#Pain medications without prescriptions | Explore Tumblr posts and blogs

macgyvermedical · 4 months ago

Note

I encountered a drug called "Dextromethorphan" when looking up things that react with grapefruits for a fic. I found out it's been banned in Sweden since the 90s, so I couldn't use it for this specific story, but if you've got any interesting history I'd be happy so know!

Are you ready for this? Like. Ask yourself. Are you really ready for this?

In 1954, a researcher with the US Public Health Service received $282,215 (1954 dollars) from the US Navy, ostensibly to find a non-addictive alternative to an opiate drug called codeine (used for pain and and as a cough suppressant).

So the researcher found a bunch of people who had substance abuse disorder and tested 800 substances on them, trying to find ones that couldn't cause physical or psychological dependence, even on people who were prone to that sort of thing.

(Now, you might be asking if this experiment was ethical. The USPHS was concurrently doing the infamous Tuskegee Syphilis Study, so while I couldn't find any concrete answer, imma guess no.)

Out of these 800 tested substances, we use 3 today: propoxyphene (used as a painkiller), diphenoxylate (used as a diarrhea medication), and dextromethophan (a cough suppressant (and, as of 2022, part of a fast-acting antidepressant)).

Importantly, it was later noted that all of these are addictive substances and today most of them require a prescription. Though depending on where you are in the world, you might just have to be over 21 and show an ID.

You might think this sounds like a pretty standard story.

You would be wrong.

Because while the US Navy was the one handing the money to the USPHS, the US Navy had come by it via the Central Intelligence Agency.

Yes. The good ol' CIA.

So what stake did the CIA have in a non-addictive codeine replacement? Nothing, it turns out. That's just what they'd told the US Navy. What they really wanted was an incapacitant- a drug that causes incapacitation like unconsciousness or continuous hallucinations- without killing. Incapacitants are also useful for discrediting prominent political figures by making them look like they have severe mental health concerns, which was another reason the CIA wanted them.

This was part of a project called MKPILOT.

And wouldn't you like to know which of the three listed above they liked the most? Dextromethorphan. Because at high doses it causes severe- and incapacitating- hallucinations (this is also why it is banned in Sweden).

The problem with it is that it requires really, really high doses (about 3 grams, which would have to be packaged in some other substrate)- this would make it difficult to slip into a drink or food.

(It should be noted that around the same time, the US Army was doing research into a much more usable incapacitant called 3-Quinuclidinyl Benzilate which required as little as 150mg of the substance to be useful- it was featured in a MacGyver episode and I did a nice little review of it here. While I have no sources that say the CIA was directly involved in funding this, based on their extensive funding of similar DoD projects at the time, they probably did.)

But you wanted to know about how grapefruit interacts with dextromethorphan:

A substance in grapefruit (along with seville oranges, limes, pomelos, and possibly pomegranates) blocks the pathway by which many drugs are metabolized in the liver. This causes the levels of drug in the body to be much higher than expected. In the case of dextromethorphan in particular, it can mean that the drug stays in the body a lot longer- up to 24 hours instead of the usual 3-4 hours. It can also make side effects and toxic effects significantly worse, leading to hallucinations and sedation, even at low doses normally used for coughing.

#whump reference #writing reference #whump #dextromethorphan #medical history #DXM #grapefruit #history

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mochatsin · 3 months ago

Text

When MC has a Cast

A small sequel to the prompt “When MC gets pushed off the stairs”. After that fiasco with those bullies, this now focuses on the short shenanigans that come with the brothers trying to take care of you after you sprained your ankle. However, not all of them are very knowledgeable when it comes to human health care.

if you haven't read the first part, please do! As there are some parts that is a reference from it (though it doesn’t dwell too heavy on it so it can be read on its own)

Lucifer

If he was already overbearing towards his brothers, then it’s so much more towards you now that you’re hurt. He asked for less work for the time being so he can take care of you after school, a request that Diavolo is happy to grant. Lucifer knows he wouldn’t mind, especially when he says it’s part of his duties to care for the exchange student, an excuse that the royals could see through. Though everyone knows how much he truly cared about you.

He has the power to transform the house into something more handicap friendly for you. Ramps on elevated areas around the house, adhesive stickers in the bathroom so you don’t slip, handles by the walls in case you need it while walking. He was this close to buying you an expensive wheelchair from the human realm that he found online, you had to stop him from doing so since you wouldn’t need it when you’re better.

Lucifer has an hourly alarm on his phone that reminds him to check up on you. No matter what he was doing during the day, he’ll stop and take out his D.D.D. to call you. He asks if you’re feeling any better and if you’re taking any pain medication or prescription pills as needed. He hates how he has to rely on Solomon when it comes to your medicine since they’re only obtained in the human realm, so Lucifer decided to take better care of you instead to make up for the lack of human knowledge.

If you ever said you needed something, whether it would be a snack that can only be bought outside or extra pillows to cushion your leg, Lucifer will definitely make it happen. If not him, then he’s asking Mammon or any brother available to attend to your needs regardless if it’s something for your recovery or not.

“They miss that favorite drink they usually have after school so I need you to go get it before coming home.” Lucifer’s tone is commanding, and if it weren’t for the fact that it was for you then the brothers would’ve made a fuss about his attitude. “I know it’s four blocks away, but that’s what they want. See to it that you come home with it.” He leaves no room for negotiation when he abruptly ends the call, expecting his brothers to come home with your drink.

When you’re finally out of that cast, Lucifer still refuses to let you go up and down the stairs alone. As if you were no longer capable of doing so without supervision. He makes sure you’re always holding onto the rails and that the stairways are always clear so that you don’t trip. You don’t see it, but he’s been more vigilant around you just in case there are more students he needs to keep an eye out for.

Mammon

Knowing that leaving you for just a few minutes already got you in this mess, Mammon decided to be glued to you this time. It’s almost difficult to pry him away from you, and he’s miserable every time he’s separated that he’ll do whatever it takes to run back to your room. To him, he thinks that something bad might just happen to you again if he lays his eyes off you for a second. Sometimes you wake up to a three-eyed crow stationed by your window like a little guard.

Chores and assignments are done in haste, the quality is questionable but it’s honest work. Once he tried to just rush his household chores but due to how poorly done it was, he was separated from you again in order to finish it properly. Now he tries being quick about it but still somewhat passable to standards. The only thing in his mind is how he gets to hang out in your room after this was all done.

Dishes and cutlery placed on the table where others had more spoons than the rest, the trash bags looked like they were just chucked into the garbage can outside, some clothes wasn’t sorted that Asmo got frustrated when he found his new shirt in Beel’s room where it was mistaken for a rag… Lucifer decided to assign chores that Mammon can take to your room, like laundry folding, to ease his brother’s nerves and lessen the stress he experiences on the daily.

Mammon often steals stuff from the other brothers if he thinks it’s something that could bring you comfort. Asmo’s scent diffuser, Belphie’s blanket, even Lucifer’s mini record player to help you sleep. They would initially get mad, though they soon see a pile of all their stuff in your room, with you resting so soundly in the middle of it like it’s a nest. As annoying as it was to have their belongings stolen, the brothers let it slide for now.

“Can’t help it aight?! My hands are feelin’ extra grabby these days.” He says as he fluffs one of Beel’s burger-shaped pillows before placing it by your back for more support. Mammon then plops down by your side with a huff, wrapping an arm around your shoulders to pull you closer. “That’s why ya gotta get better soon, ya hear me?”

He’s the one that refuses to let you walk around the house. Even if his brothers are there to supervise you, he claims that he’s your first demon so they should listen to him instead! Though it takes a little pout and maybe some puppy eyes from you to make Mammon yield.

Levi

At first Levi was a little agitated since taking care of you meant less time in his room. He always invited you there to hang out, but now with your cast it meant that he needs to adjust and relocate. It’s a small sacrifice if it means he gets to be with you. He’ll just switch base of operations.

Since he spends more time at home in the first place, he’s the one in charge of watching over you while everyone else is at RAD. Being a shut-in has its perks because it means he gets to hang out with you more, though it does a number on his nerves whenever he has to take care of you because he’s afraid he might make your condition worse somehow just by being next to you.

Lucifer already told him what he needs to do. Give you some medication at certain hours, assist if you need to walk or use the bathroom, and make sure you’re comfortable. It’s quite simple. They can’t risk stressing your injuries more, though that stress seems to be transmitting to Levi instead. “Hgnn… getting medication is like a fetch quest a-and assisting is like an escort mission… j-just like in the game.” Is what Levi mumbles to try and hype himself up by associating his tasks with something he loves.

Levi gets jumpy whenever you would walk, acting like you’d get hurt if you took a step with your bad leg. He’s good at keeping an eye out for you whenever you walk around the house because of his anxieties, and giving him bits of praise for taking care of you would usually do the trick of alleviating that. Eventually, he’s calmer when attending to your needs over the next few days.

He stayed in your room more often and he started gradually moving his stuff there so he wouldn’t go upstairs too often to get something in his room. His consoles, mangas, and games are sitting idly by in the corner of your bedroom so that there’s at least something you both could do instead of laying around. Even when you sleep, Levi is still playing games by your side but with a headset or a lower volume so you wouldn’t wake up.

The brothers eventually noticed how more and more of Levi’s things are appearing in your room. The Akuzon boxes are waiting outside your door instead of his, the latest figurine he bought is displayed in your shelf than on his collection, and they find Levi putting some of his clothes in your closet instead of his. If this went on, they might find Henry 2.0 in your room. Everyone requested a week off from RAD to do some damage control like moving some of Levi’s stuff out.

Satan

Satan stayed by your side, letting you lie down on the soft bed while he read your favorite passages. He even includes stories about the protagonist recovering from a battle, as if trying to tell you that healing from what happened is nothing to be ashamed of. You shouldn’t feel bad for resting because you need it, and Satan will see to it that you’re fully recovered with no problems.

If you were up for it, he would teach you any of the lessons you’ve missed once he’s home from RAD. He doesn’t mind giving you some of his notes and even writes it in a simpler way just for you to understand easier, even highlighting some key points so you know where to focus or what’s important. Satan wouldn’t want you to lag behind in class when you finally get back to school, but he’s only going to teach you at a pace you’re comfortable with. Your usual tutoring sessions are shorter because he wants you to focus on recovering first.

He’s got his nose glued to the human anatomy books that tackles sprains and muscles, something that Solomon provided after a lot of pestering from the demon’s end. He reads about how to treat it and the duration it would take until you’re fully better. It’s also his way of relieving his anxieties when it comes to your ankle so he can convince himself that you’re no longer suffering.

If you ever let out a grunt for whatever reason, expect Satan to suddenly be by your side asking you if you’re experiencing any of the symptoms he’s somehow memorized in his head. He’s being cautious if you might’ve accidentally aggravated your wounds and require any necessary medical attention, so he would sit you down and bombard you with questions about your condition. A brother would often have to rescue you before Satan gets halfway with his queries.

“If I don’t know any of these, then how would I tell if you need some help? There’s power in knowledge, you know.” Satan says as he flips through the pages of the thick medical book on his lap. There’s this determined look on his face where he wants to make sure to cross out all the symptoms of any possible ailments. “Now, are you experiencing ‘explosive diarrhea’ by any chance?”

Satan is the one that makes sure that all his other brothers would be useful when it’s their turn to take care of you. He takes note of when you need your next medication, reminds them to refill your water bottles, and how they’d have to check on you for each minute if they had to. If any of them caused you problems, no matter how big or small, Satan would be ready to chase them down for doing a poor job as soon as they left your room.

Asmo

Asmo is treating you like an absolute damsel sometimes whenever he sees you limping around the house with your crutches. He also hates that you need to stay home for bedrest since, as he notes, you get to see him less during school days. He loves spending time with you as much as he loves staring at his reflection in the mirror.

Since you’re not around in school, Asmo is always ready to fill you in on the cheesiest gossip like he always does during lunch time or your after school walks. Now he goes straight to your room, placing his bag to the side before dramatically plopping down on your bed with more news. Weirdly enough, some of that news was about those girls that pushed you and about how they’re both fighting more recently. You even notice how big his smile is as the story progressively gets gruesome.

“Just because my darling is stuck here doesn’t mean you shouldn’t be updated to the latest scoop, right?” He says with a grin, showing you the latest tweets about the topic. “Don’t worry, you can always rely on me to give you the juiciest gossip.” This is his way of hanging out with you like how you both would at school. Whenever he wants to talk about something with you and remembers you’re not around yet, he gets a little lonely and he makes up for that feeling when he comes home.

Asmo would want to put his name on your cast once he learns that it’s something humans tend to do. It’s written all over with a pink glittery pen accompanied by little hearts on the side, maybe a little sheep doodle next to it too. The brothers were not happy to learn that he was the first one to write his name on your cast and then insisted on putting theirs next.

He insists on playing the role of ‘Nurse Asmo!’ whenever he’s trying to take care of you, complete with a play-pretend stethoscope for the role (Solomon gave it to him). Normally he wouldn’t come near someone who’s sick because he doesn’t want to catch whatever they have, that wouldn’t look so good on him. Luckily, yours isn’t contagious at all. Asmo would insist on feeding you and there’s the occasional teasing, but it’s all in good faith.

Asmo also makes a great alert system. You once almost tripped but managed to hold onto the desk, and that was enough to make Asmo let out a high-pitched scream as he was worried your ankle must’ve gotten worse, maybe it’s not healing at all if you almost fell. It alerted every brother in the house and you not only have to deal with a worried Asmo, but now six more anxious demons as well.

Beel

Beel feeds you foods high in nutrients. He’d even run to the stores to get you those sorts of foods if it meant you’ll heal in no time. Of course, he’s mindful of getting nutritious foods you actually like eating. He wants you to be both healthy and happy.

“Here, Solomon said milk helps with healthy bones.” Beel says while carrying an entire box filled with jugs of milk. Clearly he means well, but you have to explain to Beel how drinking and eating things high in calcium doesn’t magically heal your ankle (it’s also worse if you were lactose intolerant). He’s a little disappointed, but he’ll understand. Beel could either drink them or give them to Luke as ingredients for his baking.

Whenever Lucifer asks the brothers to run errands for you, whether it's something for your ankle or for your comfort, Beel is usually the first one to respond and he’s already out the door before any of the brothers could intervene. He likes hearing your gratitude when he does something for you, even if it meant he had to fly across Devildom to get you that ice cream dessert or just walk to purgatory hall to fetch something Luke made for you.

The brothers had to convince him that you wouldn’t shatter if he gave you a hug, but he wasn’t sure if he could. If the stairs already hurt you, what more for a demon like Beel who could bend metal like paper if he wanted to? He was too afraid at first to touch you, but you could see just how much he wanted to hold you. It takes only a few words and a pout from you to make the demon fold.

If Beel would have to bulldoze everything to clear a path for you then he would. In case there was a bunch of furniture or other things all across the floor, Beel would chuck them aside to make sure you won’t have a hard time walking or risk bumping your leg onto something. Though Lucifer reprimanded him for literally shoving every couch aside just to make room for you and then forgetting to put them back properly. The house wasn’t a pleasant sight to come home to at that time.

Beel’s next solution was to help you with that ankle was to carry you around so you could get to places. You’d be in his arms bridal style while he takes you to the dining room to eat with them. He would even stop eating from the mountain of food from his plate if you needed to stand up, Beel would attend to you right away and take you wherever you needed to go.

Belphie

Belphie is not the most reliable brother when it comes to taking care of you, not when his excessive drowsiness gets in the way of actually remembering what to do. He wouldn’t be able to wake up in time to give you your medication, or have enough energy to assist you whenever you needed to use the bathroom or just get up to walk. When you needed his help with something, at some point he forgot about your cast and told you that you can do it on your own. His older brothers definitely scolded him for that and the tasks were assigned to someone else instead.

The only role that was given to Belphie was something he can easily do, which is to make sure you’re comfortable and well-rested. None of them wants to see you walking around too much, even with your crutches, as they worry that something could happen while they’re away. They fear you might fall over and won’t be able to get back up, so Belphie is in charge of keeping you in bed and making sure you don’t move more than you need to.

Whenever you sleep next to Belphie, you always feel so refreshed and rested afterwards no matter how long or short you slept. It’s the demon’s doing, where he makes sure you have the sweetest dreams and get enough sleep so that you’re energized. Belphie thinks that getting more energized meant that your ankle would heal faster, so he’s always trying to drag you in for naps.

For the moments that he’s actually awake, he would be ‘fixing’ your bed so that it would be more comfortable to sleep in. There are three times more than the usual number of pillows on your bed, with extra comforters and better quality blankets. Each time he comes home, he’s fixing your bed and sometimes he adds pillows on it or replaces your old ones.

“I only have these because I was preparing a little fort for us back at school…” Belphie is a little quiet when he speaks, trying to pass it off as being too busy fluffing your pillows but in reality he just doesn’t like remembering what happened that day. “But since you’re stuck at home, it only makes sense I bring the fort over here right?”

The only thing that upsets Belphie at this situation for now is the fact he can’t lie down on your lap like he could every time he wants to use you as a pillow. Beel had to remind him that it might hurt your ankle if he laid his head on your thighs. Even though you tried to explain that it’s not necessarily true, the twins insist on making sure nothing would hinder your healing.

#obey me #obey me shall we date #obey me headcanons #obey me scenarios #obey me lucifer #obey me mammon #obey me leviathan #obey me satan #obey me asmodeus #obey me beelzebub #obey me belphegor

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hoshieeyewrinkles · 11 months ago

Text

D o c t o r p a r k

Pairing: Doctor! Jay x Bimbo! Reader

Genre: smut

W.c: 2.5k

| Requested | Not proofread |

Tw warning: extreme humiliation, heavy degradation, anal sex, spanking, fingering, shoe humping, umm reader is put into a wedgie, Jay fingered her belly button 😭, Filth.

"I'm feeling a bit dizzy, Mr. Kim," you lamented, trying to evoke a sense of concern from your professor, who simply looked at you with skepticism. "I'm a bit concerned Miss.Y/n because you haven't been feeling well for the past few weeks. Maybe you should take the day off and ask your friends for notes." Your professor suggested the idea, and you reluctantly agreed, secretly rolling your eyes. In reality, you didn't actually have any dizziness or headaches. You just wanted an excuse to escape class and visit the nurse's office in hopes of catching a glimpse of the incredibly attractive Doctor Park, also known as Doctor Jay.

You have been on his tail since the past weeks, wanting to get into his pants than anything else. Though your plans have gone unsuccessful as he merely shrugged you off crushing your hopes in an instant. He was extremely stern and focused on his work. The university you were studying in was a prestigious one with strict protocols hiring the best lecturers, the best staff and the hottest doctor.

He was everything you ever wanted. He was smart, young, well-built and probably had a big dick too given by his attitude. Oh how you wished to feel his strong arms around your neck, keeping you in a chokehold.

There you were once again, waiting for him to notice you, in his office. With his white coat dangling by his chair, he was glancing through his phone. His well-fitting black shirt revealed his biceps, and he had his hair pulled back, his trousers ironed and his leather shoes lightly tapping the floor. You wished the floor was you instead. You were relieved that his nurse had taken a lunch break, but you found her annoying because of her privilege to always be around doctor Jay.

"Oh Miss.Y/n you again?" He questioned blankly, though the 'again' seemed a little emphasised. "Yes, doctor Park, I am feeling a little unwell." You responded in a soft tone, your voice coming across as seductive, as you had intended. Jay raised an eyebrow and slightly shook his head, his gaze drawn to your choice of outfit. A white mini skirt paired with a baby blue tube top. You were dressed in very little as usual, and his gaze was drawn to your sparkling headband and red nails, which would look stunning wrapped around his fat cock. He was fully aware of your intentions, but he could not afford to give in to them just yet.

"Miss.Y/n, you have come here three times this week. You already have a prescription from me for headache medication. Despite the fact that you showed no symptoms, you previously claimed to have a fever. What symptoms do you have now? Would you mind informing me, hm?" He inquired in the most casual tone. His tone already has your pussy throbbing. He was overconfident and a stuck-up asshole in the sexiest way possible.

"I feel some pain here, doctor." You said that, and then you moved over to the hospital bed and laid down next to his chair without asking. With a silent exhale, he looked up at you. Your top was dropping to expose your cleavage, and your skirt was perilously riding up to expose your soft mid-thighs.

"Where does it hurt, Miss Y/n?" He questioned unfazed, despite the fact that his mind was racing. You pouted slightly at his unaffected demeanour, your pink glossy lips tempting him to bite them. He was annoyed by the way you fluttered your eyes at him, acting as if you knew nothing about anything. It made him so angry that he wanted to rip off your pathetic excuse for clothes and rail you to the end. The thoughts which went through his mind every time he saw you would have him fired from the university, have his licence suspended.

"Here..." You pointed directly at your crotch, expecting him to be either flustered or disgusted. To your surprise, he smirked. "I understand what you are doing, Y/n," he said, shaking his head and dropping the honorific. He did not let you respond when he spoke again. "I must say, it is funny."

"What do you mean, doctor?" You asked innocently, but your heart raced as you wondered what he was thinking. "Nothing, are you sure your litte princess parts doesn't hurt because of taking the whole football team?" He questioned and your jaw dropped. He let out a snort at your expression "What? Am I lying?" His smirk widens when your face starts to turn red, burning in humiliation.

"Does your skirt length correspond to your level of comprehension? You dirty vulgar girl" He asked again degrading you. "Doctor....that's really mean of you! You are slut-shaming and y-you are insulting me." In reply, you stumbled over your words. "I'm not slut shaming you y/n. I'm simply stating out facts which I have heard around and which you have showed around me, how is that offensive, sweetheart?" He questioned amused, his cock twitched in his pants at the sight of your dumb expression. You were nothing but a dumb slut who could barely live her life without a cock. He noticed the way you rubbed your thighs together at the nickname he called you.

"The whole football team—hell, I do not even know their names, they did not sleep with me. Doctor Jay,how can you believe them?" You asked, your bottom lip quivering as you pouted at him. You were not so naive as to miss his taunts, but you were sick enough to take pleasure in the embarrassment he was causing you. Jay laughed because he thought you were cute and there were no rumours that you were sleeping with the whole football team. He made them up himself to see how smart you are, and you were clearly one of the dumbest girls he has ever met. Probably the sluttiest too.

Lucky for you, he loved sluts.

You did not have time to think when he lifted your skirt, revealing your drenched panties, which were stuck to your pussy lips. "I- Doctor Park, what the hell are you doing!" You yelled at him, attempting to push your skirt down, but he held it firmly between his fingers. "Stop pretending, baby; you have been doing this for weeks, trying to seduce me with your pathetic excuse of tops barely holding your saggy tits and these fucking skirts that keep getting shorter, coming to my office almost every day." He paused for a moment licking his lips at the sight of your soaked panties. "Did you enjoy the humiliation I put you through, y/n? it made your pussy throb, yeah?"

You let out a small moan and nodded desperately, letting your fake innocent demeanour slip as you grabbed his hand, which was holding the hem of your skirt and guiding it onto your cunt. "Please, Doctor Park, it hurts."

He chuckled in response, shaking his head slightly. "Well, as your doctor, I must investigate what is going on with you, princess." His eyes were filled with lust. He pushed his morality and principles to the back of his mind. Fuck, he needed your slutty pussy right now. It was the prettiest cunt he would ever see, and he was not going to pass up this opportunity to use you.

He removed his hand from your crotch and opened the drawer in front of him. You watched him with curiosity, desperate to get his fingers, mouth, and cock inside you right away. He shuffled through his belongings before reaching for a pair of white gloves and putting them on. Your eyes widened at his actions.

"Your little nasty pussy does not deserve to be touched by my bare hands." He spoke in a low deep voice earning a whine from you. "Fuck, look at those juices. You are such a shameless whore." You felt your insides twist at his tone change. He was such an unpredictable man with no filter, treating you in the most humiliating ways, which only made you want him more. You would let him do whatever he wanted with you. You were down bad for him.

Without any warning he inserted his gloved finger inside you, it went in so smoothly as you were completely drenched. "Are you enjoying this? How embarassing y/n, is this why you joined this university? To suck cocks? To have your little cunt pounded by everyone?" You didn't reply to any of his questions busy in pleasure be was giving you, letting out small whimpers. He added two more fingers, aggressively fingering you. The wet, gushing sounds filled the room: "Doctor Park... P-please. Want to feel your fingers." You begged, squirming around, getting closer to your high. He ignored your words and lifted your tube top above your stomach, exposing your belly button to him. "Would you like to be fucked there too?" He aggressively pushed his other hand's fingers inside your belly button. You give a squeak at the sensation, moaning like the whore you are.

Your cunt and belly button getting fingered by his thick fingers simultaneously, releasing waves of pleasures inside you. You were thrashing around uncontrollably, overcome with pleasure. "Calm down, slut. I'm just getting started. Turn around." He ordered and you complied feeling a bit disappointed that you didn't get to cum. "but I didn't..." He cut you off harshly after landing a slap on your pussy "Not everything is about you."

He stuck your underwear in a wedgie, and you winced at the burning sensation on your pussy lips. Without warning, he pulled the wedgie and snapped it back, causing you to let out a painful screech. "This is how dirty little girls like you deserve to be treated," he said before snapping the wedgie several more times. You thrashed around, biting your palm to muffle your voice. He eventually stopped his assault on your ass crack and removed your underwear. What further humiliated you was the way he held your underwear with just two fingers treating it like some dirty trash. "Put this drenched shit in your mouth so you'll keep your dumb mouth shut." He threw the underwear in your face, and you did as he said, shoving it inside your mouth. You could taste the sweetness of your juices inside your mouth.

You never knew being treated in such humiliating way would turn you on so much. "Fuck look at this ass" he grunted kneading the flesh in his gloved hands. His cock was about to burst through his trousers. He enjoyed treating you in this manner because that is what dumb little cock sluts like you deserve, constantly seducing people and putting their jobs in risk. You needed to be taught a lesson that would put you in your proper place.

He began spanking your ass harshly until you were numb, your moans muffled by your panties. "This. is. exactly what naughty girls like you deserve." He spat on your asshole making sure it's lubricated enough. "I have no intention of using your nasty pussy but this tight ass deserve to be pounded." He unbuckled his belt throwing it aside and letting his cock stand in all glory. You tried to turn back, to look at his cock but he smacked your ass again "Don't turn back. I don't wanna see your spit covered dirty face." He degraded you before lifting you by the stomach and placing you on your hands and knees.

He pushed his cock into your hole, letting out the most seductive moan that nearly made you cum. "Mhmm..." You let out a muffled moan, and despite the pain, you could not stop pushing back on his cock. He began to pound into you with great speed, his hips slamming into your bruised ass. The pain from the wedgie assault lingered, and him pushing his cock into your whole aggravated it.

"Messy dumb slut." He yanked your hair back, his hips moving with uncontrollable speed. "Fuck, this is what you wanted right? To be fucked by me? To be treated like nothing, you are truly shameful." His words kept pushing you to your edge. Jay bit his lip at your state, your plump ass looked so bruised. Your belly button was red from his assault. He felt all of his stress disappear as he fucked your ass. "Touch yourself for me, baby," he asked, and you began to rub your clit vigorously, feeling your high return, but before you could cum, he pulled out his cock and released himself over your ass. You took out the underwear from your mouth. "Doctor park, I couldn't cum." You whined, panting loudly. He didn't reply, taking his gloves out before disposing them into the trash can nearby.

"And? How is that my problem?" He asked cockily, sitting back in his chair, manspreading, his cock still out. "Doctor park that's not fair!" You yelled in frustration before crawling out of bed, landing on your knees. Jay bit his lip at your sight, you looked so desparate and filthy. "Suck my cock and make yourself cum, angel." He pushed his leather shoe on your clit. You immediately took his cock in your mouth slurping on it messy while grinding on his hoe. "You dirty insatiable girl!" He said chuckling at your messed up state pushing your mouth deeper onto his cock.

You were still grinding hard on his hoe, moaning on his cock and rubbing your covered breast against his leg. Lost in the blissful pleasure he was receiving from your sensual lips, he was letting out soft moans. You were truly like the wettest and the filthiest dream he ever had. You came on his shoe grinding like a whore and he pushed you back before spraying his cum on your top. You both took few minutes to catch your breath before he wore his pants back and glanced at your dumb state. "Get up." He gave the order, and you stumbled to your feet, drenched in sweat, saliva, and cum. "Pick your underwear and clean my shoe."

You obeyed his orders cleaning his shoe with your underwear "Wear them back." You were about to protest, but his one look stopped you, and you wore the dirty, completely drenched panties back. You felt so nasty yet so good. He pulled you onto his lap and pressed his lips against yours. You kissed him back, running your hand through his styled hair, messing it up. He patted your ass, breaking off the kiss. "You can rest on the bed while I bring you something to eat." He said, and you felt the heat rush back into your face as you nodded shyly. You laid back on the bed watching him collect his things. "Remember don't remove the underwear till your day ends, it will be a reminder for you to know what happens to naughty pretentious girls like you."

His words made you whine and nod submissively, "Perhaps I will use your little pussy next time, princess."

#enhypen smut #jay smut #enhypen jay smut #enhypen x reader #enhypen x you #enhypen hard hours #enhypen hard thoughts #jay x you #jay x reader #kpop smut #dark enhypen

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copperbadge · 6 months ago

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how did u psych urself up to go to therapy? my executive function has been awol for like 2 years and it's gotten to the point where it's wrecking my ability to do anything. i'm scared to waste a bunch of time and money going and getting told i'm just lazy or that the problem is just me

Happy to talk about that! But this is really two issues, so I gotta do a fly-by real first on "scared of getting told I'm just lazy". :D

It sounds to me like you're aware intellectually that laziness isn't the issue. You know this is an executive function issue and not a personal flaw, but I definitely get that it's hard to internalize that. So I'm going to drop links here to some discussion of "laziness":

How do you know you're not just lazy? (ask sent to me -- it's long, but you can skim for the laziness bits if you want.)

Lack of motivation means you are avoiding pain (second ask in response to the first)

Laziness Does Not Exist by Devon Price

These are essentially my proofs when I want to remind you that laziness is a label that stigmatizes an innate behavior -- inability to act is real, laziness is not. If a therapist tells you that you are lazy, and ESPECIALLY that you are the problem, you should fire that therapist. Don't even stay the rest of the session if you don't want to, just say "I see we are not compatible," and bounce. I don't think the odds are high that you'll encounter that, but on the off-chance that you do, that's a bright neon sign that they're a bad therapist.

In fact I would open with that pitch: "I'm struggling with executive function and the self-perception that I'm really just lazy. I need help with the actual executive function issues but also with how I view myself because of them." The therapist's response will tell you a lot about whether they'd be a good fit.

So with that out of the way...

I eased myself into therapy with the speed of a small child entering an extremely cold lake. It helped a lot that all of my therapy has been virtual via Zoom, so a lot of stuff that would have been a barrier, like going to the physical appointments, discomfort in a strange space, etc. were swept away.

I didn't even want to see a psychiatrist for my Adderall prescription, but I knew I needed help and medication seemed to be my best option, so with the assurances of several people that it wasn't therapy so much as mental health maintenance, I saw a psychiatrist. And he was lovely! (I just met with him yesterday to go over my next few months of scrip.) For a while that was all I did: talked every month to a kind person who asked specific and measurable questions about my mental health -- mood, sleep patterns, ability to work, hobbies -- without getting especially personal. I thought, okay, I can handle this, I can probably handle more, so I asked him for a recommendation for a therapist.

He looked at the network of independent practitioners he belonged to (Clarity Clinic Chicago, if you want an example of a good network) and found me a couple of options. I got extremely lucky to find someone I felt was appropriate for me right out of the gate, though some of that was also knowing what criteria I had: I wanted someone who explicitly stated they specialized in adult ADHD and disability, and who seemed like they were interested in addressing a whole person and not a single issue. When we met she seemed nice, wasn't pushy or judgey, was familiar with spoon theory and disability activism because she also has ADHD, and didn't blink (or ask overly invasive questions) when I said I was very uneasy about therapy because of past experience. She was comfortable with the ambiguity I brought -- I basically said "Look, I think this is something I need but I'm not entirely sure what my goals are yet, it's just I only recently found out I have ADHD and I am rethinking a lot of stuff," and she was like fine, let's rethink it together.

It still took me a long time to start talking about anything meaningful, but she handled the non-meaningful stuff as if it was serious and important, which helped. Admittedly I have really good insurance so I pay $20 a session for therapy, which also helps; it's pretty negligible in terms of health costs for me. I can afford to dawdle.

So, all that said...my path may not be an option for you, but I think it indicates the kinds of options you have. You don't have to jump into serious and heavily emotional processing first thing if you don't want to. You can shop around for therapists and you can drop any bad ones you encounter speedily, or if you find one you immediately like you can still spend time getting comfortable before dropping into the heavier stuff.

I would suggest that if you have a prescribing psych or doctor for any kind of mental health meds, ask them if they have a recommendation. If you don't have that, ask around people you know or believe have access to therapy and see what they think. If those aren't available to you or you're uncomfortable with that, I'd do a search for licensed therapist and your health insurance, or see if your workplace has an employee assistance program that can recommend you someone.

Good luck! I hope you get what you need. Lord knows I've been there.

#not yet fired from therapy

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gremlingottoosilly · 11 months ago

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First of all, I love your fics so much that I keep re-reading them! Second of all, I'm sorry for bad English, third of all! What about kidnapper!König and sick reader, like reader has a chronic illness that requires taking medication everyday ? Like would he just let reader die orrrr???! (Ignore if you want, I know this is dumb)

Hey, don't apologize!! English isn't my first or even second language too. Honestly, being chronically ill and relying on meds might just be the only thing that would save you from total isolation initially. When Konig just kidnapped you, he was vigilant enough to scoop all medication you had in your room - he would find your prescription and read it carefully, knowing how lack of meds can mess a person up. He is taking his anxiety meds - something he often forgets but swears it's not really important to him, as he is a strong, cool man without any problems. He had a few comrades taking prescription drugs from PTSD, and he is dealing with chronic pains from his many injuries - sometimes, when it becomes too bad, he is taking quite strong pain killers...so he won't really make you beg for your meds if you're good. If you're a nice, polite girl for him, you're having your pills in restricted time and he will be very observant to feed you and give you water - he doesn't want you sick, making you fall ill would require him finding a doctor who won't ask questions and, well, he is a mercenary, not a mafia member. In this AU, at least. (Mafia!Konig? Anyone???) If you're bad, however...if you can survive missing a day in taking your meds - you'll have to experience all the pain and withdrawals that come with it. Konig won't hesitate to cut your food privileges, and pills are being taken as well - he would wait to make sure you're not dying, of course, but you won't feel fine even after he allows you to take the minimal dosage. When you're crawling to him, all teary and ready to apologize, he would gladly accept it, and everything would return to normal. If you need to refill your prescription, however...well, Konig never planned on keeping you in the basement for forever - he wants you to be his pretty cute housewife, so he knows he had to let you go out eventually. He will watch over very carefully as you slowly run out of pills - and right before it would be over, he will suddenly make you get dressed and...let you out?? Really?? Well, don't be too happy - he is only doing a drive for a city hall because he wanted to make sure you're married first. Without a flashing wedding, unfortunately, but he'd then be able to get you under his insurance and his family doctor. Doctor visits in Austria(and Central Europe) are abysmal even if you are covered by a very good insurance, and you'd have to cling to Konig for translations - doctors are smiling and nice, but they won't acknowledge you beside the prescription you had, even if you had it in Austria too. Konig is handling all the communication and you know you're trapped - with a psycho holding your hand, holding your meds and literally taking away your last name to replace with his. But, well, at least you got your insurance, right?

#cod #konig x reader #konig #yandere konig

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mistydeyes · 2 years ago

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a panacea

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pan·a·ce·a noun

a solution or remedy for all difficulties or diseases.

summary: In pharmacy school, patient interaction was a core part of the curriculum. You tirelessly remember long, coffee-fueled nights going over your notes for each Professional Practice Skills class. The 141 boys make sure you can exercise these communication skills daily.

141's medical file reference

pairing: Task Force 141 x pharmacist!Reader

warnings: medical/pharmacy terminology, medical inaccuracies, swearing, depiction of wounds and needles, fluff, flirting, and mutual crushes

a/n: i'm an american pharmacy student so sorry for some inaccuracies about how pharmacy across the pond

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As you walked into the pharmacy and began your shift, you paged through a few recent scripts and checked in with your technicians. Your graduation from university, years of clinical experience, and now your more recent military training seemed like a distant memory. You would constantly see a variety of service men and women every day without much thought. Yes, there were some repeat individuals but overall everything seemed to blend.

Despite this, you still attempted to form a meaningful interaction with each patient regardless of what they’d be picking up. Doctors were constantly bothersome with questions about the recommended treatment and asking for a drug not listed on the formulary. Patients were different though, you would always try to have a friendly conversation and wonder what missions they would be deployed on once they left the queue. As you prepared to work through today’s prescriptions and tackle a new medication supply, you reminded yourself that today was filled with a new set of faces to meet.

price

The members of 141 were all too familiar with a distant employment in a foreign country. It was part of the job description, something you do without question. However, some countries had the luxury of also having medication to take for the duration of the trip. Malaria is no joke and you always had to ensure you ordered an abundant supply of antimalarials for the soldiers constantly going around the world.

Today was no exception, your new order had literally been flying off the shelves. It was the post-breakfast rush and you had a few boxes left of atovaquone/proguanil (Malarone). Although the frequency of taking these was a pain, you loved the easy verification and packaging of the box.

As you continued to provide the queue with their prescriptions, a familiar face and hat made its way to the front.

"Ah Captain Price, back again?" you grinned as he approached the counter.

"Back too soon," the man chuckled, the deep baritone of his laugh bouncing across the walls. "I believe I have a couple of things to pick up from you, love."

With that, you pulled his file up and confirmed his array of medications. Generally, nothing out of the ordinary you noted and acknowledged the new addition of Malarone.

"Yes just give me a moment," you replied as you went to grab his bag.

As the bottles rattled around in the bag, you took a peek and counted the correct number of bottles/boxes, and verified their appearance.

"Now are you going for leisure or work? I saw the newest order for an antimalarial." Secretly you knew the answer but there was always the possibility that the Captain was going on leave.

He let out another small chuckle, "I think you know the answer to that one, doll. Duty calls."

You smiled back, the small inclusion of pet names brightening your day. "Alright then, and I'm assuming you know the regimen. This isn't your first rodeo."

"Yeah, take one for the next day, every day there, and for the week when I get back." You hummed in agreement with his response and he gave you a quick thanks before turning to go.

"Oh but while you're here, any interest in some smoking cessation recommendations!" Like before, you knew the answer. This man was loyal to his country and even more loyal to his cigars. The air filled with the fragrance of musk and cigar smoke whenever he came in definitely made an impression on you.

With this last comment, he let out a final, breathy laugh before responding, "You are many things, Captain, but that's a fucking miracle I don't believe you can pull off."

soap

Infections were no surprise to you. Especially working in the military, there was plenty of incidence for it. Most of the time and even after the doctor patched them up and directed them on proper care, there would still be a select few that would return with an infection.

The rest of the morning was quiet, you were able to catch up on some documentation and had time to pop into the medical wing to provide your pharmacist expertise. That's why when everyone's favorite Scot came by to pick up his antibiotic you didn't mind the company.

"Hi gorgeous, I'm here because of some doc's slipshod job stitching me up." He beamed as he raised his forearm to reveal new stitches and a clearly red, inflamed area. You quickly pulled up his file and your suspicions of an infection were confirmed.

"Sure, MacTavish. I completely believe that the medic specifically botched yours out of the whole team," you sarcastically replied. You served multiple tours with the "guilty" medic and knew they were of equal expertise to you. There was a reason they were performing surgeries while you provided insight and the medication. "I also trust you managed to keep the wound clean and didn't do anything stupid like, I don't know, training instead of resting," you finished as you raised an eyebrow.

He looked like a child who got caught with their hand in the cookie jar. "Ah good one, Doc, I guess nothing is getting past you."

"Mhmm, I'll make you think twice about negatively referring to my colleagues. And again, you know I'm not a doctor. If I were, you know I wouldn't be so willing to stitch you up and send you on your way" you jokingly threatened. He shuddered slightly, he wouldn't want to imagine a world where you were his medic on the battlefield. But then again, his constant injuries would mean frequent visits.

"But I would get to see that gorgeous face of yours more," he joked and you could feel your face flush. His flirty antics and your eye rolls were a staple of this relationship.

"Do you talk to everyone this way?" you countered, "I bet your superiors love the constant flow of compliments and just blush at your tone."

"Oh yes, they do. My Lieutenant turns into a giggling mess underneath his mask. Do you know he's bloody handsome under that? You should try flooding him with pet names and admiration to see for yourself." He responded, a clear sarcasm in his voice evident even with his familiar accent.

"Will do, MacTavish. Now will you let me get your medication so I can return you to your loverboy?"

"Of course, Captain" he saluted exaggeratedly as you walked to the rows of shelves.

You opened the bag and then placed the verified medication into his hand. "You know the routine and for the love of God, please finish the amount in here. I don't want to be seeing another order for Augmentin from you any time soon!"

"Yes, love, but nothing can stop this machine from gathering more illnesses and wounds requiring your expert care." You rolled your eyes as he explained and gave a cocky gesture showcasing his chiseled injured body.

"Don't mess with me, you know I can easily sneak my way into the med ward and make sure you go nighty-night." You were bluffing, the Hippocratic oath painfully engraved in your mind. But it didn't hurt to joke back.

"Oh I'll be sure to watch out for you, scary legal drug dealer." With this last jab, he walked out and left you chuckling to yourself at his antics.

gaz

The flowers and trees were in full bloom around the base. It reminded you of the days studying outside and crying over learning your Year 2 immunology coursework. However, just like immunology, pollen just made your job more difficult. It seemed like the scripts for nasal sprays and allergy medication were endless. Day after day you would go to work with your technician as you helped their workload by filling the myriad of prescriptions.

Following the quiet lunch hour, the pharmacy quickly became flooded with people. As a younger soldier presented to your counter, you could immediately guess what they were here for.

Although he was not one of your repeat offenders, his watery eyes and the constant flow of sniffles made it clear that he was another victim of the unrelenting pollen.

“Garrick, Kyle,” he said and you couldn’t help but feel bad for him as he stood there a sniffling mess. You typed his name in and checked his credentials as he turned to sneeze.

“Ah yes, you have a nasal spray and another prescription here. Just give me a moment.” You walked away from the counter as you heard him chuckle and call out, “You wouldn’t happen to have a panacea back there would you?”

“Unfortunately I do not,” you said and frowned upon your return, “But just take these once a day with water and use the nasal spray as needed. One puff in each nose should do the trick and don’t forget to shake it!” You explained. Holding the small container of pills you noted, "Plus this is Piriteze, so you won't feel tired after taking but I usually recommend taking a half hour before you know you're going outside or having any interaction with pollen."

He nodded in agreement and took out a tissue to blow his nose for the hundredth time today. This action didn't relieve his congestion. Allergies were really the bane of everyone's existence and you felt for him as he let out a couple of sneezes and apologized.

As he took the bag you gently said, “Sometimes something spicy really clears everything out. Spice has the benefit of being both delicious and working as a decongestant. You’ll definitely need some tissues but it’s worth it in my opinion.” With that, you offered a wink and sent him on his way.

"You're truly an angel. I'll be sure to update you, love," he beamed at you with a dashing smile. You would be flattered if it had not been for his subsequent barrage of sneezes.

A few days later, a pleased Gaz returned to you and explained your life hack had worked. One half bottle of hot sauce later and he had been congestion free. Brushing your astonishment at his spice tolerance aside, you explained that it had been just the medicine. However, Gaz would soon be giving everyone an earful of your non-conventional methods. Although his mates constantly joked about the image of him drowning in snot (a picture gracefully captured by Soap), he was thankful for you, the pretty pharmacist, and the help.

ghost

You could feel the headache forming from the fluorescent lights and the busy day you were currently having. This morning new missions called for you to enforce the regimen of taking antimalarials and in the afternoon, returning soldiers required pain medication and antibiotics (although you were thankful these were tablets and not through IVs). However, this was no challenge to you and you were further encouraged by the recent positive interactions you’d been having.

Just as you stepped away for a water break, your desktop notified you of a patient awaiting their prescription. You sighed and walked over to see the patient file as well as what medication they’d be receiving today.

You read the name carefully and slowly, partially because of your tiredness as well as your irrational fear of giving the patient the wrong medication.

“Riley, Simon” you mumbled and kept repeating the name as you walked amongst the rows of bags to retrieve the medication.

Just some routine painkillers. You examined the container to verify the oval, white pills of paracetamol.

As you notified the waiting soldier, your computer showed a reminder that they were due for a flu shot. You smiled, immunizations were often done routinely through a clinic but sometimes, you would get a break from your day and be able to administer one.

You acknowledged the reminder just as the soldier walked up. Tall, brooding, and donning a unique balaclava, you presumed this was Simon Riley. Your earlier conversation with Soap made you realize that this was the man who put up with all of his antics. You wondered if the paracetamol was for an injury or his raging headache from his Sergeant.

Recognizing his rank, you greeted him warmly and went to verify his patient credentials. He was a quiet man, only replying to your necessary prompts. This further added evidence that the medication was because of Soap, the chatterbox that he is. As you handed over his prescription, you let him know the bad news.

“Unfortunately, you are due for a flu shot but I can have you out of here in less than 15 minutes if you’d like?” you smiled, "or you could always just have me refer you out to get it while you're on leave."

"I'll do it now, don't know the next time I'd be returning," he spoke lowly. You wondered where he would be off to next as he pocketed the medication and nodded in agreement.

You motioned for him to sit in the designated area and prepared the necessary materials. As you walked over to the vaccine area now occupied by the large man, you positioned yourself to the side of him. You performed your typical routine of verifying the prescription and noting the necessary numbers before you felt the need to break the silence.

“You know, I used to be terrified of these as a child. I hope you didn’t have the same experience, Lieutenant,” you chuckled as you began to clean his bicep. You admired the tattoo on his right arm, so intricate and beautiful.

“I’ve had much worse, trust me,” he replied and you could almost hear the smile in his voice. Well, I guess the man of few words has a sense of humor.

“That’s good to hear! You wouldn’t imagine the number of recruits that squirm even before I’ve begun to prep their arm. I thought all that training taught you guys to be tough.” With this, you both laughed and you began to position your hand ensuring the needle was going into the proper area.

You felt him slightly tense under your touch but you gave him a reassuring pat on the hand. You knew as a child that the best way was to finish the vaccine before they even had time to react.

“You can hold my hand if you’d like,” you joked, not realizing that he was pink under his mask. "Or you could be a good little soldier and I might give you a lolly" you continued further, teasing the man. He was so glad to have the safety of concealment as you were really rubbing it in. He waved you off with his other hand and you went about a quick administration.

“See that’s not so bad,” you smiled and you went to apply a bandage. Unfortunately, you realized you were out of your typical issued bandaids and quickly grabbed a colorful, neon star one.

He glanced down and responded with a low, “What the hell is that?”

“I’m sorry it’s the only one I have at the moment, but you should be able to take it off before bed tonight!” you apologized and you fastened it onto his strong bicep.

Little did you know that your small talk and neon bandage had endeared you to the Lieutenant. Your reassuring touch and soft actions made him believe you’d be a better fit for a position in pediatrics than here. Although he would have to explain the ridiculous stars, he found himself wanting to get all of his vaccines from you.

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first time writing and posting here in like forever! hope you enjoyed this mw2 content :)

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doberbutts · 1 year ago

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I was typing a big long thing about the changes I've experienced in a year on testosterone and how it's affected me and all that and then tumblr ate it and I really don't feel like retyping that whole thing but I am kinda salty about it so tldr:

Starting testosterone has been the best thing for my health that I've done. Ever. Better than getting a service dog. Better than restructuring my life to cater to my disabilities. Better than any procedure or medication or otherwise that I've tried. Simply rubbing a pack of gel on my arm once a day has done more for me than anything else.

When I went to my endo to start T, I went with a suspicion that I am intersex. She confirmed it via blood test and told me that with my variation I could try two different things: estrogen to control my high levels of natural androgens, or testosterone to lower my estrogen further and make it stop arguing with my androgens about whether I'm supposed to be a boy or a girl, as it's that argument that was causing a significant portion of my health problems. Estrogen has been tried in the past and only made things worse. She told me it was my choice, and only I could choose my path forward, as I knew my body the best.

When TERFs have a fit about gender affirming care, they usually leave out people like me, or they brush my story aside by saying that I'm just an anomaly, or they claim for me and my demographic that we don't want to be part of this discussion. But I don't fit their definition of a woman- I have a testicle, and my natural testosterone was within normal range on the low end for a cisgender, perisex man, and enough male sexual partners have commented on what's in my pants to tell me that it's far from the picturesque womanly pussy, especially considering I can- and have- use it to penetrate with the help of devices designed for cis men who are a little lacking in length.

When TERFs have a fit about gender affirming care, they scaremonger about side effects and changes. But, I was already hairy. I was already growing facial hair. I already had atrophied- and by 30 to the point that it's not really possible to fix without significant medical intervention. I was already infertile. I already had an adam's apple and a deep voice. I already had belly fat and blood pressure problems. My menstrual cycle was already hellish and had interfered with my school and work schedules. A popped ovarian cyst sent me to the ER.

I'd tried no treatment. I'd tried estrogen-based solutions. These not only did not work but actively made things worse. I was fainting at school. I was calling out of work. I couldn't drive without my service dog. I couldn't go out and have fun with my friends. I spent days at a time laying in bed in too much pain to move.

TERFs say, gender affirming care turns you into a forever patient.

I already was one of those. I almost died when I was a baby strictly because of lack of access to care that accepts children who are born who are both and also neither from the womb, before anyone has a chance to develop a personality or understand the difference between a boy and a girl.

Testosterone has turned me into a "once every 3 months" patient instead of a "twice a month minimum" patient. I pay less than $15/month for my prescription and it's mailed to my house in three-month increments. Stopping my wildly irregular and incredibly painful menstrual cycle has increased my quality of life so much. My body doesn't ache for no reason anymore. I don't faint anymore. I can go out and do things and not be punished for it for days on end by fevers and chills and vertigo.

Don't let a handful of transphobic assholes scare you. If this is your way forward, then live your life to its fullest.

My only regret is that I didn't have the chance to do this sooner.

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fatliberation · 1 year ago

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I totally understand and can empathize with fat activists when it comes to medical fatphobia. But I do think its important to provide nuance to this topic.

A lot of doctors mention weight loss, particularly for elective surgeries, because it makes the recovery process easier (Particularly with keeping sutures in place) and anesthetic safer.

I feel like its still important to mention those things when advocating for fat folks. Safety is important.

What you're talking about is actually a different topic altogether - the previous ask was not about preparing for surgery, it was about dieting being the only treatment option for anon's chronic pain, which was exacerbating their ed symptoms. Diets have been proven over and over again to be unsustainable (and are the leading predictor of eating disorders). So yeah, I felt that it was an inappropriate prescription informed more by bias than actual data.

(And side note: This study on chronic pain and obesity concluded that weight change was not associated with changes of pain intensity.)

If you want to discuss the risk factor for surgery, sure, I think that's an important thing to know - however, most fat people already know this and are informed by their doctors and surgeons of what the risks are beforehand, so I'm not really concerned about people being uninformed about it.

I'm a fat liberation activist, and what I'm concerned about is bias. I'm concerned that there are so many BMI cutoffs in essential surgeries for fat patients, when weight loss is hardly feasible, that creates a barrier to care that disproportionately affects marginalized people with intersecting identities.

It's also important to know that we have very little data around the outcomes of surgery for fat folks that isn't bariatric weight loss surgery.

A new systematic review by researchers in Sydney, Australia, published in the journal Clinical Obesity, suggests that weight loss diets before elective surgery are ineffective in reducing postoperative complications.

CADTH Health Technology Review Body Mass Index as a Measure of Obesity and Cut-Off for Surgical Eligibility made a similar conclusion:

Most studies either found discrepancies between BMI and other measurements or concluded that there was insufficient evidence to support BMI cut-offs for surgical eligibility. The sources explicitly reporting ethical issues related to the use of BMI as a measure of obesity or cut-off for surgical eligibility described concerns around stigma, bias (particularly for racialized peoples), and the potential to create or exacerbate disparities in health care access.

Nicholas Giori MD, PhD Professor of Orthopedic Surgery at Stanford University, a respected leader in TKA and THA shared his thoughts in Elective Surgery in Adult Patients with Excess Weight: Can Preoperative Dietary Interventions Improve Surgical Outcomes? A Systematic Review:

“Obesity is not reversible for most patients. Outpatient weight reduction programs average only 8% body weight loss [1, 10, 29]. Eight percent of patients denied surgery for high BMI eventually reach the BMI cutoff and have total joint arthroplasty [28]. Without a reliable pathway for weight loss, we shouldn’t categorically withhold an operation that improves pain and function for patients in all BMI classes [3, 14, 16] to avoid a risk that is comparable to other risks we routinely accept.

It is not clear that weight reduction prior to surgery reduces risk. Most studies on this topic involve dramatic weight loss from bariatric surgery and have had mixed results [13, 19, 21, 22, 24, 27]. Moderate non-surgical weight loss has thus-far not been shown to affect risk [12]. Though hard BMI cutoffs are well-intended, currently-used BMI cutoffs nearly have the effect of arbitrarily rationing care without medical justification. This is because BMI does not strongly predict complications. It is troubling that the effects are actually not arbitrary, but disproportionately affect minorities, women and patients in low socioeconomic classes. I believe that the decision to proceed with surgery should be based on traditional shared-decision making between the patient and surgeon. Different patients and different surgeons have different tolerances to risk and reward. Giving patients and surgeons freedom to determine the balance that is right for them is, in my opinion, the right way to proceed.”

I agree with Dr. Giori on this. And I absolutely do not judge anyone who chooses to lose weight prior to a surgery. It's upsetting that it is the only option right now for things like safe anesthesia. Unfortunately, patients with a history of disordered eating (which is a significant percentage of fat people!) are left out of the conversation. There is certainly risk involved in either option and it sucks. I am always open to nuanced discussion, and the one thing I remain firm in is that weight loss is not the answer long-term. We should be looking for other solutions in treating fat patients and studying how to make surgery safer. A lot of this could be solved with more comprehensive training and new medical developments instead of continuously trying to make fat people less fat.

#inbox #medical fatphobia #sources #surgery #anti fat bias #fat activism #fat liberation

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