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dorianbrightmusic · 2 days ago

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16 Wound Care Tips

DISCLAIMER: I’m not a doctor. The most medical advice you’re gonna get in here is ‘you should probably see a doctor if you see xyz’. I can’t definitively say if something’s infected or not, nor tell you about your specific circumstances.

TW for references to self-harm, and for somewhat graphic descriptions of wounds.

1. Your skin has 3 layers. The surface-level one is the epidermis; the white stuff beneath that is the dermis; and the yellowish stuff beneath that is the hypodermis. Any wounds that go deeper than the dermis need urgent medical care. Anything that goes deeper than the hypodermis is an emergency.

2. Deeper wounds are more likely to get infected than shallow ones. Unfortunately, deeper infections are also generally more dangerous than shallow ones. General things to look out for that signal infection are: redness; rash; a sense of heat in the wound; inflammation; red lines radiating from the wound; swelling; blistering; crust around the wound; impaired healing; pain; pus; and other discharge. (Note: a healthily healing wound may also produce some translucent-ish discharge. However, if the discharge is very yellow or very opaque, it’s time to see a doctor.)

2.5. One type of infection of the dermis or hypodermis is called cellulitis, and is a Very Bad Thing. As in medical emergency bad. As in will-spread-very-quickly-and-potentially-become-extremely-dangerous bad. Cellulitis usually looks like a red area (with soft borders), and tends to be painful to touch. Cellulitis can turn up anywhere on your body, but is most common on the legs.

2.75. If you have a fever with ANY of the aforementioned symptoms, go straight to hospital. Fever, in this context, tends to signal infection.

3. It’s better to kill an infection before it starts than to wait for symptoms. Wound care is best when it’s preventative. Wash your wounds - yes, even if they’re small - with water + soap, then use a topical antiseptic, such as povidine-iodine or chlorhexidine (that’s bepanthen). You can either get a dropper and drop it directly onto the wound, or get some gauze and swab it on yourself. Generally, covering this with a bandaid is a good idea, as it’ll stop stuff getting into the wound. If it’s relatively shallow, maybe you can get away with leaving it uncovered, but I’d err on the side of caution.

3.5. Do not put rubbing alcohol directly on your wounds - it’ll irritate the skin. However, if you are currently self-harming and seeking to minimise harm, rubbing alcohol can be used to clean any tools. (Clean before AND after, people!)

4. Some antiseptics and antibiotics are provided as creams or ointments. The difference between these is basically how much water they have in ‘em. Creams have more water, so rub into the skin. Ointments have less water, and sit on the wound instead of being rubbed into it. Don’t attempt to rub the ointment in and spread it thin as a result. You can be generous with ointment. Ointment is great, but will stain your clothes - so, it can help to cover it up with a dressing of some kind.

5. Wound dressings are anything you can put on the wound to stop stuff getting in. Wounds will heal faster if you cover them up - no, taking off the bandaid to ‘air it out’ will not, in fact, accelerate healing. Wound dressing options include (but are not limited to): bandages (good for when you need to apply pressure, which is to say anything deep); plasters (good for convenience); gauze + medical tape (more breathable, though I’m not sure of the benefits here). Change wound dressings at least once a day (unless otherwise instructed).

6. Bandaids and medical tape will leave adhesive on your skin. Wash it off with soap and water - otherwise, the sticky stuff builds up, and if you’ve got skin sensitivities, they might get flared up. If wound dressings are causing you continual flare-ups even when you wash the adhesive off, consider using a wound-prep wipe before dressing the wound (but consult with your doctor if it’s infected - I do not know the protocol here). And, for that matter, consult with your doctor anyway if you’re reacting to wound dressings - you might wanna get that checked out.

7. Your dermis contains some blood vessels, nerve endings, and hair follicles. If you hit a blood vessel, it will bleed a lot. So, if you see considerable bleeding:

If it is bright red and it spurts in time with your pulse, this is probably an artery. GO TO HOSPITAL IF YOU SEE THIS KIND OF BLEEDING. IT IS AN EMERGENCY.

If the bleeding is darker but more constant, you’ve probably hit a vein. If this doesn’t stop bleeding in 10 minutes, go to hospital. Put pressure on it in the meantime.

For the record, veins and arteries are not, in fact, bright red and bright blue like they are in textbooks. You will not know that you’re about to hit one until you do. Nerves are similarly difficult to see, but if an injury hits a nerve, it’ll be painful - either it’ll have an electric quality, a burning sensation, or it’ll sting like buggery.

8. The hypodermis contains: more nerves and blood vessels, as well as subcutaneous fat. Fat looks yellow and, uh, bean-like. If you see fat, it’s time to go to urgent care.

8.5. If you go below the hypodermis, go to A&E. I don’t care if it’s small - NOW.

9. Deep wounds may gape - that’s to say that they look, well, open. These wounds will heal quicker if you try to hold them closed to bring the skin walls together - that’s to say that steri-strips and butterfly bandages are your friend. Bear in mind that gaping wounds tend to be deep, so consider getting the wound looked at by a professional before trying to hold it closed at home.

Generally, after 48 hours, it’s unlikely that you’ll be given stitches, even if the wound was deep enough that it ought to have been stitched (that is: hypodermis or deeper). So, if it looks like it’s gonna need stitches (gaping or deep), go get stitches sooner rather than later. A good doctor or nurse will not judge you for whatever reason you’re seeking help.

10. Some skin areas are more prone to infection than others. (See: moist areas; legs; groin/lower abdomen.)

11. Don’t clean your wounds with tissue, paper towel, or toilet paper, as the materials tend to break up, and can leave a fun residue in the wound. Gauze swatches, cotton buds, and clean towels are your friend here.

12. Don’t put makeup on open wounds.

13. For deep wounds: in my experience with dermatillomania, these don’t tend to look like they fill in layer-by-layer so much as they just shrink/thin out. If it looks like it’s filling in in layers/healing slowly or healing in a way that’s incomplete, it’s time to see your doctor. For shallow wounds: if it darkens/goes yellow as it fills in, rather than scabbing, it’s time to see your doctor.

14. If you’re given a course of oral antibiotics, you need to finish the whole damn pack. Yes, even if you seem to have gotten better. Not finishing your dose, unless you’re specifically medically instructed to, may lead to the infection returning. Do not take that risk.

15. If antibiotics seem to be failing to clear things up, it’s time to see a doctor. Many funky things could be at play, but it’s not something you wanna take a risk on.

16. Check when you last had a tetanus shot. If you’re not sure, or if it’s since expired, get another tetanus shot.

#wound care

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devirnis · 1 year ago

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ooo if you do combos - 20 & 45 with some Buck h/c?

thank you for the prompts! I hope you enjoy :)

When Eddie walks into the loft and sees Buck in nothing but a towel at the top of the stairs, he nearly drops his groceries.

But not in a fun way.

“Buck!” he scolds, hurrying to deposit the bags on the kitchen island. “What are you doing up? Why did you have a shower? You’re supposed to keep the stitches clean and dry!”

He catches Buck’s full-body eyeroll as he starts furiously putting things away in the fridge. This is exactly why Eddie dropped Chris off for an impromptu weekend with Pepa – he can’t leave Buck alone for twenty minutes before the man is already ignoring doctor’s orders.

“It’s been forty-eight hours,” Buck calls. “I’m allowed to get them wet now.”

“Forty-two hours!” Eddie shoots back.

Even from down in the kitchen, he can hear Buck’s scoff. “I don’t think six hours is going to make a huge difference, babe.”

Eddie scowls into the fridge as he places Buck’s oat milk on the shelf; he’ll be the judge of that, thank you very much.

It all started two days ago, when Eddie had roped Buck into helping him replace some rotting wood on Pepa’s front porch. The job itself had gone mostly smoothly – thanks in large part to Buck’s previous experience working construction – until the very end. Buck hadn’t been watching where he was walking, texting Bobby about something, and he’d stumbled right into the pile of old, rotten wood that they needed to dispose of. It had almost been hilarious, the cacophony of Buck swearing as the wooden planks bounced hollowly against each other, right up until Eddie had caught sight of the blood.

Buck had added a nasty cut to the collection of scars on his left leg. Eddie had cleaned it and dressed it as best he could in Pepa’s bathroom before taking Buck to the hospital for stitches, but he couldn’t shake the worry from the back of his mind about something nasty lurking on the decaying wood. His fears were proven warranted the next morning when Buck had gone to change the bandages and found the skin around the wound red and swollen.

After that, it was a trip to the doctor’s to confirm what Eddie already suspected: Buck had developed a mild case of cellulitis, because of course he had. Couldn’t just be a simple cut.

The doctor gave him a prescription for antibiotics to kick the infection and a list of at-home care instructions to prevent it from getting worse. Buck hadn’t been worried; Eddie, on the other hand…

Well. There’s a reason he insisted on staying with Buck.

He finishes putting the groceries away just as Buck comes down the stairs in a pair of sweatshorts and a t-shirt – his slight limp not going unnoticed by Eddie. Buck ambles over to the couch while Eddie washes his hands and then gathers the supplies the doctor sent them home with before scuttling over to join him.

When he drops to his knees between Buck’s legs, Buck’s eyebrows shoot up to his hairline. “Well hello,” he drawls.

“Don’t get excited,” Eddie says. “I need to cover your stitches.”

Buck huffs and slouches further into the couch, but obediently props his injured leg up on the coffee table. Eddie knows how irritated Buck can get being fussed over, and the fact that he lets Eddie mother hen him without complaint (mostly) makes Eddie’s insides go all fluttery. But that fluttery feeling flies out the window when Eddie runs his hand over Buck’s shin and finds the skin warm to the touch.

Shit, does Buck have a fever? If he does, that’s bad. That’s really, really bad. Eddie really tries to stop himself spiralling, but his mind can’t help but leap to worst-case scenarios: if Buck has a fever, that could mean sepsis, which could mean septic shock, which could mean organ failure.

Buck must read the panic on his face because suddenly there’s a hand on Eddie’s chin, gently turning him to meet Buck’s gaze.

“Do you feel any body aches or chills?” he blurts.

“Eddie.” Buck smiles softly at him. “I had a hot shower. That’s why I feel warm.”

“Right.” He lets out a long, slow breath, willing his galloping heart to calm down. “Right, yeah, that makes sense. Okay, I’ll bandage your stitches now.”

“Hmm, in a minute.”

Buck leans down, and Eddie pushes up on his knees to meet him in the middle. Their lips slot together gently as Buck’s hand slides around to tangle his fingers in the hair at the back of Eddie’s head, sending shivers cascading down Eddie’s spine. He lets himself get lost in the kiss, relaxing for the first time since he took Buck to the doctor’s.

Eventually, Buck pulls away, but not before planting a quick kiss on Eddie’s nose. “Thank you for taking care of me. But you seriously need to talk to Frank about your tendency to catastrophize.”

Eddie rolls his eyes, but doesn’t argue. Buck might have a point, given that it didn’t take much for Eddie to make the jump from warm skin to organ failure. He carefully covers Buck’s stitches with a new bandage before taping it in place to make sure nothing gets in to contaminate the wound.

“Thank you for letting me take care of you,” Eddie says, getting to his feet. “Now keep that leg elevated while I make us dinner.”

Buck shakes his head in fond disbelief, but reaches for the pillows without protest.

(also on ao3)

#911 ficlet #buddie ficlet #evan buckley x eddie diaz #myfic #Anonymous #ali answers

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boomboxboi · 1 year ago

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Narancia Ghirga

An in-depth look at the character.

————————————————————————

Buckle up, folks. This post is going to be a disgustingly long one.

I’ll break it down into 5 categories;

Past

Personality

Relationships

Stand

Conclusion

This post is going to have a lot of theories presented based on facts we are given about the character. You are welcome to disagree with these theories.

That being said- there will be heavy topics addressed ahead so read with caution.

————————————————————————

Past

Narancia’s past was summed up in a total of 9 pages in the manga (yes, I counted).

I’ll give a VERY brief summary of his past here.

Narancia’s mother died from an eye disease when he was ten years old.

His father (unnamed) never showed affection to Narancia. Especially after his mother passed away.

Narancia stopped attending school and spent time with his friends, instead.

Narancia was framed and sent to juvie.

The cops beat Narancia.

Narancia left juvie with an infected eye.

Narancia’s friends avoided him.

He learned he was betrayed by his friend.

Narancia stays in the streets and gives up on life.

Fugo crosses paths with Narancia and takes him to eat spaghetti.

Bucciaratti brings him to a hospital for treatment.

Narancia asks to join the mafia and Bruno yells at him.

Narancia returns home and never trusts his father again.

6 months later, Narancia joins Passione.

All of this is a very glossed over summarization of what we learn about Narancia in 9 pages. And those nine pages are extremely telling.

Let’s take a more in-depth look at all of this information.

First, let’s start with the fact that Narancia, at age 10, effectively lost both of his parents. Between his mother suddenly dying from an unnamed eye disease (which I speculate to be orbital cellulitis) and his father (word for word in the manga) “never showed much affection for his son, and after the mothers death, he only became more and more distant”.

Narancia, without outright stating it, was neglected by his father.

The following are what is considered neglect from the written work “Child Neglect: A Guide for Prevention, Assessment, and Intervention” and examples that Narancia directly experienced in those short 9 pages;

Physical Neglect

Abandonment - the desertion of a child without arranging for his reasonable care or supervision.

{source 1}

Example:

Narancia was roaming the streets and sleeping at friends houses.

Nutritional Neglect - when a child is undernourished or is repeatedly hungry for long periods of time, which can sometimes be evidenced by poor growth.

{source 1}

Examples:

Narancia was stealing his dinners (pre-juvie).

Narancia was “scrounging for food like a cat through the trash cans behind a restaurant” (post-juvie).

“Narancia was hospitalized. With a real bed and proper nutrition—-“ (direct from the manga).

Medical Neglect

Delay in Health Care - the failure to seek timely and appropriate medical care for a serious health problem that any reasonable person would have recognized as needing professional medical attention.

{source 1}

Example:

Narancia’s eye infection- which was a result of the beatings he received from the cops while in juvie.

Inadequate Supervision

Permitting or not keeping the child from engaging in risky, illegal, or harmful behaviors.

{source 1}

Examples:

Narancia stealing food.

Narancia roaming the streets unsupervised or with other children.

Narancia dropping out of school.

Emotional Neglect

Inadequate Nurturing or Affection- the persistent, marked inattention to the child’s needs for affection, emotional support, or attention.

{source 1}

Example:

Narancia’s father was noted as being distant (and extremely so after his mother passed).

Narancia’s father (in the anime) did not reassure him of the eye disease that killed his mother and left him alone at her grave.

Other permitted maladaptive behavior - the encouragement or permission of other maladaptive behavior under circumstances where the parent or caregiver has reason to be aware of the existence and the seriousness of the problem, but does not intervene.

{source 1}

Examples:

Narancia goes to juvie.

Narancia drops out of school.

Narancia joins the mafia.

Educational Neglect

Permitted Chronic Truancy - permitting habitual absenteeism from school averaging at least 5 days a month if the parent or guardian is informed of the problem and does not attempt to intervene.

{source 1}

Example:

Narancia stops attending school.

Narancia only resumes school attendance (for a time) under Bruno’s directive.

Narancia drops out of school again and joins the mafia.

Failure to enroll or other truancy- failing to homeschool, to register, or to enroll a child of mandatory school age, causing the child to miss at least 1 month of school without valid reasons.

{source 1}

Example:

Narancia not attending school and only having a basic education due to dropping out of primary school and not attending up to age 17.

His father shows multiple signs of neglect in just 9 pages by being relatively absent in Narancia’s life. So much so that Narancia actively looks up to and admires a member of the mafia.

Studies also show that losing a parent at a young age through death typically has a negative impact on the child’s life.

Most notably being that kids who have lost a parent are more than twice as likely to show impairments in functioning at school and at home, even 7 years later.

{source 2}

Narancia is shown to struggle immensely with school and education as a whole. It’s likely that Narancia’s mother’s passing heavily influenced his behavior to drop out of school- coupled with the lack of parenting and guidance he received from his father.

All in all, it’s pretty clear that Narancia had a turbulent upbringing that led to him joining Passione.

————————————————————————

Personality

Narancia is often described as being childish, quick-tempered, and loyal towards his friends.

A lot of this is displayed throughout the manga. And a lot of this is easily explained away by his upbringing.

Let’s touch on Narancia’s behavior which clearly stems back from his childhood neglect. For this, I will focus on how neglect effects childhood development.

Children who experience neglect in their childhood often display the following symptoms;

depression

anxiety

apathy

failure to thrive

hyperactivity

aggression

developmental delays

low self-esteem

Substance misuse

withdrawing from friends and activities

appearing uncaring or indifferent

shunning emotional closeness or intimacy

{source 3}

Narancia does show signs of anxiety when he’s forced to choose in betraying Passione (granted, many would experience that. However, his response was heavily focused on at the time and he had a visceral reaction to having to make a choice for himself).

Failure to thrive is indicated heavily with his poor education. As well as developmental delays.

Narancia also appears to be aggressive. This showing in how he reacts to those he deems a threat to him or giving him any negative response.

Take for example the first time we meet Narancia as he’s studying with Fugo. The two break into a fight and Narancia is ready to stab/attack Fugo. This shows up again when he violently attacks Formaggio with his stand while also kicking the car Formaggio is in. There are other instances as well, where he kicks Zucchero’s head, attacks the man with the white suit, and other various instances where he reacts with extreme violence.

I would also argue that Narancia’s experience in betrayal from both his father and those he deemed his friends affect his personality as well.

Betrayal Trauma occurs most commonly from:

Child abuse- including physical, sexual abuse, and emotional abuse (e.g., manipulation, gaslighting, verbal abuse, etc.)

{source 4}

As discussed prior, Narancia had experienced abuse in his childhood via neglect from his father. However, betrayal trauma can occur from other instances of trauma in one’s life as well.

Betrayal trauma differs vastly from other types of trauma because it involves not just the experience of abuse but also the experience of being betrayed by a key relationship such as; a parent, caregiver, guardian, significant other, or other individual who is relied upon for support and safety.

{source 4}

It’s made relatively clear that Narancia relies on his friends for support and safety when his father does not provide it. He stays in their homes, steals food with them, and blatantly states that friendship is what he deems as most important.

A few signs of betrayal trauma are:

Intrusive thoughts and images

Nightmares or flashbacks

Avoidance behaviors

Hypervigilance (constantly scanning your environment for potential threats)

Irritability or angry outbursts

Insomnia

Fearfulness

Social withdrawal

Feeling emotionally numb

Physical symptoms of tension headaches, migraines, and fatigue

{source 4}

Narancia could be stated to be rather hyper vigilant when you realize his stand has a radar to detect carbon emissions. He also has angry outbursts (as discussed prior), irritability, and even a tinge of fearfulness (when left to make his own choices).

Those who suffer from betrayal trauma may also have issues with regulating their emotions. This is something we see in Narancia time and time again. Where as other members of the Bucci Gang are able to compose their emotions (especially when it comes to their tasks at hand), Narancia struggles with this. He’s the only one who has an outburst over Abbacchio’s death, he constantly lashes out when harmed, and overall seems to struggle with handling his emotions.

The betrayal and neglect that Narancia suffered at a young age does seem to contribute heavily to his childish personality despite not being the youngest member of the team (Narancia 17. Giorno 15. Fugo 16).

I would also say that Narancia seems to have unwavering loyalty for those that he trusts. Those he does not trust immediately receive volatile reactions from him. We see this when Formaggio is in the car (constantly referring to him as a stalker), attacking Trish when they first encounter one another, immediately claiming a civilian is an enemy and attacking them, and so on. I strongly believe that this also stems from the betrayal that Narancia faced at a young age (coupled with his role in the mafia).

————————————————————————

Relationships

Onto my favorite part about this post. Relationships. I’m going to delve into the relationships that are presented in the manga and give my thoughts on three categories;

How the relationship is outwardly presented

How it effects Narancia

Overall thoughts of the relationship

Theories (for fun)

The characters we will delve into on this section are as follows;

Narancia’s Mother

Narancia’s Father

Unnamed Blond Friend

Bruno Bucciarati

Panacotta Fugo

Guido Mista

Leone Abbacchio

Giorno Giovanna

Trish Una

Narancia’s Mother

Outwardly Presented: He does not seem to have any ill-will towards his mother. In the anime, Narancia seems to be genuinely concerned of his mother’s well-being while she’s in the hospital. And once she passes away, he even visits her grave.

Relationship Effects: While Narancia only had his mother in his life for 10 years, the impact it left on him is a core feature of his character. He constantly dwells on his mother’s death and the eye disease that killed her. He even tells his unnamed blond friend over this and then has it used against him.

Overall: I believe Narancia was close to his mother in the way any young child would be. He does seem to be worried about his mother when in the hospital and is even seen visiting her grave when older. I can’t speculate on what relationship his mother and father had together, however I feel I can say that once his mother passed, the neglect he experienced only seemed to grow.

Theories: Because Narancia’s mother had passed from an eye disease (read my thoughts on that here: https://m.facebook.com/groups/5738337702888821/permalink/6284327651623154/?mibextid=qC1gEa) that manifests due to trauma to the eye, I would say that her relationship with her husband may have involved physical altercations. I think this compounded the trauma that Narancia faced once his mother had passed and I would even say that his mother may have originally been pressured to not have Narancia but opted to do so which put a strain on the relationship.

Narancia’s Father

Outwardly Presented: It is clearly stated that Narancia does not think highly of his father. He refers to him as a piece of shit, was neglected by him, and does not trust him.

Relationship Effects: Due to the neglect that Narancia faced under his fathers care (which was gone over in above sections), I think it’s safe to say his father was a large contributing factor as to why Narancia had become a part of the mafia. Without proper guidance or parental care in his earlier years, Narancia was bound to slip into a life of crime. Especially after the people who essentially saved his life were members of a crime syndicate. Had his father been present in his life, there likely would have been a different outcome.

Overall: The manga makes a clear point that Narancia’s father was not involved in his son’s life. So much so that when Narancia was living on the streets and dealing with an eye infection that clearly was taking it’s toll on him, he did not go home or if he did, his father did not handle the situation accordingly. This lack of care is what sent Narancia on the path he wound up on.

Theories: Buckle up because I have a few theories on Narancia’s father. I’ll touch on 3 big ones that I feel are highly possible (but do not have concrete facts to back these up).

Narancia is not the unnamed man’s biological child. How his mother wound up pregnant with Narancia is irrelevant. Where the issue stems from is that the man he perceives as his father does not have the interest of the child in mind.

Narancia’s father was abusive towards his mother and it’s how she wound up with the eye infection (and why Narancia getting beat by cops resulted in the same eye infection).

Narancia’s always been a problem child and his father was not equipped to handle this and he grew distant from his child. Especially after the mother’s death.

Unnamed Blond Friend

Outwardly Presented: We only see two brief interactions with Narancia and his unnamed blond friend. The first is when he convinces Narancia to dye his hair blond. The second is when he sees him again after he’s let out of juvie. Both interactions had forms of manipulation in them to benefit the blond male.

Relationship Effects: The effects of this relationship are, essentially, what sent Narancia into the lowest point of his life. Before, Narancia had his friends to trust and rely in. He even mentally beat himself up when he suspected his friend set him up and only accepted this as a fact once he saw his friend again after juvie and learned he was spreading rumors about the eye disease that killed his mother.

Overall: Overall, this relationship is what I think solidified Narancia’s path in life. While his father set him on that path, this betrayal from a close friend is what led to him giving up on life. After all, he had valued his friendships above all and now that was torn from him.

Theories: My only theory in regards to this man is that I think he was addicted to drugs that Passione were distributing. Hence why he beat the old woman for her money and then framed Narancia. Not to mention, in both the manga & anime, he seems a bit disheveled.

Bruno Bucciarati

Outwardly Presented: Bruno is Narancia’s hero. It states as much in the manga. Bucciarati is, after all, the one who gave his food up for Narancia to eat and then took him to a hospital. Even his harsh words about Narancia not joining the mafia made Narancia realize there are people who care for your well-being. He even wants Bruno to call the shots for him when he has to make a life-altering choice.

Relationship Effects: Where as the first people mentioned are people who set Narancia down the path of becoming a mafioso, Bruno was there to try and deter him. Of course, this did not work but only because Narancia found he had far more admiration for Bucciarati than he ever had for his father. After all, Bruno showed him he cared through actions and words. He did this by getting Narancia the medical attention he desperately needed, offered him a place to stay (though immediately told him to go back home and to school), and then told him that the mafia life was not worth joining and that he would be better off having a normal life as a civilian. He also had Narancia choose his own life path and refused to order him onto the boat to betray the boss. Which, ultimately, sparked the conviction Narancia was lacking in his life.

Overall: Bucciarati had the biggest (positive) impact on Narancia out of everyone in his life. He truly wanted what was best for Narancia and not with any implications behind it. This was something that Narancia had not experienced before in his life. His father abandoned him. His friends used and betrayed him. Bruno was there for him at his lowest and remained there for him without expecting anything in return.

Theories: While Narancia did return home after his stay at the hospital, he clearly thought a lot about what Bucciarati said and did for him. It was stated that, after he returned home, he never trusted his father again. I truly believe that this was because this is the first time Narancia saw and experienced what it was like to have someone care for you with no conditions attached. I always found it curious that it was stated so clearly that Narancia NO LONGER trusted his father. Especially up to that point in his life. And after thinking on it, I believe Bruno is what made Narancia learn he deserved so much more than he was getting.

Panacotta Fugo

Outwardly Presented: This relationship has always vexed me. Clearly, the two are very close. Both have extreme tempers and easily explode on one another. But there’s also the level of care and concern they both have for one another as well. Fugo takes on a pretty large role in Narancia’s life. After all, he is the one to bring him to Bruno. He’s also the one that helps him study. And if you count PHF as canon, he’s also the one to help Narancia join Passione behind Bruno’s back.

Relationship Effects: While I could say Narancia was impacted by Fugo, I think it was the other way around. Fugo was Impacted by Narancia. Especially if we take PHF into consideration as canon. Throughout, Fugo constantly reflects on his time with Narancia. Sure, Fugo helped Narancia with getting off the streets and helped Narancia with his education, but he also helped Narancia join Passione behind Bruno’s back and against Bruno’s wishes. I certainly think he cares deeply for Narancia but I do feel there is also a level of selfishness in his care, as well.

Overall: Narancia and Fugo both have large impacts on one another. Where Fugo helps with giving Narancia a new chance at life through bringing him to the mafia and helping his education, I believe Narancia helps Fugo by showing him that there’s always room for growth and that you can better your circumstances in life even when it feels impossible to do so- solely by having the right people around you.

Theories: Here is where the fun theories begin. Aka the ship battles. So feel free to agree or disagree because it’s gonna be a hot take (maybe). I actually do not think these two would ever work out romantically. Aside from how volatile they can react to one another from time to time, there’s also a power imbalance between the two. I do feel that there may have also been some misunderstandings between the both of them in regards to having a romantic relationship but I do not ever see it truly working out between the two. Esepcially due to the fact that Narancia, in the end, decided to follow change, while Fugo remained the same (which is an allegory I would love to touch on one day).

Guido Mista

Outwardly Presented: The two come across as friendly and very close with one another. Friendly enough that 1) they know a whole choreographed dance, 2) they constantly bicker and tease each other over little things (ie.pouring soda on the speaker, the chocolate bickering, etc). and 3) the way they hang off of each other and outwardly show concern for one another.

Relationship Effects: While we don’t see a lot of interaction focused heavily on these two, there are a lot of background interactions we see that show these two are close with one another. It’s hard to really say what effect the two have on one another aside from when Narancia passed, Guido was clearly very distraught. More so than he was with Abbacchio in the sense that he did not hide his emotions through his death. And that, to me, speaks volumes.

Overall: Everyone sleeps on these two. It’s clear that they are close to one another despite the focus of their interactions not being front and center. They have a deep connection, as they’re able to have a coordinated dance routine, and Narancia’s death leaving a large impact on Mista.

Theories: They’re fuckin’. Okay no- but if it’s not clear, y’all sleepin’ on them as a couple. One day, I’m gonna write a whole essay on these two as a pairing and you’ll be subjected to my disgusting opinions. But aside from that, I just want to say that they do come across as extremely close to one another despite screen time between them never being the main focus and I wish there would have been more interactions that focused on just these two, as a whole.

Leone Abbacchio

Outwardly Presented: These two are another that don’t have a lot of direct interactions with one another. However, it does seem that Narancia holds Abbacchio in high regards, going as far as to ask him to have Fugo stop jamming him with the keys and then being distraught at Abbacchio’s passing.

Relationship Effects: I really wish we would have seen more interaction between these two. However, I still believe they’re close enough to warrant the reaction Narancia had upon his death.

Overall: Narancia seems to have respect for Abbacchio and seemed to be touched by his death. I really wish we could have gotten more interactions between the two of them but also it makes sense that we didn’t, as Abbacchio seems more the type to keep to himself.

Theories: Less of a theory and more of just a part I wish would have been explored more. I really wish that the topic of Abbacchio being a former officer and Narancia experiencing brutality from the police at juvie would have been touched up on. I’d love to have seen how Abbacchio would react to that and how Narancia would have felt upon learning about Abbacchio’s former job. (Maybe a fic idea for the future).

Giorno Giovanna

Outwardly Presented: Another person that could have had more interaction. However, it’s clear that Narancia has no qualms with Giorno. He even views him as smart and reliable. Though, Narancia seems to tease him about the age difference between them and bragging about being older.

Relationship Effects: Narancia seems to have respect for Giorno. Whether this is because his allies (especially Bruno) trust him or because Giorno earned his respect, is up for debate. However, he clearly thinks Giorno is smart- trying to relay the message of an enemy attack with his fight against Tizzano and Squalo. Additionally, he does try to save Giorno, as well. There’s also the point where they swap bodies and both seem relatively comfortable in each others skin. I do think they have very similar upbringings and would have loved for them to have a conversation about this on screen. There was a lot for them to relate to.

Overall: Narancia has respect for Giorno and has a similar upbringing as him. I would even dare to say that because of the similarities, they would have been extremely close friends had Narancia survived. I also want to point out that Giorno had seen something in Narancia enough to 1) become visibly upset over his death and 2) promise to take his body home at the end. Both of these were things he did not promise to Abbacchio nor Bruno. Though, it’s clear they all had an impact on Giorno.

Theories: Because of how similar I feel their upbringings are, I strongly believe that Narancia was meant to be a foil to Giorno. Not only do we see them have emotionally unavailable parents and neglect, but both find their savior through the mafia. However, Giorno has a clear dream and goal and a driving force to push him through where as Narancia does not have this until he’s forced to make a choice between staying behind or betraying the boss. Only then does he have a goal and direction and meaning given to his life.

Trish Una

Outwardly Presented: Narancia does not seem to have much of a connection to Trish until he sees her wrist and fully understands how she’s alone, like him. Once that happens, Narancia states he wants to protect Trish with his life and that she’s “just like him”. From there, the two seem to become rather close. Just under Trish trusting Bruno, I would say she trusts Narancia the most, after that.

Relationship Effects: Trish is Narancia’s biggest driving force to change his life. Without her, his life would have remained the same. There would have been no drive to become better and do better by himself or others. With Trish, Narancia has a reason to do better. He has a goal to protect her and, by default, now must put effort into his own life.

Overall: As elaborated, Trish is Narancia’s reason. His “why” for the actions that follow the remainder of the series. I also think that it was good for Trish to have another person aside from Bruno to put her full trust and faith in. Additionally, Narancia was able to learn from Trish that it’s possible to move past trauma and push forward to a better life.

Theories: I truly believe that Narancia and Trish would have started a new life outside of the mafia together (romantically or platonically) had Narancia survived. They both seemed to have formed a deep bond with one another after Narancia opted to protect Trish. Narancia often trying to give her some form of comfort (and Trish even seeking for comfort when their bodies swapped and she hugged Narancia’s body while forgetting that Giorno was in said body).

To wrap up this section, Narancia had his life impacted by multiple people. Some in a positive way and others in a negative way. The way each interaction helped to shape how Narancia, as a person, was shows how intricate the character. No matter if the interaction was shown direct on screen or implied off screen, he has a deep ness to his character that is shown through the interactions he holds with others and the lasting impact he left behind.

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Stand

In this section, I wanted to go over Aerosmith, as stands are stated to be a physical representation of the user’s soul. This means that Aerosmith, with all design choices in place, is a direct representation of Narancia as a whole. While most of this section is purely speculation (due to the lack of facts we are given), I want people to really consider all aspects of the stand design.

These are what I will focus on for this section:

Appearance

Abilities

Attitude

Appearance

Taking on the shape of a toy fighter jet, Aerosmith is small but deadly. A tiny pilot is inside (Mr. Smith), which seemingly controls the jet. Additionally, there are features of eyes and a mouth on the front of the plane and the primary color pallet used is red and yellow (though other color pallets are used from time to time).

A deeper dive on what these appearances convey are interesting to ponder.

The first thing to note is that it takes on a fighter jet. To me, this shows that Narancia could come across as having both a fight or flight mode, though he often chooses fight. It could be interrupted that, while he fights for smaller ordeals in his life, he tends to avoid or “fly away” from the bigger issues. To elaborate on this, Narancia easily fights off enemies and direct threats. However, he is avoiding the issue of a deeper purpose (until deciding his purpose is to protect Trish).

Next, the plane is toy-sized. This fits in with the fact that Narancia, as a character, is still very child-like. A contributing factor to this was the neglect he faced at early stages in his life. Both malnutrition, educational neglect, and lack of guidance gives him the air of being much younger than he is and room to grow, as an individual.

Mr. Smith, the pilot, is also what controls/guides Aerosmith. To me, this indicates a need for guidance. Someone else is piloting his life until he seemingly takes control. Or, it could be seen that he is attempting to escape living life on auto-pilot.

The eyes and mouth feature also is fascinating. It gives the plane a more threatening aura. Be this an outside mask to come across as more aggressive to ward off those who may try to harm Narancia.

Finally, the main color scheme being red and yellow. Red is often the color of passion. Passionate feelings arise in not just romance but in intensity of any emotion. And Narancia displays his emotions very intensely. The yellow color often is attributed to hope, youth, and joy. This, to me, shows he is striving to have a life of joy.

Abilities

Aerosmith, as a stand, has a wide range of abilities and uses. Between being a long-ranged stand that can shoot endless bullets from its machine guns, drop a bomb, and detect carbon dioxide on a small radar, it’s astounding how much this tiny stand can truly contribute to the team.

When really dissecting what each ability could relay about Narancia’s soul, you may find some interesting attributes to think through.

The difference between long range and close range stands always has me perplexed. What decides on who gets long range versus close range? I believe it’s a wide array of factors that decide this. In Narancia’s case, I believe it stems from his needs to wanting to be close to others but the struggles to truly allow himself that closeness unless earned. He, like his stand, prefers to keep a distance unless he trusts them enough to “land”.

Endless bullets, for me, shows Narancia’s boundless energy and constant rebuttals to life. He’s had to constantly keep his guard up so the fact that his ammunition never seems to run out is awfully convenient for a stand to have. On the flip side, it also shows that Narancia has had to constantly fight to keep afloat.

The singular bomb shows Narancia’s explosive attitude when angered. Small things can set him off and when he’s set off, his outburst can lead to irreversible damage. Much like a bomb going off, Narancia cannot undo the damage that is done when he lets his emotions get the better of him.

The radar, for me, really shows Narancia’s profound need to find those he can rely on and trust. It also shows how he has his guard up at all times, as well. A radar is used to search and locate. So what is it Narancia is so keen on finding that his stand- the literal representation of his soul- manifests a radar? For me, it’s finding who he can trust and keeping an eye out for danger. Carbon dioxide comes from living beings but it also comes from fire. Both can provide comfort but also hurt you. So the radar, for me, represents the duality of humans.

Attitude

This may be the hardest to dissect, as Aerosmith is not exactly a humanoid stand (though Mr. Smith is presumably a humanoid pilot). However, Aerosmith does have a few distinct actions that gives it “attitude”. Father way in which the stand moves, is what I am referring to. Specifically how it behaves when flying and landing. It can either fly erratic when attacking, slow and steady while hunting, or, when it lands, on Narancia’s arms like an airstrip.

Studying how the stand moves is an important key factor in understanding Narancia, as a character.

Erratic movements while fighting displays the same erratic behavior Narancia shows when he is upset. There is no regulation in his stand’s movements just as there are no regulations with his emotions.

Contrastly, when Aerosmith is searching for a target, it flies steady and with determination. This showcases Narancia’s capabilities of focusing when he puts his mind to something.

Finally, the fact that his stand lands on his arms like an airstrip is such a unique and compelling attribute. The fact that his stand uses Narancia to “land” really shows that Narancia, and only Narancia, has the ability to guide himself. Whether he thinks that or not is not the point. The fact that his soul manifestation uses him as a guide for landing shows that Narancia was the only one, in the end, who could make life choices for himself.

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Conclusion

Narancia is so much more than what people give him credit for. Sure, I may have speculated a lot, but this is just a character deep-dive of what I feel was shown through all aspects of his character.

You may have a different opinion, and that is okay.

But at the end of the day, Narancia is a great character with so many complexities that come across as so deeply human and he deserves more appreciation.

————————————————————————

Sources

{source 1 - https://www.childwelfare.gov/pubPDFs/neglect_ch2.pdf}

{source 2 - https://www.psychiatry.pitt.edu/news/longest-and-most-detailed-study-pediatric-grief-following-parental-loss-date-department}

{source 3 - https://www.healthline.com/health/mental-health/childhood-emotional-neglect#symptoms-in-children}

{source 4 - https://mindwellnyc.com/top-betrayal-trauma-signs-triggers-strategies-to-recovery-2022/}

Note: I wrote this and posted it on a few other sites. Also this is just me being speculative and very bored at work one day. Feel free to disagree but please don’t be rude. I just don’t have the energy for it.

#jojo part 5 #jojo's bizarre adventure #narancia ghirga #character study #character analysis #I was bored at work #I really like them #feel free to disregard #feel free to discuss #just don’t be an asshole

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daniela--anna · 10 months ago

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🐝 🍯REAL FOOD.

Royal jelly, polyn, honey are foods offered by bees, which are processed inside the hives (natural bee nests).

Each hive is capable of hosting 50,000 bees, which are well organized and clearly divided

in different castes:

🐝worker bees, queen bees and drones (male bees that die immediately after fertilizing the queen).

🐝Only the queen can generate life in a hive, and she is killed when she is unable to lay new eggs.

🐝Worker bees and the queen bee have the same DNA, genotype, but have completely different appearance and characteristics.

It happens that the nutrients, the microRNAs, the exosomes of royal jelly, exert a positive modulation on the DNA which will make the difference between queen bees and worker bees.

🐝The action of the microRNA contained in the exosomes of royal jelly has also been studied on human stem cells, showing a positive action.

Stem cells are the parent cells of other cells.

In order not to die, the human body must renew itself every day through stem cells.

🐝🍯Honey, pollen and propolis contain exosomes derived from flowers in different doses.

The most current scientific research is offering an explanation to the popular traditions that have lived the food gifts of bees with great respect.

Nature: flowers, bees, humans united and interconnected in their biological life, however remain a wonderful mystery.

Doctor Pier Luigi Rossi.

University professor.

Specialist in Food Science.

Specialist in Preventive Medicine.

📚The treasure chest of nature

🐝 🍯IL CIBO REALE.

Pappa reale, poline, miele, sono alimenti offerte dalle api, che vengono elaborati all'interno degli alveari (nidi naturali delle api).

Ogni alveare è in grado di ospitare 50.000 api, che sono ben organizzate e nettamente suddivise

in differenti caste:

🐝api operaie, ape regina e fuchi,(le api maschi che muoiono subito dopo aver fecondato la regina).

🐝Solo la regina può generare la vita in un alveare, e viene uccisa quando non è in grado di deporre nuove uova.

🐝Le api operaie e l'ape regina hanno lo stesso DNA, genotipo, ma hanno aspetto e caratteristiche del tutto diverse.

Succede che i nutrienti i microRNA, gli esosomi della pappa reale, esercitano una modulazione positiva sul DNA che farà la differenza tra ape regina e api operaie.

🐝L'azione del microRNA contenuti negli esosomi della pappa reale, è stata studiata anche sulle cellule staminali umane evidenziato un'azione positiva. Le cellule staminali sono le cellule madri di altre cellule. Il corpo umano per non morire, si deve rinnovare ogni giorno proprio attraverso le cellule staminali.

🐝🍯Miele, polline e propoli, contengono in dosi diverse esosomi derivati dai fiori. La più attuale ricerca scientifica sta offrendo una spiegazione alle tradizioni popolari che hanno vissuto con grande rispetto i doni alimentari delle api.

La natura: fiori, api, umani uniti interconnessi nella loro vita biologica, restano comunque un meraviglioso mistero.

Dottor Pier Luigi Rossi.

Professore Universitario.

Specialista in Scienza Dell'alimentazione.

Specialista in Medicina Preventiva.

📚Lo scrigno della natura

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mithliya · 2 years ago

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do you have any informational posts/sources on the risks and dangers of "top surgery" on hand?? i am talking to a friend of mine who wants to undergo it and i am trying to convince her to reconsider

i dont have it on hand, no but looking it up, i found the following:

Risks, Complications and Side Effects of Top Surgery

Top surgery scars: For chest masculinization procedures, scars may appear as horizontal lines across the chest, or circles around the areolas. For chest feminization procedures, the scars will be located underneath the breasts. It can take up to 18 months for scars to resolve, and some people elect to have further surgery to minimize them. It is important to avoid sun exposure, which can darken scars and make them more obvious.

Hematoma: Blood can gather in the tissues after surgery and form a clot, with symptoms such as pain, swelling and discoloration as well as an increased risk for infection. Hematomas form in about 1% to 2% of top surgeries.

Seroma: Fluid can collect under the skin. Small seromas may not need any treatment and go away on their own. Seromas in top surgery can be prevented by drains in the surgical area and wearing your compression vest consistently after your procedure.

Infection: This is a rare complication of top surgery, but can happen. Cellulitis in the surgical area may require treatment with oral antibiotics and drainage.

Breakdown of nipple graft: While some skin sloughing is no cause for concern, deeper tissue death (necrosis) can indicate that the graft is not successful and more surgery may be necessary.

Reduced nipple sensitivity: Numbness or tingling can happen if a nerve is disrupted or damaged during surgery. The double incision approach for chest masculinization involves removing and repositioning the nipple, which calls for cutting the nerves. Nipple numbness may improve over time, but full restoration of sensation is unlikely.

Irregular contours: Additional surgery to address chest contour may be called for in up to 32% of top procedures.

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insipid-drivel · 5 months ago

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Trans and getting surgery soon here: Plastic surgeons also help a lot with other issues that a regular doctor or surgeon may not be comfortable handling, like umbilectomies (surgically sealing up and permanently removing bellybuttons). My surgeon is going to be working in the same operating room as my OBGYN doing my hysterectomy at the same time.

The reason I'm having my bellybutton paved over is because I've always had a very narrow, deep one, and as I've gotten older, I keep getting skin infections like cellulitis in and around it regardless of how clean I keep myself and avoid getting dirt and debris in there (my plastic surgeon informed me this is surprisingly common and it's not a big deal or an unusual surgery for her, especially with bellybuttons, because they tend to be bacterial breeding grounds for everyone). So, to spare me more pain, medications, and risking drug-resistant infections, it's time to just go full Kyle XY.

For anyone curious: Your bellybutton is literally just a scar from where your umbilical cord used to connect you to your mother in the womb, and serves no real functional purpose whatsoever after birth. It's just normal to see them on everyone because most people don't have problems with theirs that require medical attention on the level of surgery.

Surgeons really, really, really don't want to give you surgery if they don't have to and that you don't want. Plastic surgeons may have a bad reputation in the USA and other countries, but it's well to remember that plastic surgery can sometimes be the best and most effective preventative care you can hope for.

Plastic surgeons are commonly called in to remove excess skin if patients who have lost a lot of weight (either intentionally or not) come to them with recurring fungal/bacterial skin infections, as well as affirming care for body dysmorphia caused by weight loss. Especially for fat and trans people, plastic surgeons often provide some of the best and most life-improving care you could ask for. If you have anything topical that is beyond the skills of a dermatologist, but still requires a surgeon's expertise and care, then you'll probably first get referred either to a general surgeon (especially if you need work done in your abdominal area), or a plastic surgeon by default.

"If they're so good, why can't my plastic surgeon do my hysterectomy?" I'm going to explain more nitty-gritty specifics that may squick or trigger some people, so I'll put a readmore here:

Because it's a more specialized surgery taught primarily to OBGYNs and any organ removal - even a routine appendectomy for appendicitis - is not considered a plastic surgery due to the nature of the risks involved, as our internal organs in our core abdomens are usually separated and protected from the rest of our bodies by layers of muscle, fat, connective tissue, and bones like ribs (many doctors refer to the protective layers around your organs as an "abdominal sheath"). If infectious bacteria, like MRSA, E. Coli, Staph, or Strep - which exist on surfaces like our skin naturally and only sometimes cause problems with infection - were to be introduced into the plural (between) spaces of our internal organs, it's pretty much guaranteed that the patient will develop a serious and potentially life-threatening case of sepsis (blood poisoning), and suffer major organ damage as a result, including to the heart and brain.

NO you absolutely WANT your PLASTIC SURGERY procedures to be done by a PLASTIC SURGEON.

As in someone who is specifically trained in it and does it every day.

Someone who is not specifically trained in pleasing cosmetic results and not actively practicing pleasing cosmetic results is how you get horrifying cosmetic results

I cannot tell you how many episodes of Botched I've seen where someone with a mangled nose job says some shit like "My dentist did 2 for 1 rhinoplasty...."

#transgender #surgery #gender affirming care #plastic surgery

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mukulaggarwal7845 · 7 days ago

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Information about Cefazolin Injection

Cefazolin for Injection is an effective and safe antibiotic mainly used to treat bacterial infections. It is a first-generation antibiotic of the cephalosporin class, specifically designed to treat a wide range of infections such as respiratory tract, urinary tract, skin and soft tissue infections.

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#Pharma Company #Pharma Manufacturing Company #Pharma Company in Delhi #Pharma Companies in India #Best Pharma Company in India #pharmaceutical manufacturer in india #Pharmaceutical Companies in Delhi #pharmaceutical company in delhi #pharmaceutical company #pharmaceutical Manufacturing Company #pharmaceutical manufacturer #pharmaceutical manufacturer company

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mglawyer · 8 days ago

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The Importance of Hiring a Dog Bite Lawyer for Serious Injuries

Dog bite incidents are unfortunately more common than many people realize. According to the Centers for Disease Control and Prevention (CDC), approximately 4.5 million people in the United States are bitten by dogs every year. While some bites result in minor injuries, others can lead to severe, life-altering consequences. If you or a loved one has suffered serious injuries due to a dog bite, hiring an experienced dog bite lawyer is crucial to ensuring you receive the proper legal representation and compensation for your injuries.

In this article, we’ll discuss why it is so important to hire a dog bite lawyer if you’ve suffered serious injuries. From understanding the legal complexities involved to ensuring your long-term recovery, a lawyer can be your advocate throughout the process, maximizing your chances of securing justice and fair compensation.

1. Serious Dog Bite Injuries Can Have Long-Term Effects

Dog bites can range from minor scratches to severe, life-threatening injuries. While many dog bite cases result in superficial wounds, others can cause significant harm, including:

Infection: Dog bites introduce bacteria into the body, which can lead to severe infections such as tetanus, cellulitis, or even more serious conditions like sepsis.

Nerve Damage: A deep dog bite may damage the nerves, leading to permanent numbness, weakness, or even paralysis in the affected area.

Scarring and Disfigurement: Dog bites, especially on the face, hands, or other visible areas, can leave permanent scars that may require extensive medical treatment and cosmetic surgery.

Psychological Trauma: In addition to physical injuries, dog bites can cause significant emotional and psychological distress. Victims may experience post-traumatic stress disorder (PTSD), anxiety, and phobias related to dogs.

Loss of Function: Serious bites, particularly on the hands or arms, may result in the loss of the ability to perform daily tasks or engage in work-related activities, leading to long-term disability.

For victims of serious dog bite injuries, the road to recovery is often lengthy and costly. This is where a dog bite lawyer brampton becomes essential.

2. Determining Liability Can Be Complex

One of the key reasons to hire a dog bite lawyer is the complexity of determining liability in dog bite cases. In most instances, the dog’s owner is responsible for the injuries caused by the dog, but the specific laws governing dog bites vary by location, and several factors can influence the outcome of your case.

Factors that can impact liability include:

Dog Owner Negligence: If the dog owner knew or should have known that their dog was aggressive, they may be considered negligent for allowing the dog to roam freely. Evidence that the dog had a history of aggressive behavior or had bitten others previously can strengthen your case.

Breed-Specific Laws: Some regions have laws that hold certain dog breeds to a higher standard of responsibility due to their aggressive nature. For example, breeds like Pit Bulls or Rottweilers are often subject to stricter regulations.

Trespassing or Provocation: In some cases, if the victim was trespassing on the dog owner’s property or provoked the dog in some way, the liability of the dog owner may be lessened. However, this can vary depending on local laws and the circumstances of the attack.

Premises Liability: In cases where the dog bite occurs in a public or commercial space, such as a park or store, premises liability laws may come into play. The property owner could be held responsible if they failed to take necessary precautions to prevent an attack, such as ensuring a dog was properly restrained or contained.

A dog bite lawyer will help you navigate the intricacies of local laws and determine who is legally responsible for the injuries you sustained. By conducting a thorough investigation, gathering evidence, and consulting with experts, a lawyer will work to establish a strong case on your behalf.

3. Negotiating with Insurance Companies

After a dog bite incident, you may find yourself dealing with the dog owner’s insurance company. In many cases, the dog owner’s homeowners or renters insurance will cover the cost of the injuries, but insurance companies often try to minimize payouts. This is where a skilled dog bite lawyer can be invaluable.

What to Expect When Dealing with Insurance Companies:

Lowball Offers: Insurance adjusters may try to settle your claim quickly by offering a low settlement amount that does not adequately cover your medical expenses, lost wages, pain, and suffering. They may even attempt to minimize the severity of your injuries.

Delay Tactics: Insurance companies often delay processing claims or may make it difficult to obtain the necessary documentation to move forward with your claim.

Disputing Liability: In some cases, the insurance company may dispute liability or argue that you were partially at fault for the attack (e.g., if you provoked the dog). A lawyer can counter these arguments and protect your interests.

A dog bite lawyer understands how insurance companies operate and will advocate on your behalf to ensure you receive a fair settlement. If the insurance company refuses to offer an adequate settlement, your lawyer can take the case to court and fight for the compensation you deserve.

4. Maximizing Your Compensation

Serious dog bite injuries often result in substantial medical bills, lost wages, and other financial burdens. A dog bite lawyer is dedicated to ensuring that you are fully compensated for all aspects of your injury, including:

Medical Expenses: This includes both immediate medical costs (e.g., emergency room visits, surgeries, hospital stays) and future medical expenses (e.g., physical therapy, reconstructive surgery, ongoing treatments).

Lost Wages and Earning Capacity: If your injuries prevent you from working, a lawyer can help you recover lost wages and potential future earnings, especially if your ability to work is permanently impaired due to the dog bite.

Pain and Suffering: In addition to medical expenses and lost wages, you may be entitled to compensation for the physical pain, emotional distress, and psychological trauma caused by the dog bite.

Permanent Disability or Disfigurement: If you’ve suffered permanent scarring or a loss of function due to the dog bite, a lawyer can help you secure compensation for the long-term impact on your life.

Psychological Counseling: If the dog bite resulted in anxiety, PTSD, or other emotional distress, a lawyer can ensure that the costs of therapy or counseling are included in your claim.

An experienced dog bite lawyer will work with medical professionals, economists, and other experts to assess the full extent of your damages and pursue maximum compensation on your behalf.

5. Navigating the Legal Process

The legal process involved in filing a dog bite claim can be time-consuming and complex. A dog bite lawyer will guide you through each step, ensuring that all legal procedures are followed and that your rights are protected.

Steps Involved in the Legal Process:

Investigation: Your lawyer will investigate the circumstances surrounding the dog bite, including gathering witness statements, examining the dog’s history, and evaluating the scene of the incident.

Filing a Claim: If a settlement cannot be reached, your lawyer will file a formal lawsuit against the responsible party (the dog owner or their insurance company).

Discovery: During this phase, both parties exchange evidence and information, including medical records, expert testimony, and witness statements.

Negotiation and Settlement: Before going to trial, your lawyer will negotiate with the defendant or their insurance company to reach a fair settlement. If a satisfactory settlement cannot be reached, the case may proceed to trial.

Trial: If necessary, your lawyer will represent you in court, presenting your case to a judge or jury and fighting for a favorable verdict.

Throughout this process, your lawyer will handle all legal aspects, allowing you to focus on your recovery.

Conclusion

If you’ve been bitten by a dog and suffered serious injuries, hiring an experienced dog bite lawyer is essential for ensuring that you receive fair compensation for your pain and suffering. The legal process involved in dog bite cases can be complex, especially when dealing with insurance companies, determining liability, and negotiating compensation for serious injuries.

By hiring a lawyer, you gain an advocate who understands the law, has experience with dog bite cases, and is committed to securing justice for you. A skilled lawyer will help you maximize your compensation, handle all legal aspects of your case, and support you through your recovery journey. Don’t wait—if you’ve suffered serious injuries from a dog bite, contact a qualified dog bite lawyer today to discuss your options and take the first step toward securing the compensation you deserve.

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iikciim · 30 days ago

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Dermatologic

Anatomy, Physiology, and Pathophysiology Overview

The skin is the largest organ of the body. It covers the body and serves several functions, including protection, sensation, temperature regulation, excretion, absorption, and metabolism. It acts as a protective barrier for the internal organs.

The skin is made up of two layers: the dermis and the epidermis. The outer skin layer, or epidermis, is itself composed of four layers. From the outermost to innermost, these are the stratum corneum, stratum lucidum, stratum granulosum, and stratum germinativum.

Traversing the dermis is a rich supply of blood vessels, nerves, lymphatic tissue, elastic tissue, and connective tissue, which provide extra support and nourishment to the skin. Also contained in the dermis are the exocrine glands—the eccrine, apocrine, and sebaceous glands—and the hair follicles.

A dermatosis is any abnormal skin condition. Dermatoses include a variety of types of dermatitis (skin inflammation). Among these are conditions such as atopic dermatitis, eczema, and psoriasis. In addition, there are also a variety of skin cancers, including basal cell carcinoma, squamous cell carcinoma, and melanoma.

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Pharmacology Overview

Drugs administered directly to the skin are called topical dermatologic drugs and are available in a variety of formulations with each having specific characteristics that make them beneficial for certain uses.

Systemically administered drugs (transdermal) are also used to treat several skin disorders.

Some of the more common therapeutic categories of dermatologic drugs include the following: antibacterial, antifungal, anti-inflammatory, antineoplastic, antipruritic, antiviral, keratolytic, and topical vasodilators. Other categories include dermatologic drugs used as emollients, debriding, local anesthetics, and for treating burns.

Antimicrobials

Topical antimicrobials are antibacterial, antifungal, and antiviral drugs that are applied topically. Although they have many of the same properties as the systemic forms, there are differences in terms of their absorption, distribution, toxicities, and adverse effects.

General Antibacterial Drugs

Bacterial skin disorders include folliculitis, impetigo, furuncles, carbuncles, and cellulitis. The bacteria responsible are most commonly Streptococcus pyogenes and Staphylococcus aureus. Dermatologic antibacterial drugs, such as bacitracin, polymyxin, and neomycin, are used to treat or prevent these skin infections. Unfortunately, due to the high incidence of infection with methicillin-resistant S. aureus (MRSA), mupirocin is now also

Antiacne Drugs

Acne vulgaris is the most common skin infection. Likely causative factors include heredity, stress, drug reactions, hormones, and bacterial infections. Common bacterial causes include Staphylococcus species (spp.) and Propionibacterium acnes.

Some of the most commonly used antiacne drugs are benzoyl peroxide, clindamycin, erythromycin, tetracycline, isotretinoin, and the vitamin A acid known as retinoic acid. Other drugs are used, such as systemic formulations of minocycline, doxycycline, and tetracycline.

Retinoids are used in the treatment of stable plaque psoriasis and mild to moderately severe facial acne.

Antifungal Drugs

A few fungi produce keratinolytic enzymes, which allow them to live on the skin. Topical fungal infections are primarily caused by Candida spp. (candidiasis), dermatophytes, and Malassezia furfur (tinea versicolor). These fungi are found in moist, warm environments, especially in dark areas such as the feet or groin.

Candidal infections are most commonly caused by Candida albicans, a yeastlike opportunistic fungus present in the normal flora of the mouth, vagina, and intestinal tract.

Two significant factors that commonly predispose a person to a candidal infection are broad-spectrum antibiotic therapy, which promotes an overgrowth of nonsusceptible organisms in the natural body flora, and immunodeficiency disorders.

Dermatophytes are a group of three closely related genera consisting of Epidermophyton spp., Microsporum spp., and Trichophyton spp. that use the keratin found on the skin to feed their growth. They produce superficial mycotic (fungal) infections of keratinized tissue (hair, skin, and nails). Infections caused by dermatophytes are called tinea, or ringworm, infections. The name ringworm comes from the fact that the infection sometimes assumes a circular pattern at the site of infection.

Tinea infections are further identified by the body location where they occur: tinea pedis (foot), tinea cruris (groin), tinea corporis (body), and tinea capitis (scalp). Tinea infections of the foot are also known as athlete’s foot and those of the groin as jock itch.

Antifungal therapy may be required for periods ranging from several weeks to as long as 1 year. Many topical antifungal drugs are available for the treatment of both dermatophytic infections and those caused by yeast and yeastlike fungi. Systemically administered antifungal drugs are sometimes used to treat skin conditions as well.

Efinaconazole (Jublia) was the newest topical antifungal approved in 2014. It is indicated for toenail fungus. Patients using efinaconazole must avoid heat, nail polish, and pedicures.

The most commonly reported adverse effects of topical antifungals are local irritation, pruritus, a burning sensation, and scaling.

Antiviral Drugs

A common topical viral infection is herpes simplex virus types 1 and 2.

Topical antivirals are now used less frequently than before because systemic antiviral drug therapy has generally been shown to be superior for controlling such viral skin conditions.

Viral infections are very difficult to treat because they live in the body’s own healthy cells and use their cell mechanisms to reproduce.

The only topical antiviral drugs currently available to treat such viral infections are acyclovir (Zovirax) and penciclovir (Denavir).

The most common adverse effects are stinging, itching, and rash.

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Anesthetic, Antipruritic, and Antipsoriatic Drugs

Topical Anesthetics

Topical anesthetics are drugs used to numb the skin by inhibiting the conduction of nerve impulses from sensory nerves, thereby reducing or eliminating the pain or pruritus associated with insect bites, sunburn, and allergic reactions to plants such as poison ivy, and other skin disorders. They are also used to numb the skin before a painful injection (e.g., insertion of an intravenous line [IV] in a pediatric patient). They are available as ointments, creams, sprays, liquids, and jellies.

A lidocaine/prilocaine combination drug (EMLA [eutectic mixture of local anesthetics]) and lidocaine alone (Ela-Max) are topical anesthetic drugs that are used frequently, especially in pediatric patients. EMLA is applied 1 hour before the procedure, whereas Ela-Max is effective within 30 minutes.

Topical Antipruritics and Antiinflammatories

Topical antipruritic (antiitching) drugs contain antihistamines or corticosteroids. Many exert a combined anesthetic and antipruritic action when applied topically.

New recommendations for topical antihistamines state that these drugs are not to be used to treat the following conditions because of systemic absorption and subsequent toxicity: chickenpox, widespread poison ivy lesions, and others involving large body surface areas.

The most commonly used topical anti-inflammatory drugs are the corticosteroids.

When topically administered corticosteroids are used, many of the undesirable systemic adverse effects associated with systemically administered corticosteroids are avoided.

The beneficial drug effects of topically administered corticosteroids are their anti-inflammatory, antipruritic, and vasoconstrictive actions.

Adverse effects of these drugs include skin reactions such as acne eruptions, allergic contact dermatitis, burning sensations, dryness, itching, skin fragility, hypopigmentation, purpura, hirsutism (usually facial), folliculitis, round and swollen face, alopecia (usually of the scalp), and the opportunistic overgrowth of bacteria, fungi, or viruses as a result of the immunosuppressive effects.

Antipsoriatic Drugs

Psoriasis is a common skin condition in which areas of the skin become thick, reddened, and covered with silvery scales. Psoriasis is actually a result of a disordered immune system, although it is generally referred to as a skin condition. It is believed to involve polygenic (multigene) inheritance. Psoriasis has fluctuating patterns of recurrence and remission.

Treatment begins with a topical corticosteroid for mild to moderate cases. If not successful, topical antipsoriatic drugs are used.

In addition to these topical drugs, there are also newer systemically administered antipsoriatic drugs. Those given by injection include the biologic response modifier etanercept (Enbrel), the antineoplastic drug methotrexate (antipsoriatic properties), and the interleukin 12 inhibitor ustekinumab (Stelara).

Ixekizumab (Taltz), is an antibody that binds to interleukin-17A, which reduces inflammation and is indicated for plaque psoriasis. Patients must receive an FDA-approved patient medication guide when receiving ixekizumab. The most serious side effect is an increased risk of infection.

Secukinumab (Cosentyx) is a similar systemic drug. Other systemic drugs include apremilast (Otezla) which is a phosphodiesterase-4 enzyme inhibitor as well as many biological drugs including, but not limited to the following: adalimumab (Humira), brodalumab (Siliq), etanercept (Enbrel), guselkumab (Temfya), risankizumab (Skyrizi) and ustekinumab (Stelara).

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Miscellaneous Dermatologic Drugs

Ectoparasites are insects that live on the outer surface of the body, and the drugs that are used to kill them are called ectoparasiticidal drugs. Lice are transmitted from person to person by close contact with infested individuals, clothing, combs, or towels.

A parasitic infestation on the skin with lice is called pediculosis.

Common findings in infested persons include itching; eggs of the lice attached to hair shafts (called nits); lice on the skin or clothes; and, in the case of pubic lice, sky blue macules (discolored skin patches) on the inner thighs or lower abdomen. Pediculoses are treated with a class of drugs called pediculicides. A second common parasitic skin infection known as scabies is caused by the itch mite Sarcoptes scabiei. Scabies are transmitted from person to person by close contact, such as by sleeping next to an infested person.

Treatment of these parasites begins with identification of the source of infestation to prevent re-infestation. The clothing and personal articles of the infested person are decontaminated.

In addition to lindane, malathion (Ovide) and crotamiton (Eurax) are also ectoparasiticidal drugs.

The newest drugs approved for lice treatment are benzyl alcohol 5% (Ulesfia), which works by suffocating the lice, and spinosad (Natroba). Natroba is indicated for children 4 years of age and older and offers the benefit of not requiring nit combing as do the other treatments.

Minoxidil (Rogaine) is a vasodilating drug that is administered systemically to control hypertension. Topically it has the same vasodilating effect, but when used in this way it is applied to the scalp to stimulate hair growth.

Minoxidil can be used by both men and women who experience baldness or hair thinning.

Systemic absorption of topically applied minoxidil may occur with possible adverse effects, including tachycardia, fluid retention, and weight gain. Local effects may include skin irritation, and the drug is not to be applied to skin that is already irritated or used concurrently with other topical medications applied to the same site.

The systemically administered drug finasteride (Proscar, 5 mg) is used to treat benign prostatic hyperplasia. A lower-strength version known as Propecia (1 mg) is also used to treat male pattern alopecia. Finasteride is classified as a pregnancy category X drug, and women are not to handle this drug without gloves or crush this drug, thereby making it airborne.

Sunscreens are topical products used to protect the skin from damage caused by the ultraviolet (UV) radiation of sunlight. Most sunscreens come in lotion, cream, gel form, or lip balm.

Sunscreens are given a sun protection factor (SPF) rating, which is a number ranging from 2 to 50 (and even higher in some newer products) in order of increasing potency of UV protection. In 2011, the FDA stated that only those with an SPF of 15 or greater may state they reduce the risk of skin cancer and early skin aging.

Skin cancer is the most common form of cancer. There are two types of nonmelanoma skin cancer: basal cell carcinoma and squamous cell carcinoma. Basal cell carcinoma is the most common and is rarely fatal, but it can be highly disfiguring. Squamous cell carcinoma, on the other hand, can be fatal, with 2500 deaths reported annually. The most aggressive skin cancer is melanoma, which accounts for only 3% of all skin cancers but is responsible for 75% of deaths associated with skin cancer. The most common cause of skin cancer is exposure to the sun and tanning beds. Early detection and prevention are of the utmost importance.

Various premalignant skin lesions and basal cell carcinomas may be treated with the topically applied antineoplastic drug fluorouracil (Efudex). It is also used topically in the treatment of solar or actinic keratosis and superficial basal cell carcinomas of the skin—often in addition to local surgical excision.

More aggressive skin cancers (squamous cell carcinoma and malignant melanoma) are not treated with fluorouracil but are usually treated with more aggressive interventions, such as surgery, radiation therapy, and/or systemic chemotherapy.

The adverse effects associated with the topical use of this antineoplastic drug are generally limited to local inflammatory reactions such as dermatitis, stomatitis, and photosensitivity. More serious effects include swelling, scaling, pain, pruritus, burning, soreness, tenderness, suppuration, scarring, and hyperpigmentation.

Another topical drug also used for the treatment of actinic keratoses and basal cell carcinomas is the immunomodulator imiquimod.

Although superficial skin wounds usually require minimal interventions, deeper skin wounds often require more definitive care for optimal healing. Vitamin C and zinc have been shown to improve wound healing when they are given orally.

Tar derivatives have antiseptic, antibacterial, and antiseborrheic properties.

Isopropyl alcohol (70%) is most commonly used to prepare the skin before minor procedures such as drawing blood or giving injections.

Other drugs that are used to prepare the skin include povidone-iodine (Betadine), chlorhexidine (Hibiclens), and benzalkonium chloride (Zephiran).

Benzalkonium chloride is a surface-active drug that works by denaturing the microorganism or essentially destroying its protein.

Chlorhexidine acts by disrupting bacterial membranes and inhibiting cell wall synthesis. It is used primarily as a surgical scrub or handwashing agent by health care professionals.

Povidone-iodine is an antiseptic that kills bacteria, fungi, and viruses. It is used for the prevention or treatment of topical infections associated with surgery, burns, and minor cuts and scrapes, and for relief of minor vaginal infections. It is the most widely used antiseptic, but patients should be screened for iodine or shellfish allergies before using it.

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Nursing Process

Topical antibacterials are associated with a wide range of reactions because of the generalized sensitivity of patients to antibiotics, even when in a different dosage form; therefore, if a patient is allergic to a systemic antibacterial, they will also be allergic to topical dosage forms.

The skin of very young and older adult patients is more fragile and permeable to certain topical dermatologic preparations. This could also lead to a higher risk of systemic absorption from the skin.

Before any topical medication is applied, cleanse the affected area of any debris, drainage, and/or residual medication, taking care to follow any specific directions such as removing water- or alcohol-based topical preparations with soap and water.

Most topical dermatologic drugs do not require the use of a dressing once the medication is applied.

Medicated areas may also need to be protected from exposure to air or sunlight.

Therapeutic responses to the various dermatologic preparations include improved condition of the skin and healing of lesions or wounds; a decrease in the size of lesions with eventual resolution; and a decrease in swelling, redness, weeping, itching, and burning of the area.

Adverse effects include increased severity of symptoms—for example, increased redness, swelling, pain, and drainage; fever; or any other unusual problems in the affected area. Adverse effects may range from slight irritation of the site where the topical drug has been applied to an allergic reaction to toxic systemic effects.

Topical anesthetics are used therapeutically to numb the skin. Indications for topical anesthetics include insect bites, sunburn, poison ivy, and prevention of pain from injections.

Corticosteroids are some of the most widely used topical drugs and are indicated for the relief of topical inflammatory and pruritic disorders. Beneficial effects of corticosteroids include anti-inflammatory, antipruritic, and vasoconstrictor actions. Some of the negative effects of potent corticosteroid use or prolonged use of weaker corticosteroids include dermal atrophy and adrenal insufficiency.

Adverse and toxic reactions to dermatologic drugs can and do occur; therefore, administer these drugs cautiously, and follow the prescriber’s orders and manufacturer’s guidelines. This is critical to ensure safe and effective treatment.

Patient education about the medication, its administration, and its effectiveness is important to ensure compliance with the treatment regimen.

With medications that block interleukin-17A, provide medication-guide and instructions for use including adverse effects, application techniques, and reporting of any infections or history of such.

Drugs inhibiting interleukin-17A, such as Taltz, require the education of patients about how to administer subcutaneous injections.

Educate the patient about the monitoring and reporting of fever, sweats, chills, muscle aches, and shortness of breath.

Monitor laboratory values, especially white blood cell (WBC) counts due to the side effect of increased risk for infection.

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Physiocare Physiotherapy & Rehab Centre: Redefining Recovery and Wellness in Ottawa

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