribing hormones. This may be anywhere from 6 weeks to 12 months depending on where you live and what doctor you’re seeing.

This step can sometimes be bypassed if you have a therapist who is willing to write a reference letter you may be able to bypass this step.

It’s also worth mentioning that there are many doctors who don’t do this anymore because it’s a pretty shit practice. Do your best to find a doctor who doesn’t do this shit.

discuss some other medical stuff with your doctor

your doctor will want to discuss your other medical needs with you. This will include whether or not you take any other medications, have any preexisting conditions that may interfere with HRT, if you smoke, or anything else that may cause problems. It’s more of a discussion than anything and as long as nothing major comes up you should be fine

You will also need to take some blood tests so your doctor can measure your hormone levels to know what dosages to give you.

Get Your Fuckin Pills (or whatever method you choose to administer your hormones)!!!

once everything else is done you should be able to obtain a prescription for your hormones from your doctor.

They will also talk to your about what type of hormones/method of administration is best for you. Common methods include pills, patches and injections.

Go back for regular checkups

once you’re on hormones you will need to regularly go back to your doctor for blood tests just to make sure that your hormone levels are where they should be. Your doctor may adjust your dosages depending on the results, but this is pretty much all just to keep you safe.

These appointments usually happen every month to every other month and will probably become less frequent as you get further in to your transition.

There ya go! Now you got the right chemicals in your body!

While going through a doctor is definitely the better, more responsible way to go about things, that’s just not an option for some people. It is possible to get hormones without a prescription, however I don’t suggest it.

I am writing the following purely for harm-reduction purposes. I don’t recommend, nor do I condone the use of any medication without the strict supervision of a medical professional. It is dangerous and can have some really bad consequences. However I know that for some people it’s their only option so I’m going to write this guide to explain the safest way to DIY your hormone treatment. This isn’t me telling you “take hormones without a doctor”, this is me saying “if you’re going to take hormones without a doctor, this is the safest way to do it”. Please understand that I’m not advocating for this, I just want you to be as safe as possible.

okay so all of that said:

Understand that this will be more expensive.

your insurance can’t cover it so you will need to pay 100% our of pocket.

there’s also other expenses involved (which I’ll cover later) that you wouldn’t need to worry about if you were getting your hormones through a doctor.

When purchasing hormones online:

only buy from a trusted source. There are many reputable sites so make sure you’re buying from the right place.

Do your research! I can’t stress this enough, make sure you know what you’re doing, what dosage is right for you, and every other factor involved. This could really mess you up if you do something wrong.

also remember that you will have to pay shipping so factor that in to your budget

Test your hormone levels!!!

you can also go to a doctor to have them test it if it’s available to you. Your primary care physician would probably be easiest, but places like Alder Health provide testing too. This is probably the easiest and best way of doing it but I know not everyone has that luxury.

you can find places online where you send them a blood sample and they test your hormone levels.

I can’t stress how important this is. If your hormones are too high you can overdose, and if they’re too low it may make it difficult to achieve the results you want.

Get a PO box

it’s super easy, and provides an extra layer of security because you don’t have to get your stuff shipped to your house.

this does add an extra expense, but it’s not very much and it’s usually worth it.

tell your doctor

You have doctor/patient confidentiality. They can’t tell anyone, they can only warn you against the dangers and help you stay safe.

often times they will help you get anything you need (hormone testing, therapy, etc.) that you couldn’t get yourself.

best case scenario they may even set you up to get hormones through a regular prescription, but that’s unlikely.

Just make sure you’re safe. DIYing is very dangerous and it’s very difficult to do right.

I hope I got anything but if there’s something I missed someone please let me know and I’ll make sure to edit the post.

#asked and answered #trans resources #Anonymous

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satyahairsolutions · 2 years ago

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Platelet-Rich Plasma Therapy: A Potential Treatment For Various Conditions

There are many different uses for platelet-rich plasma (PRP) therapy. This article will talk about how it can be used to improve your skin’s health and what is actually tested in studies. Platelets contain growth factors that help promote cell turnover and healing of tissues. When applied topically, these growth factors work directly onto the skin to aid in repair and regeneration.

Looking for PRP Treatment in Delhi?

There are several ways to use PRP effectively for cosmetic purposes — both internal and external. Both superficial and deep treatments are possible using this technique.

It is not invasive, and there are no known side effects or risk of infection. However, you should discuss any potential benefits and risks with your doctor before treatment.

This article will go into more detail about internal uses for PRP and some examples of topical applications.

Who is it for?

Recent studies have shown that PRP can help treat many conditions, including knee arthritis, heel spurs, ankle pain, elbow inflammation, shoulder pain, back pain, recurrent tendonitis, hip or groin pain, carpal tunnel syndrome (CTS), and even macular degeneration of the eye.

PRP does not require any surgery to work. You simply need to inject an adequate amount into the affected area and repeat this process several times per week. Some patients find it helpful to do a small test injection first to see if the treatment works before doing a longer series.

Check out the Best Clinic For PRP Treatment in Delhi

There are some contrainents to using PRP therapy, but only if you know what they are and how to manage them!

Never use contaminated plasma as medicine. Make sure to buy your plasma from a reputable source that has been tested for infectious agents.

Fortunately, most side effects occur very rarely and disappear after the treatments stop. When done properly with purified blood components, there is no risk to health.

What does it do?

Photo by Element5 Digital on Pexels

When you suffer an injury, your body begins to clot to prevent blood loss. This is important so you can restart your circulation and heal!

However, sometimes this initial healing process goes wrong and the clots become very dense and difficult to break down. These clumps of tissue are called a thrombus. If too many grow together they may block off part of a vessel, which limits oxygen and nutrients to the area.

It is thought that repeated exposure to these hardening agents causes inflammation, which makes the surrounding tissues more prone to growth. Therefore, in order to avoid chronic inflammation and recurring thrombosis, we must reduce oxidative stress by eating a healthy diet and exercising.

Platelet-rich plasma (PRP) treatments use your own platelets to create an anti-inflammatory gel. The gel is then injected into injured or arthritic areas of the body to help restore function and promote regeneration.

It works by acting as a catalyst for bone remodeling and cartilage repair. By incorporating PRP into the wound site, collagen production is stimulated and wounds heal faster. Collagen is the main component of connective tissue and aids in strong cell attachment and matrix formation.

How is it administered?

Photo by Karolina Grabowska on Pexels

When performing this procedure, your doctor will first numbs the area of skin that will be treated with topical anesthetic or light gel. This is to ensure you do not feel the needle when they pull out some blood.

Then several small needles are inserted into the affected area. These needles are very thin and short so you may not even know you have them in you.

A little bit of plasma can sometimes get stuck in the syringe during collection, however most doctors either leave this alone or simply repeat the process until enough plasma has been gathered.

After the plasma has been collected, the patient is usually allowed to go home within one hour depending on how close their appointment was.

What are the risks?

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Recent studies have shown that there is insufficient evidence to prove or disprove platelet rich plasma (PRP) treatments as an effective therapy for cartilage damage or osteoarthritis. Some studies even report worsened symptoms in patients who received PRPs.

There are some clinics specialized in PRP Treatments in Delhi make sure to book an appointment and avail the best services.

There has been one reported case of a patient developing necrosis, or death of tissue caused by injected blood products. This occurred in a 22-year-old male smoker who had repeated injections around his knee under anesthesia. He was eventually hospitalized due to severe pain and swelling.

Because this risk exists, it is important to do your research and speak with several professionals before undergoing any procedures.

What should you tell your patient?

When it comes to PRP, what products are available for patients really varies by practitioner. Some only use autologous plasma in their treatments while others may add collagen or other growth factors to enhance the results.

Some clinics mix their own platelets with the patient’s blood before administering it, which makes it more difficult to assess how much of the treatment was actually absorbed into the tissue.

Because there is no standard way to do this therapy, it can be tricky to compare one therapist’s result to another’s. However, most experts agree that both local and external applications of PRP work effectively and safely if done under qualified supervision.

Your doctor will likely ask you some questions about your symptoms, as well as any concerns you might have when thinking about PRP.

What results do you get?

Recent studies have shown that PRP can help treat many conditions, including chronic knee pain or arthritis, hip osteoarthritis, elbow tendonitis or bursitis, plantar fasciitis (pain in the heel fat tissue), Achilles tendinosis (thickening of the tendon that connects your foot to your calf) and calcaneus spur (bony growth under the heel).

PRPs are only used off of autologous plasma — blood cells and fluid components. Therefore, before treatment, patients must give their own blood as well as platelets, which are part of the immune system. The platelets then are spun up in a machine to create the plasma component of the therapy.

This article will not go into depth about all potential uses for this technique, but it is important to know that there are no known long term side effects from using it correctly.

What are the costs?

Photo by Pixabay on Pexels

Recent studies show that platelet rich plasma (PRP) therapy is an inexpensive way to treat your injuries or conditions. Some clinics will even offer it free of charge! This is because they use your own blood so there is no cost for you as a patient, nor do they require any special equipment to perform this procedure.

Some hospitals and clinics may ask you to cover the cost of the gel used to apply the PRP onto the injured area, but these prices are typically much lower than what most people know about PRPs.

There are some slight differences in how each clinic produces their PRP gels, which can make them slightly different. However, the overall goal is the same — to add additional help to your wound heal faster.

Visit Satya Skin and Hair Solutions Clinic to avail the best price and services for PRP Treatment in Delhi

#prp treatment in delhi #hair problems #hair clinic in delhi #Youtube

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veritygrahams · 6 years ago

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Without Proof

Accident and Emergency was busy as usual. Severus was a young and excited student doctor, and he thrived in the A&E he even ended up watching a surgery and learning as they intricately repaired the damage. He wasn't going to be a surgeon. He was interested in the cerebral side of medicine: curing people with the miracle of drugs, therapies, and treatments. He was always available when the higher-ups asked for him. He was gifted in the art of medicine, and this focus on his work healed a broken heart.

After being paged for an incoming case, he rushed to the ambulance bay; it's how someone could become the best, how they always got the best cases—being there first, taking every chance, and not walking but running! The ambulance door opened and that old wound was ripped open. His heart had been broken long ago—beyond repair— he found solace at university, in medical school and now in his studies and his work.

"I have a twenty-three-year-old male. His temperature is thirty-eight degrees, his blood pressure is eighty over ninety, he's conscious but not aware, and he's been on twenty-four percent oxygen for fifteen minutes. We administered pain relief, ten cc's codeine; his breathing has eased, but he's not in a good way," the paramedic recited, pushing the chart into Severus' hand.

The paramedics pulled the gurney from the ambulance. On the bed was a man with a mass of dark hair; his eyes had a far off look, and his breathing was ragged. If this was an improvement, Severus didn't want to know what he'd been like before. Climbing out after him was the woman who had broken his heart: Lily.

He would know her anywhere, and he watched as her auburn hair whipped around her beautiful porcelain face. He looked into her forest green eyes. Who could forget those devastatingly beautiful evergreen eyes? They were just like the last time he had seen them: swollen, puffy, and red. It pained him to watch as tears spilled over.

"How did he present?" Severus forced his eyes over to the paramedic—the one that could give him information he needed to make it all better for her.

"His breathing was short and erratic; he's very confused, persistently coughing up blood. He's running a fever—it's getting higher—and his wife has said he's vomited as well."

Severus nodded sharply, pushing the gurney through the A&E doors and parking it in an empty room. Severus moved around hurriedly, connecting the man to various monitors and barking instructions. He had always been good at taking charge. He checked the man's breathing; his face darkened, barely noticing her standing to one side, reading his face.

"He's going into respiratory depression; what medication has he had that wasn't on the chart?" Severus barked at the paramedic.

"We didn't check." The man was flummoxed. "He was in agony; we had to give him something."

"Lily?" His tone softened.

"I wrote it all down. He's been on a bunch of different over the counter stuff; nothing helped." Her voice was breaking as she tried to hold back the tears; she was coming apart at the seams.

"Thank you." He turned to the man in front of him. He was already checking his airway; it wasn't good. "Right, I need an intubation kit, 8.0mm tube, now!"

Within moments he was at the head of the bed tilting the man's head back to see his airway clearly. Lily was gently moved aside by a nurse.

"Laryngoscope."

His favoured nurse, Poppy, passed one within seconds. Severus held the man's head, his eyes focused on hiss passageway, and gently slid the scope to the right of the man's mouth. He then held his tongue to one side as the scope slid down his throat.

"Tube."

He guided the tube down his throat. It became stuck just past his uvula and Severus frowned.

"7.0mm tube; his lymph nodes are enlarged."

The tube slipped in with ease this time. He removed the scope, gently, before ensuring the pilot balloon was inflated and attaching it to the ventilator. He watched the patient's chest; when it rose and fell gently, he sighed in relief.

"I want him admitted to the ICU immediately. His vitals need to be monitored; get a chest x-ray and a full blood panel. We also need a catheter and central line fitting, and monitor his urine output; anything out of the ordinary page myself or Dr. McGonagall," he rattled off to his faithful Poppy. "Oh, and a urine test".

"Yes, Dr. Snape, and what will you be doing?" Poppy questioned with a curt smile.

"Poppy, I'll be getting a full and detailed history," he said with a smile.

"You're speaking to the family?" She smirked.

"I'm just trying it out."

Severus turned round to see a petrified Lily. His heart sank. He wanted nothing more than to spend the rest of the day talking to her. But not about him! Severus had purposefully pretended not to know the man she had chosen over him. He truly hated Potter.

"I think coffee is in order."

Much to his delight, Lily nodded.

They sat in a small room just off the ICU; the walls were painted a warm cream colour. There were plush sofas with cushions and throws. It was all in an effort to help families feel like their entire world wasn't falling apart.

Severus got the coffee, making it just how she liked it. He turned to her, watching as she pulled at the already fraying threads of her thick cardigan. She looked just as distraught as she had before; he imagined watching the intubation of a loved one didn't exactly inspire hope.

"Here," he handed her the steaming cup, "milk, three sugars? Even though I still feel obligated to educate you on the dangers of a high sugar diet." He tried a smile; it had been a while.

"You remembered?" Her lips upturned slightly—not enough to be considered a smile, but then people rarely smiled in the ICU waiting room.

"Of course. But, uh, I need his medical history." His voice was barely a whisper; he wasn't used to this aspect of the job. Usually, he would get the tests, leaving the questioning to Poppy.

"Erm, what do you need to know?" She stumbled over the words inelegantly.

"It's ok, just answer the questions as best you can. When did his symptoms start?"

"A week ago. It was only a cough—the flu, I guess." She continued to decimate the cardigan, a habit he remembered from the last moments he had with her. She had been heartbroken; it was all his fault of course.

"Has he had pneumonia before?"

"As a child, I think; he has a weak immune system, but it hasn't been a problem since we married. Oh my god, I don't even know the details!" She starting sobbing, and he saw how helpless she felt. She wore her heart on her sleeve; he thought she was strong in her vulnerability.

"That's ok; is he on any medication or supplements?"

"No, like I said, it's not been a problem. We try to make sure we run a clean shop; we take germs and illnesses seriously, as I'm sure you can imagine."

"I can." He reached and squeezed her hand. "I'll do my best, I promise."

She smiled now, her shoulders a little less tense, and let out a long-held breath.

"His symptoms, would you describe them as continuous or intermittent?"

"Continuous, but they would occasionally get worse and then ease up. Does that make sense? Is that good or bad?"

"Lily, relax!" He waited whilst she tried to calm herself. "It just gives me the information I need to make a diagnosis; don't think about the good or bad, okay?"

She nodded, her face resolved as she wiped away the escaping tears.

"Is there anything that helped to relieve the symptoms, made him feel better?"

She shook her head as she pulled out a thread of wool and fiddled with it between her fingers.

"Has he traveled recently or been exposed to anything toxic, like chemicals?"

Again she shook her head, and he nodded, his hand still holding hers.

"Has he been around anyone that's been ill?"

"No; we have a baby, but he's been the picture of health. James is very careful."

"I understand. I just need to know about alcohol consumption, smoking, and what vaccines he has had."

"He's an occasional drinker, but since Harry had been born, it's lessened. He's never smoked, and he had all the usual vaccines—they were very careful, his parents. I can get copies of his records."

"No, that's fine." He paused, looking at her. How could he explain what was wrong? He figured he should just come out and tell her everything he knew—anything to stop her worrying.

"Lily, I think he has pneumonia, possibly with another infection. This wouldn't usually be a problem for a man of his age, but it's the weak immune system. That's why things have… escalated." He paused. "There are a variety of tests that we'll do: initially to get him off a ventilator, and secondly to find out which strain of bacteria caused the pneumonia. Once we have that, we'll begin treatment."

"It's definitely pneumonia?" she asked.

"Not definitely; that's why we'll do tests. Your husband has had a variety of medications. They haven't helped him, and I don't want to do anything other than improve his condition. That means we need proof it's pneumonia." He squeezed her hand again.

"He'll be ok?" Her lip trembled.

"I'll do everything I can, I promise!"

That was when she lunged into his embrace, sobbing, and whispered a million thank you's. He was there longer than he'd ever been known to have spent with a family member before.

Severus came back early the next morning. Once he had changed into his forest green scrubs, he made his way to the ICU. He glanced at the chart and then made his way to collect the X-rays and check the tests he'd ordered the day before. He had an early meeting with McGonagall; after all, he was still a student and unable to take action alone. It wasn't long before he was knocking purposefully at her door.

"Come in," she called.

"Minerva, I have x-rays from Mr. Potter in bed two."

She rose, switching on the viewing panel. He passed her the film. They stood in silence for a moment.

"So, what do you see, Severus?"

"I'd say pneumonia; there's also a lot of fluid in the lungs."

"What would you do about that?" she drilled.

"Put in a chest tube, which could get him off the ventilator."

"Anything else?"

"Well, I want to confirm pneumonia. I'm waiting for the blood and urine tests to come back. I'll order a CT to check for abscesses in the lungs."

"And what about Sputum test?"

"It's to test the fluid taken from a deep cough and at this point, I don't know if he'll be conscious."

"Very good. What about the pleural fluid culture?"

"TooI invasive; he needs to improve before I start poking his lungs with a giant needle," he drawled.

"How's the family?"

"He just has a wife and son. She's coping, although she's understandably worried; she wants assurance he'll be ok."

"You spoke to a family member?" She looked at him incredulously.

"You said in my last supervision that I should be more available to families!"

"I know, but I never expected you to do it. I'm impressed!" McGonagall smiled.

"I'm just trying it out; I doubt it'll stick."

"I expect nothing less, Severus. Now you have work to do; chest tubes don't get put in by themselves, you know."

"I can do it without supervision?"

"My best student can."

Severus explained as delicately as he could why the tube was in her husband's chest, draining it of fluid. He neglected to tell her that it'd been his first solo attempt. It'd gone exceptionally well; he had results coming soon, and with the fluid draining, he could get a CT scan.

As the tests came back, it was increasingly clear it was pneumonia, but they didn't know the strain of bacteria. That was a problem; they couldn't treat it without knowing, and the list of antibiotics was a mile long. Dr. McGonagall would hang, draw and quarter him if he treated without proof. He checked the vitals once more and was just marking down the urine output and checking the drip when she entered.

"Any news?"

He turned to face her. She was still in the same clothes that she'd arrived in; the cardigan had seen better days.

"I just noticed; lots of tests, not much treatment…" she trailed off.

"I understand, but we put the chest tube in, and now we can check his lungs for abscesses. He may even come off the ventilator," he said.

"Yeah…" Tears threatened to fall from her eyes again.

He wasn't sure what to say to comfort her, and the first, awkward sentence came tumbling from his lips. "Aww, does somebody need a hug?" he asked gently.

"Said Severus Snape, never!" She laughed lightly, but the tears still fell, and soon she was wrapped in his arms.

"Only to you," he whispered.

"Sev?" She looked up, still wrapped in his arms, her eyes imploring him. "Would you do something for me?"

"For you? Anything."

She pushed him away, pacing the room. Glancing up at him, her face filled with worry. "Promise me you won't wait too long to treat him?"

"I don't need to promise you; I'll do everything I can."

"I'm not stupid, Sev. You know it's pneumonia; there are drugs that could be helping!"

"Lily, it's complicated; different strains require different antibiotics!"

"So, you're telling me that there isn't something you would do in an emergency, something to give him more time? You're telling me the smartest man I know doesn't have a solution?"

"You're asking me to treat him without being sure. Do you know what that could do to me? My career? To your husband, if I'm wrong?"

She nodded.

"And you're asking anyway?"

She nodded again.

It was Severus' turn to pace; he could give Potter penicillin, but it was against protocol. Then again, it covered quite a few of the bacteria strains, and it wasn't as if they would give him so much that when it counted, it would be ineffective. There was no indication he was allergic, and it had a good chance of improving his condition.

He turned to her and stared into her forest green eyes. He would risk his career for the man she chose over him, a man that had played him so that he could get the girl.

"I'll start him on penicillin, unless he's allergic?"

Her face broke into a smile. She shook her head vigorously, launching herself at him. "I knew I could count on you, Sev!"

"I did say anything," he whispered, wrapping his arms around her.

He had put Potter on the penicillin, but it wasn't long before he presented with Angioedema—welts that indicated an allergic reaction. His already low blood pressure was falling.

Severus was paged when the man's heart had stopped pumping all together. Poppy hurried Lily out of the room.

"He's going into Anaphylaxis, get the paddles!" Severus shouted. Poppy was already prepared. "Give him Epinephrine and Dopamine! We need that blood pressure up!"

"Charging to two hundred!" Poppy called whilst another nurse applied compressions. "Clear!"

Severus applied the paddles, shocking Potter's heart.

"Charge to three hundred!" he called, the compressions resuming.

"Clear!" she shouted.

Severus shocked him again.

"Charge to four hundred!" he called desperately.

"Clear!"

Severus shocked him again. Potter arched off the bed, and a faint heartbeat resumed. Severus sighed as he looked over everything that the man had been prescribed, everything that had gone into his system. At that moment he realised Potter was allergic to penicillin.

"Dr. Snape, what caused this?"

"Penicillin; we need to flush it out of his system, now!" His head was in his hands.

"Speak to McGonagall; she'll know what to do," Poppy urged.

Severus nodded. His heart sank; it wasn't looking good.

With some trepidation, he made his way up to McGonagall's office. He had the chart, and the chart didn't lie. All he could do was hope that she knew something he didn't. Once he was there, he stood outside the door, not wanting to enter. When he finally knocked, she called him in straight away. She sat behind her desk with a pile of charts, her eyes tired and her lips pursed. The usually tight bun atop her head was slipping.

"Ah, Severus, how is Mr. Potter?" She smiled like he was the student she didn't need to worry about.

The smile faded when he slumped in the chair. He told her the truth; everything, his history with the wife, the favour that he had done her, and how it had gone horribly wrong.

"Give me the chart!" she demanded, her expression not improving. "And this is the most up to date information?"

"I came straight here," he whispered.

"Of all the students to do this..." She paused. "Severus, my most detached student, brilliant, but appalling bedside manner, terrible with families, the one time you engage… you make the worst decision! We need proof for a reason!" she was shouting by the end. "You know what this chart tells me, don't you?"

"I was hoping that you could fix it." He looked up.

"I don't have a magic wand, Severus! Her husband is falling into a coma and he won't wake; you do know that, don't you?"

Severus nodded.

"You will have to tell her."

"Please, don't!" he pleaded; he couldn't stand to look in those forest green eyes and tell her what he had done. "I—I can't!"

"Severus," she paused, shaking her head, "of all my students? You will tell her.

#severus snape #Lily Evans #lily potter #harry potter fanfiction #Harry Potter #harry potter fandom #pro snily #Muggle AU

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