#Adherence Monitoring

[creativeera]

Key Factors Influencing Medical Adherence: Understanding Barriers to Treatment Compliance

What is Medical Adherence?

Medical adherence, also known as treatment compliance or medication compliance, refers to the extent to which a person follows the instructions they are given for prescribed treatments. This includes taking medications, following lifestyle changes, attending appointments and completing diagnostic tests as recommended by their healthcare provider. Medical adherence therefore necessitates active participation and cooperation from patients. Factors Affecting Adherence Subheading: Understanding What Can Impact Adherence Levels Several factors have been found to influence a person's ability and willingness to adhere to their prescribed medical regimen. These include: Complexity of Treatment Regimen: More complex treatment plans involving multiple medications, frequent dosing or lifestyle changes can be difficult for patients to follow consistently. Simpler regimens tend to see higher adherence levels. Disease Severity: Patients experiencing acute or severe symptoms are often more motivated to adhere strictly in order to feel relief. Those with chronic conditions that are managed well may become less adherent over time if they feel well. Side Effects: Experiencing bothersome or unpleasant side effects from medications can reduce adherence as patients try to avoid these issues. Minimizing side effects through dosage adjustments or alternative treatments can help. Costs: Financial burdens associated with treatments like expensive medications, frequent doctor visits or tests can hinder adherence, especially for those without adequate insurance coverage. Mental Health: Patients dealing with mental health issues like depression have difficulty remembering to take medications or keeping track of appointments. Treating any underlying mental illnesses can indirectly help improve adherence. Support Systems: Medical Adherence who have strong social support from family and friends find it easier to follow treatment plans consistently over time compared to isolated individuals. Support groups can also help boost adherence. Measuring and Tracking Medical Adherence Subheading: Methods for Evaluating Adherence Levels It can be challenging for healthcare providers to assess exactly how adherent their patients are being without direct supervision. Several methods are commonly used to evaluate and track adherence over time: Pill Counts: Counting remaining pills in medication bottles when patients return for appointments provides an estimate of how many doses have been missed. However, patients can manipulate counts. Pharmacy Refill Records: Examining patterns of refilling prescriptions on schedule per prescribed duration of treatment offers insight into adherence behaviors over longer periods. Frequent lapses in refilling raise red flags. Self-reporting Questionnaires: Asking patients direct questions about how consistently they have been following recommendations can provide useful subjective data, but replies may not always be fully honest. Electronic Monitoring Devices: Medication bottles with in-built microchips that record each opening provide precise adherence data invisible to patients. However, patients may alter behaviors knowing they are being monitored so closely. Biomarker Tests: Certain blood tests and procedures can detect biological markers indicating a medication was indeed ingested within a specific window, corroborating self-reports. Testing is expensive for regular use. Combining multiple methods paints the most accurate overall picture of a patient's true adherence profile over time to recognize issues early and target necessary support interventions. Health IT solutions leveraging electronic medical records also facilitate ongoing adherence tracking.

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About Author:

Money Singh is a seasoned content writer with over four years of experience in the market research sector. Her expertise spans various industries, including food and beverages, biotechnology, chemical and materials, defense and aerospace, consumer goods, etc. (https://www.linkedin.com/in/money-singh-590844163)

[tittyinfinity]

I overshare online because I need constant validation that every thought and action of mine is Good and Okay and Normal. Surely this is a healthy coping mechanism

[valleyofthesunhomehealthcar]

When it comes to patient recovery, the role of home health aides cannot be overstated. In healthcare services care in Phoenix, Arizona, healthcare services care significantly benefit from the dedicated support provided by these professionals. Home health aides offer personalized care that helps patients manage their recovery processes effectively from the comfort of their own homes. They assist with daily activities, provide emotional support, and ensure that patients adhere to their treatment plans, which collectively contributes to a smoother and faster recovery.

[healthcarehubhh]

Importance of Medical Adherence in Treating Chronic Illnesses.

Why Medical Adherence Matters Medical adherence, also known as treatment compliance or medication compliance, refers to a patient's active participation in their treatment as prescribed by their healthcare provider. This includes following medicine schedules, keeping appointments, and making healthy lifestyle changes recommended. Medical adherence is crucial for managing chronic illnesses effectively and preventing complications. Non-adherence can undermine treatment outcomes and disease control, leading to worse health outcomes and increased costs. According to studies, only about 50% of patients follow treatment plans as prescribed over the long run. Chronic conditions like diabetes, hypertension, asthma require lifelong medication and monitoring. Missing doses, not refilling on time, or deviating from healthy habits can undo treatment benefits. This puts patients at higher risk of complications, disability, and even premature death. Non-adherence also burdens the healthcare system with preventable hospitalizations and increased utilization of emergency services. Poor management of chronic diseases is a leading cause of rising healthcare costs worldwide. Barriers to Medical Adherence Several patient-related, disease-related, therapy-related, social-economic, and healthcare system-related factors hinder adherence to long-term treatment regimens. Some common barriers include complex dosing schedules, side effects from medications, financial constraints, forgetfulness, lack of social support, mental health issues, lack of education on treatment importance. Elderly patients managing multiple chronic conditions simultaneously also struggle with adherence due to physical limitations and cognitive decline. Distrust in healthcare providers and perceived lack of autonomy over treatment decisions can reduce adherence too. Bureaucracy, poor access to care, changes in insurance coverage or providers also interrupt continuity of care and adherence. In developing countries, shortage of essential medications, lack of diagnosis and follow-up equipment pose unique adherence challenges. These barriers need to be addressed proactively through targeted interventions at all patient care levels. Improving Medical Adherence Several strategies have proven effective in enhancing medical adherence and improving outcomes of chronic disease management programs. Some key interventions include streamlining treatment regimens, educating patients and caregivers, addressing side effects promptly, using adherence aids and reminder tools, simplifying medical documentation, connecting patients to community resources. Telehealth solutions providing remote monitoring and virtual follow-ups have boosted adherence during the pandemic. Digital health tools like medication trackers, prescription auto-refill services, daily text or call reminders also support patients' adherence, especially for those living alone or with mobility issues. Patient-centered care focusing on individuals' life circumstances, values, and goals instead of just treating diseases also improves adherence. Multidisciplinary care involving pharmacists, nutritionists, behavioral specialists along with doctors helps reinforce adherence through coordinated treatment plans and management of comorbidities and mental health issues that undermine adherence. Involving community health workers, family members have proved effective in low-resource settings. Regular communications, positive reinforcement for healthy behaviors build trust, motivation and accountability needed to sustain adherence over time.

[techdriveplay]

How Technology is Changing the Way We Workout

Over the last 10 years, the fitness industry has seen an explosion in the use and adoption of technology, from the rise of wearable fitness devices to the integration of A.I. at your local gym. There looks to be no slowing down the tsunami of tech innovation within the fitness space. The Impact of Wearable Technology According to a study published in the Journal of Medical Internet Research,…

[hargo-news]

Monitor Campaign Period, Amran Ensures Clean, Healthy, and Compliant Process

#MonitorCampaignPeriod #HealthyCampaign Monitor Campaign Period, Amran Ensures Clean, Healthy, and Compliant Process

Hargo.co.id, GORONTALO – To ensure a clean, healthy, and compliant campaign process, Amran Hulubangga, a member of Bawaslu Pohuwato and Coordinator of HP2H Division, along with the Gorontalo Provincial Bawaslu team and the Buntulia Subdistrict Election Supervisory Committee (Panwaslu), as well as local Subdistrict Supervisors (PKD), conducted the monitoring of a participant’s campaign in Buntulia…

[venomgender]

why the fuck do keyboard trays cost minimun 40 dollars

[artisticdivasworld]

Compassionate Care for Chronic Kidney Disease: A Nursing Perspective

Chronic Kidney Disease (CKD) is a progressive loss of kidney function over time. Managing CKD is not just about slowing the progression of the disease but also about enhancing the quality of life for those affected. Nurses play a crucial role in this process, providing care that is as compassionate as it is competent. This blog post will explore the nursing interventions and desired outcomes that…

[buttercupblu]

Satoru's Psyche|Teaser

"Now…would you say that human nature led me to this? Or am I a product of the cards I've been dealt?"

🗂️Patient File: Patient Gojo has been admitted to a specialized psychiatric hospital following a compulsive massacre and assault on the city of Shibuya|Causes/triggers that led to the patient’s mental decline and subsequent carnage in Shibuya are currently speculative; however, they are suspected to be linked to a prolonged period of confinement within a cube-like structure. Information regarding the mechanics of this structure and the patient’s history remain undisclosed to the ward and the public.  🩺Job Description: You are the only nurse in Tokyo—specifically assigned by an unknown secret society related to the patient—who is able to manage and care for patient Gojo. His violent and erratic behavior has left multitudes of staff members in shambles and disarray as he quickly disposed of them one after another. But for reasons unknown—a complete mystery to yourself as well—you have somehow managed to cross Gojo's barriers and earn his approval to be his one and only caretaker. Your duties include: daily routine patient care, observation and monitoring, therapy, adherence to protocol, and thorough documentation to be directly reported to the Director at the end of every shift. Be wary: Patient Gojo exhibits characteristics consistent with an extensive history of manipulation, obsessive behavior, and charismatic engagement. The patient's ability to charm and manipulate requires that staff be particularly cautious about their own psychological well-being. Exercise heightened emotional regulation and remain professional at all times to ensure that personal feelings do not affect judgment or quality of patient care. 📋Length of Admission (w.c): 10 unpredictable intervals 💊Intake Chart (tags): Patient is prone to: sporadic fits of violence; manipulation; flirtatious conduct, verbiage, and assault; over-obsessive tendencies; fluctuating attachment styles, narcissistic dialogue, and an insatiable compulsive urge to [REDACTED]. 🏥Orientation: August 14, 2024 [OUT NOW]

doctor's angel's note: - Check the acknowledgment box (like) - Forward your copy (reblog) to accept this position. - Sign below (comment) to subscribe to the patient's weekly updates (tag list). S/O: @blkkizzat for the teaser inspo|Check out their teaser of the juicy, delectable Yakuza!Toji x Reader story that I cannot wait to get my hands on, The Nursery

[wellhealthhub]

Diabetes Medicine: An In-depth Guide to Managing Diabetes

Looking for detailed information on diabetes medicine? This extensive article covers all aspects of effective diabetes management, including a wide range of treatments and medications. Gain insights from experts and real-life experiences. Introduction: Recognizing the Vitality of Diabetes Medicine Diabetes, a pervasive chronic condition afflicting millions worldwide, arises from impaired blood…

[xxmourningdove666xx]

decided to finally make another piece that has a proper bg but my dumbass really went "ooh what if chain link fence" as if i have the mental fortitude for that

anyways thinking abt starting back up streaming art & rpg maker games if this neutral episode continues for a bit longer :) having fun being able to make good art and entertain the idea of playing video games plus i have stuff that i can ramble about on streams again :3

[wandamaximoffsbadgirl]

(Are your requests just closed to fics or headcannons too? If they’re closed to both ignore this and have a nice day 💕)

I love all of the dom WandaNat x sub fem reader dynamics

SoftWandanat x reader

MeanWandaNat x reader

Soft Wanda x Mean/Strict Natasha x reader

The list could go on

But there is something so specifically alluring about Mean/Strict Mommy Wanda x Lenient (not necessarily soft) Natasha x reader

Like I can’t explain it but that dynamic of them specifically is just so * chef kiss *

Anyway can I please have Strict Wanda/Lenient Natasha x reader headcannons 🤭

Thank you for this request! I love the idea of all different Wandanat x reader HC, but there truly is something about strict/lenient Wandanat that gets me~

Strict Wanda

-Wanda’s strictness primarily stems from her protective nature. She’s been through a lot and wants to ensure you’re safe at all times. She sets clear boundaries and expects you to follow them to avoid any danger.

-If you're involved in any superhero activities, Wanda will insist on rigorous training sessions. She believes in being prepared for anything and wants you to be at your best.

-Wanda ensures you maintain a healthy lifestyle. She monitors your diet, encourages regular exercise, and makes sure you get enough rest. She might even use a bit of her magic to help you recover from minor injuries or fatigue.

-Despite her strictness, Wanda is incredibly affectionate. She rewards your adherence to rules with loving gestures, be it cooking your favorite meal, giving you a massage, or simply cuddling with you on the couch.

-Wanda is particularly strict about the use of magic, both hers and yours if you have any abilities. She teaches you about the dangers and ensures you use your powers responsibly.

Lenient Natasha

-Natasha’s leniency comes from her deep trust in you. She believes in your ability to make good decisions and only steps in when absolutely necessary.

-Natasha gives you the freedom to explore and experience life but is always there to guide you if you need advice. She shares her own experiences to help you navigate tricky situations.

-Natasha loves spending relaxed, quality time with you. Whether it’s watching movies, going for a late-night drive, or just hanging out at a café, she enjoys the laid-back moments.

-Natasha values open communication. She encourages you to share your thoughts and feelings with her and is always ready to listen without judgment.

WandaNat

-With Wanda’s strictness and Natasha’s leniency, you get the best of both worlds. They balance each other out, providing you with both structure and freedom.

-You feel incredibly safe with both Wanda and Natasha. Wanda’s strict measures and Natasha’s vigilant yet relaxed approach ensure you’re well-protected from any harm.

-You have an amazing support system with them. Wanda’s nurturing nature combined with Natasha’s encouraging attitude ensures you feel loved, supported, and motivated.

-They plan a mix of adventurous outings and relaxed downtime. You might go on a thrilling mission one day and have a cozy movie night the next, keeping your life exciting yet balanced.

-Despite their different approaches, both Wanda and Natasha share an unconditional love for you. They cherish you deeply and are committed to your happiness and well-being, each showing their affection in their unique way.

NSFW Headcanons!

Strict Wanda

-Wanda's strictness extends to the bedroom. She loves taking control and ensuring that you follow her lead. She finds pleasure in directing you and seeing you submit to her desires.

-Wanda enjoys teasing and denying you. She takes pleasure in building up your anticipation, making you earn your release. She might use her magic to heighten your senses or keep you on edge longer.

-After intense sessions, Wanda is exceptionally caring. She ensures you feel loved and comforted, providing gentle aftercare to help you relax and recover.

-Wanda enjoys incorporating her Scarlet Witch persona into your intimate moments. The sight of her in her costume, commanding and powerful, adds an extra layer of excitement.

Lenient Natasha

-Natasha loves exploring new things in the bedroom. She encourages you to express your desires and fantasies, creating a safe space for experimentation.

-Natasha’s approach is more relaxed and seductive. She enjoys taking her time, using her skills to build up a slow, sensual experience that leaves you breathless.

-Natasha likes incorporating toys and tools into your intimate moments. She’s knowledgeable and confident, making the experience thrilling and adventurous.

-Natasha enjoys whispering sweet nothings and dirty talk in your ear, her husky voice adding to the allure and intimacy of the moment.

WandaNat

-The dynamic between strict Wanda and lenient Natasha creates an exhilarating experience. Wanda’s dominance and Natasha’s playful nature complement each other perfectly, offering you a variety of sensations and experiences.

-With Wanda’s magic and Natasha’s skilled touch, they enjoy bringing you to sensory overload. Wanda might use her powers to enhance your senses while Natasha teases you with her hands and mouth.

-They are both very attentive to you, taking turns or working together to ensure you feel adored and pleasured. Their combined efforts make you feel like the center of their world.

-Above all, Wanda and Natasha’s intimate moments with you are filled with love and affection. They prioritize your happiness and satisfaction, making every encounter a deeply emotional and fulfilling experience.

[roseykat]

TITLE: Calling him ‘daddy’

SYNOPSIS: An OT8 blurb of what happens when you call each of the members ‘daddy’.

WARNING: minors DNI with this post or my blog. I create NSFW SKZ related content and I know I won't be able to regulate/monitor every single potential interaction with these posts so please do not engage with my work and page whatsoever.

TAGS: mentions of sex, orgasms, choking, using the name ‘daddy’, spitting, public sex, degradation, use of names such as ‘slut’, swearing, dirty talk, edging, bondage.

MASTERLIST

A/N: Last blurb upload before I post my Hyunjin one shot for Shutterfly Butterfly. Thank you so much for reading. ily xox (Rose)

-

BANG CHAN

Call him daddy. Just do it, because he will fuck you into next month. He already exudes that ‘daddy’ energy anyway and boy does he live up to it. He’s not always a mean top or dom. In most instances, he’s polite, subtle and unassuming. What he says in bed, goes. You know when to get on your knees and take all of him in your mouth until it’s full with his cum.

You know when to use your words wisely in bed, no matter how frustrated you get with him when he edges you for the fifth time. It’s that type of daddy energy - the ‘say something once and you bow’ type. But, be obedient, and he will reward you for being good. Be disobedient and you won’t see his dick for the next two weeks.

-

MINHO

It’s literally a ‘fuck around and find out’ if you want to call him daddy. If so, he’s dragging you to the nearest surface and fucking you on it. That name to him, drives him nuts - in the best way though. He can be one of those mean daddies who won’t give you what you want, but only on special occasions and only if you truly deserve it.

The times where you don’t deserve it are usually the times where you call him daddy in public just to rile him up. If public indecency wasn’t a crime, Minho would be fucking you in front of everyone who walks past on the street. Or ripping your clothes off with his teeth on the table in the middle of a restaurant. He’d want people to know who your daddy is, and he’s sure one person would at least enjoy the show.

-

CHANGBIN

The name ‘daddy’ flew over his head once, but it’s okay, he was just trying to understand it. The second time he hears you call him it was just as a joke, even then he laughed. But when you’re whining it out for him in bed, that man gets it and he’s done for. When Changbin is about to make you cum, and you’re repetitively calling him daddy, he’ll be fucking you harder into the mattress.

There’s an aspect of the word ‘daddy’ that makes him feel more dominant than usual. It’s like you’re relying on him for something - usually sexual favours, which he loves to uphold. But there’s also the soft requests like hugs, kisses, sometimes but not always, material thing. He’ll do them only for you and loves seeing the satisfaction on your face when he fulfills them.

-

HYUNJIN

Folds when you call him daddy. If he’s pounding into you at such a rough pace, you won’t even be able to get the word out past your lips. The same goes for when he’s choking you. So if your mouth isn’t stuffed with a ball gag or his cock and you’re able to call him daddy, Hyunjin will nearly combust. He needs to hear ‘how good daddy feels’, and ‘how much daddy is making me cum’.

It fuels the hell out of his ego but doesn’t get too cocky about it. He’ll adhere to that title by rewarding you if you’ve been good or punish you if you’ve been misbehaving. Usually his punishments are intense and cruel. Hyunjin has no trouble fixing a collar around your throat, binding your body until you can’t move, edging you until you cry, but would never let you orgasm.

-

JISUNG

The beauty of Jisung is that he’s the ultimate switch who cannot sit in the middle of the top/bottom and dom/sub spectrum. He’s a top or dom one day then flies straight over to the other side as a sub or bottom the next. In saying that when he’s not acting like a whiny, little sub, calling Jisung ‘daddy’ will expand the dominant side of his personality. Hearing that name in his ear will make him fuck you harder, make you cum harder, make you moan louder, all of the above.

He’ll say things like ‘what a gem taking all of daddy’s cock.’ Or, ‘you love it when daddy fucks you like this huh? Look at that, creaming around me like a good little slut.’ It’s insane how much he enjoys that slice of power. He just gets so into the moment that he could easily slip into a top or dom high depending on the situation. Regardless, that is his name to you whenever he’s not being a sub or bottom and he won’t settle for anything less.

-

FELIX

Felix has the personality of an angel - someone who literally cannot do wrong in the eyes of a religious goer. But in bed, he’s the son of Satan himself. The day the word ‘daddy’ accidentally slipped out of your mouth, was the day his innocence was stripped back. He fucks you differently now. It’s harsher, hand around your throat, degrading, wanting to spit in your mouth type of fucking.

He’s become so accustomed to hearing you call him daddy in bed that sometimes it’s weird if you don’t. That being said, if you call him that name outside of the bedroom too, it easily gets him horny enough to fuck you. Be it in a dressing room, the back of his car, or in a club. He could never get enough of hearing that word from you.

-

SEUNGMIN

Isn’t entirely fazed when you call him daddy. He knows he could most definitely be one, but isn’t conceited about it either. It’s the cool, calm, and collected aura around him which is a little bit unpredictable that could make him a ‘daddy’. But that’s what most ‘daddies’ emulate anyway. He needs to be able to make sure you can’t predict what he brings to the bedroom.

That way, he’ll have you screaming out ‘daddy, please’, ‘daddy fuck me’, ‘daddy you’re gonna make me cum’, whenever his cock is buried inside of you. In contrast to that, Seungmin is a master of aftercare. Since he’s harsh, he needs to make up for it afterwards by fully attending to whatever it is that you need. It’s also an unspoken aspect under the umbrella term ‘daddy.’ Either way, he lives up to it well.

-

JEONGIN

At first, Jeongin didn’t understand what the hype was when he heard about people calling their significant others ‘daddy’. It wasn’t until it slipped out of your mouth once in bed which got him hard enough again to fuck you twice. Since then, he’s never looked back. He asked, only if you were comfortable with it, for you to keep calling him that. He could melt into the mattress at the sound of your strained voice, hearing that name when he’s eating you out or taking you from behind.

So on the surface, he’s a seemingly innocent looking person but you know that underneath there is a man who’s been blessed by the gods with the ability to fuck. It’s the same person who likes to hear the word ‘daddy’ fall from your lips the same way that his cum does whenever he uses your mouth.

[musamora]

the dreadful need in the devotee — bungo stray dogs oneshot

content. f!reader. poetic prose, discussions of mortality and death, existentialism, suggestive themes, allusions to greek and abrahamic myth, romanticized unhealthy relationship dynamics, possible continuity errors. notes and translations at the end. not proofread. 3.8k+ words. ⟶ features fyodor dostoevsky. this work is a sequel to another oneshot! reading it's not a requirement, but is encouraged. this is also a collaboration with @yonseibananamilk! please check out her half of the collab ٩(^ᗜ^ )و ´-

would you like to see more? fill out the taglist or comment under this post.

The fire of Pyramus danced within its hearth, the crackles a plea for freedom. Wooden shelves shimmered in a spectrum of amber hues. The light married abstract shadows with the spines of ancient books, stories lost to civilizations no historian could neither name nor describe. However, the harsh rays softened as they reached the two huddled on a sofa in the corner.

The domestic flame of your shared nocturnal nook chiseled at your features. Meadowed plains melded into the hills of your cheeks before they dipped back into low valleys nestled on the cusp of your nose or at the curvature of your cupid's bow. Fresh streams fringed the waterline of your eyes, fluttering lashes portraying the underbrush that beckoned him, barely obscuring the mystery hidden beneath the murky brook. Such a delicate canvas, framed with messy hair, made his sick heart thump at such vulnerable dishevelment.

You drank every word of your book with reverence while he could hardly focus on the one he held. The careful movement of your fingers as you turned the page tainted his thoughts into fantasies where they instead traced the expanse of his skin—it was repulsive.

But he dreaded an infallible demise the moment you chose to lay against him, not a thought to the difference in your stations. That heated sensation of unfamiliar tenderness, shrouded from the world, only to be acknowledged in an unimportant room in an unimportant place, thumbed him with a sentiment he could not adhere a title to. You were powerless in the scheme of everything that enveloped you, yet held no regard for fear or fate.

Instead, you smiled.

He hid the quiver of his limbs as his finger brushed the underside of your chin. Your face craned upward, and he realized he had been parched for a taste of the features he had so painstakingly mapped to memory. Your eyes closed with leisure as you leaned into his touch and—

He cracked his eyes, unable to open them as they strained to readjust to the merciless glare of his monitors, their caustic luster a stark contrast to the imprisoned fireside of his daydreams. His muscles cried out when he stretched. The quiver in his limbs recurred in spasmodic vibrations, worsening the cramp of his hands as he flexed them. It was a relentless ache that had become all too familiar to him.

You were a distraction. He had lost whole minutes of time to fanciful delusions with you and that damning grin of yours at the center. In his preparations, he toyed with the idea of dispatching you to a remote location outside the ire of societal destruction before ridiculing himself upon further examination. If another one of his subordinates had become such an issue, he wouldn't have hesitated to snuff them out—you had to be the human incarnate of temptation, the ultimate test of his faith.

Men who had traversed the path before him did not do so without trial. He had scrutinized the warnings their stories contained—Adam, Samson, Saul—men who had strayed from their noble path only to lose their kingdom. Fleshly pleasures lured many a good man to condemnation, for how could such sweetness be considered a mortal sin?

The fallen had once been beautiful creatures of virtue, and you were but a testament to the scars left in their descent. It was temporary—you and the fragmented thoughts your presence created would pass in years' time. He only had to be patient.

A knock at the entrance to his workspace interrupted his internal toil.

"I'm not interrupting, am I?"

Patience would be easier said than done.

"Not at all."

Because you dissipated thought and reason from his frenzied mind the moment you blessed him with even a mumble. Your voice was the otherworldly harmony that strained atop his ballad of misery. Not the corrupt inflections he had become accustomed to over centuries of time, but rather a sincere, artless tune that only he was ordained to hear and that he alone could descry. He would only admit one fact—human companionship was a merciless mistress.

For he knew you were your happiest at his side as his right hand, but he could not understand the reason—it brought harm to your so-called "doorstep," and the workload was laborious at best. But even in this isolated instance, when the crooks of your smile didn't entirely brush the banks of your eyelids, a noticeable ease settled in your bones at the sight of him hunched over a desk. An ease he returned, albeit underneath the veil of his carefully crafted mask.

"The preparations for the cannibalism event are almost complete," you continued, maintaining an unusual manner of professionalism as you handed him a set of stapled documents and receipts. "I just need to receive your approval before sending out the orders." His eyes crossed each section without too much consideration for their actual contents, affirmed in his trust of your intellectual capabilities when it came to outlining critical components of his plans with the ire of a scrutinizing eye. 

"Thank you. These will do."

This was usually the time that you would dive head-first into a heated discussion about the latest novel from his collection or scurry off with a courteous farewell to complete the enormous amount of tasks you often procrastinated, but instead, you lingered. Your brows furrowed, locked in contemplation as your eyes stalled on his screens—schematics for his future "trip" to the European detention facility, Meursault. He cleared his throat, which luckily broke you from your daze.

"It'll be weird." You ran your thumbs across your knuckles, teasing at your bottom lip as you shifted from foot to foot. "Moving to a new hideout, I mean." The palms of your hands shifted to skim the dust and grime-coated surface of his barren shelves, toying with the clumps of debris that gathered on your fingers as your mind returned to its baseline. What did your thoughts stray to in times when they left you stranded, out of his reach, as they became more challenging to discern? He could only pray, in some twisted part of his dark mind, that they were a reflection of his own—then maybe those fantasies could be justified.

Outside his internal ramblings, he hummed lowly, acknowledging the truth behind that sentiment. Neither of you shared an attachment to the four walls that surrounded you—it was no home. It held none of the warmth or affection such a term required, though the idea of a home was foreign to you both.

Under those clouded waters, your eyes held a look he both adored and disdained. That muted hesitation had returned, like a criminal stood on trial, unable to utter a word of the truth lest they condemn themself. And you knew too much and said far too little. If you would surrender to your impulses, push him or pull him close so that, in some fashion, his conscience could be alleviated and he could refocus—but it seemed you were stuck within the same cycle of indecision.

You parted your lips, faltered, and closed them again, second-guessing yourself as you fiddled with your fist. But upon further inspection of your nervous disposition, he spotted an object that had been hidden in your back pocket. A book. He raised a brow as you slowly pulled it out.

"You've offered me so much reading material in the past." You handed him the book. Its cover was weathered and cracked; a once vibrant hue faded into a dark, timework brown. The delicate, diaphanous golden letters that spindled across the spin dulled with age but continued to catch onto the fluorescent light. "So I thought I'd return the favor. It's a book I've had for as long as I can remember."

"Poetry?" He couldn't withhold the amusement in his tone. You were such an adorable little woman—his heart squeezed in indescribable fondness at the incredibly fitting genre. The book cradled in his hands was even more charming, if possible. Several translucent tabs and disorder marks stacked the contents of the book, defining a distinct difference from his own analytical annotations. Part of him wanted you to leave sooner so he could delve into the contents away from distraction and be allowed to soak up every delectable notation.

"For wherever you plan to go. I hope you might find some use out of it." Your face softened. "I know it's helped me."

He huffed but knew that he was ultimately endeared. "Thank you, моя дорогая. If you enjoyed it, I'm certain I'll find it an enticing read."

A tremor trickled down your spine at the unexpected sound of his mother tongue. His thick accent sounded like velvet to the ears, but you quickly nodded and sent him the courteous farewell he had initially expected—but he couldn't allow you to leave without answering one more question.

"Which one should I read first?"

You paused, prodding the question around in your mind. The answer you stumbled upon was bold, and you contemplated your choices as your nails methodically drummed across the doorway's threshold. It was a risky choice, but one you had to take.

"Browning's Sonnet 22." Your expression could have locked him there for eternity. "It's my favorite."

And you left. You left, and indecision haunted him once more.

An abhorrent, unsightly torpor flooded within him like the Neva itself, the warmth of the Russian summer smearing any presence of intellect or acumen from his person. His limbs lay heavy from the sweltering heat as the underbrush tickled at his perspiration-laden skin, allowing him a momentary reprieve as he observed the breeze push against the bountiful flora that edged the bank of a creek older than he was in a homeland he had no way to return to.

"Федя."

He roused from the rush that engulfed his body and replaced his idleness, his mind ravenous at the mere whisper of such an intimate, almost forbidden name. Soft hands replaced the roughened roots of creekside plants, trailing his arms until their owner came into full view, beckoning him to lean forward with the purse of your lips.

You were somehow even warmer than the summer sun, and he melted like a tempered candlestick at your sheer touch, lips chasing your own as you drew away with a smirk and a laugh. The collision of your bodies onto the hardened ground drew the breath from his lungs, but he allowed himself to find it once more in your embrace, nose buried in your neck as he resisted the urge to indulge in mortal temptations and simply allowed himself to revel in the innocent embrace.

"Федя," you cooed. Your hands roamed the expanse of his hair, outlining the edges of his nape in a rhythmic motion that started to lure him into a dreamless sleep. 

That was until the sensation started to fade, and he felt the familiar stomach-dropping sensation of falling. His eyes shot open as the idyllic naturistic scene dissipated from view to leave a void. Only you remained, but he paled as even you started to fade, reassuring him with a pitiful smile that he had become far too acquainted with.

"I'm sorry, Федя. You'll have to go one without me this time."

Your presence melded until your touch was like the chill of an algid frost—it was like the expiration of a dying star, crumbling in on itself until it rematerializes once more. From dust, you came, and to dust, you shall return. The contact was the biting notion of where and who he was, with every incapability and flaw that marred his flesh. It whipped at his skin, burned at his eyes.

He shook as you slipped through his fingers, drifting out of his grasp as he looked around for something to hold onto, anything to help either of you escape from—

"That must be a pretty good book you've got there."

The blinding aura of his circular cell was not a sight he wished to become accustomed to, the chamber he had been "forced" to occupy with the French prison. And to his utter dismay, it had been the lousy half of the Port Mafia's former Double Black that had stirred him from his waking nightmare, Osamu Dazai. The bandaged man looked like the cat that had caught the rat; his eyes narrowed as if he had finally pinpointed the Russian's weakness. An unseemly smirk drew across his pale face.

"You've been staring at the same page for the past five minutes, Fyodor," the detective crooned, splayed on on his bed with his head dangling at the side at an uncomfortable angle, almost like he wasn't locked in a high-stakes match of chess. "Your eyes haven't moved an inch. Leaves me to wonder what could possibly be so enticing about that book. You should lend it sometime!"

"I'm simply concerned for the well-being of your fellow agents," Fyodor sneered cooly, allowing his demonic mask to slip back on with his signature smirk. "I just can't help but worry for them. I'll be sure to pray for a swift, painless demise."

"Hmm, I'm sure."

But the suspicion of the detective didn't matter. Fyodor had ensured that you had no connections to one another, and your identity was completely erased once you went underground years prior. So, for the time you remained hidden, you were safe, and that terrible concoction of his mind would not come to fruition. You were in the midst of correcting course on any minor deviations from his plans if the smoothness of his operation was a testament—but in other moments between consciousness and sleep, he wondered if you shared these same thoughts. The split seconds that expanded into hours of dreams he wished never to wake from. 

He couldn't help but linger on the horrific scenario that cast an ever-present shadow over his every thought. It was a possibility, and he shuddered to think of the notion that it would someday become a reality. But this was his one opportunity, and he wouldn't waste it.

He glanced down at his book. In truth, he wasn't much impressed by the pages anymore. This was one of the many books with copies in his personal collection, but it lacked the vitality he had become attuned to. It had been your book of poems that revitalized him, yet he was unable and unwilling to bring such a valuable item into a place such as this. He would not risk the desperation of his opponent at finding his weakness, nor the capabilities of the Special Division for Unusual Powers in finding a connection to the book's owner—so it was contained somewhere safe and sound, where no one else could find it.

That book had opened a separate world that consumed him, body and soul. But that poem that you had recommended—you were quite the romantic, weren't you? His face had flushed during his first reading and the several times after it, though your annotations were even more telling. But it only made the pressure on his heart increase, and he swore it would implode. Perhaps that was an underlying medical condition of his previous host.

And for the first time in centuries, he wasn't quite sure what he would do when he saw you again.

You dislodged yourself from the rubbled remains of the airport, fortunate to have been located further from the destruction Ame-no-Gozen created. The walls around you stood firm, but the roof caved in from pressure above, leaving only a sliver of room to escape to the intact remainder of the roof. Your hands ached and blistered with every inch of your ascent, halted as you took time to cough out the debris that generously clustered at the bottom of your lungs. You looked utterly worse for wear but couldn't find the time to mind given the circumstances.

After what seemed like hours of excruciating climbing, you made it to the top—but, of course, the fabric of your pants decided to snag onto a metal panel that had stubbornly remained intact.

"Oh, come on," you groaned, sitting down to tease and tussle with the ornery piece of cloth. It had been a restless last few weeks, and you simply wanted to sleep. You huffed as the shrapnel decided to release its grasp on your pants, but as you were about to stand back up, you took notice of the shadow before you.

There he was.

You could recognize Fyodor's striking eyes anywhere, even when he was clad in the attire of a fresh body without his signature hat and cloak, but you found that you didn't care much for the finer details when he was finally in front of you. His presence had formed a vacancy in your everyday routine, and for the first time in years, you found yourself completely alone. Even when there was work to be done and plans to create, the majority of his usual subordinates were killed as collateral—not that they had even been much company. But would you be forced to fall into the same line?

The question nauseated you, but you had known the possibilities when you took his hand for the first time. If there was a time for you to part ways, whether at his accord or your own, this would be it. This was your crossroads. But you knew as you slipped your hand into his, outstretched for you to take, that he wouldn't be letting go. The grip he had held you like it was a sin to part. It seemed your fears were unfounded since when you slipped your hand into his own, outstretched for you to take, you knew he wouldn't let you go. The grip he had held you like it was a sin to part.

You stood with his help, a contemplative tilt to your brow—but you couldn't stand the silence that continued to persist. So, in the echoes of his formulaic destruction, you allowed yourself to breathe. A release of that suspension and hesitation, unfurling your burden as you lifted your aching hands to cup his face, delighted in the widening of his eyes at the unbalanced scale between you tilted to the other side.

"Федя," you spoke, the sensation of the word foreign to your lips. A spark returned to his eyes as if you whispered the secret to raise him from the dead. "Are you alright?"

The wind rushed through him, breath tumbling with the breeze as it coasted along the metal platform you stood from. Despite reason pleading with him to run from your proximity, he instead chose to intertwine his fingers with one of your hands. He pressed kisses into the curve of your palm as he lined every scar and bruise with a tenderness that soothed your aches.

"I am."

He didn't need to utter another word—your brief separation had only strengthened your unified understanding of one another, with each crying gesture serving as the final touch. No more trials. No more secrets. The look in his eyes was one of stories. Eyes that had witnessed every dismal aspect of human nature, both in the past you shared, and in the past he traversed alone. But they had become worthless stories to him; the minuscule glimpses of resolution that had served as a sign from God of the promised end turned into the delusions of a desperate man as he found the reflection of the end in front of him—you. In every step he took since your destined encounter, you had been what he was searching for. His hope. His future. His reality. That fraudulent resolution was no longer at the end of a perilous tunnel but right before him.

You understood that the intimacy of your "relationship," with whichever label others tended to tack it with, could never be shared with another soul. Those voiceless, indulgent whispers and subtle, crinkled smiles were mere productions of your shared devotion. But more so, the hummed resonation of your souls spoke the loudest. They had remained empty for such stretches of time, so neither of you knew what to make of it when you somehow poured from your empty cups into the creation of a fulfilling bond. Your only comfort was the notion that this—this was the reason you were created. For each other.

He remembered the moment he laid eyes on you, the sensation that his long-time friend had turned foe, death no longer a temptation out of his grasp but a certainty he could not shake. Your straightforward disposition beckoned him, and he then understood why he had been made with a capacity for love despite acting as the immortal incarnation of its antonym. He had never once felt a need for fruitful devotion, not to some unseen voice from the skies, untouched by the heart and mind of humans, but instead for the one person who would take his heart to the grave with them.

He was immortal, whether by chance or fate, but it was your ability to shake off the temptations of fear that immortalized you in the end. Never once had you allowed your rift in mortality to halt the blossoming kinship between you, prodding at the walls of his solid foundations until they cracked and eroded over time. Fyodor chuckled—he thought he had a capacity for patience, between you were a godsend in comparison. He was the proclaimed "Demon of the North." The man sent to spread the wrathful will of God across the nations. So it was no wonder he had been so tempted when met with a force of benevolence, one which he had rarely witnessed and never known. He could never claim to be worthy of mortal worship when a creature like you stood before him.

You shivered at the sudden touch of his hands as they traveled across the exposed skin of your waist, soft despite his habits. They traced the contours of your figure like a sculptor transfixed on the finest marble. Time had not been merciful in his centuries alone—but it stilled for this moment. For the moment your lips met, and your odyssey was finally over. The spread of his touch was revolutionary, roaming with a cardinal fervor within this wasteland of human misfortune. It sparked a revolt within your mind—your union was taboo, but nothing had ever felt as destined to be.

The muscles of your face tendered as his thumb outlined the brushwood of your lashes. Your eyes drifted shut in a manner that wordlessly pronounced your insomnolence. He kissed a smile against your forehead as you parted, cradling your face as if you were his world. This was an intimacy that could not be replicated, and his mind shattered at the notion of loss.

"Never wander somewhere I can't follow," spoke the desperate man.

You flashed him a cheeky grin. "You won't be able to leave if you want me to stay."

He leaned in, lips close enough to brush. "I won't leave. Not ever again."

And he dipped back in for another taste, addicted to the ambrosial quality of your lips as he buried himself in the shrine of your arms. 

дорогая = dear федя = fedya

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a fyodor fic! very original for me, i know. nana and i planned out this collaboration months ago, and were luckily able to schedule it for the chapter release. again, please go check out her side of the collaboration! speaking of chapters, that update was certainly something. i'm intrigued to see the further development of atsushi and akutagawa through the end of this story arc, since it feels like they've switched roles in regards to the desperation, if that makes sense. and, of course, it was interesting to see fyodor express such strong emotion in reaction to atsushi, and i'm excited to see it unfold in the next installment! feel free to discussion discourse below :D

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