#( but it's on a 8 month period of new medication etc )
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I'm back-- I gotta wait until Sunday now to see if I'm qualified - did anyone miss me? š„ŗ
#[ ooc. mun ā i need a cuppa tea ]#medical tw#( they took blood from the back of my hand )#( let's just see if I'm suitable to partake in this study for asthma )#( next is friday 28th. around 9 so i'll be regretting waking up so early )#( but it's on a 8 month period of new medication etc )#( i'll be gone for an hour or three at most depending on the tests i gotta go through )#( hence why i'm tagging this now as medical tw 'cos y'know-- it's more reaching into the medical shit )
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A Step by Step Guide to Losing Your D**k
I recently wrote a series of messages to my aunt talking about all the steps I need to do to get bottom surgery, a penile inversion vaginoplasty at Mt. Sinai, in the next year or two. Its a long list. And everytime I added something she had a sort of āwow thats roughā reaction, but to me its just the to do list. So I decided to write them all out.
Start transition DONE
Most insurance companies and surgeons require you to have socially transitioned and have done HRT for at least 1 year at the time of operation
For social transition, this was March of 2024
For HRT it will be January of 2025
Get a referral to a surgeon (I am here)
In my case, Mt. Sinai in Manhattan
My Doctor referred me, but Mt. Sinai takes self referrals
Start laser hair removal
Book a consultation (I am here)
Go to laser frequently enough to satisfy surgeon
Convince Mom and Dad to help out DONE
Get 2 letters
Social Worker (1)
PCP's Office
Social Worker (2)
Mt. Sinai
Get a gender affirmation loan through the local credit union
Work two weeks so I can take in pay stubs
Get a letter from anybody (probably my HRT prescriber
Meet with representative and either open a line of credit or take out a loan
Consultation with Mt. Sinaiās team
Wait 3-6 months (Iām here)
Bring letters
My insurance only requires 2, less than Mt. Sinai thinks insurance will need, and Mt. Sinai provides 1 of them. Meaning the other is through IHS Behavioral
Schedule Social Work pre surgical consult appt
Schedule Mental Health and Medical Clearance with Registrar
Go to NYC for 1-2 nights, maybe for each, hopefully just once
Maybe also for Social Work thing
Consult with Surgeon
Wait until Iāve worked about 12 months to get short term disability
Probably summer (ASAP) and when Mom has time off
Do logistics
Book an airbnb, hotel, etc for recovery
Starting a few days after OR date and lasting a little over a month
Within a 90 minute drive of Mt. Sinai
Rural enough that Mom is comfortable to help and can go home if someone else shows up
Probably New Jersey, maybe Hudson Valley
Has at least 1, preferably 2, separate bedrooms
Has 2 beds
Has ADA accessible entry
Has a kitchen
Has a full bath, preferably and a half
Has internet and preferably a TV
Lodging for Mom + Dad/care team while Iām in OR
Probably 5-7 days
Preferably with a 1-2 day buffer period before OR date (included in the 7 day estimate) so I can enjoy the city
Either within a short walk from Mt. Sinai or on the same subway line as Mt. Sinai
RW, 1, or ACE
Someone to help me get from recovery location to Mt. Sinai while not in NYC
Develop and get list of items needed for recovery
Dilator
Pads
Gowns/loose clothing
Comfort food
Coordinate missing 8-9 weeks of work
Take care with who knows what before I leave
Inform HR, department manager, and work friends whats up
Get cleared for surgery and get an OR date
Probably a 6-12 month date from clearance
Get pre clearance testing through PCP or a lab in hometown
Go to NYC for that if need be
Week Before Surgery
No alcohol, no aspirin, NSAIDs, herbal supplements, or fish oil
Consult for other non aspirin blood thinners (which I am not on)
No alcohol for 3 weeks after as well
Tylenol/Acetaminophen is okay
Go downstate
See friends from NYC?
Bring Mom/Dad?
Do something fun in Manhattan
Get a COVID test
Take an anti-bacterial bath
Day before surgery
Breakfast before 9am
Last meal
Drink Golytely bowel solution around noon
Chemically induced diarrhea
Clear fluids only after golytely
(includes coffee, tea, water, broth, some juices)
Nothing goes in the stomach after midnight
Some medication okay with a sip of water
HRT???
Get surgery (a penile inversion vaginoplasty)
1 to 1+Ā½ days
Iāve heard of as long as three
3-5 day hospital stay
Mom and Dad probably stay in Manhattan then
Go to recovery location
Drive with seat reclined
Stay for 4 weeks, pretty much bedridden
Go to follow ups
Dilate
Go home
Continue recovery for another 2-4 weeks at home
Follow up with PCP
Return to life
#mtf girl#transgender#transfem#trans woman#srs#bottom surgery#mtf bottom surgery#transblr#transition journal#queer#lgbtq#lgbtqia#gender affirming care#gender affirming surgery
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Trans Floridians: "Informed Consent" guidelines are shaping up to be worse than the Harry Benjamin days
The Florida Board of Medicine is discussing the "informed consent" standards today. These will affect trans people, including adults, who are both starting and continuing care.
In short, the guidelines require a prohibitively expensive and difficult to access number of regular assessments for the life of "treatment". (Which, for most of us on HRT is the rest of our lives.) The guidelines look for any opportunity to deny care, from lack of social support to "co-morbidities" that are likely targeting autism, depression, etc.
The specific requirements for you to receive and continue HRT treatment include the following: 1. Meets the current DSM or ICD criteria for gender dysphoria; 2. Mental health and physical conditions that could negatively impact the outcome of treatment have been assessed, with risks and benefits discussed 3. Gender dysphoria is marked and sustained; 4. Demonstrates capacity to consent for the specific gender dysphoria hormone treatment; 5. Does not suffer from psychiatric comorbidity that interferes with the diagnostic work- up or treatment; 6. Has adequate psychological and social support during treatment; 7. Demonstrates knowledge and understanding of the risks, benefits, and expected outcomes of HRT as well as the medical and social risks and benefits of sex reassignment surgery; 8. Understands the effect of gender-affirming hormone treatment on reproduction and they have explored reproductive options; 9. Undergoes an evaluation by the prescribing physician at least every 3 months 10. Undergoes a suicide risk assessment by a licensed mental health care professional at least every 3 months; 11. Undergoes laboratory testing, including blood tests, at least every 6 months; 12. Bone (DEXA) scan once a year to allow monitoring of your bone density (bone strength) during treatment, which can be altered by HRT; 13. Annual mental health assessments by a board-certified Florida licensed psychiatrist or psychologist; and 14. Continued counseling with a licensed mental health care professional during the treatment period, with the frequency recommended by the licensed mental health care professional.
Erin covers here:
From Representative Anna V. Eskamani:
Beginning on page 264 of the meeting packet is the draft informed consent forms for tomorrow's meeting. In part it reads -- "Before beginning or continuing HRT, the individual needs to undergo a thorough psychological and social evaluation performed by a Florida licensed board-certified psychiatrist or a Florida licensed psychologist. The psychiatrist or psychologist must submit a letter to the prescribing physician confirming this." https://ww10.doh.state.fl.us/.../06232023_JRL_Publicbook.pdf Licensed mental health counselors and licensed social workers are trained to write evaluation letters. They know most providers have an LCSW or mental health on staff. This is cruel for the sake of bring cruel and designed to make access more difficult.
I experienced the gatekeeping during the Harry Benjamin days, including the mandatory one year "real life test" where you have to live as your gender in all aspects of your life without the benefits of HRT. It was a very stressful and dangerous practice that was designed to crush us.
This is so much worse. Even with my current salary, health benefits, and work from home schedule, I don't see how I could afford the time and money for all the assessments, nevermind how insulting and discriminatory they are.
Trans Floridians should watch this story closely as the Board of Medicine discusses and finalizes these requirements. As of today, these are not final, but in the current state, would mean the end of informed consent in Florida, and all but bans care entirely.
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Ig it was closer to 7 years ago? 8 years ago? if I check the actual timeline.
They were like oh shit it looks like you have graves disease really bad we gotta run all these tests, you could die!... For symptoms I had been having on and off since my 20's and telling them about only to be ignored.
Then they were like, no haha it's just the first stages of your immune system tearing your thyroid to shreds and letting it spill all the hormone at once. At this rate there's no need to remove your thyroid because it will die completely within 5 months and fully atrophy.
Are we going to try to stop my immune system from doing that?
No. haha.
What happens when my thyroid dies?
Oh you'll need to be on hormones for life or you'll slowly get so hyperthyroid you can slip into a coma and not wake up. haha, but it's like having and managing diabetes, people live full lives with it.
I'm having severe cardiac symptoms and etc from the obscene thyroid levels, and am unable to sleep for up to 72 hours at a time, can we check back in before 5 months? Maybe do something about the heart symptoms that isn't just knocking me unconscious for 3 days at a time with this blood pressure medication since my blood pressure is still somehow dropping to 60/45 despite the high adrenaline and cortisol and thyroid levels? [my resting heart rate was 120 at the time]
No haha, not necessary, prommy :)
So I took that for the news it was. Within 5 months my continued survival depended on the whims of whether someone would want to give me my meds or not, someone who probably didn't fully understand the severity of the issue, and like many people who rely on insulin, I could be killed by medical neglect at any time. I only had 5 months to live for sure and those 5 months were going to be hell.
I kept having the grave's disease-like symptoms until I figured out on my own to restrict b vitamins and iodine... Off the back of them telling me to slat load for the low blood pressure WITHOUT telling me to avoid iodized salt...
I tried to tell them this had been happening on and off since my early 20's, they told me that "wasn't possible" and "doesn't happen"...
I had one hope and it was that I was right and this had been happening on and off since my 20's and getting better in between.
5 months went by.
Your thyroid is doing fine actually :)
You said it was being torn to shreds. You said I had 5 months.
Yeah but it's fine and your levels are too.
Because I haven't eaten a food with iodine since 5 months ago other then a splash of cream in the morning and have stopped having b vitamins, but my neurologist says I really should be taking extra b vitamins, so just avoiding them in all foods to avoid going hyperthyroid isn't sustainable, so can we maybe entertain removing part of my thyroid so I can have some b vitamins in my diet and don't have to keep myself on the very edge of developing goiter to function?
No. haha. If your immune system keeps attacking your thyroid, it'll just die. You'll notice the symptoms and we'll put you on hormones. If it doesn't keep attacking your thyroid, you'll be fine :)
7+ years and my thyroid just keeps healing itself and taking beatings from my immune system so I have to live on the very edge of having goiter so I don't develop the symptoms of advanced grave's disease at any given time. ... And I had been living that way untreated for gods know how long because the hyperthyroid phases kept getting "diagnosed" as "maybe some kind of mania?" by doctors who don't seem to know what mania even -is- since my teens.
[hint: people who are manic or manic depressive don't generally -stay- manic for 2-6 months at a time without crashing, and aren't as psychologically stable as I was about it all, I was going hyperthyroid periodically and they were brushing it off as a mental health issue, which they also weren't treating because the treatments didn't help... because I wasn't 'manic' I was being flooded with adrenaline, cortisol and unregulated thyroid hormone, and it was getting slightly worse every time]
They have it diagnosed as "hashimotos thyroiditis" because -by mechanism, if not result- that's what it is. I haven't heard of anyone else that doesn't progress to the hypothyroid stage of that and stays stuck in the initial storm of thyroid hormones... But here we are. Hyperthyroid at all times because of *checks notes* aggressively recovering from the hypothyroid disorder, while it's still happening, in perpetuity. [there are two forces inside me]
They effectively gave my 5 months to live independent from care and that was when I was in my mid-late 20's. I am about to be 37.
Every time they catch a level of something actually acting up they go "holy shit more tests that organ seems to be dying!!!" And then when it doesn't and I get better they grasp for an explanation that doesn't -require- they do anything about it, like "you must just have gilbert's, haha" or blaming my personal habits for causing a 'temporary problem'.
I'm like the guy with the liver and the eagle, but the eagle is my immune system and all my tissues take turns.
Did I steal fire from the gods?
The pattern is that my immune system seems to just take turns attacking every system and tissue I have, and in doing so gives each a break long enough to heal in between. But it also means I have this rotating roster of autoimmune symptoms that's ever changing and an ever changing "hey I might qualify as having a kidney disorder this week and I won't know unless I do something to upset it" cycle of trying to figure out what tissue or organ needs my support the most at any given time.
Mostly it means doctors won't believe me, because the symptoms and tests results that were there even two weeks ago are gone now. And when they do believe me, how do you even treat that? Suppress my immune system when doing so will cause 1 of nine specific viruses to re-activate if it's already in my body and near immediately kill me?
I haven't met a doctor willing to acknowledge the genetic lack of proper immune response I have to specific viruses and offer to put me on an anti-viral -like other people with that condition are- at the same time as the immune suppressant. So I won't take the immune suppressant because I don't want to die suddenly and horribly of meningitis or encephalitis the way my mother almost did the moment covid crashed her immune response.
So I just live with it. Legitimately getting very dangerously sick with one autoimmune condition or organ failure problem after another and then bouncing back.
No fucking -clue- what this is doing to the cell lines in my body. Super curious really.
I know the perpetually high bilirubin plays some role in protecting me from aging, tumors and damage because it's an antioxidant. So there's that?
That's kind of why I'm not worried. This has been my reality since my 20s and beyond, and it hasn't killed me yet. Also no doctor has managed to do something useful about it yet other than run tests and give me the results. When they do find something concerning they always end up coming to the conclusion that their best course of action is to do nothing anyway. Especially since the fast metabolism and an additional mutation that makes me process some meds super fast and some super slow makes it kind of challenging to medicate me for anything at all.
#like okay give someone with a healing factor of like 3 an AUTOIMMUNE CONDITION FROM HELL and some fun little tumour genes#and then just see what happens#mostly suffering#but also new and refreshing different suffering each time and the relief of recovery so...#tiny useless normie human kind of healing factor like 3x faster recovery as opposed to like bullets fall out 100x or something like comics#I never want to see them give Wade or Logan or Laura a fucking autoimmune condition but also they should have a character like that
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If anyone is in need of some good news re: abortion
There is currently a discussion within the government of Belgium to extend the possibility of abortion beyond the current 12-week period.
Abortion was legalised in Belgium in 1990. At the time, the then-king of Belgium refused to ratify the law (this is usually just a formality) due to ethical objections. This was resolved by declaring the king "incapable of reigning" for a short time, which allowed the then-federal ministers to ratify the law themselves.
Currently, abortion is possible up to 12 weeks of pregnancy. The person wishing to end their pregnancy will have a consultation with a psychosocial health care professional to discuss it. There is then a 6-day period in which the person has the time to think it all over. You can take more than 6 days as well, but that is the minimum required. After that, you can have your abortion either at an abortion centre, or at a hospital (when there is a danger for the health of the person undergoing the abortion, or when that person wishes to have it done under anaesthesia, or when it's past the 12 weeks). There are currently 7 abortion centres in Flanders (about half of Belgium, approx. 6 million people).
Abortion beyond 12 weeks of pregnancy is legal under certain circumstances, such as when the health of the pregnant person is at risk or when it is known the unborn baby has an incurable illness.
Illegal abortion can lead to a fine or imprisonment for both the doctor and the person undergoing abortion.
Minors can have an abortion without permission from their parents.
The whole procedure is 4 euros if you've got health insurance. Note that every person living in Belgium is required to have health insurance, which is very cheap - about 8-9 euros per month, with tons of benefits. Without health insurance, it's between 100 and 550 euros (depending on where it's done).
The person undergoing abortion can also be seen at an additional appointment afterwards if such need arises. You can always go to an abortion centre afterwards as well, for both physical and mental support. They will also support you in choosing the right contraception afterwards.
That's the current situation. Here's what the discussion is mainly about:
Extending the maximum period to either 14 or 18 weeks. The 14 weeks is what the christian centre party currently part of the coalition is accepting (this changed recently, before they did not want to extend it at all). 18 weeks is what the other coalition parties want and what has been suggested by an expert committee made up of scientists. Most of these experts actually suggest it should be extend to 20 or even 22 weeks, but 18 is what they presented to the government (because of 1 expert).
Other notable suggestions the expert committee has presented (there are a total of 25 points):
More effort with regards to prevention, education, and access to contraception
certain contraception methods, such as coils or implants, to be free for longer (some of them are currently free until 18, some until 25, etc.)
The 6 days to "think it over" between the first discussion and the actual abortion should go
easier access to abortion medication
decriminalise the person undergoing abortion or doing an abortion themselves when it is done illegally
Source (in Dutch)
#abortion#reproductive rights#belgium#good news#the only thing that ickes me about all the news about this is that it's consistently talking about āwomenā and āgirlsā#I might actually send a complaint about that to the government-subsidised news#because it's not inclusive language#btw can we all applaud the ability to edit tags now
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How does medical and bereavement leave work for agents without assistants? If theyāre out for months or even years, what happens to their clients?
Many agents are not technically "employees" of their companies, they are freelancers paid by via commission on a 1099 rather than regular salary. So, technically, those of us who are paid in this fashion don't get medical leave, bereavement leave, maternity/paternity leave, sick days, PTO or vacations at all. We don't "clock in" or have set hours anyway -- which means that in practice, we COULD work 24/7 if we wanted to -- or we could work not at all if we wanted to.
(Neither option is great, obviously, so most agents split the difference and work a relatively normal-to-long work week most of the time!)
Point being, hours are flexible and our workload is pretty much whatever we need it to be at that time -- so an agent who is also a mom with young kids may choose to take on fewer clients or trim their list, whereas somebody with no kids or whose kids have grown might have extra time for more, etc.
So basically, if an agent KNOWS that they are going to be gone for a few months ahead of time (maternity leave, say, or they are having a planned medical procedure or something like that), they would likely tell their clients ahead of time, get as much done as possible before they left, so most projects are pretty much squared away or at a good pausable moment, and then somebody else at the agency would handle payments that come in and run point for any questions or issues that might come up whilst the primary agent is away.
(Quite frankly, publishing moves so slowly that most of the time, 8 or 12 weeks away would probably not be that noticeable -- once a client's book is under contract, there are often MANY MANY months where an agent would not have to be around at all. And submissions take long enough that honestly, "having to wait" for a month or three would not make a significant difference in the length of time the sale might take. In other words -- whether I submit this book in March or May, it probably won't sell till later in the year anyway, and both ways, it probably wouldn't be coming out for a year and a half/two years (or more!) after that, regardless of when I submitted it -- so if you finish the book while the agent is away, it can probably wait till they get back to be dealt with.)
If it's an acute crisis situation/family emergency/sudden illness where they DON'T know in advance, they would likely just communicate with their clients about what is going on and somebody else at the agency would step in to help as necessary, and they'd check in periodically and get back as soon as they were able.
If it is a long-term thing, they'd probably figure out a way to adjust and work through it, because few agents would be willing to give up their clients if they didn't have to -- but they might just have more limited hours, or something like that.
If they are gravely ill to the point where they CAN'T work through it, and it really might be YEARS... well, they might decide to retire at that point, or at least step back significantly. I have never encountered that situation (knock wood), but I guess what would happen is, they (or if they are unable, the boss) would let the clients know what was happening, and either the clients could be moved to other agents at the agency, or leave and choose a new agent elsewhere.
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Day.. 8
(I'm just guessing at this point) (and procrastination but will jump into it after this)
Medical gaslighting, discredit, nexplanon and my miscarriage story
so I needed mostly wanted to get this out. I had a visit with my gyno yesterday after shift for pelvic pain I've been experiencing. During my visit I got validation and confirmation of an event I haven't really talked about in depth.
Nexplanon to Pregnancy
So in June I had a miscarriage while on nexplanon. For 3 months since that time I've struggled with doctors not believing me because of how "effective" it's suppose to be at more than 99.9%.
Listening to my doctors I've kept in my nexplanon a little over 3 years because it's supposed to still be effective for up to 5 years. I did a 5 year stretch once without any issues. This was my second round. Depending on your body nexplanon can cause irregular bleeding thats really, really short, sporadic or none at all if youre lucky. For me it started of short and light nearly non-existant than it would come sporadically sometimes lasting over a week. It was a down side I was willing to deal with to avoid forgetting taking a pill and getting pregnant by accident.
Now at a pattern I've noticed is when it's coming close to replace the nexplanon for me my period would start getting back into it's normal cycle. Bleeding is more manageable and starts earlier like it usually does. At this moment, I believe I got pregnant end of may/early june. I either ovulated some point before or a bit after. I never kept track because of how irregular my periods were and with nexplanon being a progestinol (dont hold me on this ) it apparently thins the lining of the uterine wall which can cause bleeding. To add this nexplanon is suppose to make it harder for the sperm to meet the egg based on the mucus being thicker thus making it harder for it to move through.
With all that pregnancy was the last possibility on my mind, plus I wasn't active enough for it to even happen (but hey it only takes one time). A wee bit in early june the first week, I did get my period however, it was much easier this time around and much shorter. I thought the period fairies blessed me with such an easy period. After this things started to get weird for me. Emotionally, I was just feeling off and very sad, emotional, tired alot. I chalked it up to dealing with the outcome of moving towards getting divorced. I figured it was all because of that and the feelings surrounding it. Made sense.
Shortly afterword like a week and change after I noticed some scalp pain, and bald/thinning spots in my crown. I had styled my hair differently and stretched it but the loss of the hair was so profound I made an appointment with a derm immediately. The diagnosis was CCCA a form of scarring alopecia. Which devastated me because I was only 28, I didn't style my hair crazy, I wore it mostly natural. I took my new diagnosis and cried in the bathroom before making my next appointment.
In this moment, I thought I was being punished for wanting a divorce and trying to change things. I couldnt imagine what I could of done for this to happen to me. I called my grandma and cried to her on the phone about it and she told me the same thing happened to her around my age. (which made me cry more) She says it was probably triggered by stress but it mostly started when she was pregnant with my uncle. Her hair started to fall out. (yet at this moment it still thing register with me to take a test)
I bring the news back home and let my partner know whats up and the days go by. I started my meds and the following week closer to end of june my partner and I discussed what they wanted to do for their birthday. Regardless of the status of our relationship we still care about each other and still were keeping to birthdays, holidays etc. I started my period again that week and my partner thought it was weird as I just finished a few weeks ago. As I mentioned having sporadic bleeding wasn't unusual for me on nexplanon so I just thought it was that. Plus I was a bit moody before so once again I made sense of it (nearly chewed my partner's head off about peeling a boiled egg)
This time I was experiencing different cramps for the days leading up to D-Day since the "period" started. At some point some where so bad they woke me up. Still thought nothing about it. These cramps had me crouching, stretching and rocking them out. It wasn't super heavy bleeding so up comes my partner's birthday, pop some pain meds and we made a day of it. It was great.
Came home later that night with a huge craving for a ham and cheese with lettuce tomato, swiss, salt and vinegar (iykyk) on a hero. I remember mentioning it and my partner making a joke on how specific the craving was because it sounded like I was pregnant. Laughing it off like yeah, no.
D-Day : The unusual period
So I wake up with the intention to have brunch outside to continue the festivities but my partner wasn't up for it. I started to make breakfast and was hit with a sharp cramp on my right/center side of pelvis. It happened a few more times. I had to grab to the counter to steady myself. Then cramps started to come in waves, consistent. I moved slow got us the breakfast and tried to search for places to go after since the weather was so great. Then the cramping, started to spread from my pelvis, to my lower back to my legs, I could barely finish eating. I couldnt get comfortable, I shifted here, there but the pain wouldnt let up dull but distracting.
I went to bathroom try and see if it was the period poops but nothing. I repositioned myself and saw some blood when I wiped and assumed I overflowed my menstrual cup. I started to feel a bit better and I take cup out and I'm met with one of the biggest clots I've ever seen come out of me. It was more of a clot than blood in the cup. Because of it's unusual size I took it out to take a photo for my doctor as I was suppose to see them anyway that week. I lay it out and I see a small lump in it.
Upon discovery the first thing that came out my mouth was "wtf is that?" I investigate the lump and see that the lump has an attachment, to a string into the larger clot. I separate it from the string and it looked like it was made of smaller string or veins. I poked it and it was hard, the color changed from trom the blood color to a flesh tone. I'm not sure if it was the shock or if it was because I bled alot or because my body expelled this and it was alot but I started get dizzy. I nearly fainted.
I document the event in video and photos and discarded everything. My partner asked me if I was okay, I told them I saw something really concerning in my clot and I don't know how to feel about it. I left it at that. I'm still trying to wrap my mind around it. Progressively my energy dropped so low I could barely walk. Yet, I still was unsure. With my appointment days away, I tried doing some research on my own.
Eventually, a day after I called my mother talked to her about it, shared the experience and the photos/video and she pointed out what I was most afraid of it being a miscarriage. My grandmother the same. So I dug and dug, every answer pointed towards early miscarriage. The following day I bought a pregnancy test to check and see as a lovely redditor told me pregnancy test can read even after miscarriage if you want to confirm, I cross checked with more research on my own.
I both a 2pk, went home took it and it was positive 2x. The interaction between this time and to the doctors was hard. I didn't know how to feel and the experience was terrible trying to find someone to help me sooner rather than later.
Medical Gaslighting and Discredit
When I finally got to my doctors, I found the gyno wasn't available that day so I had to push for 2 days later to see someone to make sure I was all clear internally. From the start, I was hit with skepticism about what happened. As the doctor wasn't a gyno she couldn't say much on the matter. They took my blood and urine (by that time I fully expected it to negative since the lines on my test were faint) I've already stopped bleeding by this point but am still having cramps and pain.
2 Days later I see the gyno, Im nervous as all hell when I try to explain to her immediately she starts at me. She tells me it's impossible, how it could be if I'm on birth control nexplanon. My HCG levels were 0.06 and that I wasn't pregnant. Despite me telling her about the positive at home. She wanted to draw blood again and I said no, she was obviously very annoyed with me because I said I didn't want to get poked again. The doctor that took my blood earlier was very harsh and I don't want someone who's annoyed with me drawing anything from me.
I get an ultrasound same day, it's clear with the exception of some small ovarian cyst not unusual for me. The sonographer also had a hard time trying to figure out how I could have gotten pregnant. Mind you this is well over 5 days since the miscarriage. I went back to the gyno to get the test gone over and she points out I have cysts. That I need to change my birth control because it failed and how I can change it with them or try a new birth control.
I tried to prob for answers, if it wasn't a miscarriage what was it? It's weird this has never happened to me before. She gets annoyed again as if I wasn't suppose to ask and tells me it was a cyst. I passed a cyst. That didn't sit right with me but I said okay and that I'd let them know if I want to remove my birth control here. When I looked at my chart she listed it as a dermoid cyst. A cyst that doesn't pass and needs surgical removal. I got another opinion and was told that cyst rupture they don't pass in your period.
When I went back to her and expressed what I found out during a pap smear, she was quiet and didn't say anything else in regard to it being a cyst. From that point her tone changed with me. Haven't gone back since.
Today and more understanding..
I've struggled for months wondering, asking, probbing on what happened. I thought I was crazy even though I believed me, my family believed me, friends. It felt like because they didn't discover the pregnancy that it didn't happen. If their test didn't show and confirm it I was wrong, no consideration for what I physically went through.
But my most recent visit, I went in for something else and pregnancy past and present always come up. When I mentioned it to her, she listened, she asked me questions and didn't write me off because I was on nexplanon. I even told her it made it hard to really understand what was going on because of how it was effective was, they didn't believe me yet they wanted me to change the birth control because it failed.
I asked my current gyno about the possibility of it being a cyst instead of a miscarriage/pregnancy. She told me no just as my original 2nd opinion. She calmly explained to me that whether it was you or them that took the test and it was positive, it was a early pregnancy loss. The fact that I took two and they were both positive. She made note on my chart confirming the pregnancy and the loss.
Now that it is confirmed, I feel such a weight off my head. When she said nothing is 100% certain and if mary can get pregnant without having sex, then this isn't impossible. Now I feel better, I feel like I can grieve properly and know that this happened and it wasn't all in my head.
Aside from this, smaller things I've notice that support this, my hair started growing back. I shaved it off to start fresh, but it's growing slowly but surely even in the bald spots. Now if it'll be as thick as before I dunno but next I may have to see if i need a re diagnosis for my alopecia.
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1, 3, 7, 8, 15 for the disability asks please :)
I already answered number 1, so I'm just going to share a screenshot to avoid re-typing it:
3. what, if any, disability aids do you use? (mobility aids, sensory aids, braces, communicative devices, IVs, etc. meds also count here). do you customize them/their containers/outsides?
Hmmmm. I have an ice pack thing that covers my whole head for migraines, I use noise canceling headphones when needed, I have a rescue inhaler, I have a new med my neurologist just prescribed but I keep forgetting to call it in. Melatonin or benadryl for when the insomnia is super bad (should have taken some tonight as it's 1:40 in the morning already). Ibuprofen for pain, though I want to ask my new primary care doctor for something stronger when I meet him next month. And I've thought about getting a wheelchair or one of those walker things you can sit on for when I go out because it's hard to stand for long periods of time, but I don't leave my apartment often enough for it to be worth the cost.
7. what's a struggle you wish more people talked about?
How being disabled often means living in poverty, and for those in the US, also being buried under medical debt.
8. does your disability affect how you experience other parts of your identity? (gender, queerness, culture, even hobbies/life goals you're very passionate about)
It definitely messes with my hobbies. Writing is the main thing I really enjoy doing, but the energy I have to invest in it is limited these days. So it makes it a slower process than I'd like. And I also used to escape into shows/reading a lot, but again, limited energy has made me have to cut back on that.
And I think my disabilities have kind of stolen any life goals I had, not that I had many to start with. I don't really have any life goal other than to survive as long as I reasonably can.
15. what does disability pride mean to you?
For me lately, it means communicating with those in my life about what support I need and what my limitations are, and expressing those things without feeling embarrassed or burdensome.
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Hey pcos, fuck you!!!
Starting this blog (and a tiktok) to document my pcos journey. So here's the beginning, for those who are interested or also struggling:
In eighth grade (2012ish), I woke up for school like normal. Took a shower, did my makeup, etc. After I got up from sitting down, a stabbing pain radiated from my left lower abdomen. I told my mom I feel sick, and laid down. My mom is a nurse, so her immediate thought as I pointed to my right side was that my appendix had ruptured. Every bump we went over in the car had me crying out in pain. She hauled ass to the emergency room.
The doctors also originally thought my appendix had ruptured. Until they did an ultrasound.
I had 3 cysts on one ovary, 4 on the other. One, about 5cm, had ruptured, which is what was causing my pain. It took them 8 hours to figure this out.
At my follow up doctors appointment with my pediatrician, he told my mom I can't possibly have pcos because I don't have hairy nipples. I remember this conversation vividly. This was also the day I got on birth control. Apparently, it could help stop new cysts from forming.
I recieved no education and no diagnosis.
Years later, senior year of high school, debilitating periods were second nature to me. Throwing up, and then passing out on the bathroom floor were regular occurances. That was IF I got my period. Even with the placebo week on birth control, I still had very irregular periods. I just kept being told that it's normal. Switching birth controls. I ended up on depo Provera.
I originally attributed my 80 lb weight gain to the depo. So I switched back to the pill. Lost 0 weight. I eventually found a nurse practitioner who actually listened to me, ran blood work, and diagnosed me with pcos. This doctor has since left my state, so I am once again without anyone who will listen. Searching for a new one as we speak.
I remember being SO angry, because this was something I could've been diagnosed with in 8th grade. The painful periods, the cysts, the weight gain, all might've been able to be prevented if that original doctor knew what he was talking about. I was able to get my medical records about that day. They KNEW. And yet they didn't diagnose me, because my nipples weren't hairy.
Fun fact: you don't need to be showing signs of hirsutism (excessive hair growth) to have pcos. But that doctor didn't care or didn't take the time to research.
So now, I'm 25.
I've been on and off metformin, diagnosed pre-diabetic. I work out, daily, and do not lose weight. 800 calorie diets do not work for me. I've learned that this is very common for those with pcos. I am no longer on birth control. I was able to conceive and have a healthy pregnancy, which resulted in my daughter.
However, I still struggle. The biggest struggle I have is the fatigue, and painful periods. It got worse after having a baby. I was able to go from 250 lbs (post pregnancy) to now about 190ish. I am not certain what the exact number is, because I've given up on the scale (that bitch). I have not lost any weight in the months since then. I think breastfeeding benefited my weight loss more than anything.
The depression and anxiety have also been debilitating. Once again, all things that could've been prevented. I wonder how much different my life could've been if I'd learned about this in 8th grade.
I've also been diagnosed with Binge Eating Disorder. Caused by dieting or starving too much. I am currently recovering from that, and am now many months binge free. Did you know that if you have pcos, you're far more likely to have an eating disorder? I had no idea.
Well, tomorrow I'm beginning my PCOS journey. I had a 90 minute appointment with a dietician who specializes in pcos. And I'm going to share all that info with you.
I'm tired of finding website after website, promising free help with pcos but then "Hey, spend $300 if you actually want any info"
I pledge here and now that if this works, if I'm able to reverse my symptoms, I will NEVER sell the information. And shame on those who have.
My end goal here is to help people like me, who have struggled for years with no help.
My tiktok is active, search pcos.uno.reverse. The first video will be posted tomorrow (6/20).
Tomorrow, my life changes for the better. Follow along with me.
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āø» šššš šššš š
picked up by the jedi when he was a toddler, corvus displayed his extremely high intellect and proficiency for technology at a young age. his species, zatarians, rarely display any sensitivity to the force and as a result, were rarely tested for it. his connection to the force was only discovered just over a year after his birth when one of his parents watched as corvus summoned one of his favorite toys from across the room.
not long afterwards he would arrive at the temple and settle with his creche mates. as a youngling he was prone to mischievous behaviors and his curiosity often got the better of him, leading to creche masters constantly discovering disassembled pieces of tech on the floor. though he displayed a talent for tech, corvus also showed a natural affinity for force healing, to the point that after completing his initiate trials at 8 years old, he was selected to be a padawan to jedi healer, master astra duāvalle.
by around the time of the end of the clone wars, heās 15 years old and has made a name for himself within the republic due to him developing new patents for the medical field. though he is now an apprentice and has seen both victors and losses of war ( including losing a majority of his right arm in the process ), corvus still saw a hope for the future of the republic and the jedi order.
then order 66 happened.
both of them managed to hold off the clone troopers and escape with their lives, seeking refuge within the outer rim. the two of them constantly travelled, rarely staying in one location for long as the two were often a target of the inquisitors. however, their luck ran out roughly a year after order 66 and the master-padawan duo ended up being captured. taken aboard a venator-class star destroyer,, corvus and duāvalle would end up being tortured for information as the former jedi master had knowledge of the locations of several surviving jedi.
the two would escape from their cells and within the ensuing chaos, stole back their lightsabers, disable the shipās power supply and lock down most of the ship in the process. both of them had a chance of getting out were it not for the interference of the inquisitors, not given a choice, corvus was essentially forced to flee on his own while duāvalle would take on both inquisitors to give him time to steal a tie-fighter and leave.
that would be the last time corvus saw his mentor, their bond severed shortly thereafter. when he fled in the stolen tie-fighter, corvus was pursued and in the subsequent dog fight against the other tie-fighters, his ship would take damage and end up being destroyed, in which he would be left for dead. it was fortunate that for his species, zatarians are rather durable and can survive for a period of time in the vacuum of space without the need of equipment. corvus managed to last long enough for him to be picked up by a passing ship, occupied by a group known as the ravagers.
to survive, corvus temporarily fell into a coma-like hibernation state and would come to inside the medical bay of the ravager ship roughly a month after his escape. his connection to the force was damaged due to the trauma he endured from the torture by the inquisitors, making it difficult for him to utilize the force for long and intensive periods of time.
corvus decided to stay with the ravagers as a means to repay them for saving him, there he learned how to use a blaster, fight unarmed, how to pick pockets, etc, all the while bonding with the various crew members and treating their injuries. roughly five years after order 66, his body fully healed and his connection with the force still tentative, corvus made the choice to go out on his own, find his own way through an empire-led galaxy, if only to hopefully avenge his late master and make peace with the guilt for leaving her behind.
#āø» Ā« out of memory. Ā»#āø» Ā« verse drop. Ā»#āø» Ā« v. star wars i. Ā»#/ finally got this done#/ fmdklsgmkdlsf
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In 2022, I had an estimated 129 medical appointments. Many times I had 5 appts a week, 3 in a day even.
Here is some of the necessary care I fought for all year but still canāt access:
ā Surgery to address upper cervical instability and 2 bulging discs in my neck ā Physical therapy to address my thoracic pain (it took 13 months to get an MRI) and being unable to sit up for long, as well as for my right arm nerve abnormality. Every referral for PT was over an hour away. I can't sit up to drive that long anymore. They can send the disabled shuttle to pick me up, but that's actually even longer sitting up so it's not helpful. ā IV ketamine to manage my depression, C-PTSD, autoimmune disorders, and chronic pain (ended up going with at-home ketamine thanks to GFM donations, but IV would be better distribution for inflammation/pain) āAn updated sleep study since itās been nearly 10 years since my type 2 narcolepsy diagnosis and some of my other symptoms such as frequent painful myoclonus and choking in my sleep are now making it even harder to get consistent shut-eye āDisability benefits and Medicare as Iām now officially considered a ācomplexā case and have been dropped by doctors who didn't feel they could help me āEndometriosis excision surgery + getting my blood-filled ovarian cyst (red thing in photo) dealt with. After several months of going to multiple specialists to rule out other things, including cancer (being monitored for lymphoma/leukemia now), I was sent to a gynecological oncologist surgeon who does the complete wrong outdated terrible no good surgery. She wanted to just do a full hysterectomy and ablation of endo lesions. āAn updated 1 year colonoscopy after my disastrous 2021 ulcerative colitis/endometriosis flare up that landed me in the hospital. My mesorectal lymph nodes are a little enlarged and thereās a mysterious lesion in my colon, which is why they sent me to a cancer doctor for bloodwork and PET scanābut I strongly believe itās just endometriosis invading my bowels, which is why I need the endo surgery so bad as well. I'm at the point where my colon will completely go on strike and the pain from the constipation is ER-level (especially when my period from hell comes). It's also just dangerous. I've never had this problem so intensely before, so I'm being even more careful with food and supplements. āPelvic floor physical therapy to help with debilitating pelvic pain caused by endometriosis and other things ā A pain management doctor who can prescribe me Tramadol, which helps keep me out of the ER every month, and that has minimal side effects. Something Iāve taken safely for 6 years with no complications. Instead, they'll only Rx Suboxone, which makes it hard to function and has side effects that can cause colitis or narcolepsy complications. I have to take 1/8 of a dose and I still pay for it later.
I had so many arguments with doctors to correct them when they brought up the wrong treatment, wrong surgery, etc. Not only did some of them already know it was bullshit, but others wouldnāt even try to have an open enough mind to keep learning past medical school.
This year was a lot of disappointment and frustration. I feel so worn down. This kind of medical trauma erodes hope and optimism. When intuition about our own bodies and the hours we put into research means nothing to medical professionals or insurance, it feels like we're at the end of the road. I wouldnāt wish the necessity for this kind of resilience on anyone. I wouldnāt have been able to withstand this year without the ketamine therapy or support from friends and followers. I cannot express what it means to have that, especially when I'm still pretty isolated day-to-day. To manage things on my own, I paid out of pocket for acupuncture, cryotherapy, red light therapy, ketamine, many new supplements, all kinds of new massage/trigger point/gua sha/acupressure tools. I went hard on a self-care/pain mgmt routine that Iām proud of, but Iām still very much disabled by persistent, impenetrable chronic pain/fatigue. I was thankfully able to get some prescriptions that help with flare ups, such as Xanax and Toradol. This is one of my many blessings in 2022. My fight is far from over but I want to go into 2023 with softness.
No more pushing through 16 appts per month while also forcing myself to constantly record and edit new content. I want to recline my floor chair and rest my back while I focus on editing older stuff. I have no idea how long it will take to get through my backlog of projects but Iām going to be putting certain things on hiatus so I can just take it slow.
If you enjoy any of my content at all, please share it and consider donating. Your support helps me afford my supplements and medication to keep managing my symptoms even when I'm not able to work that much. GoFundMe:Ā Help New get relief from chronic pain & illness Ko-Fi:Ā Make a micro-donation (name in YouTube endscreen!) Patreon:Ā Monthly support and access to Hologram Discord server (name in YouTube endscreen!) Thank you for helping me be strong this year, Holograms. I love you all very much.
#spoonie#disabled model#disabled artist#endometriosis#chronic illness#mri#medical imaging#long post#alt text
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no pressure but I'd love to hear about these oppressive omegaverse dystopia ideas if you wanted to share!
+
well dont leave us in suspense. whats the new oppressive a/b/o universe now
I was thinking of an A/B/O universe where there's a prolonged conflict (either with another country or aliens or something), plus there are demographic challenges (that the 'developed world' will eventually face everywhere) which is not a good combo, cause war feeds on human flesh.
There would be a large Population Optimization Program (POP), under this the following legislation would be put forward:
Abortion ban
Contraceptive ban
Ī PAPA (alpha paternal payments - large tax credits based on offspring number in or out of mating bonds - or heck, maybe also some cash bonuses?)
Ī© MAMA (Omega Mandatory Mating - a huge step back for omega rights, all omegas who are not mated by age 21 would be paired up with alphas, plus any widowed omegas would also be mated again if they are still fertile)
Ī© DOLL program (Omega Debt Optimization and Loan Leniency) that makes it possible for families with a lot of debt to get all of it forgiven in exchange for giving up an unmated omega child to the state who would then go to State R&R centers (meaning Recreation and Reproduction here) where omegas who are dependents of the state 'work'
(can you tell how much I love all those acronyms and shit the US uses, lol)
Omegas are accepted in R&R centers from age 14 and up, here they are intensely bred and worked as prostitutes - referred to as Private Entertainment Technicians in polite society - aka PETs (mainly aiming services at the military and law enforcement).
The breeding program starts with health screening and an artificially induced heat that guarantees pregnancy within a day or two. Omegas are pregnant for 8 months (thanks to medical advancements, this doesn't pose much of a risk, and a lot of times they are carrying multiples that usually can't be carried to term anyway) During pregnancy they are working as PETs, they can be rented for 200/hour, tho military/law enforcement get a 50% discount, and they make up almost all customers. They are working at most 10 hours a day.
After the 8 months is up, labor is induced. After birth, there's one month of breastfeeding and recovery, then the babies are separated and placed into nurseries. The next month is continued recovery and fertility treatments that significantly raise the chance of conceiving multiples, to the point where the program averages 1.8 children per birth.
Then the 10 month cycle starts again.
Since they are giving birth roughly every 10 months, omegas are expected to give birth about 40 times during their fertile period, having between 60 to 100 babies.
Omegas in the program would be earning income after every child and also incur expenses (they would be charged for everything; medical expenses, accommodation, nutrition, overhead costs etc), which would leave them with around 20k earned at the end of a 10 month cycle, 90% of which would go towards the debts they are working off. 10% of their earnings would be saved for when they leave the program.
(of course, young omegas would be making a lot more, but their earnings would drop off - even into the negative - as they age and have less customers, so the above is the average)
That would leave omegas aging out of the program (usually mid fifties) with 80k total for the rest of their lives.
Babies born in the program (known as POP babies) would be kept in in-house nurseries where omegas not currently entertaining would be taking care of them until they are potty trained. Then they would go into state foster care. They would receive general education until age 12 when they would be tested for their dynamics. Omegas (and any betas not fit enough for the military) would be adopted out to families. Alphas and betas would be moved to military boarding schools. Here they would get general training until age 16. At that age, betas would be enlisted for a mandatory 25 years, Alphas would take competency tests, the lower 50% would be enlisted, the top would receive specialized training. After another two years there's another test with the lower 50% enlisted - in higher positions - and the rest would go on to higher education/the academy. Only these - the best 25% of Alphas - would be allowed to decide if they want to enlist or not (they usually do, but some of them go into politics).
And there you have it, a whole dystopia!
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DamiRae Hospital AU?
Ā No I am not writing one, if I could write well I would though! So here are some HCs for a hospital AU.Ā Ā If someone decides to write this then Iāll be your first reader. Also I am sort of basing things off of Greyās Anatomy just a bit and my limited knowledge of the medical field.
- Starts of as 1st year residents, specialties may vary
- TheĀ āTitansā are residents and 1st years that show great promise, this doesnāt really play a role its just what people call them behind their backs
- Dr. Kori Anders is a OBGYN (women parts and birth) resident, a year or two away from finishing
- Dr. RichardĀ āDickā Grayson is is a surgery resident, trained by the hospital owner Bruce Wayne (who is a world renowned surgeon, has awards, etc), specifically general surgery
- Dr. Garfield Logan is pediatrician (kid doctor) res, bonds well with kids, but is considering going back to school to become a vet instead
- Dr. Jaime Reyes is an oncology (cancer doctor), having had cancer as a teen and is now forever trying to rid the world of it, works mostly with kids and teens
- Dr. Jonathan Kent is a physical therapist that works with pain management. Up beat guy and is always trying to brighten his patientās lives.
- Dr. Damian Wayne is a surgical intern, blood thirsty little thing, hoping to become a neurosurgeon (brain, spine) (orĀ cardiothoracic (heart, lungs) both are competitive)
- Dr. Raven Roth is an anesthesiologist (the drug person that knocks you out) and is starting her surgical internship (she wanted to do more than just help people get high essentially or whatever) has no current preference for any specific surgical field
- Add in characters:
-- Dr. Jason Todd, trauma surgeon (fits too well)
-- Dr. Timothy Drake diagnostician (medical detective basically)Ā
-- Dr. Donna Troy gynecologist
-- Terra Markov is a nurse (i donāt like Terra but nurses are the actual best)
-Ā Story stuff:
- Damian and Raven meet as they are put under the guidance of the same resident
-Damian has an automatic dislike for Raven because she knows everyone already and is equally, if not much more, knowledgable about surgery, the OR, the ER, protocol, etcĀ He also thinks she is cold because she rarely shows emotion (pot kettle Damian)
- Raven can always be found in the medical archives researching old cases and studying new ones, Damian stumbles upon her when looking for an old cardiomegaly case (enlarged heart).
- Raven gets along with all of the past āRobinsā making her a go to intern
- Garfield can be seen whenever he is not needed trying to flirt with Nurse Markov and often goes to Raven to sulkĀ
- Damian and Raven are always early to pre-rounds and are typically the first ones there (usually early in the morning, getting there before 500)
- Jon bumps into Damian more often than not and they start becoming friends (Damian is reluctant at first and is still you know Damian about everything), Damian even recommends patients to himĀ
- Though Damian doesnāt want to really āhang outā with anyone he reluctantly hangs out with the Titans, because of Jon and Dick
Ā Ā Ā Ā Ā Ā - When in a large group when at a bar, club or whatever Damian tends to stay close to Raven because 1) they actually have things to talk about 2) she isnāt loud
- Raven & Damian are both assigned to a case that is frankly befuddling and have to start spending long nights and early mornings together to figure it out
- Over that period of time they learn things about each other:
-- Raven learns:Ā
Damian has a dog (Titus) and cat (Alfred)Ā
He is single (Kori told her) and lives in an apartment close to the hospital
He has lived in various countries
He is trained in multiple martial artsĀ
He prefers his tea with brown sugar and a slice of lemonĀ
His eyes are a true emerald color with a ring of gold and flecks scattered withinĀ
He may hide it well but when Raven compliments him he becomes flustered
He speaks to himself in Arabic when he curses, trying to remember something, doesnāt want anyone to know what he is saying
He isnāt always an asshole
When he actually smiles a true and genuine smile, she has heart palpitations
-- Damian learns:
Raven has two tattoos (neither are a bird), a gang tat (she is saving up to get it removed), and a mantra in Azarathian; Azarath Metrion Zinthos
She immigrated from Azarath when she was around 8
Her notes are in Azarathian
She actually feels a lot of emotion and knows how to control them
If she is not reading about a current or past case she is reading any book or file she can get her hands on, he has caught her reading in multiple different languages; Azarathian, English, French, Russian, Arabic, Dutch, Mandarin, (could be more or less)
She lives alone and has a cat, Nevermore, and thanks to Dick he already knew she was single
She likes all tea, no matter how prepared, but prefers the sweetener to be honey
Her hair is black but shines purple, especially under the ER lights
Her eyes are a purple that at first glance look blue, like Elizabeth Taylor, he realizes though her eyes are galaxies on their ownĀ
When she smiles the world actually stops moving, her eyes shine like stars and he never wants the world to start moving again
She always wears a necklace with a gold and ruby ring at all times (it was her motherās wedding ring)
- When Damian starts having le feelings for Raven he considers actually seeking medical advice as this has never happened to him before
- Raven tries her best to contain her feelings when at work, going so far as one day a month staying home just to scream, cry and feel her feelings
- It does not help that new feelings towards Damian start popping up, especially since he starts bringing her tea and hanging out with her at work
- During the middle of their 2nd year of residency someone holds Raven hostage in the hospital to fix someone that person loves (this person had connections to Trigon and knew who Raven was)
- That was not a fun time for either Damian or Raven; Damian was outside the hospital pacing trying to figure something out with the other Titans trying to calm themselves and him down
- Shots are fired and when all is said and done, Raven gets shot in the abdomen and the hand (she was in ICU for a hot sec)
- Damian seemed to be there every time Raven woke up, he was always checking on her during rounds even though he wasnāt on her case
- Raven did have to have surgery on her hand and in her abdomen (idk where iām not getting that specific), she hated being, in her words, coddledĀ
- Even though Raven was right handed (the one that got shot) she learned how to do everything, writing, eating, going to the bathroom, etc. (many of the other residents are impressed since she keeps working on it after her other hand heals)
- Ravenās room also becomes a space for other residents to destress and just vent about their day. She listens and gives advice, all without looking up from whatever she was doing.Ā
- During this time Raven becomes hooked on Pretty Pretty Pegasus
- Ravenās room is also full of cards, flowers, etc all from fellow staff and some from patients. When she leaves (she spends a couple weeks in thanks to multiple surgeries, recovery, and other minor injuries) all of the gifts litter her apartment, the cards end up in a box by her desk, she presses the flowers, and stuffed animals are donated to childrenās shelter (she keeps some that she has grown attached to)
- During this time Damian is more of an ass than usual (people notice and tease him)
- Damian at some points keeps working without breaks/sleep for hours on end. Dick pulls him aside after noticing, scolds and forces him to sleep in one of the on call rooms. (He really wanted him to go home, but Damian wasnāt leaving)
- Once Raven was discharged Damian and Garfield help her back home (clothes + gifts + Raven w/a healing hand/other injuries = need help) the other Titans would have helped but were needed at the hospital
- Garfield leaves after dropping off Raven and Damian (and her stuff) as he is called in on a Peds case (could be fake, may not be) and Raven & Damian spend the rest of the time basically watching terrible movies. (with Nevermore sitting on both of them)
- That is the night Damian realizes that not only does he like Raven, but he like likes her. He starts devising plans on how to get her to date him.Ā
- All his plans basically are thrown out the window because of one reason or another (he kept overthinking it)(poor guy)
- It is not until their 3rd year of residency that Raven realizes her feelings towards Damian (Have I made it clear she likes him? I canāt remember...)
- She realizes her feelings when she has to crash at his place for a night (because he lives ridiculously close to the hospital, like how expensive is that??) and he tries to make sure that she is as comfortable as possibleĀ
- She never realized how much he cared for her? Like she was always helping him out and there for him but she never realized he reciprocated that care? *Shocker*
- Raven becomes kind of a mess because of all her emotions that she is trying to bottle up. (all the corks are disintegrating and the jar is overflowing)
- Raven is during her Ortho rotation (bone surgeon people, they are cool, ik from experience) that she actually gets a good release for her emotions (setting peoples bones and drilling and hammering in pins is actually therapeutic)Ā
- Raven thinks that may be the specialty she chooses
- Damian saw her as a mess and could not fathom why she was said mess, he figured it was about a romantic interest after someone made an offhand comment about her love life and she became a blubbering mess (very un-Raven like)
- After all of well *motions with hands* that Raven asks why Damian doesnāt have a s/o or someone
- He says there is only person that he has been meaning to ask out (looks pointedly at Raven)
- All Raven says isĀ āGo for it.ā
And that is where my HCs end. Now if anyone who happens upon this post decides to write a Medical AU with any of these please tag me, tell me, message me.Ā
You do not have to give me credit, I just want to read it.Ā
This took me a couple of days to write up, so if it is disjointed I apologize.Ā
If anything needs to be corrected for any reason let me know!
Ā I hope this fuels some imaginations!
-I may post more HC AU things if they come to mind, we will have to see.
#damirae#damian x raven#demonbirds#teen titans#raven#damian wayne#rachel roth#headcanon#medical au#au
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s/p first year as a PA
I was hired as a hospitalist primarily for the transplant service. However, in the setting of the pandemic and staffing shortages, I am all over the place now and work in almost everything non-pediatric and non-surgical.Ā
In my first few months as a PA, I was incredibly overwhelmed. I went from being a learner who switches specialties every month to a fully-fledged provider making life-or-death decisions on an hourly basis. Oftentimes Iād find myself in the room of a patient actively crumping, surrounded by the patientās family and multiple nurses awaiting instructions on what to do to save the patient. I thought that I faced a lot of pressure in school, but it was nothing compared to this.Ā
And just when I started to get a hang of it all, the pandemic hit. What a nightmare. As mentioned above, I was hired to work with with transplant patients. Prior to the pandemic, my transplant colleagues and I were masking and gowning for almost every patient: 1 surgical mask and 1 gown per patient and per patient encounter. But once COVID hit, we were rationing PPE. 1 N95, 1 pair of goggles, and 1 face shield for the pandemic. 1 surgical mask per week, and 1 gown only if a patient had Cdiff or a history of MDRO bacteremia.
What did the pandemic mean for our transplant patients?Ā
Our patients are on immunosuppressant medications to prevent transplant rejection.Ā Unfortunately, this makes it difficult for them to fight infections.Ā
Our department did what it could to prevent COVID. We'd test patients on admission for COVID, regardless of symptoms or exposure history. If they were positive, they went to the COVID team and quarantined on their unit for a period of time and had to test negative before returning to our unit and being transplanted. We took many other measures to reduce COVID risk to the best of our ability.Ā
People still died. To see someone get transplanted successfully and then die of a virus is horrifying. Unfortunately, despite our admission tests, sometimes patients contracted COVID within the hospital. Patients would be happily FaceTiming their family one moment, telling them all of their plans for once they were discharged- then the next day they'd be intubated. We tried Remdesivir, Dexamethasone, prone positioning, etc. But the virus moved through them quickly, and these efforts often were too late. No amount of hoping and praying brought them back.Ā
As a first year PA, I learned to go to an empty conference room, close the door, and remove my mask before calling to the family of the deceased. This way, as they gathered around the phone in their homes, the family could hear me unmuffled as I delivered the news. Also, this way my tears didn't ruin my mask for the rest of the week.Ā
I learned a lot this year. It's been a mixture of crying and laughing. There are times that I question why I ever became a PA, and then there are times when this career feels like home. In addition to transplant, Iāve also been working in theĀ ED, IMC, ICU, inpatient hospice, clinic, and infusion center these past 6 months. Iāve learned quite a lot along the way.
Lessons learned as a first year PA:
1. Check your pager hourly: This isĀ in addition to checking it whenever you get paged. Sometimes Iāll get paged while Iām rounding, read it, and then forget about it. Now I go through my pager at every hour to ensureĀ that I already responded to all my pages and then answer ones that I missed/forgot.Ā On a semi-related note, a while back I wrote about good paging etiquette.
2. Let people know when you're out:Ā I work a rotating schedule. As a result, itās hard to predict when Iām in or out of the hospital. Sometimes Iāll come back on service and find urgent emails or texts that are a few days old. Now I leave an away message with my return date and my supervisorās contact information on both email and hospital text. If someone really needs to get a hold of me, my supervisor has my personal cell phone number.
3. Be conscientious of what time you consult: I generally try to get all of my nonurgent consults done before 3pm. Many services have only 1 resident covering after 3pm, so I try not to page/call unless I have an emergency.Ā
4.Ā Call the nurse if something needs to be done urgently: Being a nurse means being the ultimate multitasker. Room 5 is due for his IV Amphotericin, Room 2's Foley is supposed to come out prior to void trial with Urology, Room 1's infusion completed and is beeping, and Room 4 is a bit altered and yanked out her PICC. Now Iām placing an order for Room 3 to get IV Lasix due to concern for pulmonary edema. However, the nurse may be preoccupied with Room 4 and not see the order in the computer for some time. If I really need to the patient to get the Lasix right way, Iāll place the order through EMR and then call the nurse and see what their situation is. If theyāre crazy busy with Room 4 and likely to be unable to get to the Lasix within the next 15min, I ask whether theyāre okay with me asking another nurse to give the Lasix now. Usually the answer is yes.
5. Value your nurses: Nurses know the patient best. Theyāre the ones answering call bells, giving meds, doing dressing changes, etc. Unfortunately they oftentimes bear the brunt of everyoneās frustrations, from patients to patientsā families to attendings to managers. Not to mention, theyāre the ones doing the dirty work. Bedside nurses are the heartbeat of healthcare, but they also are high risk for burnout. Always support your nurses, whether thatās volunteering to answer a patientās family memberās 17th phone call of the day or responding to a patientās call bell yourself.Ā
6. Know how to get a hold of someone quickly: Itās less than ideal to page someone repeatedly. At my hospital, if I need to talk to an attending urgently, I call the operator and ask them to connect me directly to the attendingās cell phone. If a patient is crashing and weāre not in the ICU, I dial the emergency number and call a rapid response, which sends people running into my patientās room.Ā
7. Plan your discharge meds from Day 1: The goal of every admission is to treat the patient and then discharge them safely. Send medications early for prior auth and call the pharmacy to make sure that they have medications in stock. (One time a patientās insurance didnāt cover Levofloxacin, of all things.)Ā
8. Keep social work and care coordination aware of all needs from the start: Does your patient looks unsteady? Place a PT/OT consult and let social work and care coordination know that the patient might require home therapy services and/or DME so that they can start looking at services and companies that may be covered by insurance. Does your patient have a central line? Theyāll likely need a home health service to teach them how to care for it daily at home. Do they seem to require frequent transfusions? Theyāll probably need labs on discharge. Is the patientās living situation safe (no heat/AC, possible abuse at home, financial difficulties, etc)? They may need alternative housing.
9. The attending is not always right: Generally speaking, the attending has the last say on how the team manages a patient. However, Iāve come across situations in which an attendingās decision put a patient in more danger. Sometimes asking them about their decision can help steer the care plan toward better patient care. Other times you just have to stand your ground and be okay with being on the receiving end of an attendingās misdirected rant. Report these instances to your manager and to other higher-ups.
10. Always have gloves in your pocket: You never know when youāll find a mess. Or which part of the body someone asks you to examine. Or how hygienic a person is (or is not).
11. Verify weird vitals: I was very new when I walked into work, opened a patientās chart, and promptly bolted down the hallway when I saw a patientās O2 sats recorded as 15-20s. I found the patient sitting up in bed, eating breakfast, and bewildered by me bursting into the room. Turns out that overnight someone mistakenly recorded his respirations as the O2 sats.
12. Remove whatever tubes you can: Anything entering the body is an infection risk. Does your patient still need that Foley placed by the surgery team? No? Yank it (donāt actually yank because ouch). Is your patient A&O and able to eat without aspirating? Remove the NG tube. Does your patient have good veins and require infrequent transfusions/labwork? Pull their central line.
13. Take a buddy with you to emergencies: Two heads are better than one. Even if youāre a seasoned provider and well-equipped to manage an emergency, you might need another body to help with performing CPR, making urgent calls, grabbing supplies, etc.Ā
14. Ask your patients about premeds for procedures: We all have different levels of pain tolerance. A procedure goes far more smoothly if your patient is comfortable. Note: if youāre going to premed with Ativan or an opiate in the outpatient setting, make sure they have a driver.
15. Be good to your charge nurse and unit secretary: I donāt know how they do it. If I had to manage the unitās signout, patient complaints, calls from other floor, being yelled at by providers, verifying paper orders, and finding beds for incoming patients- all at the same timeĀ - Iād lose my mind.Ā
16. If your patient is mad, just shut up and listen: There are many things that you canāt control: the time it takes for a patient to get a room, the temperature of hospital food, the dismissive attitude of your attending, etc. And oftentimes the patient knows this. My reflex is to want to apologize for things and overexplain why different things are happening.Ā But sometimes the patient just needs to rant. Take a step back and just listen. That can make all the difference.
17. Fact check your notes: The framework for your progress note often is the note from the day prior. It sounds obvious, but make sure that you go through the note and make updates and changes accordingly. If today is 01/15, thereās a good chance that the Fungitell from 12/31 is not still pending.Ā
18. Try to learn some nursing skills: This is one of the areas in which I most envy my NP colleagues. If a patientās IV pump is beeping or their central line need to be flushed, I oftentimes awkwardly step out of the room and look vacantly into the distance for a nurse. Iāve finally figured out how to spike a bag (albeit I do so very slowly, and it certainly makes the RNs giggle some). I talked to our unitās nurse manager, and sheās willing for me to learn some nursing skills from the staff during a slow day- weāll see when thing slow down!
19. Be kind: Generally speaking, being in a hospital is stressful. Patients are feeling out of sorts, and staff are working with constant dinging in the background. I rant plenty on this website, but Iām kind to everyone at work (with few exceptions) because it makes things more comfortable for everyone. Additionally, if you are always kind to your patients and colleagues, your reputation will speak for itself. One time I was walking down a hall with poor reception while on my ASCOM with a notoriously standoffish nurse from another unit. My phone cut out. She called my unitās nurse manager to complain, and the nurse manager told her that I would never hang up on purpose. My interactions with the nurse going forward were always more pleasant in nature.
20. Support your team: The best colleagues are not the smartest colleagues; the best coworkers are the ones who have your back. Whether itās a medical emergency or just a strange situation, itās important to be supported and to give support.
I know that Iāve learned a lot more than this, so Iāll likely be adding to this throughout the year. Happy Snow Day, all!
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The growing secret of protecting seedlings
Planting seedlings is a pleasant but not easy job. For various reasons, seedlings can pull out, turn yellow or develop diseases. And each stage of growth needs to meet its own specific conditions. The following considers the main problems faced by gardeners when using the seedling method and protecting seedlings for growing plants, as well as methods and tools to help prevent or eliminate these problems.
THE MAIN PROBLEMS WITH SEEDLINGS The most common difficulties that await gardeners when planting protecting seedlings are the following. 1. low germination rate. 2. Pulling seedlings to grow. 3. drying out. 4. Falling over. 5. yellowing. 6. Burning. 7. slow growth or stunting. 8. appearance of pests and diseases.
WHAT TO PAY ATTENTION TO WHEN PLANTING SEEDLINGS The above problems are closely related to the agronomic techniques used to grow protecting seedlings. Whether growing vegetable crops, flowers, or berries from seeds, there are some general rules and requirements on which the quality of nursery material depends. These rules can only be adjusted to the specific plant species and varieties.
1. Sowing time When sowing seeds, always check the recommended sowing date on the package. Plants planted too early will be stretched, weakened, and more susceptible to pests and diseases. Of course, you can't plant too late, either, because you can't even count on a harvest.
2. Preparing the soil Properly prepared soil provides almost half the success. You can buy ready-made soil or you can make your own. You should pay attention to pH, moisture permeability, air permeability, nutrient properties, and other nuances.
In any case, the soil should be sterilized before sowing and should also be well moistened 2-3 days before sowing. The temperature of the prepared soil should not be lower than 18Ā°C.
3. Seed treatment Before sowing, the seeds are treated with a special disinfectant and Germinator. What does this procedure give us? 1. disease-causing organisms are killed. 2. The enzyme system inside the seed is activated, so the germination of the seed gets a powerful energy boost. 3. Seeds germinate earlier and more friendly. 4. The pathogens are more resistant to external influences. 5. Stronger root system and stronger above-ground parts compared to untreated seeds.
4. Sowing Poor quality protecting seedlings can be caused by bad soil (contaminated or too heavy to germinate), standing water in the seedling box, or lack of nutrients. The depth of embedding is very important. Some plants need only 0.2inch (0.5 cm) of soil to cover the seeds, others need 0.4-0.8inch (1-2 cm) of soil, and some plants do not need to be covered with soil at all and are sown in a shallow layer. Attention should be paid to the sowing density: the thicker the seedling, the more likely it is to be strained and lacerated. If it happens that the plants have sprouted very densely, the weakest plants need to be thinned out. The rest will get more light, air, and nutrients, and thus be healthier and stronger.
5. Light The ideal light time for protecting seedlings is 12 hours. If the seeds are sown early (February or March), more light is needed in the morning and evening, otherwise, they may elongate or turn yellow. Also, direct sunlight is very active in mid-spring and protecting seedlings can get burned during the day. To prevent stress, you can cover them with plain paper at such times, or spray them with stress inhibitors.
6. Temperature Most crops should have an air temperature of at least 73-77Ā°F (23-25ĖC) during germination. When seedlings emerge, plants should generally be moved to a cooler location-about 64Ā°F (18ĖC) and no higher. If the above-ground parts are in a warm environment and the roots of the protecting seedlings are in cold soil, there is an increased risk of cold temperatures, root rot, and black legs.
7. Air humidity and watering Dry air severely affects the growth and quality of seedlings. Prevention methods include regular spraying of seedlings with water (to solve the problem of dry air) and anti-stress medication (as an aid). The procedure is carried out in the morning or at night so that plants are not scalded by dripping water. The same goes for watering: constantly wetting the soil can lead to black feet, rotten roots, and dead protecting seedlings, especially in the early stages of germination. You can use a syringe or rubber ball to water the soil.
8. Fertilization Lack of nutrients can manifest itself in the yellowing of protecting seedlings, stunted growth, and even death. Without waiting for the appearance of macro and micronutrient deficiencies, fertilize 2-3 times throughout the seedling period. The first - at the stage of 2-4 true leaves, the third - a week before planting in the ground, the second - in between them.
9. Picking Not all plants need to be picked. However, it is strong pressure for those who need to do the procedure. After picking, the plant stops growing, sometimes for quite a long time (for example, eggplant can "freeze" for a month). You can remove the stress by using growth regulators to restore the plant's physiological functions as soon as possible and bring it back to "life" quickly.
10. Diseases and pests Seedlings are particularly weakened and vulnerable to diseases and pests (spider mites, aphids). Among the latter, the most common are: various root rot diseases, fusarium, and blackleg disease. In addition to daily inspection of the protecting seedlings, the temperature and humidity of the soil should be monitored, and the immunity of the plants should be increased by special means. Decontamination of seeds and soil before planting is important for prevention.
11. Planting in the soil Seedlings need to be hardened 10-14 days before they go into the soil. In addition to picking outdoors, it is advisable to increase the resistance of seedlings for future transplanting. Different plants react differently to "moving" to a new place. Some "wake up" quickly, some barely notice the change and continue to grow well, and some are sick for a long time. Prepare your seeds for planting by spraying or watering with a special product.
HOW TO MAKE SEEDLINGS HEALTHY AND STRONG Some people can say: "I don't use anything to water so it grows", "Why so many means, it's chemistry", etc. But we also buy formula for our children, enriched with vitamins, vitamin-mineral complexes, for example, to prevent colds. The same goes for plants, they need our support in the early stages of their growth and development, which will reward them later with a healthy and abundant harvest.
#ThumbGarden #Growing #Seedlings #Tips #Shrubs #Garden #GardeningTips #GardenPlanning #Pests #Diseases #Harvest #Fertilize #PottedPlants #Soils #Watering #Pruning #PlantCare #Care
Author: Ms.Geneva Link: https://www.thumbgarden.com/the-growing-secret-of-protecting-seedlings/ Source: ThumbGarden The copyright belongs to the author. For commercial reprints, please contact the author for authorization, and for non-commercial reprints, please indicate the source.
#thumbgarden#growing#seedlings#tips garden#tips#shrubs#gardening#vegetable garden#garden#gardeningtips#gardening tips#garden planning#gardenplanning#pests#garden pests#plant pests#diseases#diseases plant#harvest#fertilizer#potted plants#PottedPlants#soils#watering#pruning#plant care#plantcare#garden care
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