#I have a good medical team but I only have good insurance for a few more years

[jellifishiez]

hot take- medical care should be as close to free as we can make it. I know given what is going on it never will be, but maybe instead of killing people in other countries we spend money on healing the medical crisis on our country. it's time for America to do some self care.

[pbandnoj]

PartnerToji who had never regretted his vasectomy… until you came along. Having it done was great, sure he didn’t like someone being all up in his business but it was affective. To him Megumi was more than enough, actually he could barely handle the kid. Plus it was easy to mess around and not have to worry about rubber or a scary missing period text.

Oh but sometimes, sometimes you made him question it. You had been together a few years, gotten accustomed to Megs, who sometime even preferred you over his dad, teaming up with you against him. And Toji knew you��d be a permanent thing ever since he cut off all his women he used to visit, and started working a real respectable job.

And the fantasies that filled his head when he looked at you were enough to fill a whole book series, you had made him consider having a second kid… but wait that’s right, he can’t have one. Every time you bent over, wear something even partially revealing, or hell when you took especially good care of Megumi he knew he wanted to make you a real mom, even if you did convince him you were fine with just Megs.

The idea of seeing you all round and plump, with his baby inside of you, god it made him rock solid. And you felt his wrath in the bedroom. He was making you work double time. Wishing, praying somehow, his sperm could make it past the little procedure, yet it never happened.

One day you got home from wherever you went, Toji didn’t pay much attention when you were telling him. Slipping your shoes off and walking up to see him on the couch, Megumi sitting on the floor fiddling with a new toy train he got, but it was odd… the tv wasn’t on. And he was on his phone? Honestly you couldn’t remember the last time he even spent more than a few minutes on it, that being pretty much only to text you or email his boss.

Slipping your arms around his shoulders from behind the couch as you looked down, “Watcha looking at Toj’?” You asked, only to have him grunt in response. A brow raised as you looked down catching a glimpse of what he was reading… a medical page? Was something wrong with him? Did something happen?

“Baby what’s wrong?” You cooed out as you softly ran your hand over his collarbone, he huffed shaking his head, “Nothin’” the one letter response making you roll your eyes. He huffed upon seeing the look on your face, “I’m looking at a reversal.”

A reversal? Reversal of what? “What’s that sweets?” You asked a raised brow, before he smirked, “I wanna be able to put a baby in ya.” Choking on your spit, removing your arms so you could quickly cough up a lung.

“What?” You half yelled, partially startling the quiet boy sitting on the floor. “My vasectomy doll,” You grumbled… so that’s what this was about? Why he’d been actin so weird.

“Toji,” you huffed out as you looked back at him, “You seriously wanna have to go back to using condoms just so you can put one baby in me?” You asked, a brow quirking up. A soft snicker leaving your lips before he cursed under his breath.

“Besides, I’d rather put my attention on Megumi right now,” You noted, causing Toji to nod. “Yeah besides my insurance ain’t gonna cover it and I’m not givin up what little luxury I have,” he huffed out, “See? You should stop worrying about it.”

And with that the vasectomy debacle was solved… at least for now. That man has crazy baby fever.

[scientia-rex]

Hallo!! I really appreciate your blog and how open and invested you are in wellbeing outside of medical fatphobia and other ways medicine as an institution can suck. It's also great to see a humanized side of working in medicine, so thank you for your openness :) You mentioned recently not prescribing bariatric surgery to patients except in rare, specific cases. If you have time and energy, would you be able to share a little more about what you think about bariatric surgery when those particular conditions aren't present? Also please feel free to ignore this ask if you're not up for it. Hope you have a great day! 🌸🌼🌺

When someone is fat to the point where they can't do daily activities of living like dressing themselves, walking, etc., then bariatric surgery probably has a place.

However, bariatric surgery has risks. Lots of them. To start with, there's the on-the-table risks. These are a lot lower than they used to be--anesthesia in this day and age is incredibly safe. Getting to bariatric surgery is challenging for most patients, as insurance in the US will typically only work with a few centers that have wrap-around teams including the surgeons but also other specialists, especially nutritionists. So lots of patients go to Mexico. I haven't had a single one of my own patients, since I started having my own patients four years ago, get from the phase of thinking about bariatic surgery to actually having it done in the US. I've had three patients go to Mexico and have it done. I will withhold judgment, because I haven't been to those centers, I don't know what those doctors and teams are like, but I do know the overall out of pocket cost for patients is about 5 grand, which is so much cheaper than it is in the US that it doesn't bear comparison.

Just-after-surgery risks include blood clots that can go to the lungs or the heart. There is always a risk of wound infection, which can be devastating. If a prolonged hospital stay is required, pneumonia is a significant risk.

Any time you have intra-abdominal surgery, your body develops scar tissue. Places where scar tissue fuses different structures together are called adhesions. Having a re-operation after that is more risky because of those adhesions. You are also at higher risk for intestinal obstruction, because your intestines can hang up on adhesion and twist so that they cut off their own blood supply. This is a surgical emergency. When bowel dies, it becomes leaky and lets dangerous intestinal bacteria into the otherwise sterile environment of the abdomen. That higher risk of intestinal obstruction never goes away.

People who have had bariatric surgery are also at risk for dumping syndrome. This is a condition where the small intestine becomes overly stimulated immediately after a meal, because the food is not moving smoothly through the stomach into the small intestine on the natural time scale. That stimulation leads to excessive insulin release in comparison to the amount of glucose absorbed, which can means hypoglycemia, which is life-threatening.

Rapid fat loss leads to significant amounts of excess skin. Many people who've had bariatric surgery go on to have skin removal surgery. This is actually a riskier surgery than the bariatric surgery itself, because you are tampering with the barrier between the inside of your body and the world outside it. And if it's done too early, you can end up needing your skin to stretch again, and having stretch marks in addition to the scars.

After bariatric surgery, you are also worse at absorbing good nutrients. You need lifetime monitoring for vitamin levels, including vitamin B12. If you don't have enough vitamin B12, your nerves start to die. This results in pain that starts in the feet, since the neurons running from the spinal cord to the big toes are the longest and therefore most susceptible in the body.

But perhaps the most upsetting aspect of bariatic surgery to me is that it is presented as a definitive solution.

Is it?

Not for 20-25% of people who have bariatic surgery, who struggle with significant weight regain.

So if the most extreme intervention we have--literally surgically altering your gut--isn't enough to make weight loss permanent, how is anything else going to do it?

You can be skinny. For a little while. But attempts to lose large amounts of weight, including surgically, have high failure rates. The 75% success rate for bariatic surgery is significantly higher than for any other method currently widely available, but the risks are also significantly higher. I don't think it's worthwhile for most patients, especially given how many patients are lied to by their doctors about how much their weight is likely contributing to their health problems. Most of my patients focus on their weight rather than activity levels, they beat themselves up about how they're not doing intense enough exercise but don't incorporate lower-impact exercises like swimming or walking, they try to eat less rather than eating a diet more rich in vegetables and fruits and lower in highly processed foods. You can do so much for yourself without ever framing it as being about weight.

And if you've done that--if you're struggling with being so fat that you can't live your life--then sure. Talk to your doctor about a referral for bariatric surgery. But don't be shocked if the results are not what you were told to expect. Don't be surprised when you find that you actively resent the people who suddenly find you tolerable, even desirable, now that you're not so fat. Don't let them sell you bariatic surgery as a no-downside cure-all, because it most emphatically is not.

[am-i-the-asshole-official]

Am I the asshole for resenting my father after he forced me into braces?

For context I am seventeen now but was forced into braces at twelve years old. While I did have very crooked teeth, I never wanted braces, my teeth never caused me any sort of physical pain or insecurity. I told him as much before I was put into braces. But he refused to hear it.

As far as I'm aware braces were not a medical necessity for me.

I've repeatedly tried to discuss it with him but he always tells me that he has a good insurance, one that covers dental care for all children under the age of twenty one and that I should be grateful. He also told me that if he didn't make me get braces I would be angry and upset with him when I turn twenty one.

I tell him that that's not true, that it's my body and I should have a say in the matter but he only says that he's doing what's best for me and refuses to discuss it any further.

What's worse is that each appointment is a drive that's an hour and a half away from where I live—they aren't open on weekends or evenings—so every appointment (once a month) I have to miss at least half of a school day (but usually it ends up being a full day of school) even if the appointment itself is only fifteen minutes. We do have a local orthodontist but my father refuses to take me there because he thinks the guy who runs the place is money hungry.

Anyway, I'll be getting my braces off in a few months. The orthodontic team has made an entire treatment plan for me—one that involves me wearing a retainer 24/7, indefinitely. And later getting implants. I don't want to follow this treatment plan and I don't like that it was made without me ever being asked how I feel about it.

I've told other people about it, and they've said that I'm making a fuss about nothing and that parents have the right to decide what's best for thier children. But I'm not a child anymore.

I know he was doing what he thought was best but I secretly resent my father for putting me in braces when I didn't want them. I think the fact that he never took my wishes into account or asked me how I felt makes him a bad parent. But maybe I'm overreacting.

Is he right? Am I the asshole?

What are these acronyms?

[afeelgoodblog]

#075 - The Best News of Last Week - February 27, 2023

🐈 - Do you know Gacek, the most famous cat in Poland?

Hey there! It's Erica here, and I'm excited to share with you some of the most uplifting news stories of the week. In a world that can sometimes seem filled with negativity, it's important to focus on the positive and find inspiration in the good things that are happening around us. Let's dive into this week's collection of wholesome news!

1. 8-year-old boy missing from Washington state for 8 months is found in Missouri

A boy who has been missing from Washington state since at least mid-June was found safe in Missouri, the FBI office in Seattle said Tuesday.

Authorities said 8-year-old Breadson John had vanished by June 17, when a welfare check at his home in Vancouver, Washington, just across the state line from Oregon, determined his absence.

2. World’s biggest four-day working week trial hailed a ‘major breakthrough’

The trial of a four-day working week in the UK, the largest of its kind in the world, has been celebrated as a “major breakthrough” after the majority of participating companies announced their intention to continue with the shorter week.

The trial, which ran for six months from June last year, required firms to reduce their working hours for all employees by 20 per cent without any reduction in wages.

At least 56 out of the 61 companies confirmed they will continue with the four-day working week, while 18 of them have made the policy a permanent change.

3. This dying baby turtle survived after drifting 4,000 miles to Ireland

A family strolling on a beach in Ireland earlier this month spotted a seafarer that had washed up on the rocks. Less than a year old, the female loggerhead survived a months-long journey across the Atlantic Ocean, teeming with dangers including predators and plastic. Although she was still alive, the turtle was dehydrated, massively underweight.

They called her Cróga, the Irish word for “brave.” After finding Cróga in the northwestern part of Ireland, the family called a few groups that rehabilitate whales and dolphins. There, Cróga’s rehabilitation began.

4. A Hernando toddler found alive after being missing for nearly 24 hours

A 2-year-old boy was lost in the Florida woods for 24 hours. Everyone feared the worst. Hundreds of volunteers came out to look for him.

One volunteer came to a fork in a field: right or left? He trusted his gut, went left and soon heard a whimper. It was the little boy, crying but in good health.

I found something interesting while reading this article: If you are part of a SAR team looking for a child to not only call their name but also that they aren’t in trouble. Young children sometimes hide from potential rescuers because they’re afraid they’ll get in trouble.

5. German man remains free of the HIV virus years after receiving stem cell treatment.

Researchers are announcing that a 53-year-old man in Germany has been cured of HIV.

Referred to as "the Dusseldorf patient" to protect his privacy, researchers said he is the fifth confirmed case of an HIV cure. Although the details of his successful treatment were first announced at a conference in 2019, researchers could not confirm he had been officially cured at that time. Today, researchers announced the Dusseldorf patient still has no detectable virus in his body, even after stopping his HIV medication four years ago.

6. South Korea court recognises same-sex couple rights for first time

A South Korean court has for the first time recognised the rights of a same-sex couple in the country. In a landmark ruling, the Seoul High Court found a government health insurer did owe coverage to the spouse of a customer after the firm withdrew it when it found out the pair were gay.

The men had held a wedding ceremony in 2019, but same-sex marriage is not recognised in South Korea.

Activists say the ruling is a leap forward for LGBT rights in the country.

7. A fat cat has become the top-rated tourist attraction in a Polish city with a perfect 5-star average on Google Maps

A fat black-and-white cat called Gacek has become the top-rated tourist attraction in the Polish city of Szczecin.

Gacek has a perfect five-star rating on Google Maps. His name, pronounced gats-ek, means "long-eared bat" in Polish. Gacek first drew international attention when he appeared in a YouTube documentary in 2020

- - -

That's it for this week. If you liked this post you can support this newsletter with a small kofi donation:

Buy me a coffee ❤️

Let's carry the positivity into next week and keep spreading the good news!

[queenwendy]

Sometimes I get morbidly curious and scroll through the terf tag (bad idea) and half the time it makes me sad but the other half it makes me laugh my ass off because like… they seem to think anybody can walk into a doctor’s office, declare “I am trans!” And just get sex reassignment surgery??? Like, what???? That isn’t how that works at all

I’m a trans woman in the western US, and I am lucky enough to have A) supportive family and B) really fucking good healthcare through my family. To be clear, if you do not have A and especially if you do not have B good fucking luck getting blockers, much less hormones or dear god surgery! It’s nigh impossible!

In early 2018 when I was almost 15, I came out to my parents. Immediately I was put in therapy (that had more to do with the depression and suicidal ideation I experienced while in the closet than being trans). While social transition (different name, different clothes) happened pretty quickly, it wasn’t until my mental health stuff was dealt with that my therapist and doctor, both on the trans youth specialist team, started talking HRT.

The first step was puberty blockers. To get that approved I not only needed parent permission and a ton of forms, I was all but required to bank sperm (as a 15 year old!) and I had to socially transition and meet a bunch of WPATH requirements (I actually like WPATH a lot, to be clear) and wait through a months long waiting list just to get an appointment with a psychiatrist, who then asked me a bunch of questions (he was nice, I do not remember the questions, this was years ago) to ensure I didn’t have some other problem. After passing that, I got a prescription for nogonadotropin as a puberty blocker.

From the time I first told doctors I was trans to the time I had my first blockers shot, a little over 6 months had passed. To be clear, in the US, that’s fast. In the UK? That’s impossibly fast.

It then took another 6 months of blood test, questioners, meetings with my doctor and my parents and my therapists before I was finally cleared for estradoil tablets. 1 mg/day. I got them nearly on the year to the day from when I came out. I was nearly 16

Again, that is crazy fast.

Within a year and a half my estradoil doseage had increased to 6mg/day and I was on 100mg/day of progesterone as well. Eventually that became 200mg/day. Years later I switched from estradoil tablets to estradoil shots.

The entire time I have seen the same therapist, not just for trans healthcare but also mental health stuff. I got SSRIs for anxiety, got an ADHD diagnosis, etc.

In fall of 2022 (I was 19), I reached out to my doctor to say I wanted bottom surgery. We had talked about doing it before, but I had always said “I don’t know if I’m ready.” I was unsure. And even though I could have gotten at least an orchiectomy after I turned 16 if I really wanted to (with parental permission and I am sure so much medical red tape I would have been an adult by the time it happened), I never wanted it. My doctors were surprised I wanted it, so were my folks.

I had to meet with my therapist several times, coordinate with a social worker, and get 2 or 3 letters of recommendation from doctors. Then I needed to unravel who and what my insurance cost and find surgeons I wanted to consult with. That took MONTHS. It wasn’t until fall of 2023, a full year later, that I was FINALLY was able to schedule with two of the three surgeons I wanted (we’ll get to that third one in a bit).

It is now the last days of august 2024. I had my first consultation, which was out of state, earlier this month. It went well. If I had scheduled a surgery date right then and there, there would have been a year long wait time. Which again, is a very very small wait time. I didn’t though, because I wanted to consult with other surgeons and I knew that would be smack in the middle of graduate school.

My second consultation (which, ugh, I need to do some phone calls for to figure out transportation!) is in a few months. The third one? I’m still on a waiting list to GET A CONSULTATION.

To be clear, neither my parents nor my doctors ever pressured me into anything. My folks were completely blindsided when I came out and had basically no idea how to proceed besides using a different name. My doctors always said “well, here’s your options and all the risks. You want that? Okay, think on it for a month and we’ll discuss next steps at our next appointment.” All of this was my choice. Mine. And they never tried to stop me either, just make sure I was being safe and following procedure.

Both my younger sister and my cousin on my mom’s side are trans as well. Considering we have several blood relatives on that side of the family who are also LGBTQ+ going back at least to the 1940s, assume there’s a genetic predisposition for it. Both my sister and my cousin have had a lot harder of a time getting HRT, even though my sister has the same insurance, same provider, same psychologist as me (idk what my cousin’s insurance situation is).

Odds are, I will have my graduate degree (environmental engineering) before I undergo surgery. Maybe even before I have a date for undergoing surgery. If all goes well, I graduate in may 2026. I’ve agreed with my girlfriend that once we graduate in 2026 if we’re still together I’ll feel comfortable getting engaged, so it’s very possible that I will be fucking married before I get SRS. Y’know, assuming it isn’t outlawed or anything.

When I was 14, I figured out I was a girl. Without talking to anybody, I knew I wanted a female body and that the puberty I was going through wasn’t right. Looking back, there were times I almost knew when I was 11, when I was 7, when I was only 3. At that age, I considered “surgery is something I might do when I’m older. I dunno. Right now I have crippling depression and cheat dysphoria, I really just want to be called the right name and pronouns and have HRT.”

I am now 21. I haven’t undergone any surgeries in that time, at all (except wisdom teeth removal ig. Does that count?). I have had one (1) SRS consultation, and the soonest I could get surgery is a year from now, but odds are it will be in two years. Maybe three even.

There is no epidemic of children being told they are trans and getting surgeries. That doesn’t fucking happen. If you’re really worried about kids getting unnecessary surgery look into the weird world of rich white girls getting facelifts and breast enlargement surgeries and stuff. At no doctor’s office in this country can you walk in with one set of genitals and walk out with another at the drop of a hat. There is a YEARS long medical process that happens before a consultation is even scheduled. And before that there is a trans person’s entire earlier life of doubt and questioning and fear and pain.

[justkidneying]

Doctors and nurses

What do writers get wrong (be it book TV show or fanfic) about how doctors and nurses go about their jobs? I saw the post listing that common inaccurate medical tropes are having the doctor do everything.

So what should writers keep in mind about doctors and nurses and potentially other hospital staff be it for an ER scene and/or a few days of hospital stay?

So I can write about this from two perspectives: an ER tech and a medical student. First, when I worked in the ER, I was able to see how much nurses actually do. They were the ones who saw the pt first, did everything they needed, and cared for the pt throughout their stay. Doctors usually only see the pt once when they come in, and another time when they know what is wrong. The nurse does the IV, the drug pushing, the catheter insertion, all that.

Now, from the perspective of a future physician (god that sounds pretentious): I know how to do an IV, stick an NG tube, etc. Am I going to do that? No, that's a nurse's job. But if for some reason the hospital is short staffed, sometime the docs do have to do that. So docs have to know how to do everything (but some are really bad at it). They also figure out what is wrong with the pt, order testing, order meds. Also, if you need surgery or any kind of procedure, that is a doc.

So I think the main thing to remember in writing is that nurses get way more face time with the pt (and they do most of the grunt work), but the person who everything rests on is the doctor. So it is a really balanced system where the doctor is in charge, but the nurses are doing a lot of the tasks. I hope that makes sense and doesn't offend anyone. Everyone in the healthcare setting is important, but there has to be a team leader. Being able to accept a direction and accept criticism is important for everyone in order to insure good pt outcomes.

[nrdmssgs]

Darker matters (part 1)

Masterlist Next part

Comfort Pairing: Nikolai x Olga 'Zhar' Samoilova Summary: Saying goodbyes to her old life and finally getting a name. This happens a few days after A heart (part 4) Author's note: This is a sequel to A heart full of pity. Thanks: My eternal muses: @homicidal-slvt, @sofasoap and @gamergirlbonestaskforce141riot. These people started something beautiful and very important deep inside me. Thank you for a voice, i`m slowly getting.

“How did you even manage…” Price smirks, but his voice is soft.

“Let’s just say, I have a better insurance program.” Nikolai's hand lies down on her shoulder, as she signs one paper after another. Then his fingers brush her back in the most soft and caring gesture. 

Captain's gaze is louder than any words. You cunning scoundrel. And against all his habits, his old friend doesn’t turn everything into a joke this time. 

When the last signed document falls on his desk, Price sighs and sits down beside her. “A word alone, ok?” Nikolai immediately turns to exit the office, but Price adds, this time talking to him: “And you don’t try to sneak away, I still have something to say.”

Nikolai smiles ominously, leaving them two alone. 

Price looks back at her, lightly tapping his fingers on the desk. When he speaks again - he sounds different: uneasy, concerned. “How are you doing? What are medics saying?” 

“I’m gonna be fine, I promise,” she brushes Price off, but then sees her Captain's eyes and understands, she owns him much more than subterfuges. “Running or moving around fast in general is still not as easy as it was before. There is still much work ahead. But I won't let this throw me off the track. And Nik found an absolute genius of a doctor, that has been working with injuries like mine for more than 30 years. So, I guess, I have a solid support team.”

“Right.” John is relieved to hear it: no more problem denial, only willingness to work with whatever life threw at her. “Right, it's high time this man runs around for someone. Good for both of you. Now, listen to me: all these papers, you signed, to resign… I don't give a flying fuck about that. You are one of us, no matter where you are or what happens.”

She freezes for a moment, caging emotions. But John Price, the man, she idolized, looked up to, telling her, they are one team for life was too much. She jumps up and hugs him. And just before she is ready to let go - her Captain answers on that gesture. 

“One more thing. I may trust Nikolai with my life, but if he ever brings you down - don't hesitate to remind him, you have friends in the military.” 

She doesn't even step out - she flies out of Price's office. Never before has Nik seen such a wide smile on her face. He instinctively reaches out to her, but someone's hand falls down on his back and squeezed his shoulder tightly. “Now to you, comrade.” Price's grumbling didn't scare Nikolai, he just turned back to his friend and leaned against the wall. “You know, how much time I've spent on training this soldier?” Nik nods, still looking after her. “And you know, that this is one of the best urban combat strategists out there?” Once again, only a silent nod instead of an answer. “So you come marching into my office claiming, you'll get my lieutenant back in the game, then you take her ‘for a ride’ for a few weeks, just to return her for a day to sign resignation papers.” Price keeps his voice down, so that nobody hears them.

“And… she is back in the game, isn't she?” Nikolai looks back at Price with the most innocent eyes.

“She's in your game now. And I'll let this slip only this time. So remember, this is the first and the last time, you steal me of a soldier. A damn good one, Nikolai…” John straightens his shoulders and stands next to him, arms crossed on his chest. But Niks eyes are once again glued to a doorway, where she just disappeared. 

“I don't play this time. Anything, I tell her, anything I do - I mean it. Had enough games.” He finally looks back at Price and notices happy wrinkles at the corners of his eyes.

***

The first time, she tells him, Gaz doesn't believe her.

“Nikolai? Of all people out there…” He dodges a pillow thrown at his head and chuckles, helping her to pack her stuff. 

When they are done and finally sit on the edge of her bed - Gaz reaches out and hugs her with one hand. “Kyle? You think, I'm crazy?” It's only around him, when she allows herself to be soft, joking, silly even.

“For working for him? Na-a-ah, you'll do just fine anywhere. Sleeping with the guy on the other hand…” If she could grab her pillow - this time, it would definitely hit the target. But Gaz was prepared, so he pushes her potential weapon so far, it's out of her reach. “Relax, Lt, I just mess with you goodbye. Besides… I, too, may or may not have started to grow a soft spot for pilots.”

Her mouth falls open, and she hugs him back with a mischievous grin. “Next time i'm back, you are telling me everything! And if that guy manages to bring you down somehow - you just call me.” “Same goes to you.” Kyle thought for a bit and then added. “Just… make sure, Nikolai is away from his transport, and then call me.”

*** She awaited, that parting ways with Ghost would be most reserved and dry. When she came to his office to fetch some additional papers, he already had everything prepared and handed her tightly stuffed file. “Thank you, Simon.” She pulled the file from his hand, but he didn't let go, and she immediately tensed. Something was wrong? It must be his name, never before she called him like that. She slowly rose her gaze to his face. “Sorry, Lieutenant, won't ha-”

“Do you remember how to contact me in case of an emergency?” He looked confused, as this was the last thing, she thought, she'd hear. It caught her off guard, and she mumbled something incoherently, so Ghost repeated his question. 

The thing with Ghosts phone emergency numbers was that they were not to be written down anywhere. And it didn't help, that there were a few, and he made her learn by heart every last one of them. She thought, that at least now, when she's out of the TF - she may as well forget this information, but Simon had another opinion on this: he made her recite every single one for a few times and only then loosened my grip on the folder.

“Ghost? I heard this joke about reaching out to each one of you guys, in case Nikolai doesn't behave, at least for three times today. You don't find your version a bit over the top?” She flipped through the papers in a file.

“I'm not joking, Olga.” First time. It was the first time, he called her by her name. “I know, that man would never deliberately hurt you. But the business, he takes you to, this organization… Let's just say, that world, you're about to step in, is full of darker matters.”

***

Nikolai never thought, the hardest part would be to keep himself in hand after bringing her to his secluded house in the middle of nowhere. The way this woman, always reserved, weighing her every reaction, froze on the steps before his door. The way she stepped into this spacious house, sheltered from prying eyes by dense forest, reached an enormous panoramic window and just sank on the floor, made him weak. 

“You know, there is… a whole house to explore back there?” He sinks to the floor behind her and rests his chin on her shoulder, watching as she peers into the forest outside the window.

“Wait. Wait just a bit, please. This is so beautiful.” She does not take her eyes off the view. Nikolai looks at her face: from under the mask of a calm hardened soldier emerges a childish delight, long forgotten by her. 

Stay. 

He bites his tongue to not say it out loud: Nikolai knows, that this woman is not that easy to domesticate. A nice house wouldn't do the trick. But a sudden need to keep her right there, cover her from prying eyes, surround her with care, do anything just to make sure, shed be right there every morning and evening, is pressing down on him, squeezing his throat with a force that Nik had never felt before. For now a smile slowly blooming on her lips, as she watches wind high up in the crones, is enough for him.

He has to leave her for a few days to make final arrangements before their very first mission together in Chimera. And while this is not too hard - coming back to his house and finding her there, sitting in a hall on a first floor, surrounded by maps and files feels tough. Everything in the way, he finds her, reminds Nikolai of that time, they plotted an operation after the incident. Only this time he has a formal power to end it and keep her safe.

Throw away these plans, forget the maps, and just stay here. You don't need to go back to that battle. Stay with me.

He presses his face to her hair, drowns in her scents, and only that helps Nik to swallow his unspoken plea.

***

“So… still haven't changed your mind about sketchy call signs?” Despite the fact that Nikolai's voice is slightly distorted by the quality of the radio, she clearly hears the notes of a playful mischief. She shakes her head and points forward, trying to make him pay at least a slightest attention to what is about to start happening. 

“Aw, what a pity. And here I am, hoping for a little show.” Helicopter froze in one place, as they both needed a solid point for observation. Nik turned to the radio, but didn’t stop talking. “You know, there are mythical birds besides phoenix? Even in Russian fairy tales there is Sirin, Alkonost, Zhar-Ptitza, which is, by the way, a personification of eternal golden fire of sun itself.” 

Her eyebrows rose in surprise and disbelief. “Nikolai, we are about to start a full-blown armed conflict, and you have fairy tales on your mind?” “We are about to have some fun, Lieutenant, I just want you to enjoy it as much as possible.”

He switches on outer radio-chanel and addresses his subordinates.”Morning, this is your Captain speaking. This operation was planned and will be led by my second in command, Lieutenant Samoilova. Now, our rules were always simple: want to make money - make me happy. Today, we will give a test drive to a new rule: want to make me happy - make her happy. Her commands are my commands. Have fun, Chimeras, leaving you with your commander. Over.”

She is about to activate her own connection, when Nikolai catches her hand, and leans closer, as if they didn't speak through an inner radio. “Edgy names make everything more fun, i'm telling you. Last chance to come up with!”

She looks from him to a village underneath them. More fun, he says? She sighs and connects to an outer channel.

“Good morning, Chimeras, this is Lieutenant Samoilova speaking.” She stammers in mid-sentence, takes a last look at Nikolai and takes a deep breath.

“Call sign Zhar.”

Next part

[lets-donate-a-kidney]

Reasons Why You Might NOT donate a kidney

Your medication requirements aren't compatible

After donating a kidney, you may have to change the medication you take to minimize stress on the remaining kidney. For instance, all kidney donors are supposed to avoid NSAIDs like ibuprofen, Aleve and aspirin, and to take Tylenol (acetaminophen) instead. You may also have other medications (including psychiatric meds) that would need to be changed.

If you aren't able to take Tylenol or find substitutes for other medications, it may be worth thinking long and hard about whether donation is right for you. Your physician and psychiatrist will be able to give you more information if needed.

You're scared of needles or blood

You will get your blood drawn a lot in the process of donating an organ, and may also get an IV drip after surgery.

You're nervous about surgery

That's valid! All surgeries and anesthesia do carry risks. The risk of long-term complications from donating a kidney is very low, but it's your body and your choice, period.

Your family has a history of kidney disease, or you already have just one kidney.

Some people are born with only one! Or if you think there's a good chance you'll need two, it's totally rational not to donate one.

You've had issues with painkiller addiction in the past

After surgery, you may have a morphine or fentanyl drip in the hospital, and you're likely to be prescribed an opioid painkiller. The amount of painkillers is normally not enough to create a physical dependency. But for some people in addiction recovery, this may still be concerning.

If this worries you, I highly recommend discussing this topic with your physician and the surgeon, and following their advice. Medical professionals in the USA cannot report you to law enforcement for using illegal substances.

Any other medical conditions that make you a bad candidate

Your own health is important, and it might also affect whether your kidney would be viable in someone else's body.

You'll get scanned to hell and back during the screening process, so if there's any medical issues that would get in the way, the transplant team will tell you. They will NOT remove your kidney if they believe the surgery or loss of the kidney could harm your health later.

You want to make a connection with someone

Yeah...don't go into this process expecting it to change your life, or win you lots of praise, or hoping to meet the recipient (if you donate to a stranger like I did). What if your recipient turns out to be someone you don't like? What if you stay in touch but the kidney fails after a few years? What if you were hoping to feel better about yourself, but a month after surgery you realize you're still the same old you?

(Personally, I do feel like it changed my life for the better, and some people do form strong relationships with their recipient after the transplant. But people can have a lot of different reactions. Nothing is guaranteed.)

I chose not to contact or receive contact from my recipient, or to hear follow-up reports of how they were doing. I didn't want them to feel indebted to me, or for me to unwittingly place expectations on them. You might choose differently, which is valid - but make sure you'd be okay with not ever hearing from the recipient, too.

You can't afford it

This isn't always a hurdle. If you donate through the National Kidney Registry, for instance, they'll try to compensate you for any lost wages during your surgery and recovery period. You won't bear the cost of surgery or follow-up appointments, either. At least, that's how it is in the USA.

However, I did have to take time off work to go to the pre-surgery appointments. I did have to buy extra groceries for before and after the surgery, an abdominal binder and robe, and a few other costs. If I get medical complications later in life, I will have to pay for those either out of pocket or with health insurance. These may still be serious considerations for you.

You can't take enough time off to recover

My surgery team recommended two weeks off work - even though I work from home. They also wanted me to have someone present to drive me to and from the hospital, and to stay with me for the first few days after surgery. Your own job, childcare needs, or transportation/living assistance needs may impact your ability to do this.

You just plain don't want to

As I said, it's your body, your choice. You never, ever have to undergo surgery and give away part of your body for someone else. Even if you love that person and they're in pain. A donated organ should be a gift given freely, and gladly, not a source of fear or worry for you.

If you aren't able or willing to donate yourself, there are still many ways you can help people in need:

You could donate blood or plasma, which regenerate over time and don't require surgery.

You could help a prospective kidney donor by offering childcare while they're in the hospital, transportation assistance, or helping them recover after surgery.

You could register as an organ donor on death, so that your body isn't affected at all while you're alive. In the USA, only 60% of adults are registered as organ donors even though 90% support postmortem organ donation.

You can spread awareness of how organ donation works! Many people don't realize that they can donate a kidney, even without an intended recipient. Or they might believe it's more dangerous or debilitating than it actually is. By sharing educational resources about it, you can still increase the likelihood of more patients getting kidneys.

[kurgy]

shit is rough, I'm grieving, the chaos has ppl growing distant, but there are still good things happening:

my spot on the apartment waitlist has moved up, and I will likely get a choice of where I settle depending on family/job placement

an exciting job opportunity, discussing details now and prospects are looking good

my food stamp application will likely be approved

debilitating mystery illness is getting worse, but I do now have a medical team making appointments and tests trying to find the cause and proper treatment, it's been getting significantly worse the last few years, the only medical shit that helps long enough for me to properly digest food is prescription omeprazole and weed if affordable, but if I can hold out and budget a little longer they may likely find a root cause to fight and (insurance willing) my health and general quality of life will improve

I've been finally successfully placed back on testosterone, and although I've had the vile untouched for a week out of fear I swear i will build the courage to restart the process

I'm trying, I'm working hard to improve, and I'll be here for Arlo

[findingmypeace]

4/29/2023

I don’t know. I’m not even sure what to say. I want to update but I also don’t feel like I have the energy.

I’m not sure how much of the specifics I wrote, especially since it seems some of my posts ended up saved in my drafts instead of actually being posted.

After my therapist said she wouldn’t see me again until I at least started the process of getting on waitlists for treatment centers I reached out to 3 places.

*One of those places was the treatment center I was at most recently. They are the ones that think I should try somewhere new since I’ve been at their place a few times.

*The second place I reached out to is a place I have been to before but it’s been 6 years since then. I was able to get an intake assessment scheduled with them but it’s not until May 22nd. This place is actually my first choice. Yes, a *tiny* part of it is that it will be awhile until I’m admitted but, having been there before, I did actually think it was a good program.

*The third place was initially ruled out because they don’t take my insurance. However, in emailing back and forth with their admissions coordinator she mentioned that a few people with my insurance were recently able to get single case agreements and therefore be admitted. They’re going to work with me on figuring out all the insurance stuff. They wanted to move forward with an intake assessment and that somehow ended up getting scheduled for this morning!

*A few things from the assessment. The person doing the intake said I would receive a phone call next week (ie: week starting 4/30) with their recommended level of care and the next steps forward. I asked if they had a waitlist and she wasn’t sure (she was one of the therapists rather than someone from the admissions team) but she didn’t think they did. PANIC!!! I mean the insurance stuff still has to be worked out but this seems like the possibility to be admitted is very soon and I am not okay with that.

*I reached out to this specific treatment center because one of my friends from treatment had previously been there and had mentioned they have a good inpatient unit. For those not familiar with ed treatment in the US there is a difference between inpatient (ip) and residential. Inpatient treatment has a much higher focus on medical care. For the most part, in order to be admitted to a residential LOC you have to be medically stable and if you aren’t medically stable the recommendation is usually to be admitted to ip first and then step down to residential. For me, I really have no idea what would be recommended. My vitals seem fine but I feel so awful. During the intake this morning I did explain the situation so I’m really unsure of where that would put me in regards to ip vs residential.

*One thing I forgot to mention during the intake this morning (because I only found out about it on Thursday) is that I am FINALLY scheduled for my echocardiogram on Monday morning. At this point, my guess is that the results will be perfectly normal and healthy. But I know it’s probably good to get this done anyway. From the way my psychiatrist has talked about it he believes this is the test that will show us whats wrong. I don’t know.

I just feel so overwhelmed. I’m still really unsure about going to treatment. I have yet to say anything “official” about treatment at work. I mentioned it (only once), in passing to my friends and that was over a month ago. I haven’t said anything “official” because I do not want to go. I truly have no idea what I am going to do. I know I could probably fight it (ie: outright do the opposite of what my treatment providers want and not go/stay home) but I truly have no idea what the outcome of that could be either physically or mentally. I know I can’t keep going like this forever. And, yet, the idea of...any kind of change is just too much and I’d really rather just hide forever.

[harmonicsys]

The Accident

When making the best of a bad situation, a witch arrives to give an unexpected option, requiring a bit of self-reflection before the protagonist can make a decision. Trans vibes.

CW: major injury, body transformation, medical coercion, gender dysphoria, depersonalization, deadname mention, anxiety, derealization, eye contact, medical situations, consensual dehumanization, misgendering

The truck came out of nowhere. Metal buckled and squealed, glass shattered and sprayed, and plastic strained and tore.

There were no memories after that, for a while. When consciousness finally returned, everything was fuzzy; there was some sort of room with medical equipment and an attendeant.

The attendant realized the patient was awake and went to fetch the doctor.

Strolling in with a digital tablet, the doctor looked over the hospital bed and remarked, "It's great to see you finally awake."

She continued, "If you're feeling up to it, I can catch you up on what's been going on since the accident."

Accident? Oh… something about a truck and broken glass… The patient sat up a bit, or at least attempted to, and stammered, "Y-yeah, uh, go ahead." The room was less fuzzy now, but everything felt like a dream… maybe it was?

The doctor looked the patient up and down somberly before continuing, "Okay, this is a lot, so we'll go slow and I'll come back by again in case you have more questions later. Not to be a medical cliche, but there's good news and bad news. The bad news is, some of your body was damaged in the accident. The good news is, you're alive and in a world where we can replace pretty much any part of the body. It also may be possible to fix everything with surgery and extensive therapy, but the process would be long."

The dream had become even more unreal than it seemed before. Vision seemed to narrow, going dim around the edges. The patient's ears were ringing, and thinking was becoming more cloudy than it was upon first awakening.

The doctor continued explaining, "There's more bad news, though. Your insurance isn't great. So if you want to opt for replacement, it's probably only going to cover basic replacement parts, but we do have a patient advocate team that can help you try to secure a zero-interest medical loan that may enable you to have better replacement parts to give you a more normal body."

A growing sense of shock and horror crept across the patient's mind. Looking down revealed abdominal damage and tubes leading to a number of machines. The lower limbs also showed signs of major injury and had hardware mounted around them. No wonder the earlier attempt to sit up in bed failed.

The doctor tapped a few buttons on her tablet then looked up again and spoke, "My name is Dr. Corsi, but you can call me Jasmine. I'm going to have the patient advocate come by and help you figure out how to make the best of an unfortunate situation. Please don't hesitate to have someone fetch me if you have medical questions about any of your options."

Jasmine left and was soon replaced by a smiling, eager fellow with some brochures who introduced himself as Mike, with a last name that sounded like Attenboro or Aldanburo. Thoroughly overwhelmed, the patient muttered, "Could you just leave the info about my options, my head is hurting terribly and I can't focus." Mike departed, and the patient fell asleep.

* * *

"Hey, how are you feeling today?" chirped Mike, now on his fifth visit. "Have you made a decision?"

With an eyeroll, the patient answered, "Look, I just don't want to be in more debt. I know I won't have much functionality with the basic parts, but I'm not sure I'm going to be able to go back to work regardless of what option I take. So how would I ever pay off that nightmare of a loan? And I am just not interested in placing all my hope in natural healing fixing everything slowly,"

Casting his eyes down, Mike spoke more softly, "Yeah, I mean, I am trying to give you the best option here that gets you back to normal quickly, but if it's unaffordable then it would be unethical to saddle you with the debt. But… I think I know someone who can help, it's just… it's a little unconventional. And there may be some other things you'd have to be ready to sacrifice, but it wouldn't be your finances."

The patient's eyes grew wide.

Mike looked nervous, "Look, let me make a phone call. And let me look into something else more official, too. Because I really think the cybernetically controlled legs and fully synthetic organs are your best bet."

Mike left the room for a few minutes before returning with a phone. He offered it to the patient, saying, "I have someone you may want to speak to."

The strange voice on the other end of the line was strong and charming as it greeted the patient, "Hello sweetheart! The one who has been speaking to you about your options thought you might want an introduction with its owner. Rather unconventional choice for it to make, but part of the agreement is that it has full autonomy at its job. So, tell me, little one, what is your name?"

The patient began, "Hi, my name is Josep---" but was interrupted at the beginning of the 'f' sound.

Amused, the strong voice on the phone jumped in, "Hold it. Is that your real name, or the one on your birth certificate?"

The patient felt clammy and a little nauseated, unable to respond.

The voice on the phone continued, "Let's try that again. What name would you like to be called?"

The patient paused for a minute and managed to say, "Call me Jo---uh, Joanna."

The voice on the other end of the line sounded pleased, responding, "Ah, I thought so. Joanna it is, then. Joanna, if you want to be out of that hospital quickly and can't afford the cybernetically-enhanced and fully-synthetic parts, I may have an option for you. But I'm not going to discuss it over the phone. Would you like to meet me? I'll come to you. And only say yes if you're interested. If you're not, tell me no, and I will take you at your word and leave you alone."

Joanna was puzzled. She didn't have a lot of experience with people taking her word seriously, and hardly ever had anyone really wanted to know what she wanted to be called, always assuming her legal name and gender were the right ones to use.

In fact, Joanna was more than puzzled; she was overwhelmed to the point where the room started spinning. She took a deep breath and replied, "Yes, but maybe tomorrow," before handing the phone back to Mike. Joanna blurted out, "Mike, I need some privacy for now," before closing her eyes and trying to calm down.

* * *

Mike showed up the next day with a tall, mystically dressed figure, who immediately seemed to recognize Joanna.

The figure spoke in that charming voice again, "Joanna, my name is Isabel and my pronouns are they/them. For now, that's how you'll refer to me."

Isabel leaned in and asked, "How are you doing today, little one?", looking at Joanna square in the eyes, causing Joanna to squirm and look down.

Isabel stood back up straight and frowned a little, remarking, "I see I've made you uncomfortable. Let me say this: I don't expect you to make or maintain eye contact if you don't want to. I have many ways in which I can communicate; it may take some time to find the right ones to use with you."

This confused Joanna twice over. She was used to people not only expecting her to return eye contact constantly but also for people being unwilling to accomodate what she thought of as her quirks. She was also very surprised to see anybody notice that it was the intense eye contact that bothered her; most people ascribed the wrong reasons to her reactions.

Joanna replied, "Mostly, I think I want to get out of here. It's nice to meet you in person, though I'm not sure what it is you can do for me or why we had to meet in person." Joanna was not a fan of in-person conversations, as the other party would often expect her to interpret their body language.

Isabel smiled at Joanna. "Little one, because I want to show you something that I can't show you over the phone. I don't do things without a reason."

Joanna had become more annoyed and raised her voice, "Oh yeah? Well why do you keep calling me little one?"

Isabel maintainer their calm demeanor. "I have a knack for guessing what people want, but it's only a guess. If I'm wrong, don't hesitate to let me know. If you would like me to stop calling you little one, then say so --- or write it on a note if it's hard to say it out loud."

Joanna shifted from being annoyed to being tense and nervous. "Actually… it's okay. I can't understand why, but it's comforting to hear."

Isabel smiled again. "I'm grateful to hear that. My intuition was correct again, but please inform me if it becomes clear that my intuition is wrong in the future. It's not always right. Can you do that?"

Joanna was wondering what the point of all this was, but answered, "Okay, I guess I can. So what was it that you needed to show me in person?"

Isabel's eyes sparkled a bit as they simply said, "This," and waved their fingers at Mike. The air swirled around Mike for a moment then cleared.

At first, Joanna saw nothing unusual. Then she noticed one of Mike's elbows was not a normal human elbow; it looked more like ball and socket joints crafted from a composite, and his forearm was covered in runes. The upper half of Mike's face also seemed to now covered in runes, with parts of his eyes, nose, and forehead carved with whorled lines.

Mike spoke up, "There were a few injuries, to one arm and parts of the face, and there just weren't good, affordable options at the time. Isabel helped… and fixed some problems with a deviated septum, as well," gesturing at his nose, which had seemed to become shifted to one side.

Isabel clarified, "I can make small changes, or build off of existing medical work. My magic can't work any wild miracles, but it can help. What you're seeing now is how it appears without my enchantments, more or less."

Joanna's mind was racing. Not only could this offer a solution for her current quandary, but… Joanna started speaking, "Isabel? What other kind of small changes can you make? Because I… have had some things I've wanted changed for a while, just little things that…" before trailing off. Her mind started spinning and she felt her cheeks redden.

Isabel eyed her curiously. "What things do you want changed? My intuition is giving me an idea, but I am going to need you to be specific."

Joanna gulped. Her mouth and throat had gone completely dry. "I have… I've wanted to find a gender clinic, and… I mean I've looked into… I don't know how to find a doctor that can help with…" She couldn't seem to bring herself to complete her thoughts aloud.

Isabel said, "That's enough to clarify. If you are wanting to feminize your body shape or change what's in your pants, that falls under the realm of what I can do. In fact, I didn't always look how I look now, so I know quite a bit about this. Why do you think I got into the study of magic?"

Smirking, Isabel continued, "What I ask from those who seek my help is, effectively, to do my bidding. I am not going to ask for anything impossible, and I won't overly burden anyone. But it brings me great pleasure for others to carry out the tasks I give them."

They wiggled their fingers at Mike again, commenting, "I don't want to keep it standing around with eyesight missing in one eye or with reduced range of elbow motion for no good reason; I have little interest in cruelty. But I wanted to show you how it looked both with and without my enchantments so you'd understand." After another shimmer in the air around Mike, he had returned to his normal form. Wait… normal? Joanna wondered which one was actually his normal form, or whether she needed to stop thinking about what was normal and find a different way to think about all this.

Joanna, head swimming, managed to say, "Okay… so, I---I am not even sure what to say right now. I guess what I want to know is, what are these tasks? What is your bidding? Why do you keep calling him an it? That seems… dehumanizing, doesn't it?"

Isabel smiled sweetly. "Little one, most of these tasks are fairly mundane; helping me around the house, helping me with my magic. Some of these tasks do get a little spicier; a witch like me draws upon the intense power of erotic energy for some of my magic, as well as other important powers of friendship and love. In fact, I'm only interested in doing this kind of magic on those who are fully willing. As for your other question, I will let it answer on its own."

Mike spoke up, "This one is not really human. It is a combination of human flesh and medical technology and magic. It has moved beyond humanness."

Joanna, thoroughly confused, responded, "Okay sure but why are you talking so funny? It's like you stopped saying 'I' as soon as Isabel showed up."

Mike responded, "This one has embraced its new sense of self and its new role in service to its witch, as well as in service to others through patient advocacy work. It has decided to exist as a helpful animated doll, though not quite like the clockwork kind that needs winding. It chooses to function as one of the larger collective of dolls that serve this witch. Hence, it is 'this one' when it references itself, at least outside of work or in front of its witch."

This was just too much for Joanna, who had often not been treated as an equal by her peers, for having unusual interests and struggling to fit in socially. "I need you both to leave. Now. And I'm surprised nobody from my medical team has come in this room this whole time that we've been talking!"

Isabel placed a folded card on the table next to the hospital bed. "Joanna, I am happy to leave. I have written my number on this card, but it sounds like maybe you'd be better off exploring medical-only options for your injuries as well as seeking out a gender clinic. I do hope you find peace… little one." And with that, they stepped out of the room, leaving only Mike.

"Before I go," started Mike, "I did have an update on your financial situation. I was able to secure one of the limited number of medical grants available. They're normally reserved for people with no insurance, but I asked if they could make an exception. So if you want the cybernetic and fully-synthetic option, you won't end up in terrible debt."

Joanna was left alone as Mike walked out of the room as well. Her mind was racing, and she kept leaping wildly from thinking of being humiliated for much of her life for being different, to being controlled and manipulated by past abusers, to her current situation, to the display of magic she had seen Isabel demonstrate with Mike. It was far too much for her to take in. She was intimidated by what Isabel seemed capable of, but fascinated by an image that kept appearing in her mind: a doll-like figure that resembled her but with more curves, scampering around doing chores and flashing flirtatious smiles.

As her mind jumped back to replaying scenes of past hurt, she closed her eyes. Her exhausted brain started drifting away from reality, and luckily into sleep.

* * *

Joanna woke with a start. She had woken from a strange dream where she her body had been transformed into a body that she'd been much happier with than the one she'd had all her life, the one which was now in a hospital bed and in need of repair.

In the dream, she had felt free.

In the dream, she had felt like she was finally herself.

In the dream, she was beautiful and strong.

And in the dream, she was carrying out assorted household labor for a tall figure who didn't force her to make eye contact when she didn't want to, who didn't call her homophobic slurs for being different…

In her mind, she replayed the scene from when Mike and Isabel were in the room. Mike had come by at some point and left information about the grant on the bedside table with a note that read, "There's a list of resources for the other thing you mentioned available, if you want that too," very likely referencing a list of gender clinics.

Her ruminating was interrupted by Dr. Corsi.

"Hello, Jos---" started the doctor, but Joanna jumped in before the name could be completed.

"Hi, Jasmine. Mike brought me some news about a grant."

"Yes," responded the doctor, "he managed to get an exception to our policy for you. So the insurance is not going to be the problem that it seemed to be at first."

Joanna's heart was racing in her chest. She glanced nervously at Isabel's card, also sitting on the bedside table. "Doctor, I think… I think I'd prefer if the hospital kept the grant to be used for uninsured patients. My insurance covers some basic replacement parts. I know they won't be as nice-looking or as functional, but…" She could hardly believe what was saying right now. Something in her heart was telling her that she was doing the right thing, even though it didn't make sense to the logical part of her mind.

"Are you sure?" Jasmine looked at her quizzically. "That's very noble of you, but, if I were you, I'd take the chance to get the best option that I can."

"Doctor, I actually totally understand what you mean about the best option. I know it's a little hard to explain but… I think just the basic stuff is going to suit me just fine."

"Well, I'm glad you made a decision anyway. You're stabilized from the accident and need to move ahead with surgery so we can free up this bed. I'll send our surgical consult tech around to go through all the paperwork with you."

As Dr. Corsi left the room, Jasmine's heart continued its frantic pounding. It suddenly dawned on her what she had just done: she had put herself on a path where she'd only regain full functionality if she enlisted some magical aid or spent a long time doing physical therapy. She didn't think she had the patience for the latter, though.

Or had she really committed to that? She could always tell the surgical consult tech that she had changed her mind again and wanted to take the grant, right?

Two hours later, after the paperwork had been filled out, she had not changed her mind.

She dialed the witch's number.

* * *

"Hello, my name is Isabel, I'm here to pick up a patient, number 57-12576."

The receptionist replied, "Ah, yes, he's coming out of the recovery room right now. Go back through the double doors and he'll be in room five."

Isabel winced. To them, hearing Joanna misgendered was like nails on a chalkboard. But, as far as Isabel knew, Joanna had not informed the hospital of her real pronouns, and Isabel was not about to out her without her permission.

Isabel made their way into the patient room on the surgery wing. "Isa… Isabel…" muttered a very sleepy Joanna.

"Ah, little one, it is so wonderful to hear your voice!" Isabel beamed.

"Can you… are you going to help… Can you help me make these ugly robot legs dance? I've always wanted to dance… Oh, and my stomach… I don't want to have the dietary, um, restrictions of these bottom-of-the-line organs… And I want to look in the mirror and see my real self, and…" Joanna trailed off as her eyes filled with tears.

"Sweetheart. One thing at a time. First, no part of you is ugly. But we can make you curvier and adjust your appearance with magic, which may help you find your own beauty that has been hidden from you. I promise that I can make you dance. In fact, I love it when my dolls ask me to dance! I can enchant your belly, and we will feast together on all sorts of meals that I will teach you how to prepare. You won't have to worry about dietary restrictions, and I will keep your favorite foods on stock so that you can treat yourself when you want to."

Joanna's confusion was a mixture of surprise and anesthesia that was still wearing off. "Wouldn't the treats be just… just as rewards?"

"Oh, no, little one. I don't mete out food based on your behavior---unless, of course," they chuckled, "that kind of thing is fun and consensual for you. No, I've found that giving dolls plenty of access to delicious treats helps them learn better self-care. My intuition is telling me that you might appreciate some lessons in self-care…"

Joanna's eyes continued to leak their salty fluid. "I am not always so good with taking care of myself. Are you a harsh teacher? I am anxious…"

Isabel took Joanna's hand into their own. "Little one, I am a very direct and efficient teacher, but I try not to be harsh. I suspect you've already been harsh enough on yourself in this life. No, I am here to help you flourish as yourself, in exchange for your help around the house and… maybe sometimes in the bedroom."

Joanna's eyes dried, but her cheeks turned bright red. She had no idea what to say. She shied away from most discussions of sexuality due to being painfully manipulated in the past. She could only relate to this kind of subject in the context of her old life, which was a life she did not want to return to or think about right now.

Isabel squeezed her hand gently. "Nothing before you're ready for it, though. We can wait to talk about that. Maybe after your curves start coming in? I've been preparing the runes for that spell since our first conversation. In the meantime, there will be plenty of other tasks of mine that you'll be tending to… as soon as they let me take you home, that is," said Isabel, a sparkle appearing in her eye as she mentioned taking Joanna home.

Smiling, Joanna looked into their eyes for as long as she could before the eye contact started hurting, then looked down at her hand in theirs.

Joanna's voice was warm and eager with possibility as she said, "This one can't wait."

[imtheworst-imsorry]

AN UPDATE: we just heard today (like literally at 4:15 or smth) that the residential i wanted to go to has a bed available for me on the 8th, so a week from monday. This is good bc i was getting seriously anxious that insurance might try to cut me before a spot opened up and then i would probably have to go somewhere i didn’t like as much, which would suck, but now my team can tell the insurance company we have a date for when i’m going on tuesday which is my next insurance review and hopefully they’ll give me until a few days before then so there’s as smooth a transition as possible. It’s also a nice coincidence that one of the girls i made friends with here is also going there, she got discharged today and she’s going there monday, so it’ll be nice to have a friend there already, we didn’t decide to go there because of each other, it just worked out that it’s where we both felt was the best program for each of us, and then we talked about it and found out we were both going there lol. One big thing to figure out is the logistics of getting there bc it’s on the other side of the country, i’m not gonna say where bc privacy but it’s on the west coast and i’m on the east coast, so it’s like a 6-6.5 hour flight i think, but i’ll figure it out with my parents and stuff. In other news, i tried a new medication for a week, my doctor was hoping it could help with my depression and also break up some of the more persistent ed thoughts, but i started having side effects on the lowest dose that isn’t really even high enough to be helping my mood so i decided to stop taking it bc it’s not worth it. My tremor was getting worse and i was having random muscle twitches and my occasional neck tics were getting more frequent, and this is from just a week on a dose low enough that i wasn’t getting any benefit from it, if i’d been on a dose that was really helping me mentally and i was having super mild side effects i’d have considered staying on it but it’s not worth it with everything going on, but at least i gave it a solid try, especially since i was SUPER anxious about some of the more severe side effects, but i figured the best place to be if you’re trying a new medication that has possible bad side effects is in a hospital, and thankfully nothing really bad happened, just annoying, and i’m seriously hoping they go away once i’m no longer taking it. I also tried something with peanuts in it today, which aren’t like a Fear food but i don’t like them and therefore haven’t eaten anything with peanuts for literal years and the last time i did have something with peanuts i got an upset stomach, so i was worried about that, but that was at lunch and i’m still ok, i still Do Not like peanuts but i was brave about it and tried it anyway, really mostly only bc they ran out of the caramel almond sea salt kind bars bc everyone really likes them and i did Not want the almond coconut one bc i Hate coconut so i tried the dark chocolate nuts and sea salt and it was fine, i guess i’d rather have that than coconut but i still don’t like peanuts. But the point being that i was brave and tried something i was apprehensive about, so good for me ig. I really hate when they run out of things and have to substitute stuff, both bc i usually don’t like the substitution as much (or at all) and bc i do not like change especially change about food, i like knowing what i have coming and i don’t like doing menu planning but i like getting to decide what i get instead of just having whatever my dietician picked, which is what happened for the first week and change i was here and was extremely anxiety inducing.

I’ll keep updating here occasionally, especially if something big happens and once i go to res, since that’ll definitely be a big change

[wanderinglotus7]

WAITING Season

Hello friends, it seems like forever since I actually posted something on here other than some photos and videos of a few trips I've taken. Your girl has been struggling, even drowning. Yet, I'm still standing! My physical health has been my greatest enemy lately. Without retelling my whole journey- because that gets exhausting- I have updates. So, back in 2022 I was diagnosed with PCOS and most of my symptoms stem from hormonal imbalances. From there I had many lab tests conducted and a few of them repeated which sucked. However, I'm happy that Dr. S was being cautious and doing everything she could before any major decisions would have to be made. At the beginning of 2024, I found out that my body is overproducing the stress hormone cortisol. Late March, a MRI scan revealed that I have a tiny noncancerous tumor located on my pituitary gland (located in the center of my brain). This tumor pressing on this gland is the root cause of my body overproducing the cortisol and throwing my body out of whack. The remedy is surgery. June 7th I met with a pituitary gland specialist doctor and surgeon. Along with PCOS, I was diagnosed with Cushings Disease which is related to the cortisol. They both said that if the surgery is successful all of my symptoms should go away for good. Thank you Jesus! Before I can schedule the actual surgery, I have to get a vision exam (June 27th) and a CT scan (July 1st). Each person is different but the recovery process should take about 3 months.

This is a sucky way of getting an extended vacation from work. A sucky way of escaping from Boston for awhile. I keep reminding myself and telling others that I'm bless to have health insurance to help with my medical expenses. I'm bless that all my specialty care (with the PCOS clinic & Pituitary Gland clinic) is under the same medical system-Beth Israel which I'm an employee at BIDMC. Nobody wants a tumor, but I'm bless that it's small & isn't cancer. I'm bless that I'm young because I can probably recover better compared to someone of an older age. I'm just BLESSED!!!!! Also, I've been receiving lots of support from the Adelante & CVPR team once I decided to share my story with some folks from work. My supervisor Cynthia has been really supportive, and I think I even made her cry one day when I was giving her updates on my appointments (sorry). On the other hand, I've had mixed reactions from family & friends that are aware of my situation. Another reminder that I'm really out here in Boston by myself. Not only that but this situation has shown me people's true colors. I don't need people in my life who disappear and go silent on me when I need them the most. Time to say Good-bye to those people. I don't need energy leeches in my life.

Going away to SC & VA gave me the space I needed to accept the fact I have PCOS & a tumor. Honestly, I've been numb about this whole reality and just coasting emotionally because I'm still trying to process my emotions and getting frustrated with people keep asking me how I'm feeling. I can't provide a answer if I don't have a answer for myself. The funny thing is about a week or two weeks before SC, I had a total mental breakdown over everything that's going on in my life. Caroline really came thru that day! I'm bless to have her as a friend. It was nice to have someone genuinely listen to me in that moment and didn't ask anything from me which is completely new and foreign to me. There is a reason why God places certain people into our lives at a particular time. I felt so much better after our conversation. That conversation has helped me have some tough conversations with some people and in combination with a writing prompt from my poetry class. I can identify those who make up my village and are truly my friends.

WHAT IS HOME? I'm still trying to figure out what home means to me and what home looks like. I mentioned this to my Grandmother, and what she shared with me finally clicked. Home is where you feel loved. Ding dong this is why Boston doesn't feel like home. Yes, I have a support system here, but it's not the type of love I'm searching for myself. Boston isn't conducive to the future I envision and pray for myself. Like Bobbie said to me this morning, "I'm trying to find where I belong". In my heart, I know I don't belong in Boston or even in MA. I belong somewhere else and that somewhere maybe in NC or somewhere else (who knows). I love my family, but I know Gloucester isn't my forever either though Gloucester, like Thailand, will always have a special place in my heart.

Boston has really tested my strength & patience. 8/7/24 will be 4 years since I moved here from Gloucester. I might be here for another two years because I'm determined to earn my LICSW which I can start preparing for the clinical exam next year. So, I should earn my license in 2026. From there, I can go anywhere! Boston has given me the opportunity to achieve my academic dreams/goals. Because of Boston College my first internship with Amirah open the door for me to be working with Adelante. Adelante has been my gateway into my involvement within the Anti-Human Trafficking movement. However working for BIDMC makes it feel like I'm working two jobs instead of one. I'm a social work advocate with Adelante. I'm a clinical social worker/advocate for the Center for Violence Prevention & Recovery. One side of my job shows me what I like about my job (Adelante). The other side of my job shows me what I don't like about my job (CVPR). Hopefully during my recovery time, God will provide me with the answers I'm looking for related to my career after I earn my LICSW. I still would like a hybrid work model, do counseling & advocacy, but not work in a medical center and not be On-call. In an ideal world, I would like to have a manageable work/life balance where I can work in a bookstore and on the side either be a counselor for those 13 to 25 years-old or be a supervisor/mentor for young professionals in the social work field.

In the bigger picture, I’m ready for a change in scenery. I’m ready to live in my own apartment or live in my first little starter home like a two bedroom. I’m sick of living with roommates. I’m tired of feeling like I’m living on top of other people. I’m tired of living in such a crowded space. I want my personal space back! I want to be able to either sit on my front porch or in my backyard without feeling like my space is being intruded on or cannot enjoy the peace & quiet. I want to be closer to nature without having to live in the middle of nowhere. I want a good combination between the city and country life but not live in the suburbs. At 27, I’m ready to settle down. I’m ready to enjoy a slower pace of life. The freedom to enjoy my cup of tea, reading & writing, maintain a career while enjoying being a wife & mother.

I told myself before 2023 ended, I’m going to invest more into myself from my physical health to my emotional health to my creative life. I slacked a bit between April and May, but I’ve been able to lose some weight. I’m 5lbs away from my summer goal. I had a few hiccups but I’ve found peace with my relationship/breakup with my ex and my mental health is at baseline (no panic attacks). These poetry workshops I’m attending have been therapeutic and are a nice distraction from my world. A healthy avenue to channel my art and release any stress in my life. Also, I’m learning and gaining so much skills to improve as a writer and a poet. It was a disguised blessing that Mariposa didn’t become a finalist in the Button Poetry chapbook contest, but it was for the best. I realized I wasn’t truly finished writing my story until I released that piece of myself that was holding on to Erik. I’m proud of myself for setting and being firm with my boundaries in all aspects of my life!

My path may look a little different now, but the destination remains and looks the same. I’m still going to Jamaica next July (2025). I’m looking forward to attending Caroline’s wedding. In honor of my Granddaddy, I’m getting a Bluejay tattoo because he has been my protector since he passed away. I’m looking forward to publishing Mariposa. I’m emotionally prepared to enter my next relationship. I’m still growing my relationship with God and doing my best to live like Christ. I’m taking control over my life!

[hikarisouai-blog]

The perks of salary - during the off seasons, you get paid to do nothing at work except scroll social media looking for time to kill or something to do. You have weekly meetings detailing office shenanigans and how Sales is about to start a robot battle using modified Roombahs to showcase how good our firm is at the "techy nerd stuff". People want in and don't know the first thing about modifying, much less programming, Roombahs. But your team does - and your phone is blowing up from Slack messages. Teams from other offices you ain't ever heard from dub it the RoboDome. You and your coworkers at the same position/dept. across all branches are banned due to accusations of bribery, theft, and schematic alterations ripped from the iRobot website within the first few hours of the announcement. You become "consultants" for the participating teams, by accepting dog/cat pics, donuts, and covered shifts on holidays. You go back to scial media scrolling the rest of the week, before you remember that you don't need to even be at the office anymore (a habit of yours from the insane crunch period from last month) and file with HR for "work from home". You dread the upcoming crunch time in a few months so you pretend this is how work is done the entire year. You go to tumblr to view your favorite fandom trending and see Neil Gaiman' blog. You remember the dread of work in the last few 'crunches'. You doomscroll more. Still get paid to reblog.

The downsides to having a salary - you work overtime almost every day/week during crunch times with no OT pay or bonuses. You reenact a breakup scene everytime you leave your bed, it hasn't had the bedding washed in over a month, and your coworkers are all zombies begging for someone with brains (to come relieve them from the slog of chugging out code in PHP because one of our clients demanded it in that language). One of the clients called about a syntax typo that crashed everything on the user end and made their systems look "like the Matrix if it was a Scy-Fy knockoff". There's a programmer who has quit at the lunch table at least three times this week but can't officially send off his resignation because his wife is pregnant and needs his insurance benefits (she's doing her residency and can't afford shit). The coffee you reheated in your mug is from last week, and your breakfast of one wrinkly apple and half a bag of Veggie Straws was the only fresh thing you've seen in days. No one knows who is in charge of what, and you keep getting texts asking where you are hiding because all of you engineers owe the dept lead a program from last week that was due a month ago. You get the first email from the owner/CEO of the year, thanking you all from his office that he has been sleeping in for a few days now. There's 4 shareholders that you've never seen or met and they all want monthly updates from each dept. Someone's calling out because their kid is sick and you can taste the salt in the air. You are hiding with the other engineers in one of the 'executive' workstations, feeling like you are putting your forehead against a cheesegrater when you see the jumbled mess of PHP and what you think is PowerShell. You quietly type away and remind your coworkers and yourself, "I need this job".

Between all of this you have periods of normal, healthy, and productive periods of work. You stay at home, get up and shower and get to work, and you do all of your tasks from your living room. You come in for meetings once a month, excited to see people. On special projects you come in everyday. You see code and you see hardware and you see all kinds of cool things that made you fall in love with your career. You hate the "Big 4" in IT for corrupting and warping your industry. You hate what greed has done to necessary industries like IT, education, medical and public services.

You hate how everything that is a commodity eventually seems to turn into a necessity and in turn gets warped for profit and gains. Need a degree? Go get a pricey degree! Need medical attention? You need pricey insurance! You want to use public services? Sorry, we have underfunded those in the last decade or more. They aren't gonna be as helpful - or you can spend more money on this other useless service that kinda sorta works better and is more than the other one! (I'm looking right at you Amazon, and your stupid book subscription thing.)

You are sick of it, but because you make more money than should be possible at your workplace you try to suck it up and tell yourself that it's what you signed up for, like how retail workers know about Black Friday. So you suck it up. And go back to mindlessly scrolling through social media feeds while getting paid.

The benefits of salary: paid to browse.

The downside? Your career's enshittification has you regretting your life choices.

[pennzance]

Ghostbusters: Port Huron (Episode 15)

Episode 15: Joint Operations

September 14th, 1998

Summary of joint operations report from the desk of Stephen Kaye

With the contract with Wayne County fulfilled, I am issuing this summary report of the events at Eloise.

Of the 22 Ghostbusters franchisee employees involved in the contract, only 10 have not filed for any sort of medical insurance claims. Most reported injuries are not permanently debilitating, consisting mostly of bone fractures, concussions, rashes and lingering pneumonic issues from the dust and particulates in the air of the compound. Six major injuries were reported, the worst of which has left the affected employee in an unresponsive coma. An investigation is being done into the causal incident which was initially reported as ‘friendly fire’.

Specific to my branch, Amber suffered the worst of the injuries. A mild concussion and two cracked ribs have put her on a week’s worth of leave, at least. Bryan also suffered a dislocated shoulder in the battle with the gestalt entity on the final day. Everyone suffered some extensive bruising, but thankfully that was the worst of it.

With Amber out and Bryan restricted from regular duty for a while, I’ve hired a pair of temporary employees to help fill the gaps. Jason and Kelly have their own strengths and weaknesses, hopefully Eric can bring them up to speed after their orientation training is complete, so our workload does not get the better of us.

On the equipment side of things, Jeremy is going to have to recalibrate the PKE Meters after modifying them in the field to handle the saturated environment at Eloise. The Proton Packs are all in good order, although I will have an extensive conversation with Jeremy regarding his unorthodox modifications. The Ecto-908 needs a tune up, but aside from that, all franchised equipment is in working order.

Ben Daily of the Detroit branch has taken custody of the mobile containment grid and put in a requisition for the home office to come collect it. Jeremy informed me of the dangerous capacity limitations of the device and gave me the numbers for the psychokinetic energy the grid contains. If handled improperly or damaged in any way, we would be in for a very dangerous, possibly reality warping situation, or as Eric so succinctly put it ‘deep shit.’ Once the home office has received the necessary paperwork to collect it, please keep me in the loop on how disposal progresses so that the thought doesn’t keep me up at night.

Wayne County has paid us for the contract, along with some bonus money for the hazardous nature of the work. It will keep us in business for a while long and pay for a few renovations around the office like larger lockers for the employees, an external workshop (or ‘tech shed’, as Jeremy calls it), and a better-furnished break room.

I have also uncovered additional leads for the mounting issues here in Port Huron that my team and I can follow up on. I’ll be delegating the official reports on those matters to Bryan, but I feel some real progress is to be made in the next few weeks once he recovers.

End of Report.

ADDITIONAL: Just before finalizing this report, I received a call from Julius. He had a lot to say about my team and their performance, all of it glowing. In particular, he talked up Amber and, to my shock, Eric for their teamwork, leadership, and fearlessness. I’ll pass along his approval of their work at the appropriate time, I am sure it will go a long way towards picking up their spirits after a nasty week. – Stephen Kaye.