#Affordable MRI Scan

[usmanpuraimaging]

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[sanjivinidiagnosticschandigarh]

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[cannibal-king-brat]

I got a concussion… I passed out in the shower and hit my head on the ledge… I’m kinda nervous now…

[ariadne-mouse]

"His gaze pierces cloud, shadow, earth, and flesh."

Flesh?? Sauron is out there giving X-rays, MRIs, and CAT scans. He's more affordable than your primary care referral and more benevolent than your insurance company. Come to the Mordor health clinic today and be Perceived by the Eye.

[quikhealthimaging]

Choosing the right diagnostic services for an MRI scan in Toronto is essential for ensuring an accurate and timely diagnosis. By taking these factors into account, you can make an informed decision and receive high-quality diagnostic services for your MRI scan in Toronto.

[drferox]

My MS Diagnosis

So I’m approaching the 2 year mark since my Multiple Sclerosis diagnosis and I thought I’d better document how I got here, because being the patient is a weird experience, especially for a condition that had kind of vague symptoms that needed a fair amount of work up.

My symptoms actually started in early 2020, when I was in the third trimester of pregnancy. The main symptom was mistaken for carpal tunnel syndrome - numbness in my fingers that would progress to increasingly violent pins & needles sensations, that would progress to burning if I tried to push through it. Only this sensation would extend all the way up to my shoulders at times. I stopped performing surgery, because not only was I unsatisfied with my lack of sensation to know what I was doing with my tissue handling, but the pain would get worse quickly in constrictive surgical gloves in the presence of patient warming. So I stopped performing surgery in late pregnancy and was told it would get better a few months after giving birth.

It did not.

So six months after giving birth, finding myself able to use my hands for short periods but still unable to perform surgery to my standard, I went back to complain to the doctor. I also couldn’t play video games properly, my arms would often be numb when I woke up, all the way up to my shoulder, and they were super temperature sensitive. Even hot water from washing dishes would set them off.

They sent me down a carpal tunnel work up - ultrasounds and talking to a neurologist. The short version is they did tell me I had mild carpal tunnel… on one side only.

Which did not make any damn sense considering I had symptoms on both sides all the way up to my shoulder.

The worst neurologist in the world could not explain to me why a mild problem on one wrist was affecting sensation all the way up to the opposite shoulder, and just said ‘it happens sometimes’. Now, I like to think I have a solid understanding of the basics of how a body works, and was really unsatisfied with this answer. They recommended I talk to a surgeon, since I’d already been doing a bunch of physiotherapy, but I decided not to. Surgery could have put my hand in a cast for up to 6 weeks, I had a 6 month old baby to care for at home and a partner who was useless at best, and abusive at worst. I could not afford the time in a cast.

So I went to try something else, visiting an osteopath to see what they could do about my ‘mild’ carpal tunnel, and while I’m there, these headaches I’ve been getting.

She spent a good long while stretching out different muscle groups, and found that certain neck muscle stretches changed the sensations I was getting in my fingertips. So whatever was causing the hand problem was coming from somewhere in the neck, and she recommended I get a CT scan.

Went back to my doctor to get a referral for a CT scan, and explained what was going on. He thought about it for a minute, didn’t voice his concerns, and upgraded it to a neck MRI.

That MRI found a demyelinating lesion in my neck. So went back for a full Central Nervous System scan and found a couple more borderline ones.

That sent me back to a (different) neurologist, had a proper neurological exam that found a few random patches of altered skin sensation in addition to the arm weirdness I had going on. So I was probably a MS case, but not particularly severe as MS goes.

To confirm it I needed a lumbar puncture to look for oligoclonal bands in by CSF. The lumbar puncture was a moderately unpleasant experience which then mandated that I remain lying down for 24 hours so that my spinal fluid didn’t spring a leak. With a baby and a distinctly unhelpful partner, I barely made it to that 24 hours.

And then… I sprung a CSF leak. Which is a jolly weird experience I can tell you.

When your CSF leaks from a lumbar puncture you will feel perfectly fine… when you are lying flat on your back, because your spine flops over the hole and plugs the leak. If you’re upright at all the spine flops away from the hole and it slowly leaks out, and you get more of this weird frontal headache that gets worse the longer you’re upright, standing there talking to the ER admissions nurse. And the info I had explained that it can progress to seizures and similar the worse it gets, but I only got as far as pain and fuzzy vision. I seriously could only be upright for ten minutes without pain, and had to lie down to resolve it.

That required some medicine-that-looks-like-magic to fix, called a blood patch. Doctors took some of my blood, fresh out of the vein, and inserted it into my spine approximately where the leak should be, so that the clot would cover the leaky patch. Self blood magic. It worked brilliantly, about an hour later.

The CSF tap ordeal confirmed the presence of the oligoclonal bands, and then I got stunted into the public health system, in a department specifically geared towards managing Multiple Sclerosis patients. They debated for a little while, at a multidisciplinary meeting, whether I was really MS or a Clinically Isolated Syndrome (which is like Multiple Sclerosis but without the ‘Multiple’ part), but settled on MS. Yes, Tumblr, I was nearly diagnosed with CIS.

The shoe thing took about a year from when I actively complained to doctors, or about 18 months from the first probable symptoms. That’s approximate because some things that were thought to be pregnancy symptoms could have been due to MS, like fatigue and leg weakness. I’m pretty lucky that I’m comfortable in hospitals and with medical procedures, am reasonably medically literate. I think the magic phrase that got things to happen quickly was ‘these symptoms are greatly affecting my ability to do my job’.

I don’t think my MS has progressed since starting the medication (and I’ll talk about the medication in another post). I’ve acquired one additional brain lesion since diagnosis, but I have no clue what physical symptom it’s associated with.

While some symptoms are better, I still cannot perform surgery to the standard or with the endurance that I used to,so I basically don’t any more. I can do about ten minutes, which is enough to bail a new graduate vet out of trouble, but not enough to take over completely for them. I’ve had a few years to think about it but I don’t know what the MS is going to do to my career, only that I can still practice for now.

It’s not great, but it could be a whole lot worse, and that’s how I got here.

[inconstantpain42]

I am not really sure how it's started. In July i had a polip removal and they put the mirena coil in me...i was bleeding all the tome and had some mild pain and discomfort. After my dad died i went to Poland to clean the house and to make gastroscopy because here in UK I could not afford it. Second day in Poland got me acute Bronchitis (I guess from the plain aircondition) and I ended up in hospital. It was nightmare, not sleeping, bad food but they got me better and I asked to be released after 5 days, and they did with antibiotic for the next 2 weeks. After that I went to do private endoscopy which gave me another 2 weeks of antibiotics. I didn't take it well and when I came back to UK doctor switched to different.5 weeks of antibiotics..in hospital they have checked my coil and they said its too deep so they repositioned it but it didnt help with pain or bleeding..A week after I came back I hurted my back by pushing on my own the huge chair upstairs which I bought for my daughter.

I dont know why I did this but the back pain was so severe I thought i will die....I got diazepam for few days on A&E and went to toilet and I think I strained myself to much with suppositories becasue the pain in my back worsen....and it's been already 2 months exactly 2 months like this...Pain from my back progressed to my low stomach and I lost function of bladder. I had catherer for 1month and the bladder is working but I don't feel when it's full, need to press with my hand on it to feel sharp pain than I know its time to go wee....I have a pain in my tail bone as well going to my annus and horrible pain of my vagina. My theory is it's a pelvic prolapse but the doctors don't want to check it. I had emergency clil removal and, believe me or not it will sort my problems. But it didnt.They done, here in Uk MRI scan and checked my kidney with cr scan, when I was in hospital for the kidney stones, and said they can't see problem. I have some bulges in my l4l5 and s1 but they said there is no nerve compression....I do believe I have prolapsed cervix or intestine cos after going to toilet the pain of my pelvic and back and annus it's unbearable...Painkillers not working. I forgot to say that since they catheterised me I had been having UTI 5 times (in 2 months) and some problems with my vagina after coil removed. All the time infections, trush etc. The worst part is that I started to horrible muscle cramps in my both toes, but right is much worse and I am loosing the feeling in my toes. Hard to walk...Maybe you ask yourself now if I am mental, believe me anyone would get depression and anxiety of they would be me. I never had any problems like that and I am not sure what is the cause and what is solution. Of there is any solution....? Today is really bad day. I barely slept, I strained the muscles on the toilet going 4 times today and no my back, anus and pelvic is killing me. I tried to have a sex twice, after organising o have such a horrible pain in my pelvic i can't stand it...not like is better without sex but after sex is maximum and it's hard to come. I have ruined my life I don't know which of the parts contributed but my life is over for sure. I didn't go to work for already 2 months I lost 10 kilos I weight now same as my 10 years old..My partner its not like my partner no more, noone cares about me, noone talks to me. I pushed away all of my friends becasue I am daily in so much pain I dont want to talk to anyone....Gabriel doesn't even care, he doesnt even ask how I am...neither my 10 years old. She is autistic but mild autism, so she should be more engaged right? I have enough of this pain and have w enough of myself....I am not sure how much longer I can stand this pain....I am exhausted from not sleeping...crying everyday. Someone's give me hope....please cos I have no hope. My hope it's gone. I dont know whats wrong with me. Why I am getting worse? I want to be back on my feet and be good mum again and back to work and be a better partner so maybe my partner will be better for me as well...I regret everything. I just want the pain to be gone..... Is it only in my head? I DONT THINK SO..

#pelvic

[wyrddogs]

Listened to the FDC podcast episode with Dr Danika Bannasch on chondrodystrophy (CDDY). It was not dachshund-specific; since she breeds tollers she mostly focused on them. Here are my notes:

IVDD (intervertebral disc disease) is not the same thing as IVDH (intervertebral disc herniation). Dr Bannasch considers CDDY and IVDD to be interchangeable.

CDDY variant: Abnormal intervertebral discs. Can have bouts of back pain. Can have disc herniation. All discs are "diseased".

Not all dogs with disc herniation show clinical signs.

All CDDY dogs (in her study on tollers) have signs of diseased discs, but not all had clinical signs that the owners noticed. So not all CDDY dogs are brought in for medical care.

She emphasized that CDDY causes short legs, not long backs. So CDDY shows up in a lot of breeds that you wouldn't expect-- tollers, Portuguese water dogs, beagles, Chesapeake bay retrievers, etc. because the phenotype is shorter legs, not longer backs.

She feels that IVDH is the most painful disease in veterinary medicine.

The CDDY mutation is dominant. It is a "gain of function" mutation. There is no "normal" gene; it is an insertion of an entire gene on a chromosome where it does not belong.

There is a difference in calcification risk between dogs with one versus two copies of the CDDY mutation, but there is no difference in herniation risk with one or two copies.

All beagles are homozygous for CDDY. You cannot "fix" this unless you do an outcross. In breeds where the allele frequency is lower, you can select against it. But be careful-- if the frequency of the allele is high enough, there can be consequences if you remove all CDDY dogs from the gene pool.

Usual recommendations-- keep dogs lean and fit, avoid landing hard if possible, stairs seem to help. Pay attention to subtle signs of pain, eg. refusing to do things they like.

CDDY prematurely degenerates the discs. So a younger dog has "older" discs. All discs degenerate as dogs age, but a dog with CDDY degenerates faster.

What does CDDY do? It makes the legs a little shorter and the skull a little wider. Dr Bannasch believes it rounds the ear tips. This is a desirable phenotype (it seems to win in the show ring), so breeders selected for it before we knew it was bad.

Chondrodysplasia (CDPA) is not associated with IVDD but also produces short legs. Some breeds only have CDDY, some only have CDPA, and some have both. [Note: Dachshunds have both, but CDDY is more common.]

In a breed where there are a lot of homozygotes, it will take a long time to remove CDDY. First you will have to produce heterozygotes, then you will have to produce homozygotes of CDPA.

Chondrodysplasia (CDPA) may be associated with valgus (deformed/bowed legs) and elbow issues. So its not totally innocuous.

As a breeder, she worries about producing a dog that would experience back pain, or have a herniation event, or sell a dog to someone who cannot afford the $12,000 surgery.

X-rays are not great at detecting calcification. CT scans are a bit better, but much more expensive. They've been screening in Europe for a while, and have not seen much improvement. She has not seen much evidence that the amount of calcification correlates with the possibility of a disc herniation event. MRIs look at hydration status, and still aren't great at predicting herniation events, and are super fucking expensive. There are no good screening tests for predicting disc herniation.

Dr Bannasch has dealt with a lot of anger and pushback from breeders for her work on CDDY. Whenever she feels down about it, she goes into the neuro ward to look at the surgery patients for disc herniation events. Then she is rejuvinated to continue her research.

[moosemonstrous]

Ghost Rider Pacific Rim AU - night classes

“It’s so cool,” Gabe pulls his face down to get a better look at his eye. “You’re like Dr Luo! Is it like that forever now?”

Robbie wracks his brain for an image of Dr Luo – he’s pretty sure that’s one of the bad guys in Ninja Wolf. Wait, this hurts your feelings? That’s hilarious. It’s nothing. He’s just glad Gabe isn’t freaked out by the way his pupil is still misshapen, the surrounding iris cloudy-brown from the broken blood vessels. Dr Montesi said the damage is mostly cosmetic, but seemed a little taken aback that he could see without much trouble. She spent the majority of their appointment frowning and making notes while Cho rattled off incomprehensible test results. They clearly arrived at some sort of a reluctant conclusion, but didn’t translate it into non-PhD, so all he knows is that he needs to go into the resonance machine again, this time for a full-body scan. MRI became MRS, which will apparently make all the difference.

He’s been prescribed extra rations. He’s already struggling to finish what the mess hall considers regular ones – but Gabe is always hungry after finishing his, so it’s hardly a problem.

“It should go back to normal in a couple of weeks,” he says as Gabe pulls his lower eyelid down. “How was school, anyway? Did you meet anyone new?”

While school-prep was essentially quarantine, proper ‘school’ turns out to be something of a misnomer – it’s a classroom attached to the unattended minors centre where the whole base dumps their kids when their guardians are at work, or otherwise occupied. Sometimes, after a demon attack, some of the children find themselves permanent residents until alternative care can be arranged. It’s good for them to be used to the environment.

“We’ve been notified you will be joining the academy,” the teacher told Robbie while Gabe was saying goodbye to his new classmates. He didn’t offer congratulations. “You don’t need to worry about the schedule. I know Major Brooks likes to run his sessions long.”

Major Brooks can like his sessions on the moon for all Robbie cares. He’s not letting Gabe live out of a temp bunk full of abandoned and orphaned children. The nightmare he had, the one about dying in The Charger – Didn’t die. – still makes him uneasy, and he has no plans on joining any strike teams. Besides, it seems a little unfair – as in any other childcare facility he’s ever seen, the staff are stretched thin and never paid enough for all they’re asked to do. Robbie can’t imagine preparing for a shift with sixty kids and ending up with a hundred, because someone up in the dome ran an exercise for an extra two hours.

That’s because you’ve never been in a Kwoon ring. Trust me, it’s better than hanging around a cripple all day.

He freezes. Was that–

“...and Lin said her dad can make me elbow pads like hers,” Gabe finishes recounting. Crap, Robbie didn’t mean to space out like that. “I want to draw her a picture from her story. Can we get the book?”

Gabe has a school-issued tablet that came complete with a stern warning about selling Shatterdome property. It takes Robbie longer than he’d like to figure out how to access the online library. Every piece of technology they get is second-hand or renovated, and still years ahead of what he could afford back in L.A.

The e-reader has adjustable text size and screen contrast, and a read-aloud option. Damn, you’re easy to impress. The book Gabe requested seems to be some sort of a video game novelisation.

This is all too good to be true, he thinks when Gabe is busy finishing his second helping of noodle soup while following the text along to the narrator in his earphones. The stipend he’s getting from medical is slightly less than what he’d make as a mechanic, and nowhere near enough to save up and leave, but so much on the base is provided for free it’s not really a concern. It feels not unlike the first few weeks in their own flat back in Hillrock Heights – a to-date unprecedented amount of comfort. That lasted only seven months before the demon attack. According to the countdown display, the next one is due in three weeks.

“Robbie-Robbie,” Gabe sing-songs without looking away from the screen. “Your soup is getting cold.”

“You’re holding it wrong. Extend your thumb,” Robbie says to his dad, grabbing his staff to demonstrate.

Dad is only a couple of inches taller than him. He rolls his eyes. He looks… fond.

“I can still knock the snot out of you, soldier boy.”

Robbie laughs. It sounds forced. “Yeah? That a threat?”

“Hell yeah.” Dad looks a little unsure for a moment. “Seriously, Juliana is watching. Go easy on me, huh?”

Robbie doesn’t remember having dreams like that before. Normal stuff, sometimes nightmares, but never these… these weird whole-scene narratives. He lies in his cot for a good ten minutes, trying to level his breathing; it felt so real. His arms ache.

Four in. Hold four. Four out. It’s being in the Shatterdome. Back in the Shatterdome. It’s messing with whatever… block he’s got in his head. There are records – classified, but maybe if he asked–

Or you could just plug back into The Charger. It’s got what you need.

Is it weird that Gabe doesn’t seem interested? Then again, he was too little to remember dad at all. He stopped asking after mom fairly quickly too. It used to be a point of pride for Robbie – he could do it by himself. They didn’t need anyone else.

He presses his knuckles into his eyes until he sees sparks. Jesus, pull yourself together. Right. He swings down from his bunk and goes to wake Gabe up – he’s been sleeping like a log with all the noise suppression in the crew quarters. They have morning routine down to the minute – roll out the kinks from Gabe’s legs and lower back, make sure he doesn’t try to spit out the one pill that doesn’t come in a sugar shell, decant the rest of the day’s meds plus emergency supply into the plastic container, check the medical info sheet is still in his backpack where it’s supposed to be. Gabe showers in the evenings, and Robbie in the mornings while he gets dressed. Back in L.A., the harried social worker he used to harass for advice mentioned that now Gabe is a teenager, Robbie needs to occasionally leave him alone behind a closed door, and this is the best he can offer – other than never, ever thinking about it any further in any detail.

All the kids get meals at the beginning of each shift, so he drops Gabe off first before looping back to the mess hall for his prescription food. Most of everything on offer is vegetarian, but with his new academy assignment Robbie can technically access the pork. It’s half eight in the morning – he has to solemnly promise the old lady behind the counter that he won’t starve to death on just rice and beans.

It turns out to be the wrong choice.

*

Tony waves Amadeus over to the edge of the viewing platform and points to the mat to the far side of the gym, where Robbie Reyes is getting his ass handed to him for the fifteenth time in a row. He’s probably counting, too. He looks the type.

“Ouch,” Amadeus hisses in sympathy. “Wasn’t he supposed to just run laps?”

“Yep,” Tony pops the ‘p’. He wishes he’d brought popcorn. “Don’t ask me, they were already at it when I got here.”

They watch the sixteenth match end, once again, with Reyes flat on his back on the mat. Tony waits until Eric gets him up again to nod his head to the other side of the platform. “Watch the Colonel.”

Ivanov doesn’t make a habit of observing the recruits. He shows up in the Kwoon Combat Room for pair ups, because that’s always good fun, but the cadets are pretty pitiful until Eric whips them into shape, and the brass tends to train when the impressionable young people can’t hear their backs creak from the effort. He’s been watching Reyes like a hawk, though, and according to Tony’s quick dig into base surveillance, arrived just in time to potentially instruct their Fightmaster to change up his training program. Eric doesn’t sway from his routines unless directly threatened with public speaking. Or unless Carol asks nicely enough, and she’s on duty this morning.

“His orthodontist will have some work to do,” Amadeus comments. He produces a pack of jelly beans from his coat pocket and offers some to Tony. “Are we being anti-establishment again?”

“Please, we’re always anti-establishment. Say, I know nothing about martial arts. Is Reyes any good?”

Only the rangers stand any chance of winning against Eric, and usually only after several years of learning his every move. That the kid hasn’t tapped out yet is already pretty impressive, but Tony has been known to mistake stubbornness for skill before. Amadeus crunches on the jelly beans for a long moment before replying.

“It’s like he’s been studying from old movies,” he says, thoughtful. “Knows what to do, but can’t back it up.”

“Did he mention getting any lessons?”

“Two boxing classes at fifteen.” Amadeus has the good sense to appear slightly red-faced at how quickly he pulled that information out of his giant brain. Tony magnanimously lets it slide. “What are you saying?”

He shrugs. “Nothing. But something smells funny here, doesn’t it?”

“Wait till you see what Montesi pulled out of his MEG scan.”

“Oooh, do tell.”

One level below, Reyes begins losing his cool. He puts enough strength into his next hit that when the wooden staff hits the mat instead of Eric’s leg, it bounces back and nearly hits him square in the face. Tony really doesn’t know much about fighting – he’s more of a lover type – but he knows Eric Brooks, and under three hundred layers of repression and self-esteem issues no therapist in the universe could crack, the big guy appears to be surprised.

“Not here,” Amadeus pockets his jelly beans. “Patient confidentiality and all that.”

That’s even more curious. “That good?” Amadeus has that look on his face. It’s been a while since Tony had last seen it, and he can’t say he enjoyed the resulting mayhem. “Alright, boy wonder. Lead the way.”

[deadbyglitter]

finally had my appointment with the orthopedist and it turns out instead of an MRI scan as my doctor suggested, i need to get an EMG done (electromyography) which in v simple terms means i get some tiny needles stuck in my arm since that's where the pain is coming from so they can check what is wrong with my nerve cells :) fun stuff, i'm attaching the application for my EMG appointment since it still has to be done in another city (with some info blurred out ofc), i'm trying to figure it out if i can afford to have it done as soon as possible at a different hospital (which would probably be around 300 usd) either i'm leaving my k*-fi and p*yp*l here if u would like to help me out <3

[usmanpuraimaging]

Discover the benefits, pricing, and preparation tips for MRI whole spine screening at Usmanpura Imaging Centre. Learn what to expect during the procedure and how it can help detect spinal issues early.

[sanjivinidiagnosticschandigarh]

[ftvs-cm45]

Hello, I'm from Gaza, my little daughter Nour has hydrocephalus and seizures, we are now in a tent in very bad conditions, and every thing destroyed our house, hospitals and physiotherapy centers 😔 I'm waiting your reply hope you will support Nour as she's a palestinian child needs your urgent help because the seizures attacks have increased, and hospitals don't receive her because of the huge number of injuries and martyrs. She must see a neurosurgeon soon to adjust the doses of the antiseizure medications. Also she needs CT scan and MRI to ensure that the shunt is working well. She also needs to continue Physiotherapy ASAP and Occupational therapy sessions to enable her to stand and take her first steps. Please support my campaign because Nour needs special care out of Gaza war, GOAL $1350

I am sorry to hear this, and I hope your daughter will get better soon. Unfortunately, I cannot afford to donate to your campaign at this time. Sorry!

[coffeeheartaddict2]

Everybody Hurts Sometimes (14/18)

Concern

Book: Open Heart (AU)

Characters: Ethan Ramsey,Casey Valentine, Tobias Carrick, Louise Ramsey.

Word Count: 2376

Warnings: Language, mentions of addiction, vague mentions of prostitution, mentions of pregnancy loss

****trigger warning: this series deals with issues of abandonment and addiction****

Category: Angst

Rating: Mature

Summary: Louise is brought to Mass Kenmore, Tobias and Ethan have a heart to heart.

Disclaimer: Characters belong to Pixelberry

Authors note: a Louise and an Ethan and Tobias heavy chapter. We are getting to the nitty gritty of the ask which was what would happen if Ethan did not pursue her and then when he does it is too late. So this is set up for the next chapter with the final downfall in ch16. Spread out, well yes it is but some of the events I feel will get lost if I made it one chapter. It will be an angsty ride but there is a happy ending, I promise.

🤒🤒🤒😷🤒🤒🤒🤒🤒🤒

Sleep, coffee, pain medication, repeat. That is what the meager existence of Louise Ramsay had turned into. Her pain was more now though and the amount of Ibuprofen in her system was starting to make little difference. She needed something stronger but that required prescriptions and well by the time rent was paid and some food, there was barely enough to buy ibuprofen let alone a hit.

It took great effort to hide her pain. She normally did a great job of hiding it from people, especially those for whom she was providing a service for. But today her luck was going to run out.

She met the gentleman in a motel room. The pain in her stomach was quite bad today. She started with her servicing of the gentleman but then a sharp pain shot through her body. Normally it subsided quickly but today, she collapsed. The gentleman to his credit did not freak out, he woke her up, got her to his car and got her to a hospital. The closest hospital was Mass Kenmore.

It was a regular Monday morning in the ER, not too crazy but busy enough. The gentleman brought her in and told the nurse she collapsed in pain. He said he did not know her name. Louise was brought in under the alias Jane Doe. Casey and Tobias were working together that day. Casey had to do a double take. Tobias noticed straight away.

“This is not a Jane Doe, this is Louise Ramsey, Ethan’s mum.”

It was Tobias’s turn to be shocked. He looked at the chart, says nothing about drugs, severe pain and collapsed.

Casey noticed some bloating and physically examined it.

“Ouch, fuck!” Said Louise groggily.

“Where am I?”

“Louise, you are at Mass Kenmore hospital. Do you recall how you may have got here?”

“I was in a motel room, I was about to have sex with a man, then I collapsed.”

Tobias orders blood work and Casey organizes a scan. Casey was concerned about how much pain she was in when she touched her stomach.

The scan was available quickly. Louise looked visibly frightened so Casey went in with her. The technician told Louise what would be happening. The scan started and even Casey saw all the shadows and lumps and knew that it was bad. The technician asked if there was any blood work been done and Casey stated that we did a broad range with tox screen as I know this person has overdosed before when I was at Edenbrook.

The technician nodded, I recommend an MRI and do blood work to test specifically test for cancer.

Casey was shell shocked and so was Louise.

“That explains the pain medication not working and some other things too.”

“Ok, let’s get you back and organize everything else. Tobias met them both at Louise’s room.

“I got the bloods back, a very high white cell count…”

“Yeah, I am about to organize an MRI, more bloods specifically cancer and with that elevated count I am ready we would not be jumping the gun for an Oncology consult.”

“Ummm…” said Louise weakly, I have no insurance, no money, how am I affording this?”

“Well Louise, even though I know who you are, in the system you are at the moment a Jane Doe…”

“We also have a program here that assists uninsured people who are diagnosed with severe illnesses. When we have ascertained what exactly we are dealing with we will get you into that program.”

Tobias and Casey leave and Casey goes into the nearby On call Room and Tobias follows.

“Are you thinking what I am thinking?”

“How the fuck do we break this to Ethan…I think Naveen needs to be involved, at least I know Alan will find out in a timely manner.”

Tobias leans on the wall. Wait until we know what is what exactly. I would feel better breaking this having as much answers as possible.”

“What pain relief in the here and now though Tobias, she is weak but in agony.”

“Tox screen came back clean, she has obviously not had a hit for awhile so one could say we are through the worst of the withdrawal .”

“Just limit opioids as best we can I suppose.”

“Yeah, and all the rest.” Tobias walks to the door and looks back, “hey, we can do this.” Before leaving. Casey nods.

The blood test for cancer comes back and it is severe. Casey was not surprised, especially with what she saw on the ultrasound. The MRI was done with all the results sent to Oncology. Dr Mason, the head of Oncology reviewed the scans and blood work. They were dealing with stage 4 ovarian cancer which had been and is currently spreading rapidly. They all met with Louise and went through the treatment options. Dr Mason said we could operate and have a rigourous chemo regimen but that would be delaying the inevitable given how advanced the cancer and how it is spreading. Louise opted for no treatment, she confided that she had attempted to end her life with a drug overdose as few months back. Dr Mason said he would organise someone to come to organise palliative care and options. Dr Mason then left. Louise was overwhelmed. She had suspected that it was more than sti’s for a long time but cancer. In a way she felt she deserved it. After abandoning her family and what for, just so that they would not have to deal with her resentment with her life? She went to sleep.

Tobias called Naveen requesting a video conference and that Ethan be there. Naveen made it happen. Tobias phoned in, Casey was there with him.

“Good afternoon Tobias, Casey. How can I be of assistance.” Asked Naveen.

Ethan was ambivalent.

“We organised this conference because of a patient. Earlier today a man brought in a Jane Doe but it is Louise. She was not in the throes of an overdose but she has collapsed due to being in high levels of pain, I could not even touch her stomach without her being in pain.” Casey took a breath.

“We ran some tests, she has advanced stage 4 Ovarian cancer. She has denied treatment.”

Naveen was shocked. Ethan did not know what to think and he left the room.

“Well Ethan’s reaction is on the better end of what I was expecting.” Said Tobias. “She confided this afternoon that she had attempted to end her life via overdose a few months ago. We have a program here that will solve the cost issue, but can you let Alan know Naveen?”

“Of course. Do you think that is why she wanted to reach out, if she suspected she was that unwell.”

“I do not know, we have not spoken to her about that, today has been overwhelming enough for her with the diagnosis coupled with how weak and how much pain. Her tox screen was clean so we can give her something stronger than ibuprofen.”

“I will give Alan all the information and yours and Casey’s contact details.”

“Thank you Naveen, truly.”

“No trouble at all you two, thank you for doing what you can.”

“Our pleasure Naveen.”

The he call ended.

“Ethan must be going through hell again right now.”

“I do not doubt it. At least he knows that she is unwell. I might go visit him after my shift.”

“Good luck with that Tobias.” Said Casey.

Tobias was right, Ethan was in emotional hell. Was she only reaching out because she was sick? Is anything she could say on her deathbed be the truth. He was also in hell seeing Casey again. How badly he fucked up was now clear as day. Anger was now laced with regret and he had no idea what to do.

He went home at the end of his shift, poured himself a drink and wallowed in his misery. There was a knock at the door. He went to answer it, he was surprised to see Tobias on the other side. He let him in. Ethan offered him a drink for which Tobias declined.

“I would ask how you are Ethan but that question is redundant.”

“I am in hell Tobias. That woman has been dead to me since I was 11 and now she is actually dying. Is that the only reason she reached out?”

“Neither myself or Casey broached that today, it has been an emotional day for her but us too. Casey told me about your mum and how she found herself at Edenbrook.”

“Oh did she now, what else happened…huh… end up in bed?”

Tobias winced.

“Medical school was a long time ago, Estelle gave me no reason to suspect she was lying about the demise of your relationship.”

“You are not answering my question Tobias”

“I gave Casey the abridged version of our history, she told me what happened between you two, we kissed briefly, we were caught up in the emotion, how could we not. I know she still cares about you, even said if you started to heal from your trauma that she would take you back.”

“You what… how can she care about me and still be kissing you.”

“It was an emotional chat, even if she did not still love you, she still cares. None of us like you seeing you torturing yourself with your own preconceived ideas.”

“That woman had to have hated me. Why else would she leave?”

“Maybe she left because she loved you. She is an addict, whether the addiction came later but she is a broken woman, she may have been fighting her own god damn demons and thought running away was best for everyone.”

“She is dying Ethan, she has refused surgery and chemo for which I do not blame her, she is riddled with cancer. Whether you hear her out or not is upto but you need to at least say good bye properly. You need closure and you can not heal without it. I know you have pushed us all away but please stop. I know as well as you do family ain’t always going to be there but please let your chosen family be there.”

“So you are not making a play for Casey?”

“No, you should know I am not the relationship type and I told Casey that. As I said, it was an emotional chat, we got caught up.” Tobias took a breath. “You still love her don’t you?”

Ethan started to cry. He fell to the floor and cried. Tobias sat down beside him.

“Yes I do, I still do not know how I love someone when I am so unloved.”

“You are not unloved Ethan, I loved you like a brother in med school, still even after our fallout but I think we both needed to be in a place where we were ready to reconcile and before all of this happened I thought we were close to that and I hope to get there. Naveen loves you, Casey loves you. As I said before Ethan. You need the closure, please come and see her. Even if you do not find out you deserve closure. The lack of closure has ruined some of your more important relationships. Don’t let her ruin anything more for you.”

Ethan nods and Tobias takes his leave. He hoped that Ethan would listen to him, at least he seemed receptive to hear him out.

At the same time Naveen was on the phone to Alan. He told Alan about how Louise has cancer and how bad it is. Alan asked how Ethan took the news. Naveen stated he stormed out of my office. Both men hoped that Ethan would see her. Alan was not working the next day so he decided he would go see Louise.

He left a message with Casey stating he would be up the next day. Casey sent one back saying she would see him then.

The next day came, Alan was nervous, he had not seen Louise since she left him and now she was going to see her on her deathbed. He had organized to meet Casey at the lobby of Mass Kenmore. She took him to Louise’s room. Casey let them have some privacy.

“Hello Louise”

“Alan?” Asked Louise.

“Yes, it is me.”

“I am glad you came to see me.”

“Even after all this time Louise, it is the least I can do.”

“I should not have left, I left because I resenting work, you, Ethan, I still loved you both but I resented you, I left before the resentment turned to hate but I was then trapped, heroin for the last ten years but alcohol and prescription medication before that.”

“You thought you were doing the right thing Louise.”

“If only I properly managed the grief from the miscarriages…”

“Louise we did the best we could, both our grief was different and you channeled yours into work because that is what you knew”

“How is Ethan?”

“He blamed himself for so long Louise, it put a schism between us. You showing up only added to it, he is not in a happy place.”

“I saw an article of him in the Amazon, he became a great man Alan, schism or not, thank you for raising him to be a good man.”

Louise starts to cry and Alan is emotional too. They discuss her funeral and life in general. Alan can see she is tired and takes his leave, stating he is happy to come back in a few days. Louise is happy with that.

Alan knows he should see Ethan but he knows he would be working so he decides to see him another time.

Meanwhile Ethan is torn, he knew Tobias was right, as well as Naveen and Casey but he was scared. Scared that he was right and she left because of him, scared of seeing her die, scared of what to say. He did not know whether to listen to his rational side or his emotional side, so he did what he did best, he avoided the situation with work and when work was finished continued to find solace in scotch.

———

Authors note 2: so I in Australia so Cancer does not put us on the brink of financial ruin, so what happens I have no idea if it truly happens. Two more really emotional chapters and the final two will still have some angst but to a reconciliation. Thank you to everyone who has made it this far

Tagging: @jerzwriter @jamespotterthefirst @genevievemd @potionsprefect @liaromancewriter @youlookappropriate @cariantha @alj4890 @bex-la-get @crazy-loca-blog @a-crepusculo @trappedinfanfiction @binny1985 @lucy-268 @schnitzelbutterfingers @ofmischiefandmedicine @tessa-liam

@choicesficwriterscreations @openheartfanfics

[aryasing]

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[doctortwhohiddles]

Having a universal health care system is great, no doubt about that. But the waiting for an appointement part is fucking ridiculous. I have to get an MRI, my doctor called so I'd be put on the list. It's been 2 months and still no news. I get that I'm not an urgent case (thankfully), but still. I can't leave town too long because if they do call me, it'll be 2 days before the scan. Which makes planning my vacation a pain in the ass, not to mention complicating things at work.

I have private insurance, but the deductible for something like this is 300$. It's 800$ to do it in a private clinic. I pay taxes so I don't have to go to a private clinic, but it seems I'll still have to pay if the hospital doesn't call soon. I'm lucky enough to be able to afford it but it still pisses me off.