#Plasmapheresis

[simonh]

Utility of Therapeutic Plasmapheresis for Neurological Disorders by National Library of Medicine Via Flickr: Contributor(s): National Institutes of Health (U.S.). Medical Arts and Photography Branch. Publication: Bethesda, Md. : [Medical Arts and Photography Branch, National Institutes of Health], 1986 Language(s): English Format: Still image Subject(s): Plasmapheresis, Nervous System Diseases -- therapy, Consensus Development Conferences, NIH as Topic Genre(s): Posters Abstract: White poster with a multi-colored diagram representing neurons. A phone number is also given for further information. Extent: 1 photomechanical print (poster) : 71 x 56 cm. Technique: color NLM Unique ID: 101454392 NLM Image ID: C01016 Permanent Link: resource.nlm.nih.gov/101454392

[nefronkidneycare]

Plasmapheresis is a medical procedure where a patient’s blood plasma is removed, cleaned, and returned to the patient. It is a procedure used to replace problematic substances in the blood with healthier substances. Plasmapheresis has been used to treat a wide range of medical conditions, including autoimmune diseases, kidney diseases, and neurological conditions.

[intotheelliwoods]

This is part 2! Part 1 can be found here~

Masterpost

[papiermachecat]

Love seeing you on my dash when you pop up! I think about your son often and wonder how he’s doing but don’t feel like you have to post or talk about it if you would rather not. Just know a stranger somewhere is hoping for the best for you both!

This nearly made me cry if that gives you any insight to my mental state lol—thank you so much for thinking of my little buddy. Unfortunately, I don’t really have good news to report…his first Rituxan infusion gave us tremendous improvement, like 80-90% back to himself for 6 glorious weeks back in Jan/Feb. Then he had another in February which sent him back into a flare (not unusual) and he never really pulled out of it, then he had another one in May and has had his worst side effects from it yet and still not seeing improvement. He’s not as bad as he’s ever been but he’s not far from it. Just taking it one day at a time and hoping for some kind of miracle 🤷🏻‍♀️

[yoshistory]

i know this is like. stupid. but my provider let me know if i donate blood they're probably just going to throw it out cause im transgender and i didnt like, realize that

[seonidheesh]

Dialysis vs. Plasmapheresis Key Differences in Renal and Plasma Treatment

Introduction

When it comes to medical treatments for various conditions, it’s essential to understand the nuances and differences between them. Dialysis and plasmapheresis are two procedures commonly used in the field of medicine, but they serve distinct purposes and are employed in specific clinical situations. In this comprehensive guide, we’ll explore the fundamental differences between dialysis and plasmapheresis, shedding light on when and why they are used in the realm of medical treatments.

Purpose

Dialysis: Dialysis is primarily used for patients with kidney failure or severe kidney dysfunction. It is a treatment that replicates some of the functions of the kidneys, such as filtering waste and excess fluids from the blood.

Plasmapheresis: Plasmapheresis is a procedure used to treat various conditions, often autoimmune diseases or disorders related to abnormal proteins in the blood. It involves the removal of plasma (the liquid component of blood) from the blood, with the intent of removing specific substances from the plasma.

Method

Dialysis: Dialysis can be performed using two main methods — hemodialysis or peritoneal dialysis. Hemodialysis involves using a machine to filter blood through a dialyzer, while peritoneal dialysis uses the lining of the abdominal cavity to filter blood. Both methods remove waste products and excess fluids from the body.

Plasmapheresis: Plasmapheresis involves the separation of blood into its components using a machine called a cell separator. The machine removes plasma from the blood, and the remaining components are returned to the patient. In some cases, replacement fluid or donor plasma may be used to replace the removed plasma.

Conditions Treated

Dialysis: Dialysis is primarily used in the treatment of end-stage renal disease (ESRD), acute kidney injury, and chronic kidney disease. It is used to maintain electrolyte balance and remove waste products when the kidneys are not functioning adequately.

Plasmapheresis: Plasmapheresis is used in the treatment of various conditions, such as autoimmune disorders (e.g., myasthenia gravis, Guillain-Barré syndrome, and systemic lupus erythematosus), certain neurological conditions, and conditions involving the overproduction of specific proteins, like high levels of low-density lipoprotein (LDL) cholesterol.

Frequency and Duration

Dialysis: Patients with chronic kidney disease typically undergo regular, long-term dialysis treatments, which can be several hours, multiple times a week. The frequency and duration depend on the severity of the kidney disease.

Plasmapheresis: The frequency and duration of plasmapheresis treatments vary depending on the condition being treated. Some patients may require only a few sessions, while others may need more frequent and extended treatments.

Effect on Blood Components

Dialysis: Dialysis mainly focuses on removing waste products and excess fluids from the blood. It leaves the cellular components of the blood (red blood cells, white blood cells, and platelets) intact.

Plasmapheresis: Plasmapheresis specifically targets the liquid portion of the blood, which is the plasma. Cellular components are returned to the patient after plasma removal.

In summary, dialysis and plasmapheresis serve different purposes and are used for distinct medical conditions. Dialysis primarily addresses kidney dysfunction by filtering waste products and excess fluids, while plasmapheresis is utilized for conditions involving abnormal substances in the plasma, such as autoantibodies or proteins, and aims to remove or replace the plasma.

[snugglywugglysocialist]

Monotony

Late-night sheets of rain hurl themselves at the living room window of your apartment, degrading the view of streetlights below into nothing more than distorted swirls.

Irritation rises within as you realize the hostile weather has ruined your plans for the night, rendering you victim to a tortuously boring night-in. Monotony has been your most salient enemy since quitting your residency, though you’ve been able to dodge it until tonight.

You clutch the glass in your hand as you move towards the bookshelf seated in the hall. Your eyes rake over the busted spines and heavily annotated texts, realizing you haven’t had the time to leisurely read in months.

You grab one off the shelf and head for your spot on the couch, convincing yourself this is a riveting way to spend an evening; after all, you used to do this all the time. However, multiple futile attempts to keep focused on the work in front of you led to aimless pacing around the beige walls of your living room.

The last thing you expected to gain from your time at Princeton Plainsboro was a diminished ability to bear anything uninteresting, especially since the inherent lack of it in diagnostics often delivered such distress.

The actualization of this newfound intolerance didn’t make itself known so harshly until this moment, the weight of it hitting you like bricks. You toss the book you’d been holding onto the coffee table, and lace your hands behind your neck in disbelief.

Three sharp raps at the door interrupt your brooding, the color from your face surely draining as you realize who it probably is. You stand up, instinctively grabbing your glass of liquor, and begrudgingly walk to the door. You peer through the peep-hole to confirm what you already know.

House.

You swing open the door, already annoyed with his presence. He’s in his usual t-shirt and jeans—with a soaked blazer as an additive—and holding a navy blue case file in his left hand. He looks you up and down, his eyebrows raised, and you mentally kick yourself in the ass for not putting on pants before answering the door. You silently move inwards to let him in, and he does so, sizing up your flat. You slam the door closed harder than intended, and he turns.

“Did you miss me?” He says, his words steeped in sardonic cloy.

“What are you doing here?” You ask, refusing to engage with his attempt at banter.

He says nothing, wriggling the file in his hands as a response. You sigh and grab a towel, tossing it towards him in the same fashion as he does when throwing a case file at an intern. He catches it with one hand, and throws the folder on your couch before shucking off his jacket, and drying off his hair.

“Take your shoes off, you’re getting my floors wet.” You say, and he does so, but not without rolling his eyes and huffing like a toddler.

“Differential. Sixty year old-“ He begins to speak, but you cut him off quickly.

“You remember that I quit, correct?” You say, crossing your arms.

He smirks and sets the towel next to his jacket. It’s his turn to pivot a question.

“I thought you didn’t drink.” He states flatly.

“Ethanol pairs well with boredom.” You respond, your curiosity practically forcing you to pick up the file he brought. He watches you intently as you flip through the pages, trying to pick up on a reaction. You shut the file shortly thereafter, and hand it back to him.

“It’s Myasthenia Gravis; do an SFEMG and start him on plasmapheresis and steroids after the confirmation.” You sigh, running a hand through your hair. Your attempt at concealing your interest in this case does not go unnoticed by House, and you can tell. His gaze stays fixed on you, and you fight the urge to squirm beneath it.

“You already knew that though, or you’d be calling one of your lackeys to begin treatment. So again I ask, what are you doing here.” The words spill out of your mouth, and you do little to control the contempt dripping from them.

His eyes dart around before nodding slightly, and he moves to sit down on the couch. He motions for you to join him, and you oblige apprehensively. The two of you sit in silence for a few moments before he speaks.

“Why did you quit?” He asks, almost rhetorically.

“You know why.” You quip.

“No, I know what you told me. I want the real reason.” He retorts, his eyes narrowing, looking to sieze meaning from your facial expressions, to which he finds none.

Wordlessly, you stand to fix him a drink, and he sighs loudly at your lack of a response as you head towards the cupboard. You’re almost done pouring when you hear him coming into the kitchen behind you, the thumping of his cane reverberating off the barren walls of your apartment. He keeps walking until he’s mere inches from you, effectively pinning you between him and the island bar from behind. You set down the bottle with shaking hands, and turn to face him.

The backlighting of your living room shrouds his face, reducing his figure to a towering silhouette. A pang of nervousness barrels into your stomach, a feeling he often aroused in you, and one you’d tried desperately to quell.

You turn your head to avoid his piercing eyes, though you can’t even see them. He shifts his weight, and sucks a breath in through his teeth. Your thoughts drift to imagine the grimace of pain he must be wearing.

“I asked you a question.” He says lowly, snapping your wandering mind back.

“One which you know the answer to.” You say, causing him to scoff slightly in response.

You move to escape him, but he steps even closer, forcing you to brace yourself against the countertop. Blood rushes to your ears and your heart thrums in your chest with rigor.

“House…” You scold quietly, hoping to elicit some sense into him, but he stays unmoving. Centimeters make up the gap between the both of you; one sleight of hand and you know it’s over.

“My ‘lackeys’—as you so endearingly called them—have placed bets.” He chides.

“On?” You choke out, praying your voice didn’t reveal the effect he’s having on you.

“On when you’ll admit you quit because you have a thing for me.” He says, his words are wrapped in faux endearment, and you can’t discern whether the feeling in your stomach is nausea or arousal.

He closes the gap suddenly, drawing a low whine out of you. His cane clatters as it hits the hardwood floors of your kitchen, and he brings his hands up to grab your face. He nips softly at your lower lip, causing you to gasp, allowing him full access to your mouth. His hands grovel to grasp the seam of your panties, but you grab his wrists, and turn to lead him into your room.

After shutting the door behind him, he walks towards you until you’re forced to step back, the backs of your knees hitting the bed. You sit down, and watch as he grabs the bottom hem of his shirt and pulls it over his head, discarding it on the floor, his belt and pants soon to join it. He approaches the left side of the bed and joins you.

With the last shreds of your inhibition dissipated, you move on your knees to straddle him, his hard length making contact with your center. He makes quick work of your shirt, ripping it off of you, your bra soon to follow. He palms your breasts immediately, his thumbs lathing over your nipples, making your body tremble.

As he takes your breast into his mouth, you know he plans to draw this out, and you know that you’ll let him. His tongue swirls and your hands bury themselves in his hair, pulling and grabbing erratically. You attempt to stifle a moan but fail, and you can feel him smirk against your chest in response.

You pull back on his hair until his neck is exposed, and move to lavish it. You burn a trail of kisses from the shell his ear to his collarbone, and the low-octave grunts leaving his throat only spur you on. You push him back until he’s laying, and continue your assault, making bruises along his chest with your teeth.

His hand creeps to your center, and pushes aside the soaked fabric, slipping his middle finger into you with ease. He chuckles condescendingly as you flutter around him, and you bite softly into his shoulder to avoid mewling. He slips the lace garment over your hips to remove them, the wetness from his hand leaving a trail across your thigh.

You go to remove the last remaining barrier between the both of you, but he grabs your hands. He slides his boxers down just enough to reveal himself, but keep the scars on his thigh covered. Pity flashes in your eyes, but you rid your expression of it, hoping he didn’t catch it. You sit up straight on your knees, looking down at him.

“Take ‘em off or get out of my bed.” You sigh out, swathing your feelings with this ultimatum. You know it’s not a lack of trust with you, just a generalized shame, but it still pains you in a way you can’t verbalize even if you wanted to. He looks at you blankly before putting his hands above his head, allowing you to slide them down his legs. You throw them to the floor, and allow your fingertips to ghost over the scars, and he scoffs.

“I don’t care, House. I want you.” You whisper, and he doesn’t respond.

He averts his eyes in embarrassment, and looks as if he’s about to say something, but is thwarted when your hand moves to his shaft. Your movements are tentative until you land on a pace that forces his eyes to roll back, revealing white. He lets out a low moan that shoots straight to your core, and you resume lamenting his neck with your tongue.

Soon, his abdomen muscles tighten, and his legs spasm slightly, letting you know he’s close, and you stop your movements suddenly. His eyes snap open in protest, and his chest heaves as you lower yourself onto him. He grunts and throws his head back into the pillows, harshly attaching his hands to your hips.

He pushes into you slowly until you reach his hilt. Your mouth falls open as you attempt to adjust to the fullness, and a string of unintelligible words fall from his lips. You rock slowly, his hands guiding you up and down. After a moment, you come down off your knees and allow your full weight to fall on his upper body, and he welcomes the pressure greedily.

His arms envelop the small of your back, and he ruts up into you, making your breath hitch. He fucks you from beneath until your body shakes in his arms, and you can no longer control the sounds leaving your chest. You reach the precipice pathetically fast, and he follows, spilling into you indiscriminately. His hands run up your spine as he sings your praises, and forces your face upwards to meet his lips.

You continue to kiss him lazily as you brace yourself on your knees once more to get up, and he grabs your waist and keeps you there. He’s still panting as he reverses your positions, and begins kissing down your chest to your navel. His lips move to brush against your hip bones, and he spreads your legs.

Heat flushes from your chest to your center, and you fold your arms across your face. His middle and ring fingers enter you deftly, and your hips shoot up at the intrusion, causing him to hook his lithe arms beneath your thighs to prevent any future writhing. He licks a broad stripe up the length of you before coaxing your clit into his mouth, switching between paces.

You’re incredibly sensitive already, and his demonstrations leave your head spinning ten-fold. Your legs press upwards to entrap his head, but his arms keep you spread and pinned. Half formed tears fall from your eyes as you finish, your hands buried so violently in his hair you’re sure it’s hurting him, but you couldn’t care less.

He stops and collapses next to you as you revel in the after-shocks. Your head falls upon his chest, and you crane upwards to leave chaste kisses beneath his jaw. You’re still barely coherent when he speaks.

“So, when are you coming back?” He asks sarcastically, his voice raspy and laced with satiation.

“Very soon if you keep fucking me like that.” You quip breathlessly, and he bites back an assured smirk.

[jerrylewis-thekid]

About this special moment on the 15th annual Jerry Lewis Labor Day Telethon for Muscular Dystrophy in 1980 at the Sahara ♡ . “I’ll tell you one thing that I could never ever forget. Mary Passalacqua was a victim of neuromuscular disease, and I went to the hospital to see her in San Francisco, hoping that she would be better. And she was, she was skeleton-like. She was dying so badly. And we funded a thing called plasmapheresis, which flushes the bad blood out and puts new blood in, and she had been given the last rights when I arrived there. When I arrived there she was the epitome of what hero worship is, because she saw me and she, she practically came alive. And then I left, I said good-bye, never though I’d see her again, and then I get a letter from her two months later. Thanks so much for visiting me: it made the difference. I’m doing well. I’m fine. And P.S. my dream is to one day dance with you. I read the letter on television in front of eighty million people. And then I pointed to the curtain and there she came. She walked out and she and I danced dead center of that stage. There wasn’t a dry eye in the house. She’s alive and well because of our funding the plasmapheresis syndrome. And that’s probably one of the most unforgettable things, because I was trembling so, trying to dance and be cool. It was so important to her and to everyone else that was a victim. It was a special moment for people in trouble.” — Jerry Lewis

It's clear he's struggling not to cry. He fulfilled this woman's wish. He wasn't a monster, monsters are the flock of idiots who judge him without really knowing him.

Thanks for living Jerry. May you be blessed wherever you are.

[daytea]

plasmapheresis ArtFight attack on @orxhiid

[punchdrunkdoc]

Part 2, Chapter 11

Summary: After the events of S3, Matt Murdock is trying to once again balance life as a lawyer and a vigilante. But he’s been scarred by loss and betrayal - will a mysterious new neighbour help him heal? Or will her secrets drag him back into the darkness?

Notes: This is a slow burn romance with an original female character, told in 3 parts. There is mystery, intrigue, action/violence and angst - all the good stuff!

Also available on AO3 and Wattpad

Masterlist

Reference pics

————–

PART 2

Chapter 11

Sofia closed the cabin door behind her and collapsed into the seat between Yelena and Katya. The medic said nothing as she stared blankly at the trees in front of her.

They were in an idyllic location, in a private log cabin near Lake Harmony, Pennsylvania. The decking at the front of the property was furnished with comfy rocking chairs with hand-knitted afghan throws, and it offered an amazing view of the thick woodlands that surrounded the area.

But none of them cared. This was just a convenient stopping place.

“Still no change?” Katya guessed.

Sofia shook her head. She seemed to be fighting to keep her eyes open, so Yelena offered her the rest of her coffee. Sofia gulped down the lukewarm liquid without a grimace. She must have been as exhausted as she looked.

“Why isn’t she waking up?” Yelena asked, trying to keep the fear out of her voice. “Its been two days.”

“She lost a lot of blood from the wound, Yelena. Blood that she couldn’t afford to lose after cutting her treatment short.”

Yelena crossed her arms and kicked at one of the plant pots decorating the deck.

She hated this.

She hated feeling so helpless.

And so guilty.

The only reason the other Widows had been injected with those nanites was because of her defection. If it wasn’t for that, they wouldn’t have needed that damned plasmapheresis thing. Volkov’s men would never have tracked them to South Carolina.

And Calina would never have been shot.

If it wasn’t for you, they still would have been locked inside their own minds in the Red Room.

The voice in her head sounded suspiciously like Nat’s.

She wished she could talk to her. She needed her big sister. She needed Nat to tell her that she was doing a good job leading the Widows, despite all evidence to the contrary.

You’re not responsible for us. We’re sisters. Team mates. But we’re not your burden.

That voice was definitely Calina’s. She’d said the words to Yelena just a few weeks ago. Yelena hadn’t believed them back then, and she didn’t believe them now, either. She was responsible for the Widows that she’d freed. She had made the decision to take down the Red Room. And until that job was complete - until they’d killed every last one of the bastards who’d worked there - she was in charge. She was responsible.

Which meant, when one of them got hurt, it was on her.

When one of them died, it was on her.

First there was Kira…

She didn’t want to lose Calina too.

“Is there anything more we can do?” she asked.

“No. Not without an intensive care facility and a lab.”

They’d made the decision as a team not to take Calina to a hospital. It would have been too easy for Volkov to track her there, and a gunshot would have raised too many questions - questions that might have gained the attention of the agencies in charge of the Sokovia accords.

They’d tried to reach the new base in Maine, but Calina’s condition had deteriorated in the van, so they’d found this secluded cabin and set up a makeshift hospital room. Sofia had managed to stabilise her, thanks to the supplies they’d stolen from a nearby emergency clinic - oxygen, antibiotics and multiple bags of fluid and O-neg blood.

Calina had needed it all.

And it had worked…up until a point. Her blood pressure was back up and there was colour in her skin again.

But she still hadn’t woken up.

“There is something that might help,” Katya added after a few minutes.

Yelena sat up straight. “What?”

She gestured to the vibrating phone in Yelena’s pocket. “You could answer that.”

Yelena grimaced as she pulled out the phone and looked at the caller ID.

Matt fucking Murdock.

He was the reason Calina had stayed in New York - putting herself and the other Widows in danger - and he was the reason she’d eventually returned home, looking heartbroken and miserable. He’d been ringing Calina’s phone non-stop for the last few hours, as if he knew something was wrong.

Maybe he was psychic, as well as being a bastard.

“How would that help?”

Sofia cocked her head, as if thinking through Katya’s plan. “There is scientific evidence that people in suppressed conscious states like Calina can hear their loved one’s voices. Can feel their touch, and their care. It can help bring them back.”

“And,” Katya added. “You remember what happened in the van.”

Yelena huffed. She remembered.

After Calina had fainted, Sofia had quickly gotten to work stopping the bleeding. With Yelena’s help, she’d managed to fish out the bullet casing from Calina’s side and then she’d stitched the wound closed.

But half-way through the procedure, Calina had stirred, the pain of the forceps digging deep into her flesh too much to keep her fully unconscious. She’d moaned and jerked, and tears had leaked from the corners of her eyes.

And she’d whispered one word, again and again, her voice weak and broken:

Matt…Matt…Matt.

“She needs him, Calina. You and I - none of us - can really understand that. We haven’t lived the life that Calina has these past few months. But you can’t deny their connection - we all saw it when we went to New York. I think he might be able to help her.”

“You’re suggesting we bring him here? Are you crazy?”

“We could take precautions. Sedatives, blind-folds, that kind of thing. So he doesn’t know where we are.”

“You’re going to blind fold the blind man?” Sofia asked with a smile.

Katya looked sheepish. “Well, maybe not that. But he would definitely need to be unconscious. From what Calina and Anya say, he’d be able to figure out which direction he was traveling from the feel of the sun on his face and the scents in the air. But we’re only a couple of hours away from New York…”

“It’s worth a try, Yelena,” Sofia added.

Yelena sighed as she pulled the phone from her pocket. “I can’t believe I’m going to do this.”

“It’s for Calina.”

“For Calina.”

 ———

 Matt sat on the floor of his apartment, his back against the wall. His arm rested on one bent leg, and his phone was clutched tightly in his hand.

It was his only lifeline to Calina, and he hadn’t let it out of his sight in days.

He had no idea where she was, and no way to find out. He had no idea what she was doing. Or what danger she was in. All he had was a number.

So he kept calling it. And calling it. And he kept praying that she would eventually answer.

He needed to hear her voice. There was a chasm in his chest, formed of a deep, dark, all-consuming dread. It was a weight inside him, pressing against his rib cage and wrenching him apart. And he knew it would only disappear when he heard her voice on the other end of the line.

The last time they’d talked - 74 hours and counting - it was clear she’d been about to go on some sort of mission. So he’d respected her need for ‘radio silence’, as she called it. He hadn’t called again that night. Or the next morning.

But that chasm had started to open up. The dread and worry had started to build, and he’d relented. He’d dialled her number.

The need to hear her voice became as vital as breathing. He needed to know she was okay.

Even if she never forgave him. Even if she never gave him a chance to explain, and she stayed away from him forever, it wouldn’t matter - as long as she was okay. His world could keep revolving, as long as she was alive in it.

He pressed the redial button.

Then almost dropped the phone as the call finally connected.

“Calina?” he asked, his voice catching.

“No. It’s Yelena.”

The dread built, threatening to choke him. “What happened? Where’s Calina? Is she…?” He couldn’t bear to say the words aloud.

“She’s alive.”

Alive.

He exhaled, his breath shaking.

But then Yelena’s words sunk in. She hadn’t said Calina was ‘fine’. She hadn’t said she was ‘okay’. Just…alive.

“What happened?” he repeated.

“Do you care about her?”

“Yes. More than anything.”

“Then be outside your apartment in ten minutes.” She hung up.

Matt didn’t think twice. He jumped to his feet and shoved on his sneakers. He texted a quick message to Foggy then grabbed the coat by the door. He was down the stairs and out on the street in two minutes.

His only moment of hesitation came when Yelena pulled up in a nondescript van and motioned him towards the back. “Get in.”

Did he trust her?

He knew Calina did. But he also knew that Yelena’s priorities didn’t always align with Calina’s. She had a ruthless streak, and would do whatever it took to protect the Widows.

Did that include taking him out?  Did she see him as a threat now?

“Get in the van, Murdock,” she said, sounding irritated. “Do you want to see Calina, or not?”

He did. He wanted to see her more than he cared about his own safety.

Besides, what could one Widow do to him?

It turned out, one Widow could do nothing. But the two in the back of the van could do plenty -  the moment he opened the doors, they fired on him. He jerked back, clutching at one of the darts sticking out of his chest. “What the hell?”

He swayed on his feet, the tranquilliser taking effect immediately. The Widow nearest the door grabbed him by the lapels of his coat and dragged him into the van. The other slammed the doors shut behind him, and then they were moving.

As the drug flooded his system, his senses started to fail and the world on fire dimmed to a faint glow.

But before everything went dark, he found comfort in the scent drifting from the floor of the van:

Strawberries and sea salt.

Calina.

 ———

 The change in the road woke him.

As the van suddenly started to bump over an uneven surface, Matt jolted back to awareness. And the first thing he noticed was the soft pillow beneath his head.

He wasn’t used to kidnappers being so thoughtful.

“No sudden moves, Mr. Murdock.” The polite command came from his right. The speaker sounded young - even younger than Calina. But the gun she had aimed at his head belied her innocence.

“We’re sorry about this.” That voice came from his left.

And it was one he recognised. “Katya, right?”

“Yes. We’re sorry we had to sedate you,” she repeated. “But we needed to take precautions.”

Matt sat up, and a wave of nausea hit him as his body protested the sudden movement.

“Are you okay?” Katya asked. “Here take some of this.”

She pushed a bottle into his hands. He opened the cap and sniffed the contents.

“It’s just water, I promise.”

His nose told him the same thing, so he took a swig, then passed it back to her. “What’s going on? Why are ‘precautions’ necessary? And where the hell is Calina?” His voice built to an angry growl as he fired off his questions.

“We’re on the run - again. The last faction of the Red Room found us. Calina was…hurt…when we escaped.”

“Hurt how?”

“She was shot.”

“Jesus,” Matt breathed. His senses told him it was true - and that it was bad. Overlaying Calina’s scent on the floor of the van was the coppery smell of blood. Lots of it. As well as traces of adrenaline, gunpowder and fear.

She’d been in this van, in the very place Matt lay, while she bled out.

“How is she?” he whispered.

“She’s stable. But…”

“But what?”

“She hasn’t woken up.”

“She’s in a coma?” Matt choked out the words.

“Essentially.”

“For- for how long?”

“Over 48 hours.”

Matt barely had time to process the words before the van screeched to a stop. He heard Yelena jump out of the driver’s seat, then round the vehicle and open the doors. The scent of aspen and birch flooded the interior, and he could detect a large body of water nearby. The wind coming from the south felt chilled by a glacier lake.

“Is he up to speed?” Yelena asked as the others jumped out of the van. Matt followed them more slowly, his head still slightly fuzzy from the drug.

“Pretty much,” the younger Widow answered.

“Good. Come on.”

The three of them followed Yelena as she marched up the steps of a wood cabin. They were met at the door by another woman.

“Is she awake?” Yelena asked as they entered the cabin.

“No.”

She turned to Matt, and gestured to the closed door on her right. “You’re up, Murdock.”

“What do you mean?”

“I thought you said he was up to speed, Inessa?” she asked the younger Widow.

“I said ‘pretty much’ up to speed. We didn’t get to that part.”

Yelena sighed. “There was a suggestion among the group, that you might be able to help Calina. That your voice would…bring her back.”

Matt shook his head. “I’m not sure about that. I’m not exactly her favourite person right now.”

Yelena shrugged. “Well, then maybe she’ll wake up just to tell you to fuck off. I don’t care. As long as she wakes up.”

Matt took a step towards the bedroom, but hesitated. He wasn’t sure why he was holding back - he’d been dying to see Calina for days. But now that she was just a few feet away, he was suddenly rooted to the spot.

Inessa - the young, polite Widow - seemed to think he was still unsure that he’d be welcome in Calina’s presence. “She said your name, you know. In the van after she was shot. She called for you.”

She called for you.

When she was drenched in blood and wracked with pain and shock…she’d called for him. And he’d been hundreds of miles away, oblivious to her suffering.

The image of that hit him like a gut punch. And it jerked him out of his strange paralysis.

He crossed the floor, opened the door, and stepped inside.

 ———

 The room was quiet, save for the steady beeps of a monitoring device, the trickle of fluid through a cannula, and Calina’s deep, slow breaths.

Too deep. And too slow.

This was more than just sleep. She was so far under.

So far away.

Matt’s heart lurched. This is why he’d been hesitant to come in here - he couldn’t bear to see her like this. So still and lifeless. 

He slowly approached the side of the bed, and reached out a tentative hand to grasp hers. He held it like it was the most precious thing in the world.

“Hey, Callie.” His voice was barely a whisper, and the brush of his thumb over the back of her hand was feather-light - as if he was scared she would disappear again. Vanish without a trace.

Bitter irony washed over him - he’d spent days wishing he could take her hand and talk to her. And now that he had the chance, she was still so far out of reach.

The dread that he’d been living with since her call on Saturday reared its ugly head - joined by an overwhelming feeling of terror and panic.

What if she never woke up?

What if he’d lost her forever?

The thought brought him to his knees. He collapsed by the side of the bed, all strength deserting him. He pressed his lips to her delicate skin…

And he prayed.

 "Our Father, which art in heaven,

Hallowed be thy Name.

Thy Kingdom come.

Thy will be done in earth,

As it is in heaven.

Give us this day our daily bread.

And forgive us our trespasses,

As we forgive them that trespass against us.

And lead us not into temptation,

But deliver us from evil.

For thine is the kingdom,

The power, and the glory,

For ever and ever.

Amen."

 The words were a murmured litany, softly pressed into her skin. He poured every ounce of faith and conviction he had into them.

And he suddenly remembered the last time he was in this position - praying for the life of a woman he cared about. It was after Elektra had been slashed with a poison blade. He’d grasped her hand as she’d screamed in pain from the wound, and he’d been so afraid of losing her.

And ultimately…he had.

Twice.

The pain of that loss - and the fear of it happening again - had damaged something inside him. It had calcified his heart, and walled it off. It had stopped him from embracing the wonderful, beautiful woman in front of him. It had caused him to reject her, instead, and make up excuse after excuse to not be with her. Excuses that were nothing but a load of bullshit.

He needed to concentrate on work - bullshit.

He was still in love with Elektra - bullshit.

He didn’t want to take advantage of her - bullshit

He was too damaged…well there was some truth to that. But the bigger truth was that he was just…scared.

No, he was terrified.

He was terrified that one more loss would break him completely. He was terrified that he didn’t have the strength to survive being hurt again.

He was terrified of taking another chance…

“I’m so sorry,” he whispered, his head still bowed over her hand. “I’m so sorry, Calina. I’ve been such a coward. I pushed you away again and again and again, and I deluded myself that I didn’t feel this way about you. I convinced myself that if we just stayed friends, I would never have to go through something like this again. And it was…it was all for nothing. Because my heart feels like its being torn apart right now. Keeping my distance from you did nothing to stop this pain.”

He tightened his grip on her hand, but her fingers remained slack within his. The lack of response caused hot tears to leak from his eyes. 

“You need to wake up, Callie. Please. You need to wake up so that I can tell you how much I care about you. How much you mean to me.” He reached up with his free hand to brush his fingers across her cheek. "You need to forget what you heard in the bar that night. It wasn't true. You’re not a substitute, or a proxy for someone else. You’re everything. You’re the first person I want to see in the morning, and the only one I want to talk to at night. You're...you're so amazing. I'm in awe of how brave you are, and how kind you are, despite everything you've been through. I love how your mind works, and your awful attempts at being funny. I love that your closest friend is an 80-year-old German woman. I love how you manage to find a proverb for every occasion, and that you read physics textbooks and Indian philosophy for fun."

He took a deep breath, and finally banished the fear that had held him back all this time. "I-I love you, Calina. I love you so much. So please, sweetheart, you need to wake up for me. Please.”

———

CHAPTER 12 

@hollandorks @acharliecoxedfan @chezagnes @yanna-banana @stilldreaming666 @tearoseart-blog @freckledbabyyy

If you want to be added to the tag list, let me know!

[dinosaurjam]

A fun House MD drinking game to play if you want to end up in an ICU of your very own! Take a shot anytime someone says:

Sarcoidosis

Plasmapheresis

LP

Boobs

[academicelephant]

Dr. Abrams to Dr. Manning and Dr. Halstead: When did ED doctors become so polite with each other? You two dating or something? ... Never mind. Start with IV IgA and plasmapheresis. At this point I'm ready to throw a kitchen sink at this thing. Page me when her sedation wears off.

[er-cryptid]

Treatment of Myasthenia Gravis

-- cholinesterase-inhibiting drugs

-- steroids

-- plasmapheresis

[papiermachecat]

I know it's complicated, but would you ever consider moving to a state that would cover it?

The specialist we see is a pediatric neurologist in DC who is one of the top experts in the world on this and the first thing she asked us when discussing treatment plans was if we might be able to move to Maryland. We have been looking into it but unfortunately at least one of us would have to leave the school we’ve both taught at for 20 years to have insurance through a MD employer. Us moving our physical location wouldn’t matter if our insurance was still through a VA employer. But if we have to move on to plasmapheresis, probably one of us will just do it. At least teaching jobs are easy to find nowadays.

[jayanthitbrc]

Global Blood Market Analysis 2024: Size Forecast and Growth Prospects

The blood global market report 2024 from The Business Research Company provides comprehensive market statistics, including global market size, regional shares, competitor market share, detailed segments, trends, and opportunities. This report offers an in-depth analysis of current and future industry scenarios, delivering a complete perspective for thriving in the industrial automation software market.

Blood Market, 2024 report by The Business Research Company offers comprehensive insights into the current state of the market and highlights future growth opportunities.

Market Size - The blood market size has grown strongly in recent years. It will grow from $7.83 billion in 2023 to $8.32 billion in 2024 at a compound annual growth rate (CAGR) of 6.2%. The growth in the historic period can be attributed to the surge in demand for blood and plasma, an increase in the number of surgeries, a growing global population, increasing incidence of chronic diseases, rising number of blood banks.

The blood market size is expected to see strong growth in the next few years. It will grow to $10.62 billion in 2028 at a compound annual growth rate (CAGR) of 6.3%. The growth in the forecast period can be attributed to favorable government regulations, a rise in the geriatric population, rising awareness about blood donation, increase in blood transfusion, increasing number of ambulatory surgical centers (ASCS). Major trends in the forecast period include advancements in blood transfusion and blood screening instruments, computerized immunoassays, smart blood bank inventory control systems, technological innovations, precise temperature monitoring and control.

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Scope Of Blood Market The Business Research Company's reports encompass a wide range of information, including:

Market Size (Historic and Forecast): Analysis of the market's historical performance and projections for future growth.

Drivers: Examination of the key factors propelling market growth.

Trends: Identification of emerging trends and patterns shaping the market landscape.

Key Segments: Breakdown of the market into its primary segments and their respective performance.

Focus Regions and Geographies: Insight into the most critical regions and geographical areas influencing the market.

Macro Economic Factors: Assessment of broader economic elements impacting the market.

Blood Market Overview

Market Drivers - The increase in the number of surgeries is expected to propel the growth of the blood market. The rise in the number of surgeries is driven by improvements in medical technology, an aging demographic, and more chronic disease cases. Blood is essential in surgery to supply oxygen and nutrients, aiding clotting to control bleeding and enhance the immune response to combat infections. For instance, in December 2023, according to the Australian Institute of Health and Welfare, an Australia-based government administration, in 2022–2023, 735,500 patients were admitted for surgery from public hospital elective surgery waiting lists, marking an 18% rise compared to 2021–2022. Therefore, the increase in the number of surgeries is driving the blood market going forward.

Market Trends - Major companies operating in the blood market are developing advanced blood transfusion instruments, such as plasma collection systems, to improve efficiency, enhance donor safety, and increase the overall quality of blood products. A plasma collection system is a device that extracts plasma from a donor's blood by separating it from other components and returning the rest to the donor through plasmapheresis. For instance, in March 2022, Terumo Blood and Cell Technologies, a US-based blood component and cellular technology company, received Food and Drug Administration approval for the Rika Plasma Donation System (Rika). It is a next-generation plasma collection system that focuses on improving the experience for plasma center employees and donors, featuring safety measures to reduce operator errors and completing plasma collection in 35 minutes or less. Rika ensures no more than 200 milliliters of blood are outside the donor's body at any time and includes an advanced control system for operators.

The blood market covered in this report is segmented –

1) By Product: Whole Blood Collection And Processing, Source Plasma Collection, Blood Typing Products, Blood Screening Products 2) By Mode of Delivery: Infusion Solutions, Gels, Sprays, Biomedical Sealants 3) By End User: Blood And Blood Component Bank, Diagnostic Laboratories, Ambulatory Surgical Centers, Hospitals, Other End Users

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Regional Insights - North America was the largest region in the blood market in 2023. Asia-Pacific is expected to be the fastest-growing region in the forecast period. The regions covered in the blood market report are Asia-Pacific, Western Europe, Eastern Europe, North America, South America, Middle East, Africa.

Key Companies - Major companies operating in the blood market are Cardinal Health Inc., Roche Holding AG, Thermo Fisher Scientific Inc., Abbott Laboratories, Medtronic Plc, Danaher Corp., Merck KGaA, Asahi Kasei Medical Co. Ltd., Henry Schein Inc., Medline Industries Inc., B. Braun Melsungen AG, Grifols SA, Terumo Corp., Nipro Corp., QuidelOrtho Corp., Bio Rad Laboratories Inc., LivaNova PLC, Haemonetics Corp., Macopharma, DIAGAST SAS, BAG Health Care GmbH, Kawasumi Laboratories America Inc

Table of Contents

Executive Summary

Blood Market Report Structure

Blood Market Trends And Strategies

Blood Market – Macro Economic Scenario

Blood Market Size And Growth …..

Blood Market Competitor Landscape And Company Profiles

Key Mergers And Acquisitions

Future Outlook and Potential Analysis

Appendix

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