#abd sleep paralysis:(

[bandomgay]

[thek0ifish]

Skyrim's Dragonborn DLC gave us a half assed homage to Morrowind. Miraak is essentially Dagoth Ur without the Charisma or any amount of built up story telling that made him a memorable character. Miraak steals Dagoth Ur's sleeping ability and his mask looks nearly similar to Dagoth Ur's mask. You only foil Miraak in a small amount of quests. While it takes you a long long time to defeat Dagoth Ur. Dagoth Ur is willing to talk to the player. While Miraak just wants to escape. Dagoth Ur backs up being a God. While Miraak is a pretender. Dagoth Ur shown contingency plans. His most trusted followers who became Ash Vampire Tribal Leaders are his biggest source of strength. The more Dagoth Ur got worshipped the stronger and more God Like he becomes. Which is why players kill Dagoth Ur's commanders first before fighting Dagoth Ur as it weakens his states severely when doing so. Dagoth Ur showed up in Elder Scrolls 2 in a short quest and Elder Scrolls 3 as its main antagonist. Bethesda loses points for never giving us Dagoth Ur as a playable character in an media at all, not even Super Smash Bros Ultimate as a costume. Instead we get the overrated Dragonborn Protagonist even Matt and Trey Parker love to shill on their Southpark video games. I myself am upset The Dragonborn was the character who defeated a Dark Souls protagonist in a straight up close combat fight. Like damn the Dark Souls protagonsit uses stronger materials for his weapons. He should have one shotted the Dragonborn. The Dragonborn got knocked out by a thieves guild paralysis arrow in a thieves guild quest line. The Dragonborn is nowhere close to Morrowind and Oblivions protagonists brilliant accomplishments.

daggerfall, Morrowind and Oblivion are better TES games than Skyrim what a grand abd intoxicating innocence

[theforgowolf]

ONE OF THE WRAITHS IS A MOTHERFUCKING SLEEP PARALYSIS DEMON FROM ANOTHER DIMENSION! YOU KNOW HOW MANY PEOPLE HAVE BEEN TRAUMATIZED BY THIS FUCKER IN AND OUT OF UNIVERSE

AND THEN THERE IS THIS FUCKWAD!

The PLASM WRAITH

A(POSSIBLY) ELDRITCH BEING IN NATURE THAT CANNOT TRULY BE KILLED AS LONG AS A TINY BIT OF IT EXISTS(I think I’ve heard that before somewhere). IT CAN MANIPULATE PRACTICALLY ALL HAZARDS THAT KILL PIKMIN, FIRE WATER ELECTRICITY, BEING CRUSHED TO DEATH, AND WHAT DOES IT DO?!

TAKE SOMEONE HOSTAGE AND TAKE CARE OF THEM IN A REALLY CREEPY FORM OF AFFECTION THAT IS NOT HEALTHY AT ALL!

ABD DO NOT GET ME STARTED ON THE SMOKY PROGG AND THE GLOW PIKMIN!

”bro it’s just pikmin it ain’t that deep” yes the fuck it is have you SEEN the wraiths? Have you dealt with LOUIE? I didn’t think so

[gaycatpark]

my talents include drinking 3 shots of espresso and immediately sleeping for 2 hours

[goldkirk]

how I do just enough to take care of myself that I don’t totally spiral on really empty-well days

I’ve gotten 3-5 hours of sleep max for the past three days so to say that I’m not at the top of my game is an understatement. But I’m finally out of my total overwhelm and distress just enough to haul myself around today determined to do good things for my me and determined to work on therapy stuff that DOESN’T drain me or stress me out.

And to be serious about drinking water and eating at least twice and do some hygiene stuff. The more flat and hiding-downward and confused and wispy-ghost-that-can’t-hold-thoughts I am, the more I can’t do a lot of the really important routines for eating and caring for my body and getting concrete hands-on feels-satisfying-to-accomplish-it tasks that are the most critical backbone component of Katie Being a Functioning Human Who Feels As Minimally Lousy Physically As Possible (and its sequel, When Katie Has the Good Luck to Manage Several Days in a Row of Consistent Medication Times and All Basic Daily “Living Human Body”Routine Things, She Miraculously Will Actually Have More Capacity for Like, Everything). I also had an insurance issue getting a really important daily drug for several days so that. Really wasn’t a help.

THINGS ARE GOING TO BE BETTER FOR MY BODY TODAY BECAUSE I AM GOING TO GO AS SLOW AS I NEED TO BUT MAKE IT HAPPEN. No more shame. No shame and overwhelm paralysis. I only have to do three main things, and I am NOT allowed to beat myself up over it no matter if it takes me till 5 PM just to put shower and put on clean clothes. I’m gonna do it and I’m writing how I’ve learned to plan a day like this in case it can help any of you. 💛

Step 1: try to get in your body as much as possible—if you’ve got any pain or any discomfort or anything that really is making your experience of having a physical body way worse, try to drop any other plans and take care of ONE thing for that first. In my case, this morning I woke up feeling extra run down and empty and sore, and I figured out I needed food and also hadn’t drunk nearly enough water yesterday. I’m working on fixing that now. It’s taking me an hour to eat oatmeal, but it’s happening because I’m taking care of the me that shouldn’t need to be suffering this way and DEFINITELY doesn’t deserve to have me make it worse because I don’t want to do anything.

Step 2: think of a couple things that make you feel better when you do them OR bleed out feelings a bit without being too intense or hard for you to do when already low. For me, that’s petting Aoife, maybe doing a little bit of extra skincare or makeup if I’m up for it later, playing Cozy Grove if my eyes aren’t too tired, and (since I got given the homework to try it this week) trying to start doing art therapy but from literally the “what you’d have a toddler do” level instead of starting with trauma exercises or thinking/focused art things. IMPORTANT: if that art attempt starts feeling at any point like it’s making my mood bad or prompting me to get really sleepy/zoned out because my brain isn’t up for it, I’ll stop right away. I’m learning the lesson that it’s NOT worth it to push through chronic illness or mental illness symptoms that are your “pressure valve” indicators.

(I ignored my body on that issue for so long that this summer it went “FUCK’S SAKE WILL YOU LISTEN TO THIS THEN????” and escalated to literally forcing me to pass out asleep at any time of day with no more than two minutes of warning if I go too far past my body’s signals to please sit for a while or please stop trying CBT techniques or whatever. Don’t be like me. 😅)

Step 3: do not put those on to do list for yourself.

Step 4: think of the minimum body things you need to do to make your body actually feel better abd more human again—for me, that’s washing my face and putting the creams on it, washing my hair since it’s been a few days, putting on Real Shoes that lace, eating and drinking several things, and taking my medications as early as possible.

Step 5: do not those on your to do list either.

Step 6: pick THREE things. ONLY three things, or two if three is too much. The three things that you think will help you feel the most better if you do them before anything else. For me, today, that’s eating one thing, washing body/hair so I feel not gross, and putting on big-girl clothes that make me feel like I’m actually dressed for a real day.

Step 7: NOW you have your to do list. Go through those as slowly as you need to, and if/when you finish them, then you can pick two or three more things that you think would be the next nicest options for you, and then you can attempt to do those too. And once you’ve done a few things that are simple and concrete like this, it gets easier because your brain starts getting some nice dopamine rewards from seeing things visibly accomplished AND your body feels more comfortable and has more energy to do things.

I love you. You can do this. We’re all gonna be all right, believe me. Seeing as none of the trauma managed to kill us and we survived, apparently we’ve actually got plenty of time to improve and recover. We already survived! We did that part! We got the damage and now it’s about rehabbing our injuries. The story doesn’t stop right there, with us stuck in tangles of fog and dysfunction! Our bodies want to heal already, and we’re helping them when we can. Dysfunction is not what our default state is going to be stuck in forever. The story ends with us actually okay one day. 💛

[disconnected-star]

i think my interest in jsab is kinda like a sleep paralysis demon that shows up at 2:43 am bc you ate a chicken nugget that day bc sometimes in the dead of midnight im trying 2 sleep abd then all of a sudden i just

[emywashere]

A witch and her black cat

Onix always sleeps with me. I swear to Goddess he talks to me. He knows when I need him. He knows where and when the energy is low and needs his interference. And he came to me in a dark street on my birthday last year. I was with some friends but only I could hear him and I saw him before anyone else. He’s so different from my two other cats (i love them all equally ofc). The way we connect is so intense! It’s like we can actually guess each other’s thoughts. He’s presente in all my rituals. He always knows when something is going to happen and somehow tries to tell me. He lies on top of some of my instruments and gems. Sometimes he even points me what should I use.

But the most intense moment for me was when i had this dream paralysis and I was attacked by a horrible thing/energy. It was pulling my feet abd trying to drag me to a horrible hole/puddle. I saw a panther (and my animal IS a panther so onix is my lil panther) came from behind me and attack this thing. I woke up screaming with Onix attacking my feet. He always sleeps with me, by the side of me head or heart. NEVER attack me EVER. When I woke up crying, first he licked the places he attacked, then he lied on my lap and licked my hands.

So, yeah. I’m a witch with a black panther as guardian. I love him. He chose me. And he’s pawing my heart rn

[smiisevenwhyplus]

F U C K

OKAY SO IM REALLU FUCKING FREAKED OUT RN BC I HAD SLEEP PARALYSIS AFAUN AND I SAW THAT FUCKING THING I MENTIONED IN MY LAST SLEEP PARALYSIS STORY AGAIN AND I CANT STOP SHAKING AND CRYING OH GOD

IT WAS IN THE CORNER OF MY ROOM WHERE MY DOOR WAS AND CRAWLED UP TO ME AND I SWEAR TO SOME FUCKINC GOD THAT I FELT ITS FUCKING BREATH ON THE SIDE OF MY FACE AND NECK. IT FUCKINC SMILED AT ME WITH IS SHARP TEETH AGAIN AND I COULDNT SCREAM OR MOVE. IT PUT ITS FUCKING HAND ON ME AND IT WAS SO BONY SND COLD AND I COULFNT BREATHE.

THATS WHEN IT JUST FUCKIN STOOD UP ABD JUST STOOD OVER ME. I FELT SOMETHING WET HIT MY FACE AND IM 100000% SURE IT WAS FUCKING BLOOD WITH ITS SALIVA OR SOMRTHIBH. I LOOKED AT IN THE EYES AND THIS TIPE THEY WERE BLOODSHOT BUT STILL WITH NO PUPILS. IT LAUGHED AT ME AND I FELT LIKE I WAS GONNA DIE. I THOUGHT I WAS GONNA FUCKING DIE.

ITS MORHETFUCKINH EYES WENT FULLY BLACK LIKR A DAMB SHARK AND I WAS READY FIR IT TO CHOMP INTO MU THROAT BUT THEN IT JUST DECIDED TO LEAVE. LIKE IT WALKED AWAY FROM MY BED AND OUT MY BEDROOM DOOR which was open for some reason even tho i had it closed????THEN IT SHUT ON ITS OWN. THATS WHEN I COULD MOVE ANX HETE I AL TYPING THID

OH GOD WHY FUCKINC ME WHY AGAIN STOP PKEASE IM BEGGINC THIS ENTITY TO LRAVE ME ALONE

[99sshithouse]

Joseph Harvick

FC: Andy Biersack

Age: 27

Alias(es): Pastor Jo, Preacher Jo, Jo, Joey

Place of Birth: Dalitica City, USA

Eye & Hair Color: Dark Blue | Black

Height & Weight: 6'4" | 175lbs

Sex & Gender: Male and Identifies as Such

Orientation: Heterosexual

Marital Status: Single

Personality

No Room For God In It

Jo is an odd combination of a boy left to his own devices and a young man searching for excellence and remembrance. To stick out in a crowd. To be heard over loud. He thought he could have done that with acting, however he found that to be a little too difficult for his liking. So he came to Dalitica to make some cash, and then his calling dropped on his head like a pile of holy bricks. For a man who turned away from religion since his his mother had forced it upon him and his father, he found preaching to be a natural gift. He enjoys making people feel better with his words, even if there are ulterior motives behind the reason he is even speaking to them. He likes that he can sway people, give them guidance, grace them with God. He finds pride in this fact, because he's the vessel gifting the crowd this.

When in the cloth, Joey is an extremely passionate presence. He sells his role well, and has taught himself the knowledge to be comfortable in his sermons. He doesn't spread hate or shun people different than him, but instead pushes positivity and existing without fear, as fear is the reason he himself had pushed God out of his own life. He speaks of redemption because he has met many in the city who wish to atone. In a way, he simply wants people to do as they wish without worry of the repercussions. He has a calm and kind aura around him, wanting people to stick around.

When out of the cloth, he is a sarcastic and quick witted person. He isn't afraid to tease people and flash them sparkling white smiles that radiate the aura of unnecessary malice and obvious disinterest. He has no time for people who want one on one time with him, so if someone wants to speak to him, they need to attend the in person sermons he gives or text him. He takes great pride in things he does and usually doesn't take to criticisms well. Doesn't like talking to people on personal levels because he doesn't want something tying him down.

While he does have a very unapproachable way to him when he isn't in character, he has small redeeming qualities that show he isn't as jaded as he likes to believe. He is in love with pretty much any animal he has ever met and actually does seem to have a kinship with most of the creatures he's obsessed with. He is a hopeless optimistic goal-setter. It's clear he wishes for more, but doesn't know to get where he wants to be. If he sees someone being talked down to for simply being who they are, he'll pull up to defend them. He is an artistic person. And he is extremely intelligent. Just not in the average way.

Employment | Televangelist For A Local Non-Profit TV Station

Since his return to Dalitica, he has taken a position as the new take on the classic television preacher. He collects money for charity by holding weekly telethons where people call in to donate to the local churches in Dalitica. He also will hold local sermons if asked to do so, inviting DC's sinners a chance to repent... Sorta.

Criminal Specialty:

Spiritual Opportunism | Con-Artist

With a failing station and need for cash, Joseph took on the role as Preacher Jo to con the congregation into giving cash, and than instead of donating it, they split it amongst themselves, with the station getting 70% and Jo getting 30%.

Skills & Abilities

Talented Actor | Despite not much experience, the young man shows himself quite a talented performer and actor. Took on his role at the station with a comfortable ease despite it being almost completely opposite to who he is | Self-studied in Theology and Demonology | Self-Studied Christian Ideals and Methodology | Self-Taught Extensive Knowledge of Old Religions, Gods, and Civilizations

Incredible Public Speaking Voice | His voice can be loud without shouting. Clear without enunciating. Elegant but not snobby. The man was built for the stage, or at least speaking crowds | Extensive Vocabulary, filled with the best abd most classical religious phrases he'll use to make himself laugh | Creative Writer | Can write scripts but prefers not to

Flexible | Can bend into position that a lot of people couldn't | Decent Street Fighter, mostly cause he's all limbs and joints

Come to Find Out the man is actually a pretty amazing con-artist | To be honest, this is even a surprise to himself. He has the charm and personable energy that calls to people, and makes him easier to trust.

Well Off | Doesn't have a need for everything because the sinners of DC is paying him well.

Disabilities & Disorders

Sleep Paralysis | He suffers attacks on occasion and it's usually obvious when he's had one because he looks like he's been hit by a truck the next day.

Nicotine Addict | Recreational Cocaine User | You try speaking to a bunch of weeping members of the congregation everyday and not need a little pick-me-up

Vain | He's not delusional, he knows he isn't the most attractive man in the world. But he does hold his appearance in high standard than most of the other men he encounters. Some women too. He also prefers his clothes on the expensive side.

Caffeine Addict | Don't talk to him until he has his coffee. Sugar Addict | Loves candy way more than a grown man should.

Kind of an Ass | He can be a little bit petty and act out of turn if someone makes him upset.

Doesn't Have Any Substantial | Most of the things in his life are about stuff that won't last forever. The beautiful women, the money, the clothes. He doesn't believe he'll lose any of these things.

Crimes:

None on record

Gang Initiation;

He reached out when he moved back to the city and connected with the gang that lived in his area. It's always good to have friends just in case .

Parents

Virtue Harvick | Mother (Deceased)

Calvin Harvick | Father (Deceased)

Friends

FangZhou Li [Tiger]

Guanlin Wu [Wolf]

Dax Choi [Wolf]

Mei Qi Shao [Tiger]

February Savage [Tiger]

Haenim Sohn [Tiger]

Inna Huxley [Wolf]

Lux Starling [Tiger]

Roxy Savage [Tiger]

Yuna Sha [Wolf]

Gang | Wolf

[folderaman]

The Worst Trauma I’ve Personally Been In

By: #LifeofaMedStudent https://lifeofamedstudent.com/2016/08/03/the-worst-trauma-ive-personally-been-in/amp/ The other day I tweeted about the worst trauma, at least by amount of blood product given, that I had personally been a part of. This got a lot of reaction, so I decided to tell the story. Also, this will give some insight on how the trauma care works from an anesthesiologist perspective Disclaimer: The following is a fictional account based loosely on a mix of several events. Details have been changed to protect those involved. Any likeness to any persons, procedures, or health care systems is purely coincidental.  We have one major trauma hospital we train at routinely. As an anesthesia resident, you are in-house for the duration of your call, to be immediately available if a patient must be rushed to the OR. This is somewhat infrequent, as often/hopefully there is time for CT surveillance of trauma patients (aka the “pan-scan”) prior to operative intervention. This was in July of my 2nd anesthesia year (PGY3) and this was my second call as the upper level resident. I would then be working with/supervising a new anesthesia resident in only their first month of anesthesia training. As good luck would have it on this night, I had a very good if only inexperienced younger resident, “named” Jessica. My attending draw that night was also excellent luck, probably the best trauma anesthesiologist in the academic system. If I’m ever injured or shot he is who I’d want looking after me. I believe this was also his worst trauma product total as well. The night started out very promising. We had closed down the final OR cases by about 8pm, the Anesthesia attending had bought us dinner, and we were tucked away in our call rooms. It had been a quiet night, with no trauma pages (we respond to all trauma pages down in ER – this can keep you up even if you don’t go to OR). Then at ~1am the pager awoken me from a deep sleep, and unbeknownst to me my night was about to take a turn for the worst. “MALE 45yo MULTIPLE GSW TO ABD, LLQ. BP 90/palp, HR 135. ETA 3 min”   As I read the above page, I knew this had OR time written all over it. Already hypotensive and tachycardic as well, never a good sign. I rushed down to the ED to find a chaotic mix of blue gowns rushing in and out of trauma bay 1. “Shit. Looks like they are already hanging blood. ” I think to myself as I peer into the bay. Before I could think of anything further, the trauma surgeon burst out the trauma bay proclaiming “We are going straight to the OR, NOW!” Bam! I’m on the phone, calling my Anes attending – “Sir, we have a multiple gun shot victim coming up with blood hanging. Pressures are soft but reasonable at the moment, with increasing tachycardia. Single IV access. Jessica is going to get him intubated upon arrival, and I’ll work on art line and more IV access. ” I see Jessica on the way, pass along what little information I know, and direct her to the plan. We three arrive at OR 1 just moments before the patient. “Hey guy, you are about to have emergent surgery, any problems with anesthesia? Any allergies? Medical problems?” I yell towards the patient as he comes through the OR door. He mumbles answers mostly no, but he was at this point clearly loosing consciousness. “What was his last pressure?” I ask the ER nurses. “70s systolic.”  Ok. Let’s do this. The Anes attending  gives 2 of versed, 50 of ketamine, and 180 of sux. Rapid sequence intubation is successfully preformed by Jesssica. As soon as I see end tidal CO2 I begin working on an art line. I can palpate a pulse, barely. Quick alcohol swab of the skin, I aim the Arrow 20ga arterial catheter towards the pulse, quickly reaching bone with no flash. Withdraw, move medial, re-advance. BOOM, flash. Advance guide-wire, thread catheter, remove needle – a squirt of blood and I know I’m in! The trauma surgeons are opening the belly as I tape the art line. Pressure reads 65/38. Across the patient my attending has inserted an additional 16ga peripheral IV. Jessica has started giving blood through the rapid transfuser. He received 4 units packed red cells (PRBCs) in the ED, another 4 already here. Time to start thinking of balancing out our blood products, I hand Jessica two units of fresh frozen plasma (FFP). (Educational Note: In trauma literature the movement has been to a 1:1:1 ratio of blood products, that is 1 unit of PRBCs to 1 FFP to 1 of platlets. In actual practice this can be challenging to maintain. The massive transfusion protocol at this hospital brings us a cooler of 6U PRBCs and 4U of FFP and then 1 bag (6pack) of platlets every other cooler. So this sets you up for a 6:4:3 ratio. Good but not quite 1:1:1. ) We have at this point given about 16U of blood, 8U FPP, 1 bag of platlets. The blood pressure is up to 80s systolic – compatible with life at least! The patient gets little more versed and ketamine for amnesia and some cisatracurium to maintain paralysis. The trauma surgeons are surveying the abdomen and have found bleeding from multiple sites, most concerning is significant damage to the iliac system on the left side. They have clamped the artery and at this time shout for the vascular team on call to come into the OR. Another cooler full of blood products is rapidly transfused into the patient. Our first blood gas shortly into the case had been 6.9/29/390 (ph/co2/o2) with a base excess of -8. This signifies tissue hypoperfusion, in this case due to the blood loss and hypotension. Our next gas has improved, now 7.21/30/375/-3. But we note the calcium has dropped and our potassium is steadily rising. (Educational Note: During massive transfusion, it’s not unusual to have several changes in blood chemistry, most notable calcium will decrease while potassium rises. Why? Calcium in the patient will become bound to the citrate component in PRBCs. Citrate is used as an anticoagulant in red blood cell product. Eventually, your liver will metabolize the citrate and calcium homeostasis will return but during the initial phase of massive transfusion hypocalcemia can be a real issue. Potassium rises because the preserved blood cells will leach out potassium ions as they age. Thus this is more of a problem with older units of PRBCs and if potassium is a concern newer units should be used (when possible, but at the rate we were infusing this wasn’t an option). ) The vascular surgeons are in the room now working hand in hand with the trauma team. We are riding a roller coaster with blood pressure, basically only able to keep our systolic above 80 while actively transfusing. But we are doing well enough that we are keeping the patient alive while the surgeons work. Suction canister after canister is filled with blood from the surgical field.  Cooler after cooler of blood products are administered. Calcium continues to be repleted, but potassium levels are now getting dangerously high. (Educational Note: Standard treatment for hyperkalemia should be drilled into the heads of every med student. Not only is it frequently tested on boards, but it’s fairly routine to see as an intern, regardless of specialty. Usually it’s chronic due to renal failure. A common mnemonic for remembering treatment of hyperkalemia is “C BIG K Drop.” Calcium (doesn’t lower levels but stabilizes cardiac membranes against depolarization/arrhythmia)Beta-agonist (activates Na-K+ ATPase, driving K+ into cells, lowering body serum levels)Insulin (insulin stimulates glucose ATPase to drive glucose and K+ into muscle cells)Glucose (given simply to avoid dangerous drops in blood sugar following insulin administration noted above)Kayexalate (lowers total body K+ via GI excretion)Diuretics (lowers total body K+ via urinary excretion, “Loops = lose”) Other treatment options include hyperventilation and bicarbonate. Both of these will increase body pH (alkalinize) which drives K+ into cells as well. Lastly dialysis is the often final pathway for removal  of K+ in the chronic renal patient or very acutely sick patient. ) In the OR, we have only a few of those options at our disposal. We were already hyperventilating the patient to offset his acidosis and we are already giving significant amounts of calcium due to the PRBC-citrate cycle mentioned above. We did give some bicarbonate, though its effect was probably minimal. Once we went to lasix and giving insulin/D50, this finally reversed the rise in potassium. We had managed maintain anesthesia with a bit of inhaled agent but mostly intermittent ketamine to provide more stable hemodynamics.  Blood pressure continued to range from 80s-110s systolic but would drop shortly after any pauses in delivery of blood products. We had at this time crossed 100units of product given as the rapid transfuser had been running nearly continuously for 2 hours. The surgeons eventually managed to place a shunt around the damaged portion of the Iliac artery.  The venous portion however had  been nearly completely destroyed and they were struggling to stop the bleeding from this part. We had been in the OR for about 3.5 hours at this time.  In final desperation, they packed the abdomen and planned to leave the belly open, with an abthera vacuum (temporary abdominal closure device) in place. During the final 30 minutes of OR time, the surgical residents struggled to get the abthera vacuum to adhere due to blood literally continuously seeping out the edges of plastic seal.  We moved the patient off the OR bed and prepared to transfer to the surgical ICU. We infused 2 more units of blood and a unit of FFP via the rapid transfuser and hung 2 additional units for the ride upstairs to the SICU. Upon arrival to the SICU, we were greeted by the surgical ICU night team, who happened to be made up of an anesthesia resident and attending. We discussed with them the case and the continued necessity of transfusion to maintain blood pressure and the likelihood that despite multiple hours in the OR, this appeared to be a non-survivable injury. The patient received another 2 units of blood in the ICU while the patients status was further discussed with the surgical and ICU teams. Eventually the decision was made to withhold further treatment due to the futility of the heroic effort. The patient passed away less than an hour after reaching the SICU. This case was a great learning experience for myself. It touched on emergent and trauma anesthesia, complications of massive blood transfusion, and futility of care. Anesthesia in these situations is often simply doing every thing you can to keep your patient alive, while the surgeon fixes the problem. This patient’s injuries from the multiple gun shot wounds were probably never survivable from the beginning and its surprising he even made it into the operating room. However, once in an OR with a dedicated anesthesia team, we were able to give the surgical teams every fighting chance to save this patient’s life, even if they ultimately could not. That is why I love my job. We routinely give even the sickest patients a chance to survive. What else I remember so vividly about this case was the amount of blood*. The stack of blood packets on the floor. The estimated 30 LITER blood loss and the numerous canisters filled in the OR. The trail of blood that lead from the OR to the ICU. The slosh of blood to the floor when the patient was moved on to the ICU bed. Medicine is not for the faint of heart, kids. *The second thing I remember from this case is the amount of paper work required to give the massive amount of blood products. That took hours afterwards and still haunts me (I hate paperwork).

[its-subversive]

I just wanna sleep but i got sleep paralysis and hallucinations abd I was so scared :(

[principaliti]

I had a v weird experience w sleep and tiredness today

I actually remembered 2 dreams. One was i was making a story with people abd there were 4 nobles maybe kings??? Who had theor own castles n shit and ine was evil 2 were good and one was kind of undead and also it was in minecraft

The other was i was a poor russian boy who was cooking with his mother and his brother abd we were msking a mushroom pie but thwy gave me the wrong instructions so i messed up and got screamed at. Then it skipped to me being a littlw oldr and i was making another pie for an eating competition and in the end i stabbed a guy bc he stabbed a lil girl for doing better than him

Abd then when i wake up, i cant fuckin feel my body. Its not sleep paralysis, i could wihgle my toes. But everything but my back abd ny toes felt like it wasnt there. It was like everythin had disappeared and it was very odd, and itd happen even if i changed position

[newindianexp-blog]

500 kg Egyptian sheds half her weight after surgery in India

MUMBAI: The "world's heaviest woman" has shed half her weight -- around a quarter of a tonne -- in the two months she's been in India for treatment, doctors said.

Egyptian national Eman Ahmed Abd El Aty weighed 500 kilogrammes (1,100 pounds) when she arrived in Mumbai in February on a specially modified plane to undergo emergency weight-loss surgery.

In videos provided this week by the Saifee Hospital, where the 37-year-old successfully had bariatric surgery last month, Abd El Aty can be seen sitting up and smiling while listening to music.

"She looks a happier and slimmer version of her past self. She can finally fit into a wheelchair and sit for a longer period of time, something we never dreamt of three months back," said a statement from doctors, announcing that she had lost 250 kilos.

Watch Video: 500 Kg Egyptian sheds half her weight after India surgery

Abd El Aty had not left her home in Egypt's Mediterranean port city of Alexandria for two decades until she arrived in India's commercial capital on February 11.

She was put on a special liquid diet to get her weight down to a low enough level for doctors to perform bariatric surgery, essentially a stomach-shrinking bypass procedure carried out on those wanting to lose excessive weight.

The diet helped Abd El Aty lose around 100 kilos in a month, allowing doctors to operate on her in early March.

Abd El Aty's family say that as a child she was diagnosed with elephantiasis, a condition that causes the limbs and other body parts to swell, leaving her almost immobile.

The Egyptian has suffered several strokes and faced a series of other serious ailments owing to her weight including diabetes, high blood pressure, hypertension and sleep deprivation. She is unable to speak properly and is partially paralysed.

"She continues to lose weight rapidly and is awaiting the moment she can fit into a CT scan machine to know the cause of her right-sided paralysis and convulsions," doctors added in the statement published on the "Save Eman Cause" website Wednesday.

Muffazal Lakdawala, the doctor leading Abd El Aty's treatment, added in a separate post that they hoped to put her on a trial obesity drug in six months. Doctors are trying to procure it from the United States, he said.

In July last year, the Guinness Book of World Records recorded American Pauline Potter as the world's heaviest woman at 293 kilos, well above Abd El Aty's current weight.